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Article
Publication date: 22 March 2013

Louise G. Braham, Jonathan F. Heasley and Sam Akiens

Night confinement (NC) has been proposed as an appropriate and safe way to make cost improvements in a high secure NHS hospital. Given potential controversy, evaluating…

Abstract

Purpose

Night confinement (NC) has been proposed as an appropriate and safe way to make cost improvements in a high secure NHS hospital. Given potential controversy, evaluating the impact of this change is vital. This paper aims to focus on the issue.

Design/methodology/approach

The study used a mixed methods design to assess the impact of a three month night confinement pilot on four high secure admission wards. In total, 158 staff and 42 patients were approached to complete questionnaires and interview prior to and following the pilot. Questionnaires were analysed using T tests, ANOVA and Mann Whitney‐U to asses perceived changes in ward climate, working environment and quality of life. Thematic and saliency analysis was used to explore themes arising from semi structured interviews. Hospital data were collected to identify behavioural changes.

Findings

The study found that NC had no adverse effects and incidents of self harm, other incidents and seclusion hours dropped by a third during this period. This was contrary to staff expectations.

Research limitations/implications

Limitations include: a large number of researchers involved; average response rate and a disproportionate number of patients on Tilt restrictions on the pilot wards. Further evaluation is necessary if NC is to be adopted more widely.

Practical implications

This evaluation suggests that NC can contribute to providing an efficient and effective secure mental health service.

Originality/value

This study provides a unique opportunity to assess the impact of NC on patients and is of value to other secure units seeking effective cost improvements.

Details

Mental Health Review Journal, vol. 18 no. 1
Type: Research Article
ISSN: 1361-9322

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Article
Publication date: 1 March 2002

Solomon Bediako

This study was designed to determine the impact of downsizing on the quality of work life for the nursing staff of community health‐care service organizations. Its…

Abstract

This study was designed to determine the impact of downsizing on the quality of work life for the nursing staff of community health‐care service organizations. Its objectives were to: identify the perceived impact of downsizing on the quality of their work life; determine the implications; and make recommendations on how to minimize or eliminate the negative impact and maximize the positive aspects. Analysis of the qualitative data indicated that there was a significant negative impact on the quality of the staff’s work life. Further analysis of comparative data revealed that the negative impact on work life was mitigated, as staff assumed responsibility for their professional development and career path. Although the adverse effect of downsizing was strongly supported in this study, there were also indications that its lasting impact was questionable. Evidence surfaced indicating that, after downsizing, additional benefits were derived, which enhance staff’s quality of life and the organizational climate.

Details

Leadership in Health Services, vol. 15 no. 1
Type: Research Article
ISSN: 1366-0756

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Article
Publication date: 22 March 2013

Sarah J. Williams and Carol A. Adams

The purpose of this paper is to examine how disclosure of employee issues by a large UK bank may or may not promote transparency and accountability (as assessed by the…

Abstract

Purpose

The purpose of this paper is to examine how disclosure of employee issues by a large UK bank may or may not promote transparency and accountability (as assessed by the completeness of the account) toward the employee stakeholder group, and to shed light on the implications of the organisation‐society relationship for employee accountability.

Design/methodology/approach

The intrinsic stakeholder framework forms the basis of the qualitative, longitudinal analysis. It is adopted as the moral ground for the provision of a “complete” account of employee issues. In seeking to shed light on the organisation‐society relationship and its implications for reporting on employee issues the authors build a broader theoretical framework incorporating various social and political theories dealing with legitimacy, political economy, and language and rhetoric. Interpretive and critical approaches are employed. The analysis draws on an extensive review of published materials relating to employment in the UK retail banking industry and NatWest in particular, impacts of workplace changes occurring in the banking sector, and to the economic, social and political environment over the period of the study.

Findings

The findings indicate that what and how NatWest reported on employee issues was influenced by considerations other than transparency and employee accountability. The analysis highlights the complexity of the role of disclosures in the organisation‐society relationship and consequently the limitations of the use of a single theoretical framework to interpret disclosures.

Research limitations/implications

The longitudinal analysis indicates how reporting practices are issue and context dependent and points to the limitations of theorising in corporate social reporting based on a single time frame and a limited analysis of the reported issues.

Practical implications

In highlighting a lack of accountability to employees, the findings have implications for the development of reporting standards on issues relevant to employees. Over time, it is hoped that development of an employee inclusive reporting framework, along with exposure of the contradictory role that reports may play in promoting accountability, will contribute toward improved employee management practices.

Originality/value

This study contributes to the corporate social reporting literature by extending the analysis beyond the firm focused stakeholder management perspective to considering disclosures from a moral perspective and the extent to which the complex organisation‐society relationship might work against the promotion of transparency and accountability toward stakeholders (specifically employees). In this way, through an in‐depth longitudinal analysis of disclosures from multiple perspectives, the paper contributes to theorising of the role of social disclosure in the organisation‐society relationship.

Details

Accounting, Auditing & Accountability Journal, vol. 26 no. 3
Type: Research Article
ISSN: 0951-3574

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Article
Publication date: 9 February 2015

Simon Chu, Kimberley McNeill, Karen M. Wright, Anthony Hague and Tracy Wilkins

From 2012, all high-secure forensic mental health services in England began operating a policy of confining patients to their locked bedrooms overnight to increase service…

Abstract

Purpose

From 2012, all high-secure forensic mental health services in England began operating a policy of confining patients to their locked bedrooms overnight to increase service efficiency and reduce costs. The purpose of this paper is to assess the views of staff and patients concerning the policy and examine the specific impact of the policy on patients.

Design/methodology/approach

Measures of patients’ sleep hygiene, patients’ behaviour, ward atmosphere, engagement with therapy and adverse incidents were taken both before and after the night confinement (NC) policy was implemented. Both patients and staff also expressed their views of the impact of the NC policy.

Findings

Results provide converging evidence that the impact of the NC policy on patients is negligible. There were no consistent negative effects of confining patients overnight. Rather, patients and staff were broadly positive about the impact that the practice had on patients.

Practical implications

Confining patients to locked bedrooms overnight does not exert any consistent influence, positive or negative, on patients’ sleep hygiene, behaviour or engagement with therapy, and patients expressed a broadly positive view of the practice of NC. Thus, a NC policy may have a contribution to make to the provision an effective high-secure mental health service.

Originality/value

The study provides convincing evidence that secure inpatient mental health services that are considering the adoption of a NC policy may do so without fear of a negative impact on patients.

Details

Journal of Forensic Practice, vol. 17 no. 1
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 25 May 2020

Khalid Abed Dahleez, Imad Bader and Mohammed Aboramadan

This study aims to investigate how e-health system characteristics (information quality, system quality, perceived ease of use, perceived usefulness) contribute to the…

Abstract

Purpose

This study aims to investigate how e-health system characteristics (information quality, system quality, perceived ease of use, perceived usefulness) contribute to the enhancement of medical staff performance, patient care, and doctor–patient relationships at UNRWA-Gaza healthcare centers. It aims at testing an integrative single model comprising Technology Acceptance Model (TAM), D&M model and e-health system utilization.

Design/methodology/approach

This study followed the quantitative methodology and the deductive research approach. Data were collected from 241 medical staff who use the system employed in 19 different healthcare centers across the Gaza Strip. Partial least square/structural equation modeling technique was used to analyze the collected data and to test study hypotheses.

Findings

Study concluded that information quality of the adopted Health Information System (HIS) has both direct and indirect positive impact on staff performance, only direct positive impact on patient care and only positive indirect impact on doctor–patient relationship. System quality, on the other hand, was found to have negative direct impact and positive indirect impact on staff performance and has both direct and indirect positive impact on both doctor-patient relationship and patient care.

Research limitations/implications

Noteworthy that HIS has availability, speed and error detection and error prevention issues. It is recommended that these shortfalls be addressed together with improving user perception towards ease of use and usefulness of the system.

Practical implications

Management should also work to raise confidence in its medical staff to improve the effect of HIS on medical performance and patient care. It is also recommended that UNRWA should implement crowed management techniques such as queuing systems and on-phone booking to minimize patient waiting time.

Originality/value

The importance of the study stems from its context being conducted in a developing region (Gaza Strip-Palestine) which has a fragile economic, political and social environment with many other complexities. It is also conducted at United Nations Relief and Work Agency (UNRWA) healthcare centers, which provide medical services to Palestinian refugees. In addition, this study is among the few studies that address the impact of individual e-health success factors on both doctor-patient relationship and patient care constructs. Most previous studies concentrated on the impact of health system adoption as a whole on these two subject variables and one can hardly ever stop at studies that address effect of individual success factors on them. It also integrated both D&M system success model and TAM model with some additional amendments creating and tested a new model.

Details

Journal of Enterprise Information Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1741-0398

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Article
Publication date: 11 March 2019

Zofia Bajorek and David Guest

The purpose of this paper is to address a gap in the recent literature on employment of temporary workers by exploring the impact of temporary workers on the perceptions…

Abstract

Purpose

The purpose of this paper is to address a gap in the recent literature on employment of temporary workers by exploring the impact of temporary workers on the perceptions, attitudes and behaviour of permanent staff with particular reference to their implications for patient safety and service quality in hospital accident and emergency departments. The analysis is set in the context of the job demands-resources theory.

Design/methodology/approach

The research was undertaken using a case study approach with semi-structured interviews in two London hospitals. Participants included staff from the HR director level, clinical managers and permanent staff who all had an influence in the hiring and management of temporary staff in some way. Transcripts were analysed thematically using an adopted framework approach.

Findings

The results indicate that the effect of temporary staff on permanent staff depended on the quality of the “resource”. There was a “hierarchy of preference” for temporary staff based on their familiarity with the context. Those unfamiliar with the department served as a distraction to permanent staff due to the need to “manage” them in various ways. While this was rarely perceived to affect patient safety, it could have an impact on service quality by causing delays and interruptions. In line with previous research, the use of temporary staff also affected perceptions of fairness and the commitment of some permanent staff.

Practical implications

A model developing an approach for improved practice when managing temporary staff was developed to minimise the risks to patient safety and service quality, and improve permanent staff morale.

Social implications

The review highlights the difficulties that a limited amount of temporary staff integration can have on permanent staff and patient care, indicating that consideration must be placed on how temporary staff are inducted and clarifying expectations of roles for both temporary and permanent staff.

Originality/value

This paper studies the under-researched impact of temporary staff, and, distinctively, staff employed on a single shift, on the behaviour and attitudes of permanent staff. It highlights the need to consider carefully the qualitative nature of “resources” in the job demands-resources theory.

Details

Journal of Organizational Effectiveness: People and Performance, vol. 6 no. 1
Type: Research Article
ISSN: 2051-6614

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Article
Publication date: 2 February 2015

Sami Kärnä and Päivi Julin

The purpose of the study is to evaluate and discuss the extent of the satisfaction as perceived by the students and staff towards university facilities and services in two…

Abstract

Purpose

The purpose of the study is to evaluate and discuss the extent of the satisfaction as perceived by the students and staff towards university facilities and services in two campuses in Finland. The aim is to analyse which facility-related factors have the greatest impacts on students’ and staff’s overall satisfaction.

Design/methodology/approach

The extensive survey was conducted to investigate how the university students and staff assess the university campus and facility services. A framework was developed to prioritise the satisfaction factors towards the facilities in two campuses in the both groups. The study was executed with the statistical assessment method, which combines each question’s mean value and how it affects overall satisfaction.

Findings

The findings show that there are differences in the main features of the satisfaction as assessed by the groups and between the two campuses. Student satisfaction consist of factors related to comfortable learning environment, where public spaces and campus accessibility play vital roles. Staff satisfaction can be characterised as a comprehensive campus experience and where laboratory and teaching facilities create value to the staff. In general, results show that the factors related to the research and teaching spaces have the greatest impacts on the overall satisfaction in the both groups. The improvement of the quality of these spaces will then directly assist staff and students in achieving their objectives.

Practical implications

The measurement method developed in the study helps campus facilities’ management to prioritise satisfaction factors and identify the areas of the quality improvements. This information can be used widely, for instance, in the campus development, facilities management and improvement of the university services.

Originality/value

The framework analyses which factors of the facilities have the greatest impacts on the overall satisfaction as perceived by the students and staff. The outcome of the study will improve the knowledge of which aspects of the facilities created value to the universities’ core functions.

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Article
Publication date: 9 September 2013

Nicola Bethel and Nigel Beail

There continues to be a small group of people who have intellectual disabilities who need some form of restraint in their support plan due to their self-injurious…

Abstract

Purpose

There continues to be a small group of people who have intellectual disabilities who need some form of restraint in their support plan due to their self-injurious behaviour. The mechanical restraint restricts their freedom of movement to help prevent injury. Despite the growing literature on the use of such devices, there is very limited literature looking at the impact the use of mechanical restraints has upon service users and support staff using them. The aim of this study was to ascertain the experiences of support staff who apply the restraints to the people they support.

Design/methodology/approach

Qualitative methodology was utilised. A semi-structured interview was conducted with nine support workers who: directly worked with a client with intellectual disabilities who engage in self-injurious behaviours; followed positive behavioural support plans developed with a multi-disciplinary team; applied restraints as a response to severe self-injurious behaviours to prevent harm; and they had to have been directly involved in the application and removal of the mechanical restraints in the last week. Content analysis utilising emergent coding was used to analyse the data.

Findings

All participants described using mechanical restraints as having a negative impact upon them. Participants said they manage the negative impact by reframing, inhibiting their emotions, following support plans closely and gaining support from other staff. Participants described concerns and unmet needs regarding whether they were applying the restraints correctly, the responsibility of teaching others to use restraints, not feeling prepared on starting their current job and that the impact/concerns of using restraints is not talked about. Recommendations for practice are made.

Originality/value

This is the first study to explore the views of care staff who are required to use mechanical restraint. It provides insight on the impact of this on them.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 7 no. 5
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 10 April 2017

Anisha Vyas, Cathy Spain and David Rawlinson

The purpose of this paper is to explore the impact working in a therapeutic community (TC) has on staff practice and personal development.

Abstract

Purpose

The purpose of this paper is to explore the impact working in a therapeutic community (TC) has on staff practice and personal development.

Design/methodology/approach

Eight female members of staff who work in the TC participated in semi-structured interviews. Interviews were recorded and transcribed. Thematic analysis was used.

Findings

The findings of this paper show three superordinate themes: confidence gained within TC; the staff impact of the intensity of TC; and staff value for specific TC principles.

Research limitations/implications

Limitations include researcher bias as both authors work in the TC and/or in the service. Reasonable adjustments were made in order to account for this.

Practical implications

Implications for future research include understanding and supporting the needs of staff and further exploration of the impact of staff working within TCs for people diagnosable with emotionally unstable personality disorders.

Originality/value

The research was carried out at one of the longest running TCs for people with emotional instability in the country. It offers a unique opportunity to garner the views of staff members with up to 27 years of experience. Findings may be of value to practitioners, administrators, policy makers and researchers interested in therapeutic communities.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 38 no. 1
Type: Research Article
ISSN: 0964-1866

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Article
Publication date: 5 October 2020

Claire Powell, Karen Ciclitira and Lisa Marzano

Imprisoned mothers are at increased risk for poor psychological health and psychological distress when separated from their children, so staff need to be highly skilled to…

Abstract

Purpose

Imprisoned mothers are at increased risk for poor psychological health and psychological distress when separated from their children, so staff need to be highly skilled to support the women. However, there is a paucity of research focusing on staff experiences around sensitive issues such as mother–child separation. This study aims to understand the challenges faced by staff and how these might be addressed.

Design/methodology/approach

This qualitative interview study explored the views and experiences of 24 prison-based staff in England working with female prisoners separated from their infants.

Findings

Staff emphasised the challenges of working with separated mothers, specifically the emotional impact of this work, and the impact of the wider criminal justice system on their sense of agency.

Originality/value

A focus on the experience of separation highlights the broader problem of incarcerating women in general. Reducing the number of mother–child separations would mitigate the impact on both women and staff.

Details

Journal of Criminal Psychology, vol. 10 no. 4
Type: Research Article
ISSN: 2009-3829

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