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Article
Publication date: 19 September 2016

Birgitte Enslev Jensen, Pauline Anne Found, Sharon J. Williams and Paul Walley

Ward rounds in hospitals are crucial for decision-making in the context of patient treatment processes. However, these tasks are not systematically managed and are often extended…

Abstract

Purpose

Ward rounds in hospitals are crucial for decision-making in the context of patient treatment processes. However, these tasks are not systematically managed and are often extended due to missing information or equipment or staff unavailability. This research aims to assess whether ward rounds can be structured more efficiently and effectively from the perspective of patients and staff.

Design/methodology/approach

This mixed-method approach examines the ward rounds conducted in three units within a haematology department of a major Danish hospital. Baseline measures were collected to capture the value of the ward round described by patients and staff. The information on patient and equipment flows associated with a typical ward round was mapped with recommendations for improvement.

Findings

Staff aspired to deliver a good-quality ward round, but what this meant was never articulated and there were no established standards. The duration of the ward round was unpredictable and could take 6 hours to complete. Improvements identified by the team allow the ward rounds to be completed by mid-day with much more certainty.

Research limitations/implications

This research provides an insight as to how ward rounds are conducted within a Danish haematology department.

Practical implications

The research has implications for those involved in ward rounds to reduce the time taken whilst maintaining quality and safety of patient care.

Social implications

This research has implications for patients and their families who wish to spend time with consultants.

Originality/value

Previous research has focused on the interactions between doctors and nurses. This research focuses on the operational process of the ward round and presents a structured approach to support multi-disciplinary teams with a focus on value from the patient’s perspective.

Details

International Journal of Quality and Service Sciences, vol. 8 no. 3
Type: Research Article
ISSN: 1756-669X

Keywords

Article
Publication date: 11 February 2019

Paul Walley, Pauline Found and Sharon Williams

The purpose of this paper is to assess failure demand as a lean concept that assists in waste analysis during quality improvement activity. The authors assess whether the…

Abstract

Purpose

The purpose of this paper is to assess failure demand as a lean concept that assists in waste analysis during quality improvement activity. The authors assess whether the concept’s limited use is a missed opportunity to help us understand improvement priorities, given that a UK Government requirement for public service managers to report failure demand has been removed.

Design/methodology/approach

The authors look at the literature across the public sector and then apply the failure demand concept to the UK’s primary healthcare system. The UK National Health Service (NHS) demand data are analysed and the impact on patient care is elicited from patient interviews.

Findings

The study highlighted the concept’s value, showing how primary care systems often generate failure demand partly owing to existing demand and capacity management practices. This demand is deflected to other systems, such as the accident and emergency department, with a considerable detrimental impact on patient experience.

Research limitations/implications

More research is needed to fully understand how best to exploit the failure demand concept within wider healthcare as there are many potential barriers to its appropriate and successful application.

Practical implications

The authors highlight three practical barriers to using failure demand: first, demand within the healthcare system is poorly understood; second, systems improvement understanding is limited; and third, need to apply the concept for improvement and not just for reporting purposes.

Originality/value

The authors provide an objective and independent insight into failure demand that has not previously been seen in the academic literature, specifically in relation to primary healthcare.

Details

International Journal of Health Care Quality Assurance, vol. 32 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 5 August 2014

Kate Silvester, Paul Harriman, Paul Walley and Glen Burley

– The purpose of the paper is to investigate the potential relationships between emergency-care flow, patient mortality and healthcare costs using a patient-flow model.

1078

Abstract

Purpose

The purpose of the paper is to investigate the potential relationships between emergency-care flow, patient mortality and healthcare costs using a patient-flow model.

Design/methodology/approach

The researchers used performance data from one UK NHS trust collected over three years to identify periods where patient flow was compromised. The delays’ root causes in the entire emergency care system were investigated. Event time-lines that disrupted patient flow and patient mortality statistics were compared.

Findings

Data showed that patient mortality increases at times when accident and emergency (A&E) department staff were struggling to admit patients. Four delays influenced mortality: first, volume increase and mixed admissions; second, process delays; third, unplanned hospital capacity adjustments and finally, long-term capacity restructuring downstream.

Research limitations/implications

This is an observational study that uses process control data to find times when mortality increases coincide with other events. It captures contextual background to whole system issues that affect patient mortality.

Practical implications

Managers must consider cost-decisions and flow in the whole system. Localised, cost-focused decisions can have a detrimental effect on patient care. Attention must also be paid to mortality reports as existing data-presentation methods do not allow correlation analysis.

Originality/value

Previous studies correlate A&E overcrowding and mortality. This method allows the whole system to be studied and increased mortality root causes to be understood.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 7
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 January 1995

Paula O'Brien and Paul Walley

Harboro Rubber Company is a small manufacturing business which has managed a successful strategic change in a short space of time. The plan involved moving the company from an…

Abstract

Harboro Rubber Company is a small manufacturing business which has managed a successful strategic change in a short space of time. The plan involved moving the company from an uncompetitive, loss‐making position to one where the company is enjoying growth and profitability. The distinguishing feature of the changes is the extent to which strategic decisions have been influenced by lower level employees who previously had no say in how the business was managed. Critical success factors which made the transition so successful are identified, the most important being the avoidance of programmatic change.

Details

Journal of Small Business and Enterprise Development, vol. 2 no. 1
Type: Research Article
ISSN: 1462-6004

Article
Publication date: 1 March 1992

Paul Walley and Emil Kowalski

Recent research shows that, despite a number of companies claimingsuccess for their total quality (TQ) programmes, most programmes arefailing to achieve their objectives because…

Abstract

Recent research shows that, despite a number of companies claiming success for their total quality (TQ) programmes, most programmes are failing to achieve their objectives because of a number of implementation failings. Describes the TQ programme in the UK sales region of Hewlett‐Packard (HP UKSR) which, after a slow start, is being implemented with a high degree of success. A sample of the company′s employees completed a questionnaire requiring their motivation for TQ training. This revealed that they had attended the training course because of management pressure and the identification of one specific work‐related problem, which could potentially be solved using TQ techniques. In general, employees were not motivated by factors such as the company′s competitive environment. Recommends that TQ training programmes emphasize the company′s objectives of the programme, and guide participants in the selection of TQ projects. Sees the role of facilitators as important in order to achieve participation in TQ in the long term, since training possibly provides only short‐term motivation.

Details

Journal of European Industrial Training, vol. 16 no. 3
Type: Research Article
ISSN: 0309-0590

Keywords

Content available
Article
Publication date: 1 December 1999

Paul Walley

4161

Abstract

Details

International Journal of Operations & Production Management, vol. 19 no. 12
Type: Research Article
ISSN: 0144-3577

Content available
Article
Publication date: 1 October 1999

Paul Walley

168

Abstract

Details

International Journal of Operations & Production Management, vol. 19 no. 10
Type: Research Article
ISSN: 0144-3577

Keywords

Content available
Article
Publication date: 1 April 1999

Paul Walley

972

Abstract

Details

International Journal of Operations & Production Management, vol. 19 no. 4
Type: Research Article
ISSN: 0144-3577

Keywords

Content available
93

Abstract

Details

International Journal of Operations & Production Management, vol. 18 no. 2
Type: Research Article
ISSN: 0144-3577

Content available
Article
Publication date: 1 August 1998

Paul Walley

292

Abstract

Details

International Journal of Operations & Production Management, vol. 18 no. 8
Type: Research Article
ISSN: 0144-3577

Keywords

1 – 10 of 133