Rebecca N. Warburton, Belinda Parke, Wynona Church and Jane McCusker
Reports on the authors' experience with a patient safety quality improvement program, intended to reduce the incidence and severity of adverse outcomes for emergency department…
Abstract
Reports on the authors' experience with a patient safety quality improvement program, intended to reduce the incidence and severity of adverse outcomes for emergency department (ED) patients aged ≥75. The Identification of Seniors at Risk scale was used for screening, and those at high risk were referred for appropriate intervention. The plan‐do‐study‐act improvement cycle was followed, conducting process evaluation to diagnose and correct implementation difficulties. Reports that: implementing an ED screening and referral program is deceptively difficult; process evaluation multidisciplinary working group meetings are an essential improvement tool; screening inclusion criteria had to be adapted to the subject population in order to make efficient use of staff time; the screening questions and process required ongoing assessment, revision, and local adaptation in order to be useful; and high‐risk screening in the ED is critical to a hospital system's ability to anticipate clinical problems; the plan‐do‐study‐act improvement cycle is a practical and useful tool for improving quality and systems in a real care setting.
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Belinda Parke and Jane McCusker
The purpose of this paper is to establish policy recommendations to address service and care delivery challenges facing hospital emergency departments (EDs) responding to the…
Abstract
Purpose
The purpose of this paper is to establish policy recommendations to address service and care delivery challenges facing hospital emergency departments (EDs) responding to the needs of increasing numbers of older adults.
Design/methodology/approach
The consensus development process used an international expert interdisciplinary panel, convened at an international conference. Following a round table discussion and think‐tank session, a nominal group method with constant comparative analysis and coding techniques was used to identify policy recommendations. Two rounds of electronic input followed the face‐to‐face meeting to reach consensus on priority ranking of the policy recommendations. Findings underwent an external review by four independent experts.
Findings
A total of seven categories of policy recommendations were developed: education, integration and coordination of care, resources, ED physical environment, evidence‐based practice, research and evaluation, and advocacy.
Research limitations/implications
The consensus development process did not include a systematic literature review on the topic. However, participants included experts in their disciplines.
Practical implications
The recommendations may assist administrators, policy makers, clinicians, and researchers on future directions for improving emergency care and service delivery for older adults.
Originality/value
The paper describes the process and results of a consensus development activity for ED care and services of older adults.
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The purpose of this article is to report preliminary outcome and cost‐benefit results for a patient safety quality improvement program intended to improve outcomes for patients…
Abstract
Purpose
The purpose of this article is to report preliminary outcome and cost‐benefit results for a patient safety quality improvement program intended to improve outcomes for patients aged 75 or more visiting the Emergency Department (ED). The program uses the Identification of Seniors at Risk (ISAR) scale to screen, and refers patients at high risk for appropriate intervention.
Design/methodology/approach
The Plan‐Do‐Study‐Act improvement cycle was used as a framework. Simple outcomes have been assessed by comparing patient sub‐groups based on risk status and interventions received. Cost and benefits were assessed based on estimated program outcomes and average costs. Sensitivity analysis was performed to test alternate assumptions.
Findings
The screening tool appears to be accurate, and screening and referral appears to have a positive impact, reducing length of stay, returns to the ED, and subsequent admissions to hospital. However, most results are not statistically significant at the 95 percent level. The value of avoided care exceeds program costs under most assumptions.
Originality/value
Screening and referring all eligible patients has still not been achieved; these are areas for future investigation and improvement. Screening and referral appear to be effective in improving outcomes but because program costs were low, net benefits may have been achieved; however given global budgeting for hospital care improvements in the use of resources (rather than budgetary savings) would be expected. The methods for improvement (the Plan‐Do‐Study‐Act framework; process evaluation; multidisciplinary working group meetings; outcome assessment) are practical and useful for improving quality and safety in a small community hospital with limited resources.
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Contemporary global mobility and dual careers are two key features of working life today. Little is known, however, about where they intersect, where one partner travels for their…
Abstract
Purpose
Contemporary global mobility and dual careers are two key features of working life today. Little is known, however, about where they intersect, where one partner travels for their career, while the other partner is left behind, caring for the family and attempting to manage their own career. The purpose of this paper is to explore how the partner’s career is impacted by the traveller’s absence, and the strategies employed to enable their continued career development.
Design/methodology/approach
The paper employs a qualitative methodology, drawing on semi-structured interviews with the partners of international yachtsmen.
Findings
The findings highlight the prioritisation of the traveller’s career, for reasons of finance and their passion for their career. The implications of this could be detrimental to the partner’s career. Personalised, flexible working arrangements are essential in order for the partner to achieve a sustainable career of their own.
Research limitations/implications
The gendered nature of the sample provides an opportunity for further research examining the implications of the female being the traveller and the male the stay at home partner.
Practical implications
The paper examines a range of alternative strategies for maintaining or developing the career when also faced with additional family responsibilities.
Originality/value
This paper gives consideration to the career of the stay at home partner. A new dual-career strategy is identified – the entrepreneurial secondary career strategy, which has the potential to deliver the flexibility required to manage both work and family demands, and allow partners to enact their authentic career.
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Madeleine Parkes, Katja Milner and Peter Gilbert
People go into employment for a range of reasons. One of those is usually to find a sense of meaning, as humans are meaning‐seeking animals.In the public sector there is even more…
Abstract
People go into employment for a range of reasons. One of those is usually to find a sense of meaning, as humans are meaning‐seeking animals.In the public sector there is even more likelihood of some kind of ‘calling’. This may not be a religious call, or even an overtly spiritual one, but there will usually be some sense in which the role and the individual reach out to one another.In a time of recession and strain on public finances and services, leaders need to work in a way that appeals to the spirit, the vocation in each person and the team.
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Arpita Agnihotri and Saurabh Bhattacharya
The purpose of this paper is to explore a conceptual model on the influence of corporate social responsibility (CSR) “fit” on organizational attractiveness among job applicants…
Abstract
Purpose
The purpose of this paper is to explore a conceptual model on the influence of corporate social responsibility (CSR) “fit” on organizational attractiveness among job applicants under the boundary conditions of chief executive officer (CEO) activism and CSR credibility.
Design/methodology/approach
The study is based on archival research, largely reviewing extant in CSR and drawing propositions based on existing theory.
Findings
Paper draws propositions based on CSR fit, credibility and CEO activism. The paper asserts the influence of CSR fit on organizational attractiveness among job applicants. It further explains moderated mediating mechanism through which CSR fit influences organizational attractiveness among job applicants.
Originality/value
Recruitment has primarily explored the role of CSR in attracting potential job candidates. This paper presents the role of CSR “fit,” an aspect not explored before in recruitment. This paper also introduces the role of CEO activism in recruitment.
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The purpose of this paper is to identify the factors informing spousal global mobility decisions within the context of sporting expatriation. Findings contribute to the…
Abstract
Purpose
The purpose of this paper is to identify the factors informing spousal global mobility decisions within the context of sporting expatriation. Findings contribute to the non-corporate global mobility literature as well as providing an empirical enhancement to the family relatedness of work decisions framework.
Design/methodology/approach
In this qualitative study, in-depth interviews gave voice to 21 spouses of professional sailors who have experienced both trailing their spouse and staying behind.
Findings
Access to empathetic social support, the potential impact on children, and the spouse’s career were all found to influence the spouse’s dynamic global mobility decision making.
Research limitations/implications
The study is limited by the cross-sectional nature of the research. Future longitudinal research into the impact of spousal preferences would identify the on-going effect of their decision(s) to relocate or to stay behind.
Practical implications
Providing organisations with an understanding of the familial issues their global talent may factor into their work mobility decisions will allow them to implement appropriate family-focussed support, irrespective of the choice to engage, or not engage, in global mobility.
Originality/value
By grounding the study in the under-researched sporting arena, the author contributes to the emerging non-corporate expatriate conversation. Furthermore, the family relatedness of work-related decisions framework was found to provide a useful conceptual foundation for understanding decision making in an international context.