Karen Parsley and Joanne Barnes
Over the recent past, a number of different approaches to qualityimprovement have been introduced to the field of health‐care delivery.Presents an overview of the approach…
Abstract
Over the recent past, a number of different approaches to quality improvement have been introduced to the field of health‐care delivery. Presents an overview of the approach developed at Brighton Health Care Trust. Outlines the strategic approach incorporating: the recognition of the need for staff education to enable them to participate fully in improving the quality of patient care; the identification of seven core components; the development of an educational package; and the development of a structure to support the implementation.
Details
Keywords
Rural schools have typically been strong on community but weak on professional learning. Their small size and geographical isolation have meant that much of the recent reform…
Abstract
Rural schools have typically been strong on community but weak on professional learning. Their small size and geographical isolation have meant that much of the recent reform movement focused on professional learning communities has passed them by. But there is no reason why rural educators cannot participate in professional learning networks (PLNs) and benefit from heightened levels of collegiality that can be experienced across schools. However, intentional design for deeper collaborative work and face-to-face connection is necessary for PLN members to reap the benefits from increased professional capital and teacher leadership opportunities. This chapter describes the work of the Northwest Rural Innovation and Student Engagement (NW RISE) network in the United States. NW RISE brings together rural educators in gatherings that take place every six months, helps them to form “job-alike” groups focused on academic subject matter or cross-contextual themes, and provides support for shared curriculum design. This chapter describes how rural educators have seized upon the resources in NW RISE to promote student engagement and to develop their professional capacity across the network’s schools.
Details
Keywords
Karen Ann Craig and Brandy Hadley
This paper aims to investigate the political cost hypothesis and the effects of political sensitivity-induced governance in the US bond market by using yield spreads from bonds…
Abstract
Purpose
This paper aims to investigate the political cost hypothesis and the effects of political sensitivity-induced governance in the US bond market by using yield spreads from bonds issued by a diverse sample of US government contractors.
Design/methodology/approach
Fixed effects regression analysis is used to test the relation between the political sensitivity of government contractor firms and their cost of debt.
Findings
Results illustrated that government contractors with greater political sensitivity are associated with larger yield spreads, indicating that bondholders require a premium when firms endure the costs of increased political oversight and the threat of outside intervention, reducing the certainty of future income. However, despite the overall positive impact of political sensitivity on bond yield spreads on average, the authors found that the additional government oversight is associated with lower spreads when the firm is facing greater repayment risk.
Practical implications
Despite the benefits of winning a government contract, this paper identifies a direct financial cost of increased political sensitivity because of additional firm oversight and potential intervention. Importantly, it also finds that this governance is valued by bondholders when faced with increased risk. Firms must balance their desire for government receipts with the costs and benefits of dependence on those expenditures.
Originality/value
This paper contributes to the literature in its exploration of political sensitivity as an important determinant of the cost of debt for corporate government contractors. Specifically, the authors document a significant risk premium in bond pricing because of the joint effects of the visibility and importance of government contracts to the firm.
Details
Keywords
The formulated proposals for this legal principle in the trade battern of the European Community have again appeared in the EEC draft Directive. It has been many years in coming…
Abstract
The formulated proposals for this legal principle in the trade battern of the European Community have again appeared in the EEC draft Directive. It has been many years in coming, indicating the extreme difficulties encountered in bringing some sort of harmony in the different laws of Member‐states including those of the United Kingdom, relating to the subject. Over the years there were periods of what appeared to be complete inactivity, when no progress was being made, when consultations were at a stand‐still, but the situation was closely monitored by manufacturers of goods, including food and drink, in the UK and the BFJ published fairly detailed reviews of proposals being considered — in 1979 and 1981; and even as recently as the last few months — in “Consumerism in the Community”, the subject was briefly discussed.
The purpose of this paper is to explore the appropriateness of the term “implementing into practice” when describing the way nurse managers attempt to ensure staff compliance with…
Abstract
Purpose
The purpose of this paper is to explore the appropriateness of the term “implementing into practice” when describing the way nurse managers attempt to ensure staff compliance with hospital policy.
Design/methodology/approach
A narrative exploration of an unexpectedly difficult interaction with a nurse concerning their non‐adherence to uniform policy, drawing on the theoretical frameworks of writers such as Mead, Stacey and Elias.
Findings
Personal and shared reflections on this surprising interaction have uncovered many layers of complexity, not only in an individual's adherence or non‐adherence to policy, but also in the whole process of determining and communicating the need for behavioural changes.
Originality/value
Though “implementing into practice” is commonly used in reference to the nurse manager's responsibility for compliance with hospital policy, the term is misleading and appears to derive from taken‐for‐granted assumptions about organisational systems and models of communication. The nurse manager cannot control staff behaviour; and while their intervention does have some influence on the outcome, they in turn are also influenced by ongoing processes of interaction and reflective adaptation that cannot be predicted. This article demonstrates how the behaviour of staff within an organisation is not directed by the nurse manager, but co‐created in continuous interactions through which every participant contributes to the shaping of complex factors that have the potential to influence the development of a policy as well as its degree of acceptance.
Details
Keywords
Fawad Ahmad, Michael Bradbury and Ahsan Habib
This paper aims to examine the association between political connections, political uncertainty and audit fees. The authors use various measures of political connections and…
Abstract
Purpose
This paper aims to examine the association between political connections, political uncertainty and audit fees. The authors use various measures of political connections and uncertainty: political connections (civil and military), political events (elections) and a general measure of political stability (i.e. a world bank index).
Design/methodology/approach
The authors measure the association between political connections, political uncertainty and audit fees. Audit fees reflect auditors’ perceptions of risk. The authors examine auditors’ business risk, clients’ audit and business risk after controlling for the variables used in prior audit fee research.
Findings
Results indicate that civil-connected firms pay significantly higher audit fees than non-connected firms owing to the instability of civil-political connections. Military-connected firms pay significantly lower audit fees than non-connected firms owing to the stable form of government. Furthermore, considering high leverage as a measure of clients’ high audit risk and high return-on-assets (ROA) as a measure of clients’ lower business risk, the authors interact leverage and ROA with civil and military connections. The results reveal that these risks moderate the relationship between political connection and audit fees. Election risk is independent of risk associated with political connections. General political stability reinforces the theme that a stable government results in lower risks.
Originality/value
The authors combine cross-sectional measures of political uncertainty (civil or military connections) with time-dependent measures (general measures of political instability and elections).
Details
Keywords
Noraishah Mohamed Nor, Suriati Sidek, Nurulwahidah Saad, Nurul Hazirah Jaafar and Nor Azwani Mohd Shukri
This paper aims to identify and explore the factors affecting type 2 diabetes mellitus (T2DM) patients' adherence to lifestyle change recommendations, with the guidance of the…
Abstract
Purpose
This paper aims to identify and explore the factors affecting type 2 diabetes mellitus (T2DM) patients' adherence to lifestyle change recommendations, with the guidance of the trans-theoretical model (stages of change).
Design/methodology/approach
This study was conducted in two parts. In Part A, 163 randomly selected participants were asked to complete a cross-sectional survey. Data regarding demographics, stages of change and levels of confidence to engage in lifestyle changes were collected. In Part B, in-depth interviews were conducted among 30 individuals, aged between 30 and 65 years, had been diagnosed with T2DM and had seen dietitian at least once. Purposive sampling was used to recruit participants with different sociodemographic characteristics.
Findings
Part A showed that most of the participants were in the pre-action group (60%), with a higher mean HbA1c (8.9%) as compared to the action group (40%) which had a mean HbA1c of 6.9%. Part B further revealed the pre-action group and action group identified four key themes concerning lifestyle changes adherence: stumbling block; self-care belief; knowledge implementation; and self-empowerment.
Practical implications
Health-care providers should identify patients' stages of change before lifestyle changes implementation.
Originality/value
This study highlighted that many factors might influence a T2DM patient's adherence to lifestyle change recommendations. Determining the stages of change and self-confidence of T2DM patients is needed to ascertain long-term adherence.