Using health-related quality of life instruments for children with long-term conditions : On the basis of a national quality registry system

Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments. Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system. Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings. Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations. Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.

Factors facilitating a national quality registry to aid clinical quality improvement : findings of a national survey

Objectives: While national quality registries (NQRs) are suggested to provide opportunities for systematic follow-up and learning opportunities, and thus clinical improvements, features in registries and contexts triggering such processes are not fully known. This study focuses on one of the world's largest stroke registries, the Swedish NQR Riksstroke, investigating what aspects of the registry and healthcare organisations facilitate or hinder the use of registry data in clinical quality improvement. Methods: Following particular qualitative studies, we performed a quantitative survey in an exploratory sequential design. The survey, including 50 items on context, processes and the registry, was sent to managers, physicians and nurses engaged in Riksstroke in all 72 Swedish stroke units. Altogether, 242 individuals were presented with the survey; 163 responded, representing all but two units. Data were analysed descriptively and through multiple linear regression. Results: A majority (88%) considered Riksstroke data to facilitate detection of stroke care improvement needs and acknowledged that their data motivated quality improvements (78%). The use of Riksstroke for quality improvement initiatives was associated (R2=0.76) with ‘Colleagues’ call for local results’ (p=<0.001), ‘Management Request of Registry data’ (p=<0.001), and it was said to be ‘Simple to explain the results to colleagues’ (p=0.02). Using stepwise regression, ‘Colleagues’ call for local results’ was identified as the most influential factor. Yet, while 73% reported that managers request registry data, only 39% reported that their colleagues call for the unit's Riksstroke results. Conclusions: While an NQR like Riksstroke demonstrates improvement needs and motivates stakeholders to make progress, local stroke care staff and managers need to engage to keep the momentum going in terms of applying registry data when planning, performing and evaluating quality initiatives.

Os princípios da organização focada na estratégia: um estudo em empresas vencedoras do prêmio nacional de qualidade

The Balanced Scorecard (BSC) has been used as a communication tool and strategy monitoring, helping organizations alignment, inserting a new vision with integrated use of performance indicators nonfinancial together with some financial measures. Their proper use leads to a new management style, focused on management strategies, using for this, basically three dimensions: strategy, which should be translated as the primary responsibility for the organizational agenda, the focus that should be concentrated, and the organization with the mobilization of employees. This paper deals with theoretical considerations about strategies, strategic planning, BSC and principles of the organization focused on strategy (OFE). Describes a study of four companies that won the National Quality Award - PNQ, among which, three have adopted the BSC and adopts a particular model of strategic management. The research aimed to make an analysis of the companies regarding adherence to the five principles of OFE, proposed by the BSC, seeking to answer whether the use of BSC is a prerequisite for accession to the Principles of OFE. The results showed that the BSC is a strategic management model that promotes focus and organizational alignment and is a major facilitator in the process, however, cannot be considered a prerequisite for accession to the principles of the OFE, because the four companies studied, including the one that adopt its own model of strategic management, have great levels of adherence to such principles. Making the organization focused on strategy can be considered a natural movement essential for the strategic management, which is not necessarily conditioned by the use of BSC

Estudo de caso de avaliação dos ativos intangíveis utilizando o modelo de excelência de gestão do prêmio nacional da qualidade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O modelo de excelência de gestão do prêmio nacional da qualidade - PNQ: análise da evolução dos critérios de excelência

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Religião, ética e axiologia no campo empresarial: um estudo das empresas que adotam a cultura da excelência

Este trabalho tem como objeto de estudo a ética e a constituição dos valores que fundamentam os campos religioso e empresarial e suas similaridades levando em consideração os aspectos socio-antropológicos. A ética dentro do campo das organizações empresariais vem se tornando tema de fundamental importância não apenas na visão dos empresários, mas, principalmente, na visão dos investidores e consumidores, e, muitas vezes, tem definido o sucesso ou o fracasso dessas organizações. A religião é aqui estudada como um fato social e cultural que influencia e é influenciada por outros fenômenos sócio-culturais. A pergunta principal que norteia este trabalho é se há influência de valores religiosos na formulação da conduta ética empresarial, tendo como universo de pesquisa os ciclos de premiação do Prêmio Nacional da Qualidade (PNQ). Buscando respostas para esta questão são abordados os aspectos simbólicos dos rituais de premiação; os valores culturais que permeiam os campos religioso e empresarial; e, uma análise da conduta ética empresarial tendo como referência a implementação da Cultura da Excelência do PNQ, com destaque aos seus critérios de excelência que têm incorporado as demandas de mercado, tais como responsabilidade social, ambiental e ética.(AU)

Religião, ética e axiologia no campo empresarial: um estudo das empresas que adotam a cultura da excelência

Este trabalho tem como objeto de estudo a ética e a constituição dos valores que fundamentam os campos religioso e empresarial e suas similaridades levando em consideração os aspectos socio-antropológicos. A ética dentro do campo das organizações empresariais vem se tornando tema de fundamental importância não apenas na visão dos empresários, mas, principalmente, na visão dos investidores e consumidores, e, muitas vezes, tem definido o sucesso ou o fracasso dessas organizações. A religião é aqui estudada como um fato social e cultural que influencia e é influenciada por outros fenômenos sócio-culturais. A pergunta principal que norteia este trabalho é se há influência de valores religiosos na formulação da conduta ética empresarial, tendo como universo de pesquisa os ciclos de premiação do Prêmio Nacional da Qualidade (PNQ). Buscando respostas para esta questão são abordados os aspectos simbólicos dos rituais de premiação; os valores culturais que permeiam os campos religioso e empresarial; e, uma análise da conduta ética empresarial tendo como referência a implementação da Cultura da Excelência do PNQ, com destaque aos seus critérios de excelência que têm incorporado as demandas de mercado, tais como responsabilidade social, ambiental e ética.(AU)

Religião, ética e axiologia no campo empresarial: um estudo das empresas que adotam a cultura da excelência

Este trabalho tem como objeto de estudo a ética e a constituição dos valores que fundamentam os campos religioso e empresarial e suas similaridades levando em consideração os aspectos socio-antropológicos. A ética dentro do campo das organizações empresariais vem se tornando tema de fundamental importância não apenas na visão dos empresários, mas, principalmente, na visão dos investidores e consumidores, e, muitas vezes, tem definido o sucesso ou o fracasso dessas organizações. A religião é aqui estudada como um fato social e cultural que influencia e é influenciada por outros fenômenos sócio-culturais. A pergunta principal que norteia este trabalho é se há influência de valores religiosos na formulação da conduta ética empresarial, tendo como universo de pesquisa os ciclos de premiação do Prêmio Nacional da Qualidade (PNQ). Buscando respostas para esta questão são abordados os aspectos simbólicos dos rituais de premiação; os valores culturais que permeiam os campos religioso e empresarial; e, uma análise da conduta ética empresarial tendo como referência a implementação da Cultura da Excelência do PNQ, com destaque aos seus critérios de excelência que têm incorporado as demandas de mercado, tais como responsabilidade social, ambiental e ética.(AU)

Local politico-administrative perspectives on quality improvement based on national registry data in Sweden : a qualitative study using the Consolidated Framework for Implementation Research.

Background. Through a national policy agreement, over 167 million Euros will be invested in the Swedish National Quality Registries (NQRs) between 2012 and 2016. One of the policy agreement¿s intentions is to increase the use of NQR data for quality improvement (QI). However, the evidence is fragmented as to how the use of medical registries and the like lead to quality improvement, and little is known about non-clinical use. The aim was therefore to investigate the perspectives of Swedish politicians and administrators on quality improvement based on national registry data. Methods. Politicians and administrators from four county councils were interviewed. A qualitative content analysis guided by the Consolidated Framework for Implementation Research (CFIR) was performed. Results. The politicians and administrators perspectives on the use of NQR data for quality improvement were mainly assigned to three of the five CFIR domains. In the domain of intervention characteristics, data reliability and access in reasonable time were not considered entirely satisfactory, making it difficult for the politico-administrative leaderships to initiate, monitor, and support timely QI efforts. Still, politicians and administrators trusted the idea of using the NQRs as a base for quality improvement. In the domain of inner setting, the organizational structures were not sufficiently developed to utilize the advantages of the NQRs, and readiness for implementation appeared to be inadequate for two reasons. Firstly, the resources for data analysis and quality improvement were not considered sufficient at politico-administrative or clinical level. Secondly, deficiencies in leadership engagement at multiple levels were described and there was a lack of consensus on the politicians¿ role and level of involvement. Regarding the domain of outer setting, there was a lack of communication and cooperation between the county councils and the national NQR organizations. Conclusions. The Swedish experiences show that a government-supported national system of well-funded, well-managed, and reputable national quality registries needs favorable local politico-administrative conditions to be used for quality improvement; such conditions are not yet in place according to local politicians and administrators.

Increasing national capability for quality higher education the case of the Sultanate of Oman

This paper explores a number of quality enhancement initiatives being implemented in a developing country, the Sultanate of Oman, to increase the national capability for quality higher education. Oman is a young country with a youthful and rapidly growing population. A brief description of the relatively short history of Oman’s national systems for secondary and postsecondary education is provided. This highlights the challenges for quality education resulting from a strategy of importing postsecondary education from a variety of countries, and delivering the programs through a largely privatized sector.

The paper then describes the outcomes of an initial needs analysis that led to the development of a National Quality Plan. Some of the strategies in this plan for improving and increasing capability are considered, most particularly the establishment of a practitioner‐oriented Oman Quality Network, and the design and implementation of a National Quality Training Program. These two strategies attempt to address common obstacles to capability, namely a paradigm that entrenches compliance and helplessness, and only early awareness of effective quality enhancement and quality assurance principles and methods.

Evaluation results are presented that comment on progress thus far, and suggest critical success factors. These include building legitimacy and trust to overcome barriers to sharing information in a competitive privatized environment. They also include the establishment of peer to peer mechanisms that build confidence and create sustainability over time, as imported or external expertise gives way to local capability and expertise.

Library technician course recognition : meeting the challenge of a distributed national education program

This paper looks at the challenges presented for the Australian Library and Information Association by its role as the professional association responsible for ensuring the quality of Australian library technician graduates. There is a particular focus on the issue of course recognition, where the Association's role is complicated by the need to work alongside the national quality assurance processes that have been established by the relevant technical education authorities. The paper describes the history of course recognition in Australia; examines the relationship between course recognition and other quality measures; and describes the process the Association has undertaken recently to ensure appropriate professional scrutiny in a changing environment of accountability.

Relationship between quality certification and financial and non-financial performance of organizations

At present, many countries have either embraced ISO9001 or used it as the basis of their national quality certification systems. However, few studies have been conducted to examine the benefits companies’ gain from achieving and implementing ISO9001 standards (Chikuku et al. 2012; Psomas et al. 2013; Sampaio et al. 2011a,b). Analysis has brought much more confused and uneven results across the countries. Turning to the experience of Malaysia, this country has witnessed a spectacular growth at an average rate of 9.89% per annum of ISO certificates issued to companies operating within its borders (ISO Survey 2012). While many companies rush to be ISO 9001 certified whether this brings about better benefits (both the financial and the non-financial) is still an open question. In this study, the research problems were first formulated from the literature and then a questionnaire survey was conducted to test the hypotheses. A survey was administered to chief executives officers and managers across manufacturing and service organizations in Malaysia. Multivariate analysis and SPSS macro developed by Preacher and Hayes were used as statistical techniques to the financial and non-financial benefits of ISO9001 certification. The survey instrument was a two-page questionnaire comprising three sections. The first section of the questionnaire covered the company’s profile. The second section consisted of 25 items on internal benefits and third section consisted of 7 items on external benefits measured on 1–5 Likert scale to assess the benefits of ISO9001 certification. Total 201 valid responses were received. Results of the study indicate that there was no significant direct relationship between ISO9001 certification and organizational financial performance, while strong statistical evidence was found to support the direct relationship between ISO9001 certification and non-financial performance. The findings of the study discovered that financial performance is actually directly related to two non-financial measures, namely quality performance and local and international business performance, which are directly and significantly influenced by ISO9001 certification. Therefore non-financial performance measures are involved in the mediational process. The findings will assist practitioners in taking right courses of action that make the implementation of this standard more effective. For example, the study findings study suggests that companies should put emphasize on nonfinancial factors to improve their financial performance.

From Quality Management to Socially Responsible Organisations: the Case for CSR

Purpose – The purpose of this paper is to focus on the growing interest of the role of business in society, commonly referred to as CSR. Historically CSR can be traced back to the 1950s, although in very recent times there has been a virtual explosion of interest in its use and applicability in organisations. However, there are many unresolved issues, most notably in terms of how CSR should or can be implemented and embedded in an organisation. This paper therefore seeks to explore the relationship and potential synergies between quality management and CSR. Design/methodology/approach – The qualitative exploratory study in this paper represents the first stage of an ongoing research programme, and is based on an in-depth analysis of quality award submission documentation from six case organisations that have recently been recognised as winners in relation to their quest for business improvement. Findings – The paper finds that substantial evidence from each of the case organisations demonstrates the breadth and depth of activities in which they are engaging under the broad headings of workplace, environment, social impact, and economic impact. However, whilst there is no doubting the sincerity of the actions, the approaches and activities, a strategic focus on CSR is still very much in its infancy. Research limitations/implications – In this paper there is a paucity of empirical research examining how existing management tools, techniques and methodologies can be used to further the CSR debate. This paper represents an important first step in redressing this imbalance. Practical implications – The paper suggests that the quality management and business excellence frameworks can offer a strong foundation from which to develop CSR strategies, behaviours and activities in an organisation. Originality/value – This paper represents an important first step in understanding how and where CSR “fits” into an organisation and potentially how existing quality methodologies, tools and frameworks can be used to aid the implementation of CSR.