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Article
Publication date: 3 June 2014

Cheng Hung Sun, Thomas Lew, Doris Tan, Shu Yin Hoi, Raj Khandan and, Choo Hwee Poi, Reddy Surender, Shirley Tay, Gervais Wan, Y.S. Lee, Lee Lee Lim, Handi Solikin and Samuel Yeak

The purpose of this paper is to outline considerations and steps taken to introduce electronic reporting and verification from systems design and multidisciplinary…

Abstract

Purpose

The purpose of this paper is to outline considerations and steps taken to introduce electronic reporting and verification from systems design and multidisciplinary collaborations to gap analysis and devising solutions. It also evaluates carefully placed forcing functions’ impact on verification rates.

Design/methodology/approach

A multidisciplinary workgroup was formed to stop print and establish electronic reporting. The electronic verification's success was assessed by weekly activity analysis.

Findings

Introducing a verification forcing function markedly improved verification activity. Thereafter, non-verified results stabilized at 7 percent up to 75 weeks post-implementation.

Practical implications

This paper illustrates how results reporting and verification could be implemented in a tertiary hospital using a mixed electronic and paper record. Factors that were critical to success include stakeholder engagement and applying systems design that focussed on patient safety as a key priority. The electronic reporting system was augmented by strategically inserted forcing functions, clear clinical-responsibility lines and ancillary alert systems.

Originality/value

The systems design method's value in managing non-critical but abnormal results appears to have been under-appreciated. This paper describes how systems design could be used to improve health information delivery and management.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 5
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 January 1990

T.C.E. Cheng, Y.K. Lo and K.W. Ma

Over the last twenty years the financial markets of Hong Kong have developed rapidly. Although empirical studies on the behaviour of the Hong Kong stock market abound…

Abstract

Over the last twenty years the financial markets of Hong Kong have developed rapidly. Although empirical studies on the behaviour of the Hong Kong stock market abound, much controversy over the efficiency of the market still exists. Some recent studies have shown that the market is inefficient in the “weak” form. Therefore one can justify employing the “fundamental approach” for stock price forecasting This study explores the use of multiple regression techniques to forecast stock price index. The results show that unemployment rate, trade balance, consumer price index and money supply are all significant in leading the stock price index. However, the regression models are still short of sufficient power to effectively predict change of direction of the index. Further enhancement of the models is needed if they are to be of real use for investment purposes.

Details

Managerial Finance, vol. 16 no. 1
Type: Research Article
ISSN: 0307-4358

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Article
Publication date: 4 January 2013

Sia Beng Yi, Janice Chan Pei Shan and Goh Lay Hong

Medication reconciliation is integral to every hospital. Approximately 60 percent of all hospital medication errors occur at admission, intra‐hospital transfer or…

Abstract

Purpose

Medication reconciliation is integral to every hospital. Approximately 60 percent of all hospital medication errors occur at admission, intra‐hospital transfer or discharge. Effectively and consistently performing medication reconciliation at care‐interfaces continues to be a challenge. Tan Tock Seng Hospital (TTSH) averages 4,700 admissions monthly. Many patients are elderly (>65 years old) at risk from poly‐pharmacy. As part of a medication safety initiative, pharmacy staff started a medication reconciliation service in 2007, which expanded to include all patients in October 2009. This article aims to describe the TTSH medication reconciliation system and to highlight common medication errors occurring following incomplete medication reconciliation.

Design/methodology/approach

Where possible, patients admitted into TTSH are seen by pharmacy staff within 24 hours of admission. A form was created to document their medications, which is filed into the case sheets for referencing purposes. Any discrepancies in medicines are brought to doctors' attention. Patients are also counseled about changes to their medications. Errors picked up were captured in an Excel database.

Findings

The most common medication error was prescribers missing out medications. The second commonest was recording different doses and regimens. The reason was mainly due to doctors transcribing medications inaccurately.

Research limitations/implications

This is a descriptive study and no statistical tests were carried out. Data entry was done by different pharmacy staff, and not a dedicated person; hence, data might be under‐reported.

Practical implications

The findings demonstrate the importance of medication reconciliation on admission. Accurate medication reconciliation can help to reduce transcription errors and improve service quality.

Originality/value

The article highlights medication reconciliation's importance and has implications for healthcare professionals in all countries.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 1
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 2 October 2009

Lim Wei Kheong Jimmy, Timothy Barkham, Chen Qian Ming, Lynda Lim, Jia Lin, Goh Lay Hong and Heng Wee Jin

Prolonged hospital stay in the course of management of microbial keratitis patients has been a burden to the resources of a multi‐disciplinary tertiary hospital. The paper…

Abstract

Purpose

Prolonged hospital stay in the course of management of microbial keratitis patients has been a burden to the resources of a multi‐disciplinary tertiary hospital. The paper aims to evaluate the impact of streamlining the workflow and increased cross‐disciplinary interactions on the average length of hospitalisation. It also seeks to study secondary outcomes including the average time for initiation of therapy, microbial culture positive rate, patients' satisfaction and resource savings.

Design/methodology/approach

The authors employed the model of clinical practice improvement (CPI) (New South Wales Health Department) methodology for a systematic approach to improve processes of care and service delivery. A team consisting of ophthalmologist, microbiologist, pharmacist and nursing staff was formed to brainstorm and highlight the problems. A new workflow was formulated and data were prospectively collected to evaluate and to identify areas where improvements could be made.

Findings

The average length of hospitalisation stay was reduced from 7.43 to 5.93 days with a mean difference of 1.50±0.63 days (p<0.05). The microbial keratitis culture positive rate increased from 54.6 to 73.0 per cent (p>0.05). The average time taken to initiate antibiotic eye drops after first contact with the doctor was 26.1 minutes (n=28), and 74.4 per cent of the patients surveyed were satisfied with their length of stay.

Research limitations/implications

Intervention was carried out on the top 20 per cent of areas for improvement after voting by the team members.

Practical implications

The reduction in average length of hospitalisation can be improved by strict adherence to a formulated workflow and coordinated cross‐disciplinary interactions.

Originality/value

The management protocol discussed in the paper for microbial keratitis enables more effective and efficient treatment for the inpatients. Increased cross‐discipline and nursing coordination decreases length of hospitalisation of microbial keratitis patients and achieve better care for these patients.

Details

International Journal of Health Care Quality Assurance, vol. 22 no. 7
Type: Research Article
ISSN: 0952-6862

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Book part
Publication date: 31 December 2013

Monica Macquet and Emma Sjöström

Purpose – To discover how SRI develops in the Asian context.Methodology/approach – Extended search of SRI initiatives analyzed with Scandinavian neo-institutional approach…

Abstract

Purpose – To discover how SRI develops in the Asian context.

Methodology/approach – Extended search of SRI initiatives analyzed with Scandinavian neo-institutional approach on how ideas travel and Buddhist Economy.

Findings – Chinese SRI-initiatives imitate western peers, but the imitation results in partial isomorphism that will probably have a weak influence on Chinese companies in ESG.

Research limitations/implications – A limitation of the study is a lack of information and transparency on Chinese homepages.

Practical implications – Chinese SRI is in an early state, and will need back-up and push to become active if it will be able to influence Chinese companies.

Social implications – It is important to have a critical stance, and not trusting optimistic statements about SRI in China as a mean to integrate ESG activities in Chinese companies.

Originality/value of chapter – One of the first overviews and critical analysis of SRI in China.

Details

Institutional Investors’ Power to Change Corporate Behavior: International Perspectives
Type: Book
ISBN: 978-1-78190-771-9

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Article
Publication date: 3 May 2013

Juliette Koning and Can‐Seng Ooi

Researchers rarely present accounts of their awkward encounters in ethnographies. Awkwardness, however, does matter and affects the ethnographic accounts we write and our…

Abstract

Purpose

Researchers rarely present accounts of their awkward encounters in ethnographies. Awkwardness, however, does matter and affects the ethnographic accounts we write and our understanding of social situations. The purpose is to bring these hidden sides of organizational ethnography to the fore, to discuss the consequences of ignoring awkward encounters, and to improve our understanding of organizational realities.

Design/methodology/approach

This paper presents awkward ethnographic encounters in the field: encounters with evangelizing ethnic Chinese business people in Indonesia (Koning), and visiting an artist village in China (Ooi). Based on analysing their awkwardness, and in the context of a critical assessment of the reflexive turn in ethnography, the authors propose a more inclusive reflexivity. The paper ends with formulating several points supportive of reaching inclusive reflexivity.

Findings

By investigating awkward encounters, the authors show that these experiences have been left out for political (publishing culture in academia, unwritten rules of ethnography), as well as personal (feelings of failure, unwelcome self‐revelations) reasons, while there is much to discover from these encounters. Un‐paralyzing reflexivity means to include the awkward, the emotional, and admit the non‐rational aspects of our ethnographic experiences; such inclusive reflexivity is incredibly insightful.

Research limitations/implications

Inclusive reflexivity not only allows room for the imperfectness of the researcher, but also enables a fuller and deeper representation of the groups and communities we aim to understand and, thus, will enhance the trustworthiness and quality of our ethnographic work.

Originality/value

Awkwardness is rarely acknowledged, not to mention discussed, in organizational ethnography.

Details

Qualitative Research in Organizations and Management: An International Journal, vol. 8 no. 1
Type: Research Article
ISSN: 1746-5648

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Article
Publication date: 6 May 2014

Petrina Tan, Fong Yee Foo, Stephen C. Teoh and Hon Tym Wong

The purpose of this paper is to determine the safety of substituting the first day post-operative review after routine cataract surgery (phacoemulsification) with a…

Abstract

Purpose

The purpose of this paper is to determine the safety of substituting the first day post-operative review after routine cataract surgery (phacoemulsification) with a telephone survey.

Design/methodology/approach

Prospective non-randomised cohort study. A standardised questionnaire of five common ocular symptoms (general condition, vision, eye pain, headache, nausea or vomiting) was administered by a trained nurse on the first post-operative day. The patients were reviewed in clinic two to 14 days later. Patient charts were retrospectively reviewed for complications (endophthalmitis, raised intra-ocular pressure, wound leaks and uveitis) requiring deviation from standard treatment.

Findings

Over 13 months, 256 eyes of 238 patients underwent uncomplicated phacoemulsification by four consultant surgeons. Only one patient reported poor general condition, blurred vision and eye pain. She was subsequently found to have corneal oedema and raised intra-ocular pressure when recalled for an earlier review. Best corrected visual acuity better than 20/40 was achieved in 80.5 per cent of patients. There were no other post-operative complications noted from medical records review.

Research limitations/implications

Non-randomised nature, skewed surgical expertise, lack of a control group and patient experience data. In all, 22 patients (9.2 per cent) were also uncontactable for the telephone interview.

Practical implications

A nurse-administered telephone survey seemed to be a safe and effective alternative to first day post-operative review after routine phacoemulsification. The survey also enabled the detection of serious post-operative complications. The first day post-operative hospital visit may be safely substituted in a selected patient population with greater patient convenience achieved and liberation of clinic resources.

Originality/value

This is the first study which utilises a standardised questionnaire as a form of post-operative review in an Asian population.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 23 August 2013

Pow-Li Chia, Deanna Rapi Santos, Tit Chai Tan, Candice Leong and David Foo

This article aims to explore coronary care unit (CCU) extubation structures, processes and outcomes. There were 13 unplanned-extubation cases (UE) among 251 intubated…

Abstract

Purpose

This article aims to explore coronary care unit (CCU) extubation structures, processes and outcomes. There were 13 unplanned-extubation cases (UE) among 251 intubated patients (5.2 per cent) in a cardiologist-led CCU in 2008. Seven did not require re-intubation, implying possible earlier extubation. A quality improvement project was undertaken with a goal to eliminate CCU UE within 12 months.

Design/methodology/approach

Using the clinical practice improvement (CPI) method, the most significant root causes were missing sedation/analgesia protocol, no ventilator weaning protocol and absent respiratory therapist during the CCU morning rounds. Non-physician directed sedation/analgesia and ventilation weaning protocols were created and put on trial in Plan-Do-Study-Act cycles before formal implementation. Arrangements were made to allocate a respiratory therapist to the CCU daily for morning rounds.

Findings

For 12 months after fully implementing the interventions, UE incidence dropped from 5.2 per cent to 0.9 per cent (p=0.006). There were no adverse outcomes, re-intubation and/or readmission to CCU within 48 hours.

Practical implications

Through a multi-disciplinary CPI approach, adopting non-physician directed protocols has successfully streamlined and improved airway management in mechanically ventilated patients in a cardiologist-led CCU.

Originality/value

There is little published data on improving intubated patient care in cardiologist-led CCUs. Previous studies centered on intensive care units managed by critical care specialists.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 7
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 January 1998

Michael E. Parker and Tammy Rapp

The various stock market indexes are interrelated due to the similar fundamentals which determine the movement in the respective markets. Applying the efficient market…

Abstract

The various stock market indexes are interrelated due to the similar fundamentals which determine the movement in the respective markets. Applying the efficient market hypothesis, an investor should not be able to predict the movement of one index based on the past movement of another index. If the stock markets are efficient, then no long term comovement should exist between stock market indexes. The existence of a long term relation can be tested by use of cointegration tests and common serial correlation feature tests. If no cointegration exists and if no common serial correlation feature exists, then we would not be rejecting efficiency of the stock markets. Using the S&P 500 stock index, the Wilshire 5000 index, and the NASDAQ index, the Hang Seng index, the Footsie index, and the Nikkei index to proxy world stock market indexes, the empirical results of the cointegration and common feature test support the efficiency of the stock markets in most instances. However, the Footsie index consistently demonstrated a relation with the three US stock market indexes included in the study.

Details

Studies in Economics and Finance, vol. 19 no. 1/2
Type: Research Article
ISSN: 1086-7376

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Article
Publication date: 28 October 2020

Abel Duarte Alonso, Seng Kok and Jeremy Galbreath

The purpose of this study is to investigate about women involved in the wine industry of emerging economies, including their journey, perceived progression in the…

Abstract

Purpose

The purpose of this study is to investigate about women involved in the wine industry of emerging economies, including their journey, perceived progression in the industry, their impact and required characteristics to adapt to this industry. Because of its significance in the context of this research, social cognitive theory (SCT) will be adopted.

Design/methodology/approach

Face-to-face, in-depth on-site interviews were conducted with 15 female winery owners and managers in three separate South American wine regions.

Findings

While overall participants recognised persistent barriers for women to work in the wine industry, they also acknowledged increased opportunities for females, which have led to stronger roles for women. Importantly, sensitivity, by being detail-oriented in service encounters while practicing subtlety in winemaking, was revealed as a key differentiating trait. Further, fundamental tenets of SCT, particularly self-efficacy, became apparent when participants reflected on their own journeys, as well as on how future female entrants could successfully adapt to the wine industry.

Originality/value

The study draws on SCT’s underpinnings to examine an under-researched area, notably, the journey of entrepreneurial women in the wine industry of emerging economies. Apart from the gathered empirical evidence concerning such a journey, a proposed framework extends SCT, thereby highlighting the role of self-efficacy, a determinant factor in enhancing women’s presence and involvement in the wine industry. This presence is closely linked to women’s progression and journey in the industry, where determination contributes to their adaptation, learning and accumulation of knowledge, with important implications for their future and the future of other female entrants.

Details

International Journal of Wine Business Research, vol. 33 no. 2
Type: Research Article
ISSN: 1751-1062

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