Jennifer Martin, Zuneera Khurshid, Gemma Moore, Michael Carton, John J. Fitzsimons, Colm Henry and Maureen A. Flynn
This paper describes a quality improvement project to improve oversight of quality at national board level using statistical process control (SPC) methods, complimented by a…
Abstract
Purpose
This paper describes a quality improvement project to improve oversight of quality at national board level using statistical process control (SPC) methods, complimented by a qualitative experience of patients and frontline staff. It demonstrates the application of the “Picture-Understanding-Action” approach and shares the lessons learnt.
Design/methodology/approach
Using co-design and applying the “Picture-Understanding-Action” approach, the project team supported the directors of the Irish health system to identify and test a qualitative and quantitative picture of the quality of care across the health system. A “Quality Profile” consisting of quantitative indicators, analysed using SPC methods was used to provide an overview of the “critical few” indicators across health and social care. Patient and front-line staff experiences added depth and context to the data. These methods were tested and evolved over the course of six meetings, leading to quality of care being prioritised and interrogated at board level.
Findings
This project resulted in the integration of quality as a substantive and prioritised agenda item. Using best practice SPC methods with associated training produced better understanding of performance of the system. In addition, bringing patient and staff experiences of quality to the forefront “people-ised” the data.
Originality/value
The application of the “Picture-Understanding-Action” approach facilitated the development of a co-designed quality agenda item. This is a novel process that shifted the focus from “providing” information to co-designing fit-for-purpose information at board level.
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Jennifer Martin, Maureen A. Flynn, Zuneera Khurshid, John J. Fitzsimons, Gemma Moore and Philip Crowley
The purpose of this study is to present a quality improvement approach titled “Picture-Understanding-Action” used in Ireland to enhance the role of healthcare boards in the…
Abstract
Purpose
The purpose of this study is to present a quality improvement approach titled “Picture-Understanding-Action” used in Ireland to enhance the role of healthcare boards in the oversight of healthcare quality and its improvement.
Design/methodology/approach
The novel and practical “Picture-Understanding-Action” approach was implemented using the Model for Improvement to iteratively introduce changes across three quality improvement projects. This approach outlines the concepts and activities used at each step to support planning and implementation of processes that allow a board to effectively achieve its role in overseeing and improving quality. This approach matured over three quality improvement projects.
Findings
The “Picture” included quantitative and qualitative aspects. The quantitative “Picture” consisted of a quality dashboard/profile of board selected outcome indicators representative of the health system using statistical process control (SPC) charts to focus discussion on real signals of change. The qualitative picture was based on the experience of people who use and work in health services which “people-ised” the numbers. Probing this “Picture” with collective grounding, curiosity and expert training/facilitation developed a shared “Understanding”. This led to “Action(s)” from board members to improve the “Picture” and “Understanding” (feedback action), to ask better questions and make better decisions and recommendations to the executive (feed-forward action). The Model for Improvement, Plan-Do-Study-Act cycles and a co-design approach in design and implementation were key to success.
Originality/value
To the authors’ knowledge, this is the first time a board has undertaken a quality improvement (QI) project to enhance its own processes. It addresses a gap in research by outlining actions that boards can take to improve their oversight of quality of care.
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Stacey Leavitt and Carly Adams
In recent decades, significant advances have been made at both the grassroots and professional levels of women's ice hockey in North America. Yet, despite recent achievements…
Abstract
In recent decades, significant advances have been made at both the grassroots and professional levels of women's ice hockey in North America. Yet, despite recent achievements, such as the establishment of ‘professional’ leagues, and compelling narratives of progress, athletes and league organisers still face significant challenges. The barriers women face, such as reduced access to resources and opportunity, lack of legitimacy, and league instability, and a continued reliance on relationships with men's sporting leagues, such as the National Hockey League, suggest that women's ice hockey is accommodated into the game in ways that reinforce and perpetuate systems of gender, reproducing a neoliberal notion of failure. Using Halberstam's (2011) notion of failure as the place from which reform and transformation can take place, we offer a critical reading of the (re)formation of the National Women's Hockey League and the developments in women's (semi)professional ice hockey in North America.
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Michelle L. Frisco, Molly A. Martin and Jennifer Van Hook
Social scientists often speculate that both acculturation and socioeconomic status are factors that may explain differences in the body weight between Mexican Americans and whites…
Abstract
Social scientists often speculate that both acculturation and socioeconomic status are factors that may explain differences in the body weight between Mexican Americans and whites and between Mexican Americans and Mexican immigrants, yet prior research has not explicitly theorized and tested the pathways that lead both of these upstream factors to contribute to ethnic/nativity disparities in weight. We make this contribution to the literature by developing a conceptual model drawing from Glass and McAtee’s (2006) risk regulation framework. We test this model by analyzing data from the 1999–2012 National Health and Nutrition Examination Survey (NHANES). Our conceptual model treats acculturation and socioeconomic status as risk regulators, or social factors that place individuals in positions where they are at risk for health risk behaviors that negatively influence health outcomes. We specifically argue that acculturation and low socioeconomic status contribute to less healthy diets, lower physical activity, and chronic stress, which then increases the risk of weight gain. We further contend that pathways from ethnicity/nativity and through acculturation and socioeconomic status likely explain disparities in weight gain between Mexican Americans and whites and between Mexican immigrants and whites. Study results largely support our conceptual model and have implications for thinking about solutions for reducing ethnic/nativity disparities in weight.
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Imagine the scene. A manager at a blue‐chip company has a heart‐to‐heart with his staff. They talk openly and freely, even admitting personal weaknesses and failings in the…
Abstract
Imagine the scene. A manager at a blue‐chip company has a heart‐to‐heart with his staff. They talk openly and freely, even admitting personal weaknesses and failings in the workplace. They develop such a rapport that before they know it they have unanimously agreed on suitable working practices and performance targets for the year. The result? At the year’s end they have doubled the company’s growth rate. This impressive story is an example of a growing number of extraordinary turnarounds facilitated by professional coaching.
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– The purpose of this paper is to present an overview of the current state of debates surrounding Open Access (OA) in non-STEM disciplines.
Abstract
Purpose
The purpose of this paper is to present an overview of the current state of debates surrounding Open Access (OA) in non-STEM disciplines.
Design/methodology/approach
This paper uses a selective literature review and discussion methodology to give a representative summary of the state of the art.
Findings
Non-STEM disciplines persistently lag behind scientific disciplines in their approach to OA, if the teleology towards open dissemination is accepted. This can be attributed to a variety of economic and cultural factors that centre on the problem of resource allocation with respect to quality.
Originality/value
This paper will be of value to policymakers, funders, academics and publishers. The original aspect of the paper pertains to the identification of an anxiety of irrelevance in the humanities disciplines and a focus on “quality” in Open-Access publishing debates.
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Virginia Quick, Kirsten W. Corda, Jennifer Martin-Biggers, Barbara Chamberlin, Donald W Schaffner and Carol Byrd-Bredbenner
The purpose of this paper is to create a series of 30-60-second short videos to promote improved food safety behaviors of middle school youth, determine the feasibility of…
Abstract
Purpose
The purpose of this paper is to create a series of 30-60-second short videos to promote improved food safety behaviors of middle school youth, determine the feasibility of disseminating the videos through peer networks, and measure their effects on food safety attitudes, perceived social norms, and behaviors of youth.
Design/methodology/approach
Food safety content specialists, learning experts, programmers, illustrators, project managers, instructional designers, scriptwriters, and stakeholders were involved in creation of the Don’t Be Gross short videos before evaluation by middle school youth (sixth to eighth grades). The experimental group (n=220) completed the following activities at about one-week intervals: pre-test, viewed videos, post-test, and follow-up test. The control group (n=112) completed the same activities at similar intervals but did not have access to the videos until after the follow-up test.
Findings
Controlling for grade and gender, linear mixed-effects models revealed significant time by group effects for participants’ perceived susceptibility to foodborne illness; intentions to perform recommended food safety behaviors approached significance. Additionally, compared to the pre-test, the experimental group perceived their friends as being significantly more confident in performing food safety behaviors at post- and follow-up tests. Google Analytics data revealed that the bounce rate from the home page of the videos was low (38 percent) suggesting that the videos were engaging.
Originality/value
The Don’t Be Gross videos were liked by youth and shared among their peers and may have the potential to promote positive food safety behaviors and intentions among youth.
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The National Labor Relations Act (NLRA) creates rights for covered employees, defines conduct that violates those rights, and deems that conduct an unfair labor practice. But…
Abstract
The National Labor Relations Act (NLRA) creates rights for covered employees, defines conduct that violates those rights, and deems that conduct an unfair labor practice. But while given broad remedial powers under the Act, the Board's options were curtailed by the Supreme Court's limit on the use of deterrence as an express remedial justification. The Board was left with a strongly make-whole, i.e., ex-post, focus to undo the consequences of a violation.
Put differently, the current NLRA remedies reflect a pay-or-play philosophy. The goal is restoration after the fact, using ex-post remedies to give parties the benefit or status quo that they expected. An actor willing to pay may use a cost–benefit analysis and strategically choose to violate the Act, accepting the make-whole remedies later. But the Act created ex-ante statutory rights, not agreed-upon contractual terms. By statutory enactment, employees are given something of value deemed worthy of protection. Assigning value to compliance with the law in the first instance not only prevents sometimes irreparable harm but also reaffirms the inherent value of the right itself.
The impact of the Board's limited remedies is therefore a broad value-driven one. Without ex-ante deterrence, the available ex-post make-whole remedial options make a normative statement about individuals' rights under the Act: those rights may not be inherently worth enough to incentivize legal compliance. The make-whole focus can imply that financial compensation for the portion of harm that can be calculated and “undoing” some nonfinancial effects is sufficient. There is little drive to deter infringement before the fact. By examining the remedial philosophy behind contrasting approaches in the common law of torts and contract, this Article asserts that the current remedial strictures and framework undermine both the Act and the worth of its rights in the eyes of the public and the employees who hold them.
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Lisa A. Keister, John McCarthy and Roger Finke
The association between religion and material well-being is fundamental to research on inequality and stratification. Broadly considered, this association includes questions about…
Abstract
The association between religion and material well-being is fundamental to research on inequality and stratification. Broadly considered, this association includes questions about how religious affiliation and religiosity are associated with work behaviors, education, income, wealth, and related family processes. Early social sciences debated if and how these traits and outcomes are related and offered important insight into the mechanisms that might explain empirical patterns (Simmel, 1997; Sombart, 1911; Weber, 1905/1930). However, the religious landscape and the mechanisms creating religion and well-being have both changed dramatically since the early days of the social sciences. The proliferation of Protestant denominations, the changing role of Catholics, and the increased presence of other religious traditions are beyond the scope of these early works. Moreover, the relationship between religion and stratification is no longer a function of large-scale shifts in the mode of production but rather reflects changing individual and group approaches to human capital, work, and saving. In the 1960s, sociologists revived these debates, but empirical challenges and a narrowing of the discussion to focus on Protestant–Catholic differences weakened and ultimately ended the literature's momentum (Broom & Glenn, 1966; Glenn & Hyland, 1967; Laumann, 1969; Lazerwitz & Rowitz, 1964; Lenski, 1961).