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1 – 10 of over 6000This paper reports on the application of Data Envelopment Analysis (DEA) to the classical scoring system of quality management assessments used in the European Foundation for…
Abstract
This paper reports on the application of Data Envelopment Analysis (DEA) to the classical scoring system of quality management assessments used in the European Foundation for Quality Management’s Business Excellence Model (EFQM‐BEM). Following a brief description of the way in which the DEA method of analysis can be applied, an illustrative example demonstrates the power of the approach in identifying meaningful exemplar organisations for each individual component element of the EFQM‐BEM. The method uses these exemplars to set realistic targets in each component which are currently being achieved by exemplar organisations. Preserving rank order, the DEA scoring system is a radical development of the original EFQM‐BEM system which overcomes the resistance to the standard component values often articulated by public and voluntary sector service providers in particular.
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Mansoor Akhtar, Mohamed Boshnaq and Sathyan Nagendram
Delay in histologically confirming rectal cancer may lead to late treatment as histological confirmation is required prior to chemo-radiotherapy or surgical intervention…
Abstract
Purpose
Delay in histologically confirming rectal cancer may lead to late treatment as histological confirmation is required prior to chemo-radiotherapy or surgical intervention. Multidisciplinary colorectal meetings indicate that there are patients who require multiple tissue biopsy episodes prior to histologically confirming rectal cancer. The purpose of this paper is to examine a quality improvement (QI) measure’s impact on tissue biopsy process diagnostic yield.
Design/methodology/approach
The authors performed the study in two phases (pre- and post-QI), between February 2012 and April 2014 in a district general hospital. The QI measures were derived from process mapping a rectal cancer diagnostic pathway. The primary outcome was to assess the tissue biopsy process diagnostic yield. The secondary outcome included total breaches for a 62-day target in the pre- and post-QI study phases.
Findings
There was no significant difference in demographics or referral mode in both study phases. There were 81 patients in the pre-QI phase compared to 38 in the post-QI phase, 68 per cent and 74 per cent were referred via the two-week wait urgent pathway, respectively. Diagnostic tissue biopsy process yield improved from 58.1 to 77.6 per cent after implementing the QI measure (p=0.02). The 62-day target breach was reduced from 14.8 to 3.5 per cent (p=0.42).
Practical implications
Simple QI measures can achieve significant improvements in rectal cancer diagnostic tissue biopsy process yields. A multidisciplinary approach, involving process mapping and cause and effect modelling, proved useful tools.
Originality/value
A process mapping exercise and QI measures resulted in significant improvements in diagnostic yield, reducing the episodes per patient before histological diagnosis was confirmed.
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Psychopathy and antisocial personality are controversial disorders with alternate behavioral and dynamic formulations. As such, diagnostic approaches are often fragmentary and…
Abstract
Purpose
Psychopathy and antisocial personality are controversial disorders with alternate behavioral and dynamic formulations. As such, diagnostic approaches are often fragmentary and inconsistent. The purpose of this paper is to delineate the various conceptual parameters and to propose a comprehensive diagnostic approach.
Design/methodology/approach
A model is presented based on the congruence and differences among various categories of psychopathic and antisocial personality disorders and their clinical manifestations. Diagnostic approaches are critiqued and evaluated. Specific assessment tools and measures are recommended based on referrals and symptomatology.
Findings
Key factors of low frustration tolerance, poor social intelligence, aggression-driven psychopathy, sadism, and superego impairment are shown as central in the differential diagnostics of antisocial individuals.
Originality/value
The model enables the differentiation of problematic behaviors which may appear similar but require different forensic, legal, diagnostic, and intervention strategies.
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Solomon Shatananda, Abimbola Oyedokun, Mahesh Odiyoor, Sujeet Jaydeokar and Saman Shahzad
The purpose of the study is to identify and ascertain if there were any validated tools for diagnosing or screening autism spectrum disorder in adults with ID. The estimated…
Abstract
Purpose
The purpose of the study is to identify and ascertain if there were any validated tools for diagnosing or screening autism spectrum disorder in adults with ID. The estimated prevalence of intellectual disability (ID) in the general population is about 10.37/1,000 population (Maulik et al., 2011). In total, 1 out of 4 individuals with ID suffers from an autism spectrum disorder (ASD) (Sappok et al., 2010). Early diagnosis and support for ASD is key to having a good quality of life. The diagnosis of ASD in people with an ID presents its own challenges and it is likely under-identification of ASD amongst adults with ID by about 20% to 30% (Emerson and Baines, 2010).
Design/methodology/approach
Studies were selected based on the following criteria: studies that reported either screening or diagnostic tools for ASD, participants had an ID i.e. a mean IQ of <70, adults i.e. participants were >18 years of age at the time of entry to the study and articles reported either sensitivity, specificity or area under the curve. Relevant studies that were published up to January 2020 were identified from EMBASE, PsychINFO, CINAHL and PubMed. In total, 75 papers were identified of which 15 papers met the criteria.
Findings
The screening or diagnostic tools currently in use is dependant on the degree of ID. A number of the tools had good psychometric properties and utility when used in people with specific degrees of ID or when used in combination with another screening or diagnostic tool. The authors could not identify a diagnostic tool that could be used across all levels of severity of ID unless used in combination. Hence, concluded that there is a need for a diagnostic tool with good psychometric properties for the assessment of ASD in adults with all degree of ID within a reasonable time period without the need for an additional tool to be used in conjunction.
Originality/value
Currently, the “gold standard” for diagnosing ASD is a lengthy and time-consuming process carried out by trained multi-disciplinary team members who assess historical, behavioural and parent/carer report to arrive at a diagnosis. There are a number of tools that have been developed to aid diagnosis. However, it is important to identify the tools that can optimise the procedures and are also time-efficient.
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According to current estimates, the prevalence of autism spectrum disorders (ASDs) ranges from 1 in 500 children to 1 in 150 children (Centers for Disease Control and…
Abstract
According to current estimates, the prevalence of autism spectrum disorders (ASDs) ranges from 1 in 500 children to 1 in 150 children (Centers for Disease Control and Prevention/CDC, 2007; Desmon, 2007). In the past such disorders usually were not identified until a child was school-aged, but these disorders are now more likely to be diagnosed in affected individuals during the preschool years (McConachie, Le Couteur, & Honey, 2005; Rutter, 2006). For example, Mandell, Novak, and Zubritsky (2005) surveyed over 900 caregivers of children with ASDs and learned that on an average, children with autistic disorder were diagnosed at 3.1 years of age. These researchers also reported that children who exhibited such characteristics as severe language impairment, toe walking, hand flapping, and sustained unusual play behaviors were diagnosed earlier than children without these features.
Brian Sullivan, Cecelia Zhang, Kara Wegermann, Tzu-Hao Lee and David A. Leiman
Inpatient colonoscopy bowel preparation quality is frequently suboptimal. This quality improvement (QI) intervention is focused on regimenting this process to impact important…
Abstract
Purpose
Inpatient colonoscopy bowel preparation quality is frequently suboptimal. This quality improvement (QI) intervention is focused on regimenting this process to impact important outcomes.
Design/methodology/approach
Define, Measure, Analyze, Improve and Control (DMAIC) methodology was employed, including generating a root-cause analysis to identify factors associated with inpatient bowel quality. These findings motivated the creation of a standardized electronic health record (EHR)-based order set with consistent instructions and anticipatory guidance for administering providers.
Findings
There were 264 inpatient colonoscopies evaluated, including 198 procedures pre-intervention and 66 post-intervention. The intervention significantly improved the adequacy of right colon bowel preparations (75.0 percent vs 86.9 percent, p = 0.04) but not overall preparation quality (73.7 percent vs 80.3 percent, p = 0.22). The intervention led to numerical improvement in the proportion of procedures in which the preparation quality interfered with making a diagnosis (10 percent–6 percent, p = 0.29) or resulted in an aborted procedure (3.5 percent–1.5 percent, p = 0.39). After the intervention, provider satisfaction with the ordering process significantly increased (23.3 percent vs 61.1 percent, p < 0.001).
Practical implications
The QI intervention significantly reduced the number of inpatient colonoscopies with inadequate preparation in the right colon, while also modestly improving the diagnostic yield and proportion of aborted procedures. Importantly, the standardized EHR order set substantially improved provider satisfaction, which should justify broader use of such tools.
Originality/value
Novel clinical outcomes such as ability to answer diagnostic questions were improved using this intervention. The results align with strategic goals to enhance provider experience and continuously improve quality of patient care.
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This study aims to examine the combined effect of the interactive and diagnostic management accounting system (MAS) use and organizational culture on performance. Using the…
Abstract
Purpose
This study aims to examine the combined effect of the interactive and diagnostic management accounting system (MAS) use and organizational culture on performance. Using the contingency perspective, this study suggests that the performance is enhanced by the interaction of organizational culture and the simultaneous use of both types of MAS.
Design/methodology/approach
Data were collected through a questionnaire, and responses from 147 senior managers provide support for the research model and demonstrate that each type of organizational culture requires different combinations of both types of MAS uses to enhance performance.
Findings
The results of the study indicate that although both uses of MAS are required, highest performance for flexibility value firms is achieved when high interactive and low diagnostic MAS use is employed. On the other hand, for control value firms, this study indicates that using both high diagnostic and interactive MAS creates a positive effect on performance.
Research limitations/implications
As in the case of most survey empirical studies, this study is static and may not capture the changes in organizational culture over time. To prevent this bias, longitudinal follow up studies would be required. Second, the self‐report data may be affected by common method bias.
Practical implications
The present study indicates that managers should be aware of the dominant values of their organization cultures before deciding to use MAS in a specific way, and thus contributing to the effectiveness of organizations when both interactive and diagnostic are employed simultaneously.
Originality/value
The results of the present study increase extant knowledge and understanding on the knowledge of the relationships between organizational culture and the use of MAS and how they influence performance. This is important because there are few empirical studies that have examined organizational culture using the competing values framework.
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Stephen D. Steinhaus and Gary W. Morris
Selection systems have been viewed asrelatively static screens whicheliminate less desirable job candidates.In an environment of scarcity thisceases to be an appropriate…
Abstract
Selection systems have been viewed as relatively static screens which eliminate less desirable job candidates. In an environment of scarcity this ceases to be an appropriate model. Instead, employers will use person‐focused approaches, which identify individual abilities, capitalise on those abilities, and circumvent the individual′s limitations through training, job assignment or reallocation of tasks within the work group. As a consequence, a shift is required from an emphasis on selection to a broader span of diagnostic procedures which yield information which others in the organisation will use to govern how (not if) they will work with the individual. In addition, characteristics of the diagnostic procedures must be adapted to new job and workforce conditions. Evaluation of skill development and employee qualification throughout one′s career will become the norm.
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Unaccompanied refugee minors (URMs) are known to be subjected to several potentially traumatic life events, risking more mental health problems than other populations of same age…
Abstract
Purpose
Unaccompanied refugee minors (URMs) are known to be subjected to several potentially traumatic life events, risking more mental health problems than other populations of same age. Evidence concerning the mental health of Eritrean URMs in Ethiopia is scarce. This paper aims to present an estimate of probable posttraumatic stress disorder (PTSD) within this group and describes its associations with traumatic life events and participants’ characteristics.
Design/methodology/approach
This cross-sectional quantitative study surveyed a random sample of 384 Eritrean URMs, aged 12–17 years, in the Shimelba refugee camp. The Stressful Life Events (SLE) questionnaire and the Reactions of Adolescents to Traumatic Stress (RATS) questionnaire were used to assess traumatic events and PTSD symptoms, respectively. Descriptive statistics, the chi-square test with the odds-ratio and stepwise regression were used to analyze data.
Findings
Large proportions of the URMs had experienced traumatic events including physical abuse (261, 68%), separation from family against will (240, 62.5%), a stressful life event in which they were in danger (198, 51.6%), and important changes in family life (196, 51%). About 38% of the URMs met the criteria for classifying probable PTSD diagnosis, suggesting that they are likely to have PTSD. The odds-ratio statistic revealed that girls and the oldest age group (15–17 years) were at a greater risk for PTSD. The total score on the SLE appeared to be the robust predictor, explaining 28% of the variance in RATS total scores.
Research limitations/implications
Self-report questionnaires used in this study yield less diagnostic information than extensive interviews. Additional information should be collected from the viewpoint of significant adults (caregivers/ teachers). Such information would be crucial in assessing the degree of impairment in daily functioning and the severity of the symptoms.
Originality/value
Awareness of the stressful experiences and the mental health status of the URMs has implications for taking preventive and curative measures to provide a broad range of intervention programs and psychosocial support.
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Explains how the collection and subsequent analysis of informationon the personal interactions within an organization, and theidentification of natural work groups, can provide a…
Abstract
Explains how the collection and subsequent analysis of information on the personal interactions within an organization, and the identification of natural work groups, can provide a powerful diagnostic tool to evaluate the organizational health of a company, measuring internal customer/supplier relationships, the degree of cross‐functional working, the level of teamwork, and the dominant management style.
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