Search results

Patients with severe asthma were choosing not to use the emergency department (ED) in extremis and were self-medicating when experiencing severe asthma, putting their lives at risk. This local issue reflected a nationwide situation. The purpose of this paper is to better understand the reasons behind patients’ reluctance to attend ED and to consider practical solutions in a structured way.

Systems thinking (soft systems methodology) was used to examine the issues resulting in this reluctance to attend the ED. Once this tame (well-defined) problem was revealed, a potential solution was developed in co-production with patients.

Patients feared attending the ED and felt vulnerable while in the ED for several reasons. This appeared to be a well-defined and solvable problem. The solution proposed was an asthma patient passport (APP), which increased patient’s confidence in their ability to communicate their needs while in severe distress. The APP decreases (from 12 to 5 steps) the work patients had to do to achieve care. The APP project is currently being evaluated.

The APP should be offered to all people with severe asthma.

By revisiting systems thinking and identifying problems, a solution was identified. Although methods such as soft systems methodology have limitations when used in wicked (difficult or impossible to resolve) problems, such methods still have merit in tame problems and were applicable in this case to fully understand the issues, and to design practical solutions.

Incident reporting systems are commonly deployed in healthcare but resulting datasets are largely warehoused. This study explores if intelligence from such datasets could be used to improve quality, efficiency, and safety.

Incident reporting data recorded in one NHS acute Trust was mined for insight (n = 133,893 April 2005–July 2016 across 201 fields, 26,912,493 items). An a priori dataset was overlaid consisting of staffing, vital signs, and national safety indicators such as falls. Analysis was primarily nonlinear statistical approaches using Mathematica V11.

The organization developed a deeper understanding of the use of incident reporting systems both in terms of usability and possible reflection of culture. Signals emerged which focused areas of improvement or risk. An example of this is a deeper understanding of the timing and staffing levels associated with falls. Insight into the nature and grading of reporting was also gained.

Healthcare incident reporting data is underused and with a small amount of analysis can provide real insight and application to patient safety.

This study shows that insight can be gained by mining incident reporting datasets, particularly when integrated with other routinely collected data.

Despite the generation of mass data by the nursing workforce, determining the impact of the contribution to patient safety remains challenging. Several cross-sectional studies have indicated a relationship between staffing and safety. The purpose of this paper is to uncover possible associations and explore if a deeper understanding of relationships between staffing and other factors such as safety could be revealed within routinely collected national data sets.

Two longitudinal routinely collected data sets consisting of 30 years of UK nurse staffing data and seven years of National Health Service (NHS) benchmark data such as survey results, safety and other indicators were used. A correlation matrix was built and a linear correlation operation was applied (Pearson product-moment correlation coefficient).

A number of associations were revealed within both the UK staffing data set and the NHS benchmarking data set. However, the challenges of using these data sets soon became apparent.

Staff time and effort are required to collect these data. The limitations of these data sets include inconsistent data collection and quality. The mode of data collection and the itemset collected should be reviewed to generate a data set with robust clinical application.

This paper revealed that relationships are likely to be complex and non-linear; however, the main contribution of the paper is the identification of the limitations of routinely collected data. Much time and effort is expended in collecting this data; however, its validity, usefulness and method of routine national data collection appear to require re-examination.

Representations of female perpetrators of political violence contribute to society's thinking about women, gender, violence and agency. Analysis of this discourse is vital to understand its influence on society's knowledge of women and violence. The study investigates how gendered narratives are used to frame female ex-combatants in Nationalist and Unionist newspapers in the post-conflict society of Northern Ireland. The media is a central agent in the construction of knowledge; and this is significant for women who have perpetrated crimes or (political) violence. The existing research found that violent women are narrated and interpreted through gendered discursive frameworks to dismiss or make sense of their violence. However, in the Northern Irish case, although the women are constructed within gendered frames, this does not deny their agency in past political violence.

The purpose of this paper is to explore the differences in international student mobility (SM) in two contrasting countries: UK and China, at national, institutional and individual levels. Both are countries in transition in a greater global context. The objective is to identify what these countries can learn from each other about the issues and policies surrounding the management of educational mobility.

An inductive approach was employed to understand real-life experience via multiple case studies. Participant observation and semi-structured interview methods with a variety of stakeholders were used to collect data which were then subjected to a thematic analysis to identify in which areas countries had developed good practice.

Over-arching themes were developed through comparing national findings. These reveal that national policy and family support are most influential in China, while British universities largely drive SM at an institutional level.

The significance of this knowledge lies in the potential for social impact and reform of successful mobility schemes. International mobility equates to social mobility through global employability of those who engage. Global citizenship is regarded as one of the paths to world peace and understanding. Mobilising a younger generation can contribute to better regional integration and international stability as part of an idealistic approach to geopolitics.

Concluding that neither country has a comprehensive and complete approach, this study proposes the areas in which all both could develop and details good practice. The value therefore emerges from the comparison and contrast and the practical focus of the research.

The purpose of this study is to explore the role of professional and leader identity and the maintenance of identity, through identity work as IT professionals transitioned to a permanent hybrid role. This study therefore contributes to the under-researched area of permanent transition to a hybrid role in the context of IT, where there is a requirement to enact both the professional and leader roles together.

The study utilised a longitudinal design and two qualitative methods (interviews and reflective diaries) to gather data from 17 IT professionals transitioning to hybrid roles.

The study findings reveal that IT professionals engage in an ongoing process of reconciliation of professional and leader identity as they transition to a permanent hybrid role, and they construct hybrid professional–leader identities while continuing to value their professional identity. They experience professional–leader identity conflict resulting from reluctance to reconcile both professional and leader identities. They used both integration and differentiation identity work tactics to ameliorate these tensions.

The longitudinal study design, the qualitative approaches used and the unique context of the participants provide a dynamic and deep understanding of the challenges involved in performing hybrid roles in the context of IT.

Purpose – Both misbehavior and commitment in organizations have attracted substantial attention. This chapter reviews the misbehavior and commitment literature to investigate the implicit negative correlation between these two important organizational phenomena.

Methodology/approach – A four-dimensional typology of counterproductive workplace behaviors (CWBs) is developed from the misbehavior literature, describing individual behaviors in terms of: their target(s), the vehicle for misbehavior, their social acceptability, and their quantity. The typology facilitates characterization of CWBs, and, more generally, comparisons between workplace commitment and the field of misbehavior, comprising the range of CWBs.

Findings – The chapter supports the assumed negative relationship between commitment and misbehavior although the strength of the relationship varies across some of the four dimensions.

Research limitations/implications – The reliance on secondary data limits evaluation of the typology. Further research using primary data is commended.

Practical implications – More insightful audits of organizational misbehavior can be produced to guide interventions. For example, CWBs that are directed at individuals, through a person's work role, and are socially unacceptable will require different interventions to those who are directed at the organization, through extra-role behavior, and are more socially acceptable (e.g., minor thefts).

Social implications – Clarifying the impact of CWBs on commitment and, hence, turnover, etc., highlights the cost of CWBs and may motivate organizations to address CWBs and, thereby, promote healthier workplaces.

Originality/value of chapter – This chapter is novel in developing a more comprehensive typology of CWBs. Describing the various CWBs in a single, comprehensive framework provides additional insight into misbehavior.

There has been an increasing emphasis on developing officers who can effectively make decisions in dynamic and stressful environments to manage volatile situations. The aim of this paper is to guide those seeking to optimize the limited resources dedicated to police training.

Drawing on research related to stress exposure training, principles of adult learning, the event-based approach to training and policing more broadly, the authors show how carefully crafted training scenarios can maximize the benefits of police training.

The authors’ review highlights various training principles that, if relied on, can result in scenarios that are likely to result in the development of flexible, sound decision-making skills when operating under stressful conditions. The paper concludes with an example of scenario development, which takes the reviewed principles into account.

The authors hope this discussion will be useful for police instructors and curriculum designers in making evidence-informed decisions when designing training scenarios.

The Bureau of Economics in the Federal Trade Commission has a three-part role in the Agency and the strength of its functions changed over time depending on the preferences and ideology of the FTC’s leaders, developments in the field of economics, and the tenor of the times. The over-riding current role is to provide well considered, unbiased economic advice regarding antitrust and consumer protection law enforcement cases to the legal staff and the Commission. The second role, which long ago was primary, is to provide reports on investigations of various industries to the public and public officials. This role was more recently called research or “policy R&D”. A third role is to advocate for competition and markets both domestically and internationally. As a practical matter, the provision of economic advice to the FTC and to the legal staff has required that the economists wear “two hats,” helping the legal staff investigate cases and provide evidence to support law enforcement cases while also providing advice to the legal bureaus and to the Commission on which cases to pursue (thus providing “a second set of eyes” to evaluate cases). There is sometimes a tension in those functions because building a case is not the same as evaluating a case. Economists and the Bureau of Economics have provided such services to the FTC for over 100 years proving that a sub-organization can survive while playing roles that sometimes conflict. Such a life is not, however, always easy or fun.