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Article
Publication date: 1 June 2004

J.L. Foote, N.H. North and D.J. Houston

Hospital waiting lists are a feature of publicly funded health services that result when demand appears to exceed supply. While much has been written about surgical…

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Abstract

Hospital waiting lists are a feature of publicly funded health services that result when demand appears to exceed supply. While much has been written about surgical waiting lists, little is known about the dynamics of radiology waiting lists, which is surprising given that rational treatment, and indeed the medical profession's claim to expertise, rests on establishing a diagnosis. This paper reports the findings of a case study of a problematic ultrasound waiting list. In particular, this paper highlights how the management of the ultrasound waiting list served to subordinate the needs of waiting patients and their general practitioners to the interests and values of radiologists. Radiologist concern to protect specialist expertise from encroachment by outpatient clinicians and sonographers is implicated in the growth of the ultrasound waiting list. It is argued that an adequate understanding of ultrasound waiting lists depends on grasping how radiologists are successful in structuring problems of access in ways that enhance radiologist control over ultrasound imaging. The case study reported helps to shed light on why increasing funding to clear waiting lists proves ineffective.

Details

Journal of Health Organization and Management, vol. 18 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 March 2002

Susan Morris, Rowdy Yates and Jane Wilson

This article focuses on self‐reported child neglect and abuse in residential drug treatment drawing on data from clients in Scotland collected 1996‐1999. The authors'…

Abstract

This article focuses on self‐reported child neglect and abuse in residential drug treatment drawing on data from clients in Scotland collected 1996‐1999. The authors' findings suggest that the prevalence of childhood abuse histories are higher in female drug users than male drug users but argues that diversity of abuse experiences in drug users negate broad treatment plans for those traumatised by such experiences.

Details

Drugs and Alcohol Today, vol. 2 no. 1
Type: Research Article
ISSN: 1745-9265

Keywords

Article
Publication date: 1 March 1985

Turan GÖNEN and John C. THOMPSON

A new stochastic load forecasting model to predict load growth on radial feeders has been developed. Present methods of making such predictions have no underlying a priori

Abstract

A new stochastic load forecasting model to predict load growth on radial feeders has been developed. Present methods of making such predictions have no underlying a priori model on which to rely. This paper summarizes an attempt to apply developmental models to the load growth prediction problem. A parameter study is described which suggests the relative importance of the model's parameters. Using actual data obtained from a utility company, forecasts are compared with network growth.

Details

COMPEL - The international journal for computation and mathematics in electrical and electronic engineering, vol. 4 no. 3
Type: Research Article
ISSN: 0332-1649

Article
Publication date: 31 July 2019

Lijuan Li, Magdalena Mo Ching Mok and Weidong Wu

The purpose of this paper is to examine the writing development of Hong Kong kindergarten students over 12 months. They attended 18 kindergartens territory-wide and were…

Abstract

Purpose

The purpose of this paper is to examine the writing development of Hong Kong kindergarten students over 12 months. They attended 18 kindergartens territory-wide and were followed from June 2002 to June 2003 for the collection of three waves of teacher-rated data at six-month intervals.

Design/methodology/approach

First, the construct validity of the translated and culturally adapted version of Morrow’s (2012) checklist which assesses writing development was confirmed, considering that the students attended Hong Kong kindergartens who wrote in the Chinese language. The multilevel analysis, which employed corrected measures captured through Wolfe and Chiu’s (1999a, 1999b) five-step Rasch scaling method for a common frame of reference, estimated the effects of the factors, namely, student age, gender, class level and schools.

Findings

The children’s progress over the second six months was also apparently much smaller than the first SIX months for this cohort. The dramatic slow-down in the second six-month period for both cohorts might be partly attributed to the peculiar arrangement of schooling at that time.

Research limitations/implications

The recommendation from this study is that random sampling and student test scores on writing need to be taken for the identification of the general trend of young children’s writing development in Hong Kong, as well as other Chinese communities alike.

Originality/value

The profile of the student’s emergent writing development at each six-month follow-up and over the 12 months was explored. Differences between the groups based on age, gender, class level and school in terms of student writing development on average were statistically significant.

Details

International Journal of Comparative Education and Development, vol. 21 no. 3
Type: Research Article
ISSN: 2396-7404

Keywords

Article
Publication date: 17 July 2009

Ulla Isosaari, Seija Ollila and Pirkko Vartiainen

The allocation of resources is a complex problem in health care. In Finland there has been an effort to solve the problems with a program called “Securing the Future of…

Abstract

Purpose

The allocation of resources is a complex problem in health care. In Finland there has been an effort to solve the problems with a program called “Securing the Future of Health Care”. The main focus of this research is on assessing how managers view the health care policy called guarantee of care from an ethical perspective.

Design/methodology/approach

The theoretical basis of the research covers theories regarding rationing, prioritization, as well as the ethics of health care. The empirical data were gathered through an internet questionnaire. The questionnaires were sent to the top managers in all Finnish health care districts (20 in all). The data were analyzed qualitatively.

Findings

According to respondents, ensuring access to treatment partially fulfilled the ethical principles of the right to good care, respect for human dignity, fairness, and co‐operation and mutual respect quite well. On the other hand, trust, impressiveness, non‐partiality in decision making and the right of self‐determination were not as well realized. The shortening of waiting lists had caused exhaustion and motivation problems among personnel and in addition, staff shortages were being experienced.

Originality/value

The administrators of the hospital districts agreed that centralizing resources as a reconstructive action is ethically wrong for the whole health care system. There is a great need for an ethical discussion concerning the choices made in health care policy. Long‐term results need sustainable solutions.

Details

Leadership in Health Services, vol. 22 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 27 April 2012

Latif Al‐Hakim and Xiao Yan Gong

Disruption considerably prolongs session times for surgery, affects the quality of patient care, and prolongs waiting lists. In addition, there is a strong relationship…

Abstract

Purpose

Disruption considerably prolongs session times for surgery, affects the quality of patient care, and prolongs waiting lists. In addition, there is a strong relationship between disruption and surgical error. This research aims to provide a platform for healthcare services to identify the sources of preventable disruption affecting operative time within the perioperative process and to effectively reduce it.

Design/methodology/approach

Events inside and outside operating rooms that disturb the operative time were recorded for 31 elective surgeries over the period of five months. Disruption events were classified according to the hospital's requirements and the findings were reviewed by the surgical teams. Lean thinking approaches were used to achieve the purpose of this study.

Findings

Preventable disruption caused an increase in surgical time of approximately 25 per cent. Preventable disruption consisted of poor information flow, failure to follow concepts of methods study, lack of communication and lack of coordination. Coordination failures were the main reason for disruption followed by the lack of following the principles of motion economy.

Originality/value

Surgical disruption has substantial financial implications for hospitals. This research indicates that it is possible to reduce operative time considerably by eliminating preventable disruption. Such additional time could be utilised to deal with the pressure of emergency cases, reduce the waiting lists for elective surgery, increase operating room utilisation, and reduce medical errors.

Details

International Journal of Health Care Quality Assurance, vol. 25 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 12 June 2017

George Boak, Ruth Sephton, Elaine Hough and Ruth ten Hove

The purpose of this paper is to evaluate a process change in physiotherapy services and to explore factors that may have influenced the outcomes.

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Abstract

Purpose

The purpose of this paper is to evaluate a process change in physiotherapy services and to explore factors that may have influenced the outcomes.

Design/methodology/approach

This is a multiple case study and information was gathered from eight physiotherapy teams over 24 months.

Findings

The process change was successfully implemented in six teams. It had a clear, positive effect on service quality provided to patients in three teams. Whilst quality also improved in three other teams, other issues make changes difficult to assess. Factors that enabled process change to be effective are suggested.

Research limitations/implications

The findings are based on results achieved by only eight English teams.

Practical implications

This process change may be appropriate for other teams providing therapy services if attention is paid to potential enabling factors, and a learning approach is adopted to designing and introducing the change.

Originality/value

To the best of the authors’ knowledge, no other longitudinal process change study in therapy services has been published.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 5 September 2008

Varinder Singh and V.P. Agrawal

The purpose of this paper is to attempt to integrate manufacturing system analysis to obtain system‐wide optimized solutions and to increase the level of comprehensiveness…

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Abstract

Purpose

The purpose of this paper is to attempt to integrate manufacturing system analysis to obtain system‐wide optimized solutions and to increase the level of comprehensiveness of the manufacturing system modelling and to develop method of characterization of manufacturing systems based on its structure.

Design/methodology/approach

Elements constituting the manufacturing plant and the interactions between them have been identified through a literature survey and have been represented by graph‐based model. The matrix models and the variable permanent function models are developed for carrying out decomposition, characterization and the total analysis.

Findings

Structural patterns and combination sets of subsystems interacting in various ways have been recognized as capabilities of manufacturing system in different performance dimensions. The permanent function of the manufacturing system matrix has been proposed as a systematic technique for structural analysis of manufacturing system. Also, the terms of permanent multinomial characterize the manufacturing systems uniquely and are highly useful for computational storage, retrieval, communication as well as analysis of the structural information of manufacturing system.

Research limitations/implications

The structure‐based characterization technique developed has the potential of aiding the ongoing research activities in the field of benchmarking, and business process reengineering. The graph theory‐based methodology will serve as a framework to develop composite performance measures building on the performance measures of the individual elements of the manufacturing system graph in various dimensions.

Practical implications

Through the use of proposed methodology, a manufacturing manager will be able to make better informed decisions towards organizational efforts of improving the productivity and speed. For aiding several decisions, different “what‐if” scenarios may be generated with several structural modifications.

Originality/value

This graph theory‐based methodology is a novel mechanism to seamlessly integrate manufacturing system giving way to system wide optimization. The paper is an attempt to address the need for comprehensive and integrated analysis of the manufacturing system.

Details

Journal of Manufacturing Technology Management, vol. 19 no. 7
Type: Research Article
ISSN: 1741-038X

Keywords

Article
Publication date: 4 October 2011

Henrik Eriksson, Ing‐Marie Bergbrant, Ingela Berrum and Boel Mörck

The aim of this paper is to investigate how waiting lists or queues could be reduced without adding more resources; and to describe what factors sustain reduced waiting‐times.

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Abstract

Purpose

The aim of this paper is to investigate how waiting lists or queues could be reduced without adding more resources; and to describe what factors sustain reduced waiting‐times.

Design/methodology/approach

Cases were selected according to successful and sustained queue reduction. The approach in this study is action research.

Findings

Accessibility improved as out‐patient waiting lists for two clinics were reduced. The main success was working towards matching demand and capacity. It has been possible to sustain the improvements.

Research limitations/implications

Results should be viewed cautiously. Transferring and generalizing outcomes from this study is for readers to consider. However, accessible healthcare may be possible by paying more attention to existing solutions.

Practical implications

The study indicates that queue reduction activities should include acquiring knowledge about theories and methods to improve accessibility, finding ways to monitor varying demand and capacity, and to improve patient processing by reducing variations.

Originality/value

Accessibility is considered an important dimension when measuring service quality. However, there are few articles on how clinic staff sustain reduces waiting lists. This paper contributes accessible knowledge to the field.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 18 May 2012

Gail Gilchrist, Alicia Blázquez and Marta Torrens

This paper's aim is to examine the relationship between intimate partner violence, childhood abuse and psychiatric disorders among 118 female drug users in treatment in…

Abstract

Purpose

This paper's aim is to examine the relationship between intimate partner violence, childhood abuse and psychiatric disorders among 118 female drug users in treatment in Barcelona, Spain.

Design/methodology/approach

Secondary analysis of a cross‐sectional study of the psychiatric, behavioural and social risk factors for HIV. DSM‐IV disorders were assessed using the Spanish Psychiatric Research Interview for Substance and Mental Disorders; the Composite Abuse Scale assessed intimate partner violence and the Child Maltreatment History Self‐Report assessed childhood physical and sexual abuse.

Findings

The odds of experiencing intimate partner violence were 2.42 times greater among those with any depressive disorder (95 per cent CI 1.13, 5.20), over three times greater for those who reported ever attempting suicide (OR 3.20; 95 per cent CI 1.29, 7.94), met criteria for borderline personality disorder (OR 3.05; 95 per cent CI 1.31, 7.11), had been abused in childhood (OR 3.38; 95 per cent CI 1.45, 7.85) or currently lived with a substance user (OR 3.74; 95 per cent CI 1.29, 10.84). In multiple logistic regression, only living with a substance user (OR 3.42; 95 per cent CI 1.08, 10.86) and a history of childhood abuse (OR 2.87; 95 per cent CI 1.05, 7.86) remained significant in the model examining intimate partner violence victimisation.

Research limitations/implications

The small sample size, together with the fact that the study was not originally powered to examine differences in intimate partner violence may have increased the possibility of type II errors.

Originality/value

Histories of psychiatric disorders, intimate partner violence and childhood abuse are common in female substance users in treatment. Research suggests that such histories result in poorer treatment outcomes. Histories of intimate partner violence and childhood abuse should be identified and addressed in substance abuse treatment to enhance treatment outcomes.

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