Search results

Point-of-care testing (POCT) at the Emergency Department (ED) attains better objectives in patient care while aiming to achieve early diagnosis for faster medical decision-making. This study assesses and compares the benefits of POCT in the ED in Germany and Malta, while considering differences in their health systems.

This chapter utilizes multiple case study approach using Six Sigma. The German case study assesses the use of POCT in acute coronary syndrome patients, compared to the central lab setting. The Maltese case study is a pilot study of the use of medical ultrasonography as a POCT to detect abdominal free fluid in post-blunt trauma.

This study provides clear examples of the effectiveness of POCT in life-threatening conditions, as compared to the use of traditional central lab or the medical imaging department. Therapeutic quality in the ED and patient outcomes directly depend upon turnaround time, particularly for life-threatening conditions. Faster turnaround time not only saves lives but reduces morbidity, which in the long-term is a critical cost driver for hospitals.

The application of Six Sigma and the international comparison of POCT as best practice for life-threatening conditions in the ED.

Purpose: As specific emotional arenas, hospitals are characterized by the interweaving of various emotional requirements, arising from different sources of norms, rules, or guidelines. This study aims to highlight an often-overlooked dimension of emotional labor in healthcare by describing the coexistence of emotional rules (i.e. feeling and/or display rules) through a multilevel perspective (institutional level, cluster/department level, service level, ward level, professional level). Study Design/Methodology/Approach: These emotional requirements for nurses and nursing assistants are investigated through three sets of data (observation, interviews, and internal documents) in a French public hospital, focusing on two hospital services: three long-term care units (primary field of investigation), and five adult medical emergency wards (secondary field of investigation). Findings: The results of the analysis show the pervasive nature of emotional requirements which are intertwined and more or less implicit/explicit according to the level analyzed. In addition to organizational rules, professional and social emotional rules contribute to shaping emotional requirements, particularly through rules of “empathetic expression” and those of retenue bienveillante. Research Limitations/Implications: This research has contributed to showing the dynamic nature of emotional requirements and their appropriation and modulation by healthcare professionals. The qualitative methodology used allows for unique insights but limits the generalization of results. Originality/Value: This research has addressed various gaps in the existing literature by describing emotional requirements through a multilevel analysis, by outlining a set of rules that had not been previously described (retenue bienveillante) and by including the population of nursing assistants as well as nurses in a study on hospital emotional labor. Future research could envisage spatial analysis of emotional labor to help better understand emotional requirements' variability according to emotionalized zones.

Purpose – Statistics about the level of crime continue to attract public and political attention but are often presented in conflicting ways. In England and Wales, police-recorded crimes are no longer considered “national statistics” and, instead, the crime survey of England and Wales (CSEW) is used. However, it is not clear why partial population data (e.g., police-recorded crime) are considered less reliable or valid for measuring temporal crime trends in society than inferential statistical estimation models that are based on samples such as CSEW. This is particularly the case for approximating rare events like high-harm violence and specific harmful modus operandi (e.g., knife crime and firearms). In this chapter, the authors cross-reference victim survey and police-recorded data to determine similarities and contradictions in trends.

Methods – Using police data and CSEW estimates, the authors contrast variance and logarithmic trend lines since 1981 across a range of data categories and then triangulate the results with assault records from hospital consultations.

Findings – Change in crime rates in recent years is neither as unique nor extreme as promulgated in media coverage of crime. Moreover, analyses show conflicting narratives with a host of plausible but inconclusive depictions of the “actual” amount of crime committed in the society. The authors also conclude that neither source of data can serve as the benchmark of the other. Thus, both data systems suffer from major methodological perils, and the estimated crime means in CSEW, inferred from samples, are not necessarily more valid or accurate than police-recorded data (particularly for low-frequency and high-harm crimes). On the other hand police-recorded data are susceptible to variations in recording practices. As such, the authors propose a number of areas for further research, and a revised taxonomy of crime classifications to assist with future public interpretations of crime statistics.

Originality – There is much public and academic discourse about different sources of crime measurement yet infrequent analysis of the precise similarities and differences between the methods. This chapter offers a new perspective on long-term trends and highlights an issue of much contemporaneous concern: rising violent crime.

This paper looks at the current portrayal of emotion in healthcare as delivered within formal organisational settings, notably the UK National Health Service (NHS). Its purpose is to set out some examples of the problems and suggest new ways of conceptualising issues that will assist healthcare organisations in gaining a better understanding of the role of emotion and its impact, using appropriate examples. Developing understanding of the location of emotion and its differing constructions indicates that interdisciplinary and interpersonal boundaries differentiate interpretations of emotion, often for instrumental purpose as examples drawn particularly from the Public Inquiry into Paediatric Cardiology at Bristol Royal Infirmary (The Kennedy Report) demonstrate. The privileging of rationality over emotion as part of the dominant paradigm within the healthcare domain is shown to affect outcomes. However, the boundaries between organisations and individuals are changing, so are the location, access, technologies and timing of activities, and these are reconstructing healthcare organisation and the patient's experience of healthcare at both rational and emotional levels. It is suggested that in healthcare it is the patients’ journey through their lives (the macro context), as well as their individual encounters with the system at different times of need (the micro context), that iteratively constitute the construction of the emotional terrain. The conclusions drawn could have wider implications for the development of emotional understanding, across organisations that are subject to similar changes.