Susan Holmes and Douglas Maclnnes
It is often assumed that prison staff are particularly stressed due to their frequent exposure to traumatic events, which may damage not only individuals but also prisons and…
Abstract
It is often assumed that prison staff are particularly stressed due to their frequent exposure to traumatic events, which may damage not only individuals but also prisons and prisoners. While the impact of such stress may be recognised, the factors contributing to its development are unclear.The work reported here is part of a larger investigation of health care provision in a Greater London prison. Qualitative approaches were used to access the understandings of staff and key informants of the difficulties associated with their working environment. This enabled us to accommodate different working contexts, ensuring that the findings were grounded in the reality of the work undertaken by the participants.The data revealed that lack of training contributed significantly to the development of stress, reducing confidence in dealing with the many traumatic situations encountered. However, interpersonal relationships provided mutual support during crises. General working conditions, including workload and staff redeployment, were also important contributors to high levels of sickness‐absence which, in turn, exacerbated stress. Poor management practices, combined with a perceived lack of support, further aggravated stress.While it may be tempting to blame individuals for their inability to cope, all organisations have a duty of care to their employees and must take steps, at both the individual and organisational level, to prevent and manage work‐related stress.
Despite high unemployment, a collapse in manufacturing output andemployment, a government‐engineered fall in internationalcompetitiveness that has resulted in an unprecedented…
Abstract
Despite high unemployment, a collapse in manufacturing output and employment, a government‐engineered fall in international competitiveness that has resulted in an unprecedented deficit in non‐oil trade and zero net growth in the Gross Domestic Product between 1979‐83, the basic features of British workplace industrial relations remain unchanged. The economic changes wrought by the recession since 1979 in Scotland and the UK and the resurgence of older traditions in industrial relations are described.
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Despite high unemployment, a collapse in manufacturing output and employment, a government‐engineered fall in international competitiveness that has resulted in an unprecedented…
Abstract
Despite high unemployment, a collapse in manufacturing output and employment, a government‐engineered fall in international competitiveness that has resulted in an unprecedented deficit in non‐oil trade and zero net growth in the Gross Domestic Product between 1979 and 1983, the basic features of British workplace industrial relations remain unchanged. The economic changes wrought by the recession since 1979 in Scotland and the UK and the resurgence of older traditions in industrial relations are described.
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Claire Powell, Karen Ciclitira and Lisa Marzano
Imprisoned mothers are at increased risk for poor psychological health and psychological distress when separated from their children, so staff need to be highly skilled to support…
Abstract
Purpose
Imprisoned mothers are at increased risk for poor psychological health and psychological distress when separated from their children, so staff need to be highly skilled to support the women. However, there is a paucity of research focusing on staff experiences around sensitive issues such as mother–child separation. This study aims to understand the challenges faced by staff and how these might be addressed.
Design/methodology/approach
This qualitative interview study explored the views and experiences of 24 prison-based staff in England working with female prisoners separated from their infants.
Findings
Staff emphasised the challenges of working with separated mothers, specifically the emotional impact of this work, and the impact of the wider criminal justice system on their sense of agency.
Originality/value
A focus on the experience of separation highlights the broader problem of incarcerating women in general. Reducing the number of mother–child separations would mitigate the impact on both women and staff.
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Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these…
Abstract
Purpose
Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens.
Design/methodology/approach
This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma’s Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean’s primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change.
Findings
The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time.
Practical implications
This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve the blood draw process for a 1,000 bed tertiary care teaching hospital. The blood draw process is a standard process used in hospitals to collect blood chemistry and hematology information for clinicians. The methods used in this case study demonstrated valuable and practical applications of process improvement methodologies that can be used for any hospital process and/or service environment.
Originality/value
While this is not the first case study that has demonstrated the use of continuous process improvement methodologies to improve a hospital process, it is unique in the way in which it utilizes the strength of the project focussed approach that adheres more to the structure and rigor of Six Sigma and relied less on the speed of lean. Additionally, the application of these methodologies in healthcare is emerging research.