Search results

Interdisciplinary healthcare education and collaboration facilitates healthcare quality improvement (QI). Education challenges include cost, logistics and defining the optimum staff-engaging method. The purpose of this paper is to determine the optimum QI educational model and measure its impact using plan-do-study-act (PDSA) cycles.

The authors established an on-site interdisciplinary QI learning collaborative: weekly 30-minute learning sessions close to the working environment; a learning materials Twitter repository; and junior doctor-led QI work streams aligned with surgical directorate quality goals supported by a mentorship network. Delivery style (lectures, workshops and QI project reporting) and learning session content was planned weekly using PDSA cycles and modified using participant feedback (score 0-10). All surgical directorate QI work streams were measured before and at nine months.

From May 2014 to February 2015, there were 32 learning sessions with 266 scores (median 12 weekly, range 5-21). Workshop delivery scored the highest (mean score 9.0), followed by live project reports (mean score 8.8). The surgical QI work streams increased threefold from four to 12, including six junior doctor-led projects.

By proactively acting upon feedback, the authors centralised QI measurement and tailored learning sessions to staff needs. Building sustainability involves continually refining learning curriculum and QI work streams, and expanding the mentorship network.

The collaborative was established at no additional cost. Twitter is used to promote meetings, facilitate conversations and act as a learning repository. The mentorship framework builds QI and coaching expertise.

The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety.

An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives.

The response rate was 37 percent, 46 surveys were completed from 125 acute care hospitals. QI initiatives had positive impacts on patient safety and care. Staff in all hospitals reported conducting past or present hand-hygiene QI projects and C. difficile and surgical site infection were the next most frequent foci. Hospital staff not having time and problems with staff prioritizing QI with other duties were identified as important QI barriers. All respondents reported hospital leadership support, data utilization and internal champions as important QI facilitators. Multiple regression models identified nurses’ active involvement and medical staff engagement in QI with improved patient care and physicians’ active involvement and medical staff engagement with greater patient safety.

There is the need to study how best to support and encourage physicians and nurses to become more engaged in QI.

QI initiatives were shown to have positive impacts on patient safety and patient care and barriers and facilitating factors were identified. The results indicated patient care and safety would benefit from increased physician and nurse engagement in QI initiatives.

Improving access and the quality of health services requires community health initiatives. However, in order for such efforts to be successful, there has to be some agreement at the community level as to which community initiatives ought to be pursued. With diversity of population, health disparities, limited resources, and competing needs, agreement is unlikely; instead a negotiated consensus among key stakeholders (community advocates, agency leaders, service providers, and consumers) must be developed. A negotiated consensus takes into account differences and allows for some kind of resolution of these differences in order to achieve a given end. A negotiated consensus is necessary for the identification of common goals, prioritizing these goals, and either seeking funding or utilizing available funding for selected community initiatives. The chapter examines efforts by a regional health care system which fostered community initiatives in four diverse sites. We develop a framework which can guide other community initiatives in health care.

This essay examines a common assertion among middle-class shoppers in Ho Chi Minh City, Vietnam, that place of manufacture, rather than brand markers, largely determines the quality of goods. For shoppers in Ho Chi Minh City, unity of place, people, raw materials, and trade secrets at the source – a corporation’s home country – is essential to the production of high quality goods. This stands in contrast to the brand logic through which corporations outsource their production presumably without compromising product quality. By privileging production sites over brands, shoppers in Ho Chi Minh City interpret the recent increase of famous foreign brand name goods in Vietnam as an increase of domestic, rather than foreign goods.

This paper aims to analyze the mechanism underlying the impact of boundary-spanning search (BS) on the sustainable development ability (SDA) of service-oriented manufacturing enterprises and to emphasize the intermediary role of knowledge integration (KI). The moderating role of knowledge inertia on the link between BS and KI is also investigated.

This study constructs direct, mediating and moderating effects, selects 110 service-oriented manufacturing enterprises as research samples and obtains empirical data from questionnaires and annual reports. Among them, triangulation is skilfully used to obtain questionnaire data, and the regression method is used to test model relationships.

The results show that BS not only directly enhances SDA but also indirectly affects it through KI, which plays a mediating role in the impact of BS on SDA. In addition, knowledge inertia negatively moderates the relationship between BS and KI.

This paper makes three contributions. First, it enriches the research on the antecedent variables related to the SDA of service-oriented manufacturing enterprises. Second, by examining the mediating role of KI and the moderating role of knowledge inertia, the relationship between BS and SDA is revealed. Third, the research on knowledge management related to the SDA of service-oriented manufacturing enterprises is expanded.

Multinational small-to-medium-sized enterprises (SMEs) are increasingly participating in cross-border digital platforms – especially amid the COVID-19 pandemic. Accordingly, knowledge integration (KI) has become more and more important. In fact, it has been deemed by many as the key to organizational resilience. Given this burgeoning phenomenon, this study aims to explore a path for improving the resilience of multinational SMEs. Through this process, this study also finds a relationship between the KI processes associated with adopting global digital platforms and the resiliency of local–global businesses. Hence, in part, this paper also explores the effectiveness of all these mechanisms.

This study used the stepwise regression method in Stata 16.0 to analyze the direct effects of both horizontal and vertical KI processes on the resilience of local–global businesses. Additionally, t-tests were also used to compare the differences in coefficients between the mechanisms. The sample analyzed comprised data on multinational manufacturing SMEs in the Yangtze River Delta region of China who are using global digital platforms.

The KI processes of these firms, both horizontal and vertical, positively correlate to resilience. Horizontal KI processes more efficiently increase the resilience of global businesses, whereas vertical processes more efficiently increase the resilience of local businesses.

First, this study provides insights into how multinational SMEs can improve their resilience in a crisis. In addition to adding to the knowledge of KI processes, this expands the KM literature on pandemics. Second, by creating two KI processes based on global digital platforms and discussing their influence on resilience, this research deepens the understanding of affordance in the KM literature. Third, focusing on the KI research stream, the results shed light on how KI processes might occur and how firms develop their KI processes.

Health services continue to face economic and capacity challenges. Quality improvement (QI) methods that can improve clinical care processes are therefore needed. However, the successful use of current QI methods within hospital settings remains a challenge. There is considerable scope for improvement of elective clinical pathways, such as hip and knee replacement, and so the use and study of QI methods in such settings is warranted.

A model to manage variability was adapted for use as a QI method and deployed to improve a hip and knee replacement surgical pathway. A prospective observational study, with a mixed-methods sequential explanatory design (quantitative emphasised) that consisted of two distinct phases, was used to assess its effectiveness.

Following the use of the novel QI method and the subsequent changes to care processes, the length of hospital stay was reduced by 18%. However, the interventions to improve care process highlighted by the QI method were not fully implemented. The qualitative data revealed that staff thought the new QI method (the model to manage variability) was simple, effective, offered advantages over other QI methods and had highlighted the correct changes to make. However, they felt that contextual factors around leadership, staffing and organisational issues had prevented changes being implemented and a greater improvement being made.

The quality of QI reporting in surgery has previously been highlighted as poor and lacking in prospective and comprehensively reported mixed-methods evaluations. This study therefore not only describes and presents the results of using a novel QI method but also provides new insights in regard to important contextual factors that may influence the success of QI methods and efforts.

The purpose of this paper is to empirically demonstrate how knowledge management, particularly knowledge integration (KI), acts as a mediator in enterprise systems (ES) post-implementation stage and how transactional and transformational leadership styles are impacted toward ES success.

Drawing on the insights of 508 valid respondents from various business backgrounds that used ES in Malaysia, structural equation modeling was employed and the path modeling approach was used to investigate the underlying relationships between variables. The mediating effects were tested using the bootstrapping procedures presented by Preacher and Hayes.

The results support the mediating effects of KI mechanisms and both leadership styles toward ES success. The analysis revealed the importance of KI in an organization, especially by the leaders who manage the complexity of the ES in the post-implementation stage.

The study can be extended by analyzing other leadership styles in-detail.

This paper is useful for practitioners as it acts as a guide to conduct management practice for business managers.

The results demonstrate the importance of leaders’ adoption of KI mechanisms in various business domains. This study approach can be used to investigate which sub-items of the leadership styles are more likely to promote KI mechanisms.

The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania.

A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs.

Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months.

The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures.

Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

This article is based on a small‐scale study into a tai chi class for older people at risk of falling. The aims of the research were first, to explore what benefits the class members felt they derived from practising tai chi and second, and more specifically, whether or not the class members actually practised tai chi at home. The study was based on two broad assumptions. The first being that the practice of tai chi has benefits for older people at risk of falling. The second assumption being that, such benefits that might result from tai chi, increase with more frequent practice. The latter assumption prompted the desire to investigate whether the class members practised tai chi at home. It was hoped that if it was discovered that class members derived benefits from tai chi, and were, for whatever reason, prevented from practising at home, that some solutions could be found in order to facilitate further practice.The research revealed, somewhat surprisingly, that the members did not believe that tai chi had necessarily reduced their risk of falling. However, notwithstanding this, their commitment to tai chi was very strong. The findings suggest that tai chi had a symbolic value for this predominantly middle‐class group. It allowed them to ‘buy into’ a third age lifestyle, despite increasing intimations of entering the fourth age. The members used tai chi, not only to improve balance and fitness, but also as a means of achieving a positive self‐image. It was therefore an age‐resisting strategy that operated on both a physical and symbolic level.