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Article
Publication date: 1 June 2001

Robin Dowie and Andrew Kennedy

Clinical audit may undergo organisational change as the new primary care trusts assume responsibility for community health services. Very little has been published…

Abstract

Clinical audit may undergo organisational change as the new primary care trusts assume responsibility for community health services. Very little has been published, however, about community‐based audit. A survey of audit activities involving clinical audit staff was carried out in seven acute hospital trusts and seven community trusts in south east England in 1997. Audit staff completed survey forms for 65 acute projects and 75 community projects on defined topics. Managers in community trusts were much more likely to initiate audit projects or act as lead investigators than managers in the acute trusts, and they more frequently received copies of project reports. Clinical audit staff in community trusts participated more fully in the various phases of the audit process than staff in the acute trusts. If the best of the conventions for community audit practice are transferred to primary care trusts, the foundations of their clinical governance programmes should be strengthened.

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British Journal of Clinical Governance, vol. 6 no. 2
Type: Research Article
ISSN: 1466-4100

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Article
Publication date: 1 June 2004

Boyka Stoykova, Robin Dowie, Richard P.F. Gregory, Kathleen V. Rowsell and Stephen Lane

An “event” tree technique was used alongside conventional methods for structuring and reporting an audit of ambulance services in Lancashire, UK, for patients with…

Abstract

An “event” tree technique was used alongside conventional methods for structuring and reporting an audit of ambulance services in Lancashire, UK, for patients with suspected acute myocardial infarction (AMI) and cases of cardiac arrest. The audit covered 4,100 patients attended by ambulance crews. Cross tabulations showed that audit targets were not achieved for recording heart rhythms in non‐arrest cases, administering aspirin and intravenous cannulation. The event tree, linked electronically with the audit database, demonstrated explicitly that only one‐third of non‐arrest patients received all three procedures. With cardiac arrests, the event tree showed that survival rates to hospital were similar for patients in ventricular fibrillation who were defibrillated regardless of whether or not they received anti‐arrhythmic drugs. Interpretation of their performance levels is facilitated by the event‐tree technique that allows relationships between clinical procedures and outcomes of ambulance journeys to be displayed.

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Clinical Governance: An International Journal, vol. 9 no. 2
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 1 April 1998

Robin Dowie, Richard P.F. Gregory, Kathleen V. Rowsell, Shân Annis, A.D. Gick and Christopher J. Harrison

The paper discusses how a decision analytic framework has been used by an English health authority in relation to the commissioning of ambulance cardiac services…

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Abstract

The paper discusses how a decision analytic framework has been used by an English health authority in relation to the commissioning of ambulance cardiac services. Strategies for the management by ambulance personnel of victims of cardiac arrest and persons with acute chest pain of cardiac origin were modelled in a decision‐event tree, and a bibliographic database established. The international research literature prior to 1997 was searched in order to derive probability values for the tree. However, after checking whether the sub‐groupings of results in the papers were in accordance with the variables in the tree, the number of useful papers on acute chest pain was found to be only two. In the almost complete absence of information ‐ even from small observational studies ‐ on the management of the great majority of patients with cardiac symptoms transported by ambulance, the local ambulance service and the main providers of hospital services in the district are now collaborating in field studies of cardiac care in order to improve the inputs into the model.

Details

Journal of Management in Medicine, vol. 12 no. 2
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 1 March 1991

Martin McKee and Nick Black

Proposed changes in medical staffing levels and pressure forreduced hours of work by junior doctors have focused attention onout‐of‐hours work by junior doctors in the…

Abstract

Proposed changes in medical staffing levels and pressure for reduced hours of work by junior doctors have focused attention on out‐of‐hours work by junior doctors in the United Kingdom. Junior doctors are on average on duty for over 90 hours per week, and preregistration house officers typically spend almost 70 hours per week actually working. There has been a decline in contracted hours for junior doctors during the 1980s, but an increase in the number of hours on duty and, in the cases of paediatrics and general surgery, an increase in the number of hours worked. Current policy is for expansion in consultant numbers and reduction in junior staff. Critics argue that the planned expansion of consultant posts is inadequate and the absence of registrars in some specialties is dangerous. Previous attempts to reduce the number of hours on duty had little success: suggested solutions have not been implemented widely. One possible solution may be reducing and reallocating out‐of‐hours work. It has been suggested that many of the current tasks undertaken by junior hospital doctors could be performed by non‐medical staff. A thorough examination of the tasks actually undertaken by junior hospital doctors outside normal working hours is required.

Details

Journal of Management in Medicine, vol. 5 no. 3
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 1 December 2003

David J. Collison

This paper examines the nature of propaganda and its use by corporations, particularly in the USA, over a period of nearly 100 years. It emphasises the invisibility of…

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Abstract

This paper examines the nature of propaganda and its use by corporations, particularly in the USA, over a period of nearly 100 years. It emphasises the invisibility of much of this activity and propaganda’s importance for shaping acquiescence in corporate hegemony. The role played by corporate propaganda in the development of different forms of capitalism is addressed. The inculcation of accounting and finance students with values that serve corporate interests is considered: in this context propaganda is inferred in both the longstanding misrepresentation of Adam Smith, and the sustained illusion of competitive “free markets”. The role and language of the business media as a form of propaganda is considered, particularly regarding colonisation of social market economies by Anglo‐Saxon capitalism, which takes as incontestable the maximisation of shareholder value as the proper and necessary aim of corporate activity. It is argued that corporate propaganda has contributed to the accounting measure of business success being justified as an end in itself at the explicit expense of wider societal considerations.

Details

Accounting, Auditing & Accountability Journal, vol. 16 no. 5
Type: Research Article
ISSN: 0951-3574

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Article
Publication date: 1 May 1992

Marilyn M. Helms and Betty A. Hutchins

Suggests that declining product quality and manufacturers′ socialresponsibility is of increasing concern to consumers and tomanufacturers, who must bear the cost of such…

1234

Abstract

Suggests that declining product quality and manufacturers′ social responsibility is of increasing concern to consumers and to manufacturers, who must bear the cost of such faulty practice. Reviews documented cases of poor quality products and matches them with the ethical theories of utilitarianism, universalism, rights, justice and Natural Law. Obligations to stakeholders are examined, and future research suggested.

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Management Decision, vol. 30 no. 5
Type: Research Article
ISSN: 0025-1747

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Article
Publication date: 1 March 1971

Hugh K. Mackay

THAT DR T. C. SMOUT in his highly praised A History of the Scottish People, 1560–1830 (1969) felt able to dismiss Robert Fergusson (‘the dissipated son of an Edinburgh…

Abstract

THAT DR T. C. SMOUT in his highly praised A History of the Scottish People, 1560–1830 (1969) felt able to dismiss Robert Fergusson (‘the dissipated son of an Edinburgh clerk’) with the verdict ‘nothing more serious than the celebration of food and drink was ever his business’ indicates yet again the continuing depreciation that, with honourable exceptions, has been Fergusson's critical fate since his bourgeoning fame disappeared in the furore excited by the appearance of Burns.

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Library Review, vol. 23 no. 3
Type: Research Article
ISSN: 0024-2535

Article
Publication date: 1 May 1899

Mr. Cutter commences his classic “Rules” with a statement of the objects some or all of which a catalogue is intended to compass. I have put these objects in the form of…

Abstract

Mr. Cutter commences his classic “Rules” with a statement of the objects some or all of which a catalogue is intended to compass. I have put these objects in the form of “wants,” confining them, it will be observed, to the catalogue considered merely as a finding list I may go to the catalogue, then, with any of the following half‐dozen wants:—

Details

New Library World, vol. 1 no. 11
Type: Research Article
ISSN: 0307-4803

Article
Publication date: 1 February 1932

FINANCIAL fears are only less cruel than those of war, and lead men into extravagances which they would repudiate indignantly in their cooler moments. If the doings of the…

Abstract

FINANCIAL fears are only less cruel than those of war, and lead men into extravagances which they would repudiate indignantly in their cooler moments. If the doings of the Economy Committee at Manchester in relation to children's libraries, as described in the article by Mr. Lamb in our last issue, are true, we have in them an example of a kind of retrenchment at the expense of the young which we hope is without parallel and will have no imitators. Some reduc‐tion of estimates we hear of from this or that place, but in few has the stupid policy which urges that if we spend nothing we shall all become rich been carried into full effect. Libraries always have suffered in times of crisis, whatever they are; we accept that, though doubtfully; but we do know that the people need libraries.

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New Library World, vol. 34 no. 8
Type: Research Article
ISSN: 0307-4803

Article
Publication date: 1 January 1971

Allan Leach

MY INTEREST in Robert McLellan's work is a fairly recent one, dating as it does from shortly after my arrival in Scotland five years ago. Several pointers made me anxious…

Abstract

MY INTEREST in Robert McLellan's work is a fairly recent one, dating as it does from shortly after my arrival in Scotland five years ago. Several pointers made me anxious to know more of his plays and other writings, not least an article by Miss Moira Burgess. I found, however, that an interest was easier to arouse than to satisfy: bibliographies listed practically nothing by him; my own local collection catalogue (McLellan has been an Arran resident since 1938) showed only two articles, one by and one about him, and inquiries of colleagues elicited only surprise that they could find no more than I had done.

Details

Library Review, vol. 23 no. 1/2
Type: Research Article
ISSN: 0024-2535

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