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Article
Publication date: 13 June 2008

Belinda Parke and Jane McCusker

The purpose of this paper is to establish policy recommendations to address service and care delivery challenges facing hospital emergency departments (EDs) responding to…

642

Abstract

Purpose

The purpose of this paper is to establish policy recommendations to address service and care delivery challenges facing hospital emergency departments (EDs) responding to the needs of increasing numbers of older adults.

Design/methodology/approach

The consensus development process used an international expert interdisciplinary panel, convened at an international conference. Following a round table discussion and think‐tank session, a nominal group method with constant comparative analysis and coding techniques was used to identify policy recommendations. Two rounds of electronic input followed the face‐to‐face meeting to reach consensus on priority ranking of the policy recommendations. Findings underwent an external review by four independent experts.

Findings

A total of seven categories of policy recommendations were developed: education, integration and coordination of care, resources, ED physical environment, evidence‐based practice, research and evaluation, and advocacy.

Research limitations/implications

The consensus development process did not include a systematic literature review on the topic. However, participants included experts in their disciplines.

Practical implications

The recommendations may assist administrators, policy makers, clinicians, and researchers on future directions for improving emergency care and service delivery for older adults.

Originality/value

The paper describes the process and results of a consensus development activity for ED care and services of older adults.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 October 2004

Rebecca N. Warburton, Belinda Parke, Wynona Church and Jane McCusker

Reports on the authors' experience with a patient safety quality improvement program, intended to reduce the incidence and severity of adverse outcomes for emergency…

1303

Abstract

Reports on the authors' experience with a patient safety quality improvement program, intended to reduce the incidence and severity of adverse outcomes for emergency department (ED) patients aged ≥75. The Identification of Seniors at Risk scale was used for screening, and those at high risk were referred for appropriate intervention. The plan‐do‐study‐act improvement cycle was followed, conducting process evaluation to diagnose and correct implementation difficulties. Reports that: implementing an ED screening and referral program is deceptively difficult; process evaluation multidisciplinary working group meetings are an essential improvement tool; screening inclusion criteria had to be adapted to the subject population in order to make efficient use of staff time; the screening questions and process required ongoing assessment, revision, and local adaptation in order to be useful; and high‐risk screening in the ED is critical to a hospital system's ability to anticipate clinical problems; the plan‐do‐study‐act improvement cycle is a practical and useful tool for improving quality and systems in a real care setting.

Details

International Journal of Health Care Quality Assurance, vol. 17 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 December 2005

Jane McCusker, Nandini Dendukuri, Linda Cardinal, Lilly Katofsky and Michael Riccardi

The purpose of this article is to investigate the performance of scales to assess the work environment of hospital professional staff, other than nurses or physicians.

1989

Abstract

Purpose

The purpose of this article is to investigate the performance of scales to assess the work environment of hospital professional staff, other than nurses or physicians.

Design/methodology/approach

A survey was conducted among professional (non‐nursing or medical) staff at a 300‐bed urban, university‐affiliated Canadian hospital. A total of 24 work environment items were adapted from a scale previously validated among nursing staff. Scales were developed based on a principal components analysis, and were compared among four groups of staff. The relationships between the scales and the following measures were then explored using univariate and multivariate analyses: satisfaction with the work environment, perceived quality of patient care, perceived frequency of patient/family complaints, work‐related injuries, and verbal abuse of staff.

Findings

The survey response rate was 154/200 (76.6 percent). Four scales were identified (with corresponding Cronbach's alpha), assessing the following aspects of the work environment: supervisory support (0.88), team‐work (0.84), professionalism (0.77), and interdisciplinary relations (0.64). In multivariate analyses, there were significant differences between the job groups in all four scales. One or more of the scales was significantly associated with overall satisfaction, perceived quality, and adverse incidents, even after adjustment for other staff characteristics.

Research limitations/implications

Limitations include: the cross‐sectional design, subjective measurement of quality of care, small sample sizes in some groups of staff, and the single study site.

Practical implications

The scales developed in this study may be used by managers to assess hospital staff perceptions of the work environment.

Originality/value

The four proposed scales appear to measure meaningful aspects of the working environment that are important in determining overall satisfaction with the work environment and are related to quality of care.

Details

International Journal of Health Care Quality Assurance, vol. 18 no. 7
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 October 2004

Jane McCusker, Nandini Dendukuri, Linda Cardinal, Johanne Laplante and Linda Bambonye

The literature suggests that improvements in nurses' work environments may improve the quality of patient care. Furthermore, monitoring the work environment through staff…

3101

Abstract

The literature suggests that improvements in nurses' work environments may improve the quality of patient care. Furthermore, monitoring the work environment through staff surveys may be a feasible method of identifying opportunities for quality improvement. This study aimed to confirm five proposed sub‐scales from the Nursing Work Index – Revised (NWI‐R) to assess the nursing work environment and the performance of these sub‐scales across different units in a hospital. Data were derived from a cross‐sectional survey of 243 nurses from 13 units of a 300‐bed university‐affiliated hospital in Quebec, Canada, during 2001. Using confirmatory factor analysis, the five sub‐scales were confirmed; three of the sub‐scales had greater ability to discriminate between units. Using hierarchical regression models, “resource adequacy” was the sub‐scale most strongly associated with the perceived quality of care at the last shift. The NWI‐R sub‐scales are potentially useful for comparison of work environments of different nursing units at the same hospital.

Details

International Journal of Health Care Quality Assurance, vol. 17 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 May 2002

David C. Bell, John S. Atkinson and Victoria Mosier

Describes how HIV and AIDS are carried and spread, particularly for high‐risk groups, but adds that it is not only behavioural but also those behaviours in conjunction…

Abstract

Describes how HIV and AIDS are carried and spread, particularly for high‐risk groups, but adds that it is not only behavioural but also those behaviours in conjunction with others. Employs figures and tables for added explanation and emphasis. Chronicles some individual case studies showing different “risk” behaviours and types of “unsafe” practices. Makes clear that the use of varied types of education are of major importance in the fight against ignorance and nonchalance in the battle against AIDS.

Details

International Journal of Sociology and Social Policy, vol. 22 no. 4/5/6
Type: Research Article
ISSN: 0144-333X

Keywords

Article
Publication date: 1 October 2005

Rebecca N. Warburton

The purpose of this article is to report preliminary outcome and cost‐benefit results for a patient safety quality improvement program intended to improve outcomes for…

649

Abstract

Purpose

The purpose of this article is to report preliminary outcome and cost‐benefit results for a patient safety quality improvement program intended to improve outcomes for patients aged 75 or more visiting the Emergency Department (ED). The program uses the Identification of Seniors at Risk (ISAR) scale to screen, and refers patients at high risk for appropriate intervention.

Design/methodology/approach

The Plan‐Do‐Study‐Act improvement cycle was used as a framework. Simple outcomes have been assessed by comparing patient sub‐groups based on risk status and interventions received. Cost and benefits were assessed based on estimated program outcomes and average costs. Sensitivity analysis was performed to test alternate assumptions.

Findings

The screening tool appears to be accurate, and screening and referral appears to have a positive impact, reducing length of stay, returns to the ED, and subsequent admissions to hospital. However, most results are not statistically significant at the 95 percent level. The value of avoided care exceeds program costs under most assumptions.

Originality/value

Screening and referring all eligible patients has still not been achieved; these are areas for future investigation and improvement. Screening and referral appear to be effective in improving outcomes but because program costs were low, net benefits may have been achieved; however given global budgeting for hospital care improvements in the use of resources (rather than budgetary savings) would be expected. The methods for improvement (the Plan‐Do‐Study‐Act framework; process evaluation; multidisciplinary working group meetings; outcome assessment) are practical and useful for improving quality and safety in a small community hospital with limited resources.

Details

International Journal of Health Care Quality Assurance, vol. 18 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 February 1999

Emma Jane Riddle, David A. Bradbard, Jane Boyd Thomas and Doris H. Kincade

In response to international competition and pressure from retailers, US apparel manufacturers and their suppliers initiated the Quick Response (QR) program. QR seeks to…

Abstract

In response to international competition and pressure from retailers, US apparel manufacturers and their suppliers initiated the Quick Response (QR) program. QR seeks to provide retailers with the exact stock‐keeping units (SKUs) which consumers demand and to deliver these SKUs quickly. An effective QR program requires rapid transmission of data throughout the value chain, from the retailer back to apparel manufacturers, fabric producers and fibre manufacturers. Therefore, electronic data interchange (EDI) is a key component of QR and should be tightly linked with other information systems at each level of the value chain. This research is an empirical study of the degree to which EDI has been implemented by US apparel manufacturers and the extent to which EDI is integrated with other information systems. It was found that apparel manufacturers use EDI to establish tight linkages with their customers, the retailers. Manufacturers are less likely to increase their own efficiencies by linking EDI with internal information systems or by establishing EDI linkages with suppliers. The lack of supplier linkages may reduce manufacturers' ability to replenish retail inventories quickly, which is the primary objective of QR.

Details

Journal of Fashion Marketing and Management: An International Journal, vol. 3 no. 2
Type: Research Article
ISSN: 1361-2026

Keywords

Article
Publication date: 1 September 2000

Jonathan C. Morris

Looks at the 2000 Employment Research Unit Annual Conference held at the University of Cardiff in Wales on 6/7 September 2000. Spotlights the 76 or so presentations within…

29846

Abstract

Looks at the 2000 Employment Research Unit Annual Conference held at the University of Cardiff in Wales on 6/7 September 2000. Spotlights the 76 or so presentations within and shows that these are in many, differing, areas across management research from: retail finance; precarious jobs and decisions; methodological lessons from feminism; call centre experience and disability discrimination. These and all points east and west are covered and laid out in a simple, abstract style, including, where applicable, references, endnotes and bibliography in an easy‐to‐follow manner. Summarizes each paper and also gives conclusions where needed, in a comfortable modern format.

Details

Management Research News, vol. 23 no. 9/10/11
Type: Research Article
ISSN: 0140-9174

Keywords

Article
Publication date: 25 January 2019

Tara Samantha Styles-Lightowlers

Feminism has provided a sustained challenge to the widespread occurrence of violence against women (VAW). Yet despite the tremendous efforts of feminist activists and…

Abstract

Purpose

Feminism has provided a sustained challenge to the widespread occurrence of violence against women (VAW). Yet despite the tremendous efforts of feminist activists and academics, it continues to be one of the most tolerated crimes in the world. This paper offers an account of the author’s experiences teaching about VAW in higher education (HE) and an overview of how specific approaches to teaching this subject can provide an empowering space for students who have experienced such violence. The paper aims to discuss these issues.

Design/methodology/approach

Drawing upon the works of feminists committed to ending VAW, transformative education as envisioned by Paulo Freire and Foucault’s work on knowledge and power, the author proposes a feminist informed teaching practice that facilitates empowerment through: giving voice to women who have experienced violence; exploring and promoting the transformative potential of education and; challenging traditional and dominant forms of knowing.

Findings

A recognition of the social, historical and political context in which violence occurs, and how traditional knowledge about it is accepted, is vital in empowering women who have experienced violence to challenge dominant discourses that do not fit with their own perceived reality.

Originality/value

Whilst there is currently a growing interest in the barriers to HE participation, the author seeks to explore the ways in which some of the barriers can be addressed that students may face whilst on HE courses, particularly in relation to self-awareness, empowerment and healing.

Details

Equality, Diversity and Inclusion: An International Journal, vol. 38 no. 4
Type: Research Article
ISSN: 2040-7149

Keywords

Article
Publication date: 10 August 2015

Katie Marlow, Belinda Winder and Helen Jane Elliott

– The purpose of this paper is to gain insight into the experiences of staff working with transgendered sex offenders in a prison setting.

Abstract

Purpose

The purpose of this paper is to gain insight into the experiences of staff working with transgendered sex offenders in a prison setting.

Design/methodology/approach

The study utilised a qualitative approach, with semi-structured interviews used to explore the experiences of staff working with transgendered sexual offenders (n=6). Data were analysed using thematic analysis.

Findings

Three themes were identified in the data. The first relates to how staff become educated on transgender issues and the content of this information. The second describes situations in which boundaries are overstepped by both transgender offenders and others in the prison. The third relates to the ways in which staff manage change, such as tailoring treatment to specific needs and being mindful of what adaptations may be required.

Research limitations/implications

The main drawback of this research was the limited sample; female prison staff. Future research should expand this sample to encompass male staff and staff working in alternate category prisons.

Practical implications

The research illustrates the utility of staff collaboration with transgendered sex offenders on transgender issues but also suggests some additional guidance is required when it comes to determining the boundaries. Staff may also benefit from more education on the possible ways in which a transgendered identity can impact on criminogenic needs.

Originality/value

The present research offers insight into the current state of care and management of transgendered offenders in custody and the nature of interactions between staff and this minority group. At present, there is limited research in this area.

Details

Journal of Forensic Practice, vol. 17 no. 3
Type: Research Article
ISSN: 2050-8794

Keywords

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