Sherif Shawer, Shirley Rowbotham, Alexander Heazell, Teresa Kelly and Sarah Vause
Many organisations, including the Royal College of Obstetricians and Gynaecologists, have recommended increasing the number of hours of consultant obstetric presence in UK…
Abstract
Purpose
Many organisations, including the Royal College of Obstetricians and Gynaecologists, have recommended increasing the number of hours of consultant obstetric presence in UK National Health Service maternity units to improve patient care. St Mary’s Hospital, Manchester implemented 24-7 consultant presence in September 2014. The paper aims to discuss these issues.
Design/methodology/approach
To assess the impact of 24-7 consultant presence upon women and babies, a retrospective review of all serious clinical intrapartum incidents occurring between September 2011 and September 2017 was carried out by two independent reviewers; disagreements in classification were reviewed by a senior Obstetrician. The impact of consultant presence was classified in a structure agreed a priori.
Findings
A total of 72 incidents were reviewed. Consultants were directly involved in the care of 75.6 per cent of cases before 24-7 consultant presence compared to 96.8 per cent afterwards. Negative impact due to a lack of consultant presence fell from 22 per cent of the incidents before 24-7 consultant presence to 9.7 per cent after implementation. In contrast, positive impact of consultant presence increased from 14.6 to 32.3 per cent following the introduction of 24-7 consultant presence.
Practical implications
Introduction of 24-7 consultant presence reduced the negative impact caused by a lack of, or delay in, consultant presence as identified by serious untoward incident (SUI) reviews. Consultant presence was more likely to have a positive influence on care delivery.
Originality/value
This is the first assessment of the impact of 24-7 consultant presence on the SUIs in obstetrics.
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This article challenges the notion that using a consultant is a luxury inappropriate in the library community. A consultant can offer access to hard‐to‐find information, an…
Abstract
This article challenges the notion that using a consultant is a luxury inappropriate in the library community. A consultant can offer access to hard‐to‐find information, an impartial viewpoint, flexible arrangements, and timely completion of a project. Using a consultant can therefore mean sounder decisions, cost savings, and enhanced effectiveness for the library. The author discusses specialized consulting services available to libraries, as well as how to select a consultant and build a successful client/consultant relationship.
The role of consultant obstetricians is under considerable debate. This has particularly focused on the role of consultants in intrapartum care. The article explores the role of…
Abstract
The role of consultant obstetricians is under considerable debate. This has particularly focused on the role of consultants in intrapartum care. The article explores the role of the consultant in delivery suite from the view point of a consultant, a clinical director, a training programme director and a chief executive. These viewpoints determine a range of common themes which mean the duties of consultants over their career lifecycle need to be addressed; the need to expand consultant posts; and the tensions which inevitably occur. The authors believe these need to be addressed because of the need to ensure consultant roles in delivery suite are developed as a key part of seeing quality improvement.
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This study is an analysis of client‐consultant relationships centered around a large capital project, specifically in planning to build a self contained steel production plant in a…
Abstract
This study is an analysis of client‐consultant relationships centered around a large capital project, specifically in planning to build a self contained steel production plant in a country on the North African coast. The total contract value was £350m ($800m approximately). A number of consultants bidded for the project and the contract was given to two companies, both based in Europe but of different nationalities. Two products were required from the consultants, an engineering systems plan for the total steel plant and a manpower plan assessing labour requirements, training needs and an analysis of individual jobs and hierarchical roles. Relatively few problems were experienced in the drafting of the engineering plan. The point at issue centered over the manpower plan.
Jan A. De Jong and Ilse M. Van Eekelen
Although much has been written on skills and strategies of management consultants, little research has been done on what management consultants actually do. In this study, three…
Abstract
Although much has been written on skills and strategies of management consultants, little research has been done on what management consultants actually do. In this study, three senior consultants were shadowed, each for a one week period. Management consultancy turns out to be a hectic and highly interactive job. Important interaction partners are clients, colleagues, and secretaries, although only the first are highlighted in literature. Catalytic intervention is the most dominant approach in client contacts. The relatively rare desk work sessions of management consultants are even more interrupted than those of managers. An important function of their desk work (and of their work as a whole) is structuring information gained in client contacts.
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Use a nine‐phase process in every consulting relationship.
Gerald P. Chickillo and Brian H. Kleiner
The practice of consultancy primarily in the US is discussed and isbroken down into five separate sections. The first section takes a lookat the history of consulting and what…
Abstract
The practice of consultancy primarily in the US is discussed and is broken down into five separate sections. The first section takes a look at the history of consulting and what trends it is taking into the 1990s. The second section takes a brief look at who does do consulting and what types of firms operate in consulting. The third and fourth sections are the heart of the article. The third section examines the different roles of consultants as looked at through two models. The fourth section examines the consulting analysis process and the diverse skills required to succeed in the field of consulting. Finally, the last section explains some of the most critical issues affecting the nature of training and developing individuals to be effective consultants.
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This article examines the process of setting up a contract betweenthe training manager and the training consultant. It argues that thepotential for the training event, that is the…
Abstract
This article examines the process of setting up a contract between the training manager and the training consultant. It argues that the potential for the training event, that is the subject of the contract, to be ineffective, is great. Consequently the process has to be well managed by the training manager. It lays out eight steps in the contracting process that the training manager should observe to have a greater chance of success. These are: check the consultant′s credentials; clearly specify your needs; ensure a fit with your organisation; arrange for written programme details; make clear evaluation arrangements; monitor newly appointed consultants; give clear feedback to the consultant; be prepared to answer awkward questions.
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Johanna Fullerton and Michael A. West
Examines both consultant and client perceptions of the consulting relationship, focusing on internal process consultants and a sample of their clients. Employs a procedure based…
Abstract
Examines both consultant and client perceptions of the consulting relationship, focusing on internal process consultants and a sample of their clients. Employs a procedure based on repertory grid technique to elicit dimensions of client‐consultant relationships from 22 consultants and 16 of their clients within a major UK company. Develops a questionnaire in order to determine the importance and frequency of these dimensions, and also to investigate any perceived differences between the views of clients and consultants. Dimensions fell within four broad categories: clients’ skills and behaviours; consultants’ skills and behaviours; contract details or the logistics of the project; and dimensions focusing specifically on the client‐consultant relationship. Clients focused particularly on the contract details, placing less emphasis on the importance of either their own skills and behaviours or the relationship they formed with the consultant. Consultants, on the other hand, viewed relationship building as most important. Makes recommendations for establishing and enhancing client‐consultant relationships.
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Presents research on the contributions of consultants to organizational change. Respondents to a multi‐company survey were asked to describe specific change projects. A total of…
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Presents research on the contributions of consultants to organizational change. Respondents to a multi‐company survey were asked to describe specific change projects. A total of 107 respondents said that consultants had supported the change effort. These respondents were asked: “What value did the consultant contribute to the change effort?”, “In what ways could the consultant have been more effective in supporting the change effort?” Responses were sorted into categories: one set for contributions and a second set for improvements. The categorization led to suggestions to clarify expectations, involve stakeholders, promote communication between project staff and stakeholders, institute a change management process, and encourage the evaluation of consultant performance and feedback to consultants.