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Article
Publication date: 11 April 2023

Hesham Metwalli Mousli, Iman El Sayed, Adel Zaki and Sherif Abdelmonem

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for…

Abstract

Purpose

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

Design/methodology/approach

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

Findings

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

Research limitations/implications

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Practical implications

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

Originality/value

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.

Details

The TQM Journal, vol. 36 no. 2
Type: Research Article
ISSN: 1754-2731

Keywords

Article
Publication date: 5 December 2022

Xue Zhang, Yezheng Liu, Xin Li and Jianshan Sun

Leveraging information technology (IT) to improve the treatment and support of patients is a widely studied topic in healthcare. For chronic diseases, such as diabetes, the use of…

Abstract

Purpose

Leveraging information technology (IT) to improve the treatment and support of patients is a widely studied topic in healthcare. For chronic diseases, such as diabetes, the use of information technology is even more important since its effect extends from a clinic environment to patients’ daily life. The purpose of this paper is to investigate the impacts of one widely adopted information technology, the mobile phone, on diabetes treatment, specifically on the complicated process of patients’ health, emotions and compliance.

Design/methodology/approach

We leverage a unique longitudinal dataset on diabetes patients’ health status in rural areas of China to study the problem. We also cross-link the dataset with mobile carrier data to further differentiate mobile phone use to phone calls and network use. To address the endogeneity concerns, we apply PSM and a series of instrument variables.

Findings

We identify clear evidence that mobile phone use can significantly improve patients’ emotions and compliance, where the effect is generally larger on patients in worse health conditions. While mobile phone calls clearly benefit diabetes patients, we do notice that mobile phone network use has a negative moderating effect with patients’ health condition on improving compliance.

Originality/value

This study not only enriches our theoretical understanding of the role of mobile phones in diabetes management, it also shows the economic benefit of promoting patients’ use of mobile phones, which should be considered by medical care providers and medical policymakers.

Details

Information Technology & People, vol. 36 no. 7
Type: Research Article
ISSN: 0959-3845

Keywords

Article
Publication date: 20 November 2023

Gabriella Tazzini, Brioney Gee, Jon Wilson, Francesca Weber, Alex Brown, Tim Clarke and Eleanor Chatburn

This paper aims to examine the barriers and facilitators of conducting and implementing research in frontline child and youth mental health settings in the UK.

Abstract

Purpose

This paper aims to examine the barriers and facilitators of conducting and implementing research in frontline child and youth mental health settings in the UK.

Design/methodology/approach

Researchers, clinicians and commissioners who attended a workshop at the Big Emerging Minds Summit in October 2022 provided their expert views on the structural barriers and possible solutions to integrating research in clinical practice based on their experiences of child and young people mental health research.

Findings

The identified barriers encompass resource constraints, administrative burdens and misalignment of research priorities, necessitating concerted efforts to foster a research-supportive culture. This paper proposes the potential actionable solutions aimed at overcoming challenges, which are likely applicable across various other health-care systems and frontline NHS services. Solutions include ways to bridge the gap between research and practice, changing perceptions of research, inclusive engagement and collaboration, streamlining ethics processes, empowering observational research and tailored communication strategies. Case examples are outlined to substantiate the themes presented and highlight successful research initiatives within NHS Trusts.

Originality/value

This paper provides an insight into the views of stakeholders in child and youth mental health. The themes will hopefully support and influence clinicians and academics to come together to improve the integration of research into clinical practice with the hope of improving service provision and outcomes for our children and young people.

Details

Journal of Public Mental Health, vol. 22 no. 4
Type: Research Article
ISSN: 1746-5729

Keywords

Open Access
Article
Publication date: 12 January 2024

B.S. Patil and M.R. Suji Raga Priya

The purpose of this study is to target utilizing Human resources (HRs) data analytics that may enhance strategic business, but little study has examined how it affects components…

1474

Abstract

Purpose

The purpose of this study is to target utilizing Human resources (HRs) data analytics that may enhance strategic business, but little study has examined how it affects components. Data analytics, HRM and strategic business require empirical investigations and how to over come HR data analytics implementation issues.

Design/methodology/approach

A semi-systematic methodology for its evaluation allows for a more complete examination of the literature that emerges theoretical framework and a structured survey questionnaire for quantitative data collection from IT sector personnel. SPSS analyses data.

Findings

Future research is essential for organisations to exploit HR data analytics’ performance-enhancing potential. Data analytics should complement human judgment, not replace it. This paper details these transitions, the important contributions to theory and practice and future research.

Research limitations/implications

Data analytics has grown rapidly and might make HRM practices faster, more efficient and data-driven. HR data analytics may improve strategic business. HR data analytics on employee retention, engagement and organisational success is insufficient. HR data analytics may boost performance, but there is limited proof. The authors do not know how HRM data analytics influences firms and employees.

Originality/value

Data analytics offers HRM new opportunities, along with technical and ethical challenges. This study makes a significant contribution to HR data analytics, evidence-based practice and strategic business literature. In addition to estimating turnover risk, identifying engagement factors and planning interventions to increase retention and engagement, HR data analytics can also estimate the risk of employee attrition.

Details

Vilakshan - XIMB Journal of Management, vol. 21 no. 1
Type: Research Article
ISSN: 0973-1954

Keywords

Open Access
Article
Publication date: 5 December 2023

Birgitta Schwartz and Karina Tilling

Research and experience show that evidence-based practice (EBP), i.e. using the best available knowledge in daily professional work, is difficult to achieve in social services…

Abstract

Purpose

Research and experience show that evidence-based practice (EBP), i.e. using the best available knowledge in daily professional work, is difficult to achieve in social services. The purpose of this study is to understand the development of organizational EBP learning processes in daily work through workplace education for staff and managers of supported homes for people with cognitive disabilities. The authors examine how the EBP model and new knowledge are understood and made actionable in the workplace, applying theories of organizational learning.

Design/methodology/approach

The authors used empirical material collected from an EBP workplace education pilot in Sweden, as well as documents on national EBP implementation in Swedish social services. Before the pilot, a focus group interview was conducted with regional senior managers. Participating managers and staff were individually interviewed two to three years after the pilot.

Findings

The study illustrates how knowledge-based action emerged from education where EBP was interpreted, understood, reflected on, and tested, supported by codified EBP tools in the work context. The participants, when supervised, and when observing and questioning their own behaviors in practice, contributed to double-loop learning (DLL) processes. Codification of EBP knowledge into useful tools and socialization processes during education and workplace meetings was crucial in developing individual and group DLL and knowledge-based actions.

Originality/value

The bottom-up approach to EBP development and the adaptive contextual learning at the workplace gave new insights into organizational learning in social service workplaces.

Article
Publication date: 21 March 2023

Ulrika Karlsson Stigsdotter, Gaochao Zhang, Marie Christoffersen Gramkow and Ulrik Sidenius

The point of departure for this viewpoint paper is the current development in which landscape architects are working towards achieving the United Nations sustainable development…

Abstract

Purpose

The point of departure for this viewpoint paper is the current development in which landscape architects are working towards achieving the United Nations sustainable development goals and the associated cross-cutting pledge “Leave No One Behind”. The sustainable development goals 3 and 11 can be achieved through landscape projects that are inclusive and health promoting, and the authors argue that an evidence-based design process is needed to ensure that project designs deliver what they promise. However, most landscape architects are not trained in evidence-based design and are therefore unsure of what can be used as evidence. A further challenge is the lack of relevant and applicable research evidence for design processes.

Design/methodology/approach

The authors present a process model for evidence-based health design in landscape architecture as an overall framework on which the authors base their arguments. The model includes four topics of evidence: target group, human health, environment and use of nature. For each topic, the authors present their view on what may be considered as evidence and where it can be found or generated. The study view is supported by a detailed presentation of where and how evidence was found and generated in a design project for an accessible and health-promoting forest trail for people with mobility disabilities.

Findings

The authors suggest a broad definition of evidence, and that the design process should draw on evidence from relevant research and practice disciplines. Evidence can be found in multiple sources, for example, scientific articles, theoretical works and design guidelines. It can also be generated by landscape architects themselves, for example, through landscape analyses and stakeholder workshops. The evidence should guide and support the landscape architect and not dictate the design process.

Practical implications

The authors hope that the knowledge provided on the evidence-based health design process and on where to collect or how to generate evidence may inspire landscape architects in their future health design projects.

Originality/value

People with mobility disabilities face many health challenges and should potentially be able to benefit from visiting green spaces. The authors hope that the knowledge provided on the evidence-based health design process and on where to collect or how to generate evidence may inspire landscape architects in their future health design projects.

Details

Archnet-IJAR: International Journal of Architectural Research, vol. 18 no. 1
Type: Research Article
ISSN: 2631-6862

Keywords

Article
Publication date: 13 March 2024

Michael J. Cameron, Jenifer Shahin and Nicole Lockerman

This paper aims to endorse and elaborate on the recommendations put forward by the Sharland Foundation Developmental Disabilities Applied Behavioural Research and Impact Network…

Abstract

Purpose

This paper aims to endorse and elaborate on the recommendations put forward by the Sharland Foundation Developmental Disabilities Applied Behavioural Research and Impact Network (SF-DDARIN), emphasising their significance in the field of developmental disabilities.

Design/methodology/approach

This paper outlines a specific point of view. The first section focuses on integrating developmental theory and advanced technology in interventions for developmental disabilities. Subsequently, the commentary explores virtual reality (VR) and generative artificial intelligence (AI) for enhancing social skills and personalising support. Finally, the piece highlights innovations like SocialWise VR and Custom Generative Pre-Trained Transformers in aligning interventions with developmental stages.

Findings

Technologies like VR and generative AI hold vast potential to revolutionise how clinicians provide timely and relevant knowledge to individuals with developmental disabilities.

Research limitations/implications

This is strictly a commentary.

Practical implications

Availability of technology.

Social implications

Both VR and generative AI will impact service delivery in a meaningful way.

Originality/value

The paper advocates for incorporating these technologies into SF-DDARIN's approach, emphasising their potential to revolutionise evidence-based interventions in developmental disabilities.

Details

Tizard Learning Disability Review, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1359-5474

Keywords

Article
Publication date: 20 September 2022

Jillian Cavanagh, Timothy Bartram, Matthew Walker, Patricia Pariona-Cabrera and Beni Halvorsen

The purpose of this study is to examine the rostering practices and work experiences of medical scientists at four health services in the Australian public healthcare sector…

Abstract

Purpose

The purpose of this study is to examine the rostering practices and work experiences of medical scientists at four health services in the Australian public healthcare sector. There are over 16,000 medical scientists (AIHW, 2019) in Australia responsible for carrying out pathology testing to help save the lives of thousands of patients every day. However, there are systemic shortages of medical scientists largely due to erratic rostering practices and workload issues. The purpose of this paper is to integrate evidence-based human resource management (EBHRM), the LAMP model and HR analytics to enhance line manager decision-making on rostering to support the wellbeing of medical scientists.

Design/methodology/approach

Using a qualitative methodological approach, the authors conducted 21 semi-structured interviews with managers/directors and nine focus groups with 53 medical scientists, making a total 74 participants from four large public hospitals in Australia.

Findings

Across four health services, manual systems of rostering and management decisions do not meet the requirements of the enterprise agreement (EA) and impact negatively on the wellbeing of medical scientists in pathology services. The authors found no evidence of the systematic approach of the organisations and line managers to implement the LAMP model to understand the root causes of rostering challenges and negative impact on employees. Moreover, there was no evidence of sophisticated use of HR analytics or EBHRM to support line managers' decision-making regarding mitigation of rostering related challenges such as absenteeism and employee turnover.

Originality/value

The authors contribute to HRM theory by integrating EBHRM, the LAMP model (Boudreau and Ramstad, 2007) and HR analytics to inform line management decision-making. The authors advance understandings of how EBHRM incorporating the LAMP model and HR analytics can provide a systematic and robust process for line managers to make informed decisions underpinned by data.

Details

Personnel Review, vol. 53 no. 1
Type: Research Article
ISSN: 0048-3486

Keywords

Article
Publication date: 14 March 2024

Louise D. Denne, Emily J. Roberts-Tyler and Corinna Grindle

Evidence-informed decision-making is considered best practice when choosing interventions in applied settings across health, social care and education. Developing that evidence…

Abstract

Purpose

Evidence-informed decision-making is considered best practice when choosing interventions in applied settings across health, social care and education. Developing that evidence base, however, is not straightforward. The pupose of this paper is to describe the process implemented by the Sharland Foundation Developmental Disabilities Applied Behavioural Research and Impact Network (SF-DDARIN) that systematically develops an evidence base for behaviorally based interventions.

Design/methodology/approach

In this case study, the progressive research steps undertaken by the SF-DDARIN to develop the evidence base for an online reading intervention, the Headsprout® Early Reading programme (HER®), which uses behavioural principles to promote learning to read, are described.

Findings

A series of discrete projects targeting gaps in the evidence base for HER® led to funding two randomised controlled trials in England, one in education and one in health and social care.

Originality/value

This case study illustrates an original, creative and effective way of collaborating across academic research departments and applied settings to extend the evidence base for a chosen intervention systematically.

Details

Tizard Learning Disability Review, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1359-5474

Keywords

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