Optimizing health literacy: improving health and reducing health inequities: a selection of information sheets from the health literacy toolkit for low- and middle-income countries

This series of information sheets introduces health literacy, its relevance to public policy, and the ways it can be used to inform the promotion of good health, the prevention and management of communicable and noncommunicable diseases, and the reduction of health inequities. It provides information and links to further resources to assist organizations and governments to incorporate health literaacy responses into practice, service delivery systems, and policy.

Inter-organizational information systems adoption for service innovation in building sector

The building sector has experienced a significant decline in recent years in Spain and Europe as a result of the financial crisis that began in 2007. This drop accompanies a low penetration of information and communication technologies in inter-organizational oriented business processes. The market decrease is causing a slowdown in the building sector, where only flexible small and medium enterprises (SMEs) survive thanks to specialization and innovation in services, which allow them to face new market demands. Inter-organizational information systems (IOISs) support innovation in services, and are thus a strategic tool for SMEs to obtain competitive advantage. Because of the inherent complexity of IOIS adoption, this research extends Kurnia and Johnston's (2000) theoretical model of IOIS adoption with an empirical model of IOIS characterization. The resultant model identifies the factors influencing IOIS adoption in SMEs in the building sector, to promote further service innovation for competitive and collaborative advantages. An empirical longitudinal study over six consecutive years using data from Spanish SMEs in the building sector validates the model, using the partial least squares technique and analyzing temporal stability. The main findings of this research are the four ways an IOIS might contribute to service innovation in the building sector. Namely: a) improving client interfaces and the link between service providers and end users; b) defining a specific market where SMEs can develop new service concepts; c) enhancing the service delivery system in traditional customer?supplier relationships; and d) introducing information and communication technologies and tools to improve information management.

Improving supportive care for women with breast cancer in Australia: The challenge of modifying health systems

Although the benefits of many psychosocial support strategies in improving well being in women with breast cancer have been demonstrated, few women receive these programs as part of routine care. This paper provides some recommendations, based on experience in Australia, about how access to evidence-based supportive care strategies might be improved through modification of health systems. It demonstrates the paucity of research about the costs and health service implications of psychosocial support strategies, which is vital to health planning and service delivery change. It outlines the systematic approach taken in Australia to improving psychosocial support nationally by: the development of research reviews; preparation of guidelines about supportive care, implementation of programs to foster the adoption of guidelines through modification of policy, health service delivery and clinician training; and monitoring programs. Coalitions of government, health care professionals and consumers are key to effective lobbying for change. If all women with breast cancer are to receive better supportive care, there is a need for approaches which: refocus the research effort in psycho-oncology; develop more strategic approaches to generating change in health systems and health policy and foster partnerships to advocate for improved resources. Copyright (C) 2003 John Wiley Sons, Ltd.

The drivers of perception: Identifying the driving factors of resident perceptions of municipal service quality in cities of South Florida

The idea of comparative performance assessment is crucial. Recent study findings show that in South Florida the use by most municipalities of external benchmarks for performance comparison is virtually non-existent. On one level this study sought to identify the factors impacting resident perceptions of municipal service quality. On a different and more practical level, this study sought to identify a core set of measures that could serve for multi jurisdictional comparisons of performance. ^ This study empirically tested three groups of hypotheses. Data were collected via custom designed survey instruments from multiple jurisdictions, representing diverse socioeconomic backgrounds, and across two counties. A second layer of analysis was conducted on municipal budget documents for the presence of performance measures. A third layer of analysis was conducted via face-to-face interviews with residents at the point of service delivery. Research questions were analyzed using descriptive and inferential statistic methodologies. ^ Results of survey data yielded inconsistent findings. In absolute aggregated terms, the use of sociological determinants to guide inquiry failed to yield conclusive answers regarding the factors impacting resident perceptions of municipal service quality. At disaggregated community levels, however, definite differences emerged but these had weak predictive ability. More useful were the findings of performance measures reporting via municipal budget documents and analyses of interviews with residents at the point of service delivery. Regardless of socio-economic profile, neighborhood characteristics, level of civic engagement or type of community, the same aspects were important to citizens when making assessments of service quality. For parks and recreation, respondents most frequently cited maintenance, facility amenities, and program offerings as important while for garbage collection services timely and consistent service delivery mattered most. Surprisingly municipalities participating in the study track performance data on items indicated as important by citizen assessments but regular feed back from residents or reporting to the same is rarely done. ^ The implications of these findings suggest that endeavors, such as the one undertaken in this study, can assist in determining a core set of measures for cross jurisdictional comparisons of municipal service quality, improving municipal delivery of services, and to communicate with the public. ^

Improving access for community health and sub-acute outpatient services: protocol for a stepped wedge cluster randomised controlled trial

BACKGROUND: Waiting lists for treatment are common in outpatient and community services, Existing methods for managing access and triage to these services can lead to inequities in service delivery, inefficiencies and divert resources from frontline care. Evidence from two controlled studies indicates that an alternative to the traditional "waitlist and triage" model known as STAT (Specific Timely Appointments for Triage) may be successful in reducing waiting times without adversely affecting other aspects of patient care. This trial aims to test whether the model is cost effective in reducing waiting time across multiple services, and to measure the impact on service provision, health-related quality of life and patient satisfaction.

METHODS/DESIGN: A stepped wedge cluster randomised controlled trial has been designed to evaluate the impact of the STAT model in 8 community health and outpatient services. The primary outcome will be waiting time from referral to first appointment. Secondary outcomes will be nature and quantity of service received (collected from all patients attending the service during the study period and health-related quality of life (AQOL-8D), patient satisfaction, health care utilisation and cost data (collected from a subgroup of patients at initial assessment and after 12 weeks). Data will be analysed with a multiple multi-level random-effects regression model that allows for cluster effects. An economic evaluation will be undertaken alongside the clinical trial.

DISCUSSION: This paper outlines the study protocol for a fully powered prospective stepped wedge cluster randomised controlled trial (SWCRCT) to establish whether the STAT model of access and triage can reduce waiting times applied across multiple settings, without increasing health service costs or adversely impacting on other aspects of patient care. If successful, it will provide evidence for the effectiveness of a practical model of access that can substantially reduce waiting time for outpatient and community services with subsequent benefits for both efficiency of health systems and patient care.

The Impact of Internal Market Orientation on Staff Service Behaviours

The impact of service direction, service training and staff behaviours on perceptions of service delivery are examined. The impact of managerial behaviour in the form of internal market orientation (IMO) on the attitudes of frontline staff towards the firm and its consequent influence on their customer oriented behaviours is also examined. Frontline service staff working in the consumer transport industry were surveyed to provide subjective data about the constructs of interest in this study, and the data were analysed using structural equations modelling employing partial least squares estimation. The data indicate significant relationships between internal market orientation (IMO), the attitudes of the employees to the firm and their consequent behaviour towards customers. Customer orientation, service direction and service training are all identified as antecedents to high levels of service delivery. The study contributes to marketing theory by providing quantitative evidence to support assumptions that internal marketing has an impact on services success. For marketing practitioners, the research findings offer additional information about the management, training and motivation of service staff towards service excellence.

An Investigation of Cognitive, Emotional and Negative Behavioural Responses to Service Recovery Strategies

Despite the best intentions of service providers and organisations, service delivery is rarely error-free. While numerous studies have investigated specific cognitive, emotional or behavioural responses to service failure and recovery, these studies do not fully capture the complexity of the services encounter. Consequently, this research develops a more holistic understanding of how specific service recovery strategies affect the responses of customers by combining two existing models—Smith & Bolton’s (2002) model of emotional responses to service performance and Fullerton and Punj’s (1993) structural model of aberrant consumer behaviour—into a conceptual framework. Specific service recovery strategies are proposed to influence consumer cognition, emotion and behaviour. This research was conducted using a 2x2 between-subjects quasi-experimental design that was administered via written survey. The experimental design manipulated two levels of two specific service recovery strategies: compensation and apology. The effect of the four recovery strategies were investigated by collecting data from 18-25 year olds and were analysed using multivariate analysis of covariance and multiple regression analysis. The results suggest that different service recovery strategies are associated with varying scores of satisfaction, perceived distributive justice, positive emotions, negative emotions and negative functional behaviour, but not dysfunctional behaviour. These finding have significant implications for the theory and practice of managing service recovery.

The relationship between Internet use and perceived performance in retail and professional service firms

lnformation technology (IT) and, in particular, the Internet is dramatically impacting on the services sector. This paper specifically investigates the relative impact of several forms of internet use on perceived performance for two groups of service organisations - retail service firms and professlonal health service firms. Using a mailed out self-administered questionnaire, 625 completed questionnaires were obtained and 43 per cent of respondents reported that they used the lternet. Thus the final usable sample in the study comprised 262 respondents. Results showed that the Internet does significantly influence perceived performance in both types of service firms. However,there are differences in the forms of lntemet use between the two service groups and their relative effect on performance. For retail firms, use of transactional function, such as ordering, selling and payment was found to be positively related to increases in perceived performance. In contrast, for professional health service firms, the ability to search for information on products and/or services was found to be positively associated with perceived performance. Finally, theoretical and managerial implications of the findings of this study are discussed.

Streamlining local government : evaluating an eGovernment initiative in south east Queensland

Recent initiatives around the world have highlighted the potential for information and communications technology (ICT) to foster better service delivery for businesses. Likewise, ICT has also been applied to government services and is seen to result in improved service delivery, improved citizen participation in government, and enhanced cooperation across government departments and between government departments. The Council of Australian Governments (COAG) (2006) identified local government development assessment (DA) arrangements as a ‘hot spot’ needing specific attention, as the inconsistent policies and regulations between councils impeded regional economic activity. COAG (2006) specifically suggested that trials of various ICT mechanisms be initiated which may well be able to improve DA processes for local government. While the authors have explored various regulatory mechanisms to improve harmonisation elsewhere (Brown and Furneaux 2007), the possibility of ICT being able to enhance consistency across governments is a novel notion from a public policy perspective. Consequently, this paper will explore the utility of ICT initiatives to improve harmonisation of DA across local governments. This paper examines as a case study the recent attempt to streamline Development Assessment (DA) in local governments in South East Queensland. This initiative was funded by the Regulation Reduction Incentive Fund (RRIF), and championed by the South East Queensland (SEQ) Council of Mayors. The Regulation Reduction Incentive Fund (RRIF) program was created by the Australian government with the aim to provide incentives to local councils to reduce red tape for small and medium sized businesses. The funding for the program was facilitated through a competitive merit-based grants process targeted at Local Government Authorities. Grants were awarded to projects which targeted specific areas identified for reform (AusIndustry, 2007), in SEQ this focused around improving DA processes and creating transparency in environmental health policies, regulation and compliance. An important key factor to note with this case study is that it is unusual for an eGovernment initiative. Typically individual government departments undertake eGovernment projects in order to improve their internal performance. The RRIF case study examines the implementation of an eGovernment initiative across 21 autonomous local councils in South East Queensland. In order to move ahead, agreement needed to be reached between councils at the highest level. Having reviewed the concepts of eGovernment and eGovernance, the literature review is undertaken to identify the typical cost and benefits, barriers and enablers of ICT projects in government. The specific case of the RRIF project is then examined to determine if similar costs and benefits, barriers and enablers could be found in the RRIF project. The outcomes of the project, particularly in reducing red tape by increasing harmonisation between councils are explored.

FM as a Business Enabler

As a functioning performing arts centre, commercial enterprise, tourist attraction and major national asset, Sydney Opera House must continue to demonstrate the optimal use and effectiveness of its facilities management (FM) to provide value for its stakeholders. To better achieve this, the Cooperative Research Centre for Construction Innovation focussed on the following three themes for investigation in the FM Exemplar Project — Sydney Opera House: digital modelling — developing a building information model capable of integrating information from disparate software systems and hard copy, and combining this with a spatial 3D computeraided design (CAD)/geographic information system (GIS) platform. This model offers a visual representation of the building and its component elements in 3D, and provides comprehensive information on each element. The model can work collaboratively through an open data exchange standard (common to all compliant software) in order to mine the data required to further FM objectives (such as maintenance) more efficiently and effectively. services procurement — developing a multi-criteria performance-based procurement framework aligned with organisational objectives for FM service delivery performance benchmarking — developing an FM benchmarking framework that enables facilities/ organisations to develop key performance indicators (KPIs) to identify better practice and improvement strategies. These three research stream outcomes were then aligned within the broader context of Sydney Opera House’s Total Asset Management (TAM) Plan and Strategic Asset Maintenance (SAM) Plan in arriving at a business framework aligned with, and in support of, organisational objectives. The Sydney Opera House is managed by the Sydney Opera House Trust on behalf of the Government of the State of New South Wales. Within the framework of the TAM Plan prepared in accordance with NSW Treasury Guidelines, the assimilation of these three themes provides an integrated FM solution capable of supporting Sydney Opera House’s business objectives and functional requirements. FM as a business enabler showcases innovative methods in improving FM performance, a better alignment of service and performance objectives and provides a better-practice model to support the business enterprise.

Getting creative in health care

Health care accounts for a substantial and growing share of national expenditures, and Australia’s health-care system faces some unprecedented pressures. This paper examines the contribution of creative expertise and services to Australian health care. They are found to be making a range of contributions to the development and delivery of health-care goods and services, the initial training and ongoing professionalism of doctors and nurses, and the effective functioning of health-care buildings. Creative activities within health-care services are also undertaken by medical professionals and patients. Key functions that creative activities address are innovation and service delivery in information management and analysis, and making complex information comprehensible or more useful, assisting communication and reducing psycho-social and distance-mediated barriers, and improving the efficiency and effectiveness of services.

Mental health issues and resources in rural and regional communities : an exploration of perceptions of service providers

Objective: To identify service providers’ and community organisations’ perceptions of the resources available to support people with mental illness and the unmet needs of this client group in rural Queensland. Design: An exploratory study was undertaken involving focus group interviews across the study sites. Setting: Five regional towns in rural Queensland. Participants: Ten to 14 members were recruited for each of the five focus groups. The groups represented a diverse mix of participants including health and community service providers and representatives from community organisations. Results: Participants identified gaps in services in relation to health, employment and education, housing and accommodation, transport and social inclusion and health promotion. Inter-service communication and inappropriate funding models were themes affecting service delivery. Conclusions: Specific service issues of housing and transport were identified to be particularly problematic for people with mental illness across all towns. Intersectoral communication and funding models require further research.

The moderating role of self-efficacy on the relationship between emotional exhaustion and job strain for boundary-spanning service employees

Appropriate behaviours toward customers often requires employees to suppress some genuine emotions and/or express other emotions; genuine or contrived. Managing one's emotions in this way gives rise to emotional exhaustion. This can have consequences for psychological ill health, in the form of work place strain, and ultimately employee's desire to leave. This student examines the relationships between emotional management, emotional exhaustion and turnover intentions amongst diversional therapy professionals. We find that some forms of emotional management have a significant impact on emotional exhaustion and that this predicts workplace strain. Furthermore, the deleterious effects of emotional exhaustion are mitigated somewhat for employees who have strong beliefs in their ability to provide good service, compared to employees with lower self efficacy beliefs.

Service identification through value chain analysis and prioritization

In a resource constrained business world, strategic choices must be made on process improvement and service delivery. There are calls for more agile forms of enterprises and much effort is being directed at moving organizations from a complex landscape of disparate application systems to that of an integrated and flexible enterprise accessing complex systems landscapes through service oriented architecture (SOA). This paper describes the deconstruction of an enterprise into business services using value chain analysis as each element in the value chain can be rendered as a business service in the SOA. These business services are explicitly linked to the attainment of specific organizational strategies and their contribution to the attainment of strategy is assessed and recorded. This contribution is then used to provide a rank order of business service to strategy. This information facilitates executive decision making on which business service to develop into the SOA. The paper describes an application of this Critical Service Identification Methodology (CSIM) to a case study.

Rethinking public service media and citizenship : digital strategies for news and current affairs at Australia’s Special Broadcasting Service (SBS)

This article considers the concept of media citizenship in relation to the digital strategies of the Special Broadcasting Service (SBS). At SBS, Australia’s multicultural public broadcaster, there is a critical appraisal of its strategies to harness user-created content (UCC) and social media to promote greater audience participation through its news and current affairs Web sites. The article looks at the opportunities and challenges that user-related content presents for public service media organizations as they consolidate multiplatform service delivery. Also analyzed are the implications of radio and television broadcasters’ moves to develop online services. It is proposed that case study methodologies enable an understanding of media citizenship to be developed that maintains a focus on the interaction between delivery technologies, organizational structures and cultures, and program content that is essential for understanding the changing focus of 21st-century public service media.