Françoise Cluzeau, Peter Littlejohns, Jeremy Grimshaw and Gene Feder
There is anecdotal evidence of a plethora of guidelines developed throughout the NHS. A national survey was carried out between March and June 1995 to identify the number of…
Abstract
There is anecdotal evidence of a plethora of guidelines developed throughout the NHS. A national survey was carried out between March and June 1995 to identify the number of clinical guidelines produced in the UK in the clinical areas of coronary heart disease, asthma, breast cancer, lung cancer and depression. The response to the survey ranged from 95% (interest groups) to 10% (Ministry of Defence and prison hospitals). Four hundred and seventy two guidelines were identified in the survey. Most had been produced locally, only 21 guidelines were classified as national. Results confirm that there is a proliferation of guidelines in most parts of the UK. The survey illustrates the difficulties involved in conducting a UK survey of this kind, and highlights the need for national guideline coordination.
Marlene Westland, Jeremy Grimshaw, Jim Maitland, Maureen Campbell, Edna Ledingham and Ellie Mcleod
Reports a qualitative study of practice managers’ roles and responsibilities in eight practices in the Grampian region of Scotland. Observes wide variations in the roles and…
Abstract
Reports a qualitative study of practice managers’ roles and responsibilities in eight practices in the Grampian region of Scotland. Observes wide variations in the roles and responsibilities of managers associated with the size and fundholding status of the practice. Notes that larger practices had better developed management structures allowing the managers to delegate tasks and undertake a more proactive planning and executive role, and that medium and smaller practices had less well developed management structures and managers were more likely to act as practice administrators with limited autonomy. Concludes that practice managers are playing an increasingly important role in general practice. Also that the influential role of the practice manager in the development of practice policies and the transfer of administrative responsibilities from the partners to the manager have all contributed to a change in general practitioners’ perceptions of the practice manager.
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Paula Whitty, Ruth Thomas and Jeremy Grimshaw
Discusses the feasibility of disseminating and implementing guidelines in routine practice, informed by discussions with senior actors in the field of guidelines implementation…
Abstract
Discusses the feasibility of disseminating and implementing guidelines in routine practice, informed by discussions with senior actors in the field of guidelines implementation. Comments about the lack of protected budgets to support guideline dissemination and implementation strategies and common strategies of using “soft money” or resources for specific initiatives to support such activities. The “opportunity costs” of strategies need to be considered. In addition there are implications for the implementation of the NHS information strategy. For clinical governance as a whole, not only is it likely that widespread cultural change is required, but also the capacity of the system still needs considerable expansion if sufficient educational activities are to become routine.
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Jeremy Grimshaw and Hermione Youngs
Surveys a 50 per cent sample of Scottish practices (stratified by healthboard area), concerning whether they had a practice manager and who hadresponsibility for practice…
Abstract
Surveys a 50 per cent sample of Scottish practices (stratified by health board area), concerning whether they had a practice manager and who had responsibility for practice management tasks. The overall response rate was 73 per cent, with 63 per cent of responding practices employed a practice manager. Reports the findings from practices employing a manager, and reveals marked variations in levels of managers pay and responsibility. The development of practice management structures varied with only 85 per cent of practices holding regular practice management meetings. The results suggest that practices which previously coped without a manager have recognized the need for one as the complexity of practice administration increases and that the traditional career path of managers involving internal promotion is changing.
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Anastasia Zabaniotou, Aigli Tsirogianni, Monica Cardarilli and Massimo Guarascio
Gender competence as part of engineering education can better prepare men and women to work on sustainable solutions that benefit entire societies. This chapter describes the…
Abstract
Gender competence as part of engineering education can better prepare men and women to work on sustainable solutions that benefit entire societies. This chapter describes the framework and lessons learned of a community of practice (CoP) for gender equality facilitated by the Mediterranean Engineering Schools Network. Faculty and students from Mediterranean European, North African and Middle Eastern countries came together in this CoP, which was supported by the TARGET project, to develop a practical plan using a reflexive approach. The transfer of knowledge between generations is achieved by using participatory learning processes, facilitating mindful awareness, widening experiences, deepening understandings and building a gender-sensitive mindset. Students embarked on the journey to become change agents. The process led to the consolidation of gender equality knowledge, competence building and the development of change agents for gender equality. This CoP can inspire other institutions to undertake a participatory path towards gender equality – at local, regional, or global level.
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Monica Stolt Pedersen, Anne Landheim, Merete Møller and Lars Lien
Audit and feedback (A&F) often underlie implementation projects, described as a circular process; i.e. an A&F cycle. They are widely used, but effect varies with no apparent…
Abstract
Purpose
Audit and feedback (A&F) often underlie implementation projects, described as a circular process; i.e. an A&F cycle. They are widely used, but effect varies with no apparent explanation. We need to understand how A&F work in real-life situations. The purpose of this paper, therefore, is to describe and explore mental healthcare full A&F cycle experiences.
Design/methodology/approach
This is a naturalistic qualitative study that uses four focus groups and qualitative content analysis.
Findings
Staff accepted the initial A&F stages, perceiving it to enhance awareness and reassure them about good practice. They were willing to participate in the full cycle and implement changes, but experienced poor follow-up and prioritization, not giving them a chance to own to the process. An important finding is the need for an A&F cycle facilitator.
Practical implications
Research teams cannot be expected to be involved in implementing clinical care. Guidelines will keep being produced to improve service quality and will be expected to be practiced. This study gives insights into planning and tailoring A&F cycles.
Originality/value
Tools to ease implementation are not enough, and the key seems to lie with facilitating a process using A&F. This study underscores leadership, designated responsibility and facilitation throughout a full audit cycle.
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Minna Pikkarainen, Laura Kemppainen, Yueqiang Xu, Miia Jansson, Petri Ahokangas, Timo Koivumäki, He Hong Gu and Julius Francis Gomes
Covid has increased the usage of multisided digital platforms. For companies, this has become a business opportunity. Data usage on platforms requires that platform companies…
Abstract
Purpose
Covid has increased the usage of multisided digital platforms. For companies, this has become a business opportunity. Data usage on platforms requires that platform companies co-create services for common customers. In this case, the target is not to make the same value proposition but rather to use the resources such as data, knowledge, technology, or institutions in a complementary manner. Platforms are characterized as a combination of hardware and software including standards, interfaces, and rules making it possible for different ecosystem players to complement and interact in the ecosystem. Current ecosystems include several platforms that do not work without resource integration. The purpose of this study is to increase understanding what do we mean by resource complementarity in service ecosystems.
Design/methodology/approach
This study was done via an in-depth qualitative case study in which a health service ecosystem co-creating technological surgery innovation was used as a unit of analysis.
Findings
The authors’ findings suggest that key resource capabilities, to enable complementarity in service ecosystems, are motivation, knowledge, skills, data and complementary designed technology components.
Research limitations/implications
The authors’ study increases theoretical understanding of what does one mean by construct of resource complementarity.
Practical implications
From a managerial perspective, it is shown that organizations need to develop adaptive capabilities to utilize internal and external competencies and resources and enable co-creative processes within the service ecosystem.
Originality/value
Very few empirical studies in the marketing literature have focused on multi-sided digital platforms and their resource complementarity in the data-driven healthcare ecosystem settings.
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This paper looks at facilities management (FM) in the wider context of the social, economic and political changes that are taking place at the end of the twentieth century. It…
Abstract
This paper looks at facilities management (FM) in the wider context of the social, economic and political changes that are taking place at the end of the twentieth century. It argues that the core of FM relates to managing the changes that are taking place in the relationship between organisations, their employees and their facilities, all of which are being fundamentally altered by external forces. It pleads for a greater understanding of the issues raised by the debate around postmodernism and the impact they have had on the development of FM to date and will have on its future.
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This paper aims to report findings from an evaluation of the Strengthening Families Programme 10‐14 (UK) (SFP 10‐14 UK), focusing on the strategies used to recruit families into a…
Abstract
Purpose
This paper aims to report findings from an evaluation of the Strengthening Families Programme 10‐14 (UK) (SFP 10‐14 UK), focusing on the strategies used to recruit families into a universal prevention intervention, the approach taken to group composition, and the experiences of participating families.
Design/methodology/approach
Methods comprised interviews with programme coordinating team members, a focus group with programme facilitators, focus groups with parents and young people, observation of programme sessions and coordinator visits to families, and analysis of programme questionnaires.
Findings
Paying attention to group composition and the needs of families with challenges holds promise in terms of reach and acceptability, delivery fidelity, enabling intended psycho‐social programme processes and promoting positive changes in parenting and family communication.
Originality/value
First, the paper examines the development of strategies for recruiting participants, which has been identified as a key implementation challenge. Second, it explores approaches for managing group composition and dynamics in family‐based programmes. While much has been written about the development of group norms and peer learning processes in interventions for young people, less has been written about how group dynamics work in programmes involving both parents and young people and the implications for implementation fidelity.
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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 industry, their…
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.