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Article
Publication date: 7 December 2020

Annie K. Lewis, Nicholas F. Taylor, Patrick W. Carney and Katherine E. Harding

Long waitlists in outpatient clinics are a widely recognised problem. The purpose of this paper is to describe and report the impact of a waitlist reduction strategy for an…

379

Abstract

Purpose

Long waitlists in outpatient clinics are a widely recognised problem. The purpose of this paper is to describe and report the impact of a waitlist reduction strategy for an epilepsy clinic.

Design/methodology/approach

This observational study described the local impact of a methodical approach to tackling a long waiting list, using targeted strategies supported by a modest additional budget. The interventions were described using the template for intervention description and replication (TIDieR).

Findings

Over an eight-month period, the waitlist for the epilepsy clinic was reduced from 599 to 24 patients without increasing the number of days until the next available appointment. Most referrals were removed from the waitlist without an appointment. Auditing revealed a high proportion of patients no longer required the service or referrals remained on the waitlist due to administration error. A short-term increase in clinic capacity of 51 extra appointments met the needs of the remaining waiting patients. The additional project funding invested in this process was AUD $10,500 and a time-limited amount of extra work was absorbed by using existing clinic resources.

Practical implications

This waitlist reduction strategy resulted in a very small waitlist for the epilepsy clinic, which is now well placed to trial further interventions with the aim of sustaining the service with minimal waiting times. Not every referral on the waitlist, particularly the very long waiters, required an appointment. Other outpatient clinics may be able to apply this process to reduce their waitlists using a modest budget.

Originality/value

Although there are reports of successful waitlist reduction, few report the intervention in detail. Use of the TIDieR in reporting enables the intervention to be appraised or adapted to other settings where long waitlists are problematic. Considerations related to implementation of policy are discussed and in this case, a locally led and executed change management strategy was a key to achieving the result.

Details

Journal of Health Organization and Management, vol. 35 no. 1
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 7 August 2024

Annie K. Lewis, Nicholas F. Taylor, Patrick W. Carney and Katherine E. Harding

Interventions that improve timely access to outpatient health services are essential in managing demand. This process evaluation aimed to describe the implementation, mechanism of…

40

Abstract

Purpose

Interventions that improve timely access to outpatient health services are essential in managing demand. This process evaluation aimed to describe the implementation, mechanism of impact and context of an intervention to reduce waiting for first appointments in an outpatient epilepsy clinic.

Design/methodology/approach

The UK Medical Research Council framework was used as the theoretical basis for a process evaluation alongside an intervention trial. The intervention, Specific Timely Appointments for Triage (STAT), is a data-driven approach that combines a one-off backlog reduction strategy with methods to balance supply and demand. A mixed methods process evaluation synthesised routinely collected quantitative and qualitative data, which were mapped to the domains of implementation, mechanisms of impact and contextual elements.

Findings

The principles of the STAT model were implemented as intended without adaptation. The STAT model reached all patients referred, including long waiters and was likely generalisable to other medical outpatient clinics. Mechanisms of impact were increased clinic capacity and elimination of unwanted variation. Contextual elements included the complexity of healthcare systems and the two-tier triage practice that contributes to prolonged waiting for patients classified as non-urgent.

Originality/value

This process evaluation shows how a data-driven strategy was applied in a medical outpatient setting to manage demand. Improving patient flow by reducing waiting in non-urgent, outpatient care is a complex problem. Understanding how and why interventions work is important for improved timeliness of care, and sustainability of public health services.

Details

Journal of Health Organization and Management, vol. 38 no. 8
Type: Research Article
ISSN: 1477-7266

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Book part
Publication date: 27 October 2016

Alexandra L. Ferrentino, Meghan L. Maliga, Richard A. Bernardi and Susan M. Bosco

This research provides accounting-ethics authors and administrators with a benchmark for accounting-ethics research. While Bernardi and Bean (2010) considered publications in…

Abstract

This research provides accounting-ethics authors and administrators with a benchmark for accounting-ethics research. While Bernardi and Bean (2010) considered publications in business-ethics and accounting’s top-40 journals this study considers research in eight accounting-ethics and public-interest journals, as well as, 34 business-ethics journals. We analyzed the contents of our 42 journals for the 25-year period between 1991 through 2015. This research documents the continued growth (Bernardi & Bean, 2007) of accounting-ethics research in both accounting-ethics and business-ethics journals. We provide data on the top-10 ethics authors in each doctoral year group, the top-50 ethics authors over the most recent 10, 20, and 25 years, and a distribution among ethics scholars for these periods. For the 25-year timeframe, our data indicate that only 665 (274) of the 5,125 accounting PhDs/DBAs (13.0% and 5.4% respectively) in Canada and the United States had authored or co-authored one (more than one) ethics article.

Details

Research on Professional Responsibility and Ethics in Accounting
Type: Book
ISBN: 978-1-78560-973-2

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Book part
Publication date: 10 May 2017

Maya Manian

As numerous scholars have noted, the law takes a strikingly incoherent approach to adolescent reproduction. States overwhelmingly allow a teenage girl to independently consent to…

Abstract

As numerous scholars have noted, the law takes a strikingly incoherent approach to adolescent reproduction. States overwhelmingly allow a teenage girl to independently consent to pregnancy care and medical treatment for her child, and even to give up her child for adoption, all without notice to her parents, but require parental notice or consent for abortion. This chapter argues that this oft-noted contradiction in the law on teenage reproductive decision-making is in fact not as contradictory as it first appears. A closer look at the law’s apparently conflicting approaches to teenage abortion and teenage childbirth exposes common ground that scholars have overlooked. The chapter compares the full spectrum of minors’ reproductive rights and unmasks deep similarities in the law on adolescent reproduction – in particular an undercurrent of desire to punish (female) teenage sexuality, whether pregnant girls choose abortion or childbirth. It demonstrates that in practice, the law undermines adolescents’ reproductive rights, whichever path of pregnancy resolution they choose. At the same time that the law thwarts adolescents’ access to abortion care, it also fails to protect adolescents’ rights as parents. The analysis shows that these two superficially conflicting sets of rules in fact work in tandem to enforce a traditional gender script – that self-sacrificing mothers should give birth and give up their infants to better circumstances, no matter the emotional costs to themselves. This chapter also suggests novel policy solutions to the difficulties posed by adolescent reproduction by urging reforms that look to third parties other than parents or the State to better support adolescent decision-making relating to pregnancy and parenting.

Details

Studies in Law, Politics, and Society
Type: Book
ISBN: 978-1-78714-344-9

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Book part
Publication date: 26 January 2022

Katherine C. Cotter

Globalization introduces new challenges related to increased levels of diversity and complexity that organizations cannot meet without capable global leaders. Such leaders are…

Abstract

Globalization introduces new challenges related to increased levels of diversity and complexity that organizations cannot meet without capable global leaders. Such leaders are currently lacking, so a theory-based approach to global leader development is needed. A critical intermediary outcome that enables competent global leadership performance is global leader self-complexity, defined by the number of unique leader identities contained within a leader's self-concept (self-differentiation) and the extent to which the identities are integrated with the leader's sense of self (self-integration). This research aims to generate and test a theory of the development of global leader self-complexity through identity construction during international experiences. In Study 1, I gathered qualitative data through retrospectively interviewing 27 global leaders about identity-related changes following their international experiences. Using a grounded theory approach, I developed a theoretical model of global leader identity construction during international experiences, which I empirically tested using quantitative data in Study 2. Specifically, I tested the hypothesized relationships through structural equation modeling with cross-sectional survey data from a sample of 610 global leaders. Findings from both studies indicate global leader identity construction during international experiences primarily occurs through interacting with locals and local culture over a sustained period, motivated by appreciation of cultural differences and resulting in increased global leader self-complexity. These results advance understanding of the global leader self-complexity construct (i.e., what develops) and global leader development processes (i.e., how it develops). Additionally, the findings have practical implications for global leader development initiatives.

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Book part
Publication date: 5 February 2016

Donald Tomaskovic-Devey and Dustin Avent-Holt

After multiple decades stumbling in the status attainment wilderness, the sociological study of inequality is now cultivating a new garden: the workplace generation of…

Abstract

After multiple decades stumbling in the status attainment wilderness, the sociological study of inequality is now cultivating a new garden: the workplace generation of inequalities. While our theories have long focused on contextually embedded social relations – often in production – as generating inequality, our methods have lagged, focusing instead on individual status attainment, abstracted from social relations including those at work. In this chapter, we outline first how we got into this mess, and then advocate a principled comparative methodological framework for studying the organizational generation of durable inequalities. We highlight the particular contribution of Randy Hodson to the original critique of individualistic status attainment research and his role in developing alternative methodologies, some of which we think should be further developed today.

Details

A Gedenkschrift to Randy Hodson: Working with Dignity
Type: Book
ISBN: 978-1-78560-727-1

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Details

Transformative Leadership in Action: Allyship, Advocacy & Activism
Type: Book
ISBN: 978-1-83909-520-7

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Article
Publication date: 9 March 2015

Katherine Pollard, Anne-Laure Donskoy, Pamela Moule, Christine Donald, Michelle Lima and Cathy Rice

A growing literature reports the benefits and challenges of patient and public involvement (PPI) in research; nevertheless, understanding PPI in research design remains…

2265

Abstract

Purpose

A growing literature reports the benefits and challenges of patient and public involvement (PPI) in research; nevertheless, understanding PPI in research design remains under-developed. The purpose of this paper is to report learning experiences from involving service users as research partners in two projects that developed and evaluated guidelines for good practice in this regard. The main objective was to evaluate these guidelines.

Design/methodology/approach

PPI research guidelines were developed through five workshops involving service users/patients, carers, health and social care professionals/managers and academics. Using a participatory qualitative approach, these guidelines were evaluated through mapping them against the two service user research partners’ experience within another project.

Findings

The guidelines were found to be fit for purpose, as they allowed problems to be easily identified and reassurance that required standards were being met. Both academic and service user research partners learned and gained relevant skills. Two service user research partners also found their daily living skills unexpectedly enhanced by project participation.

Originality/value

The PPI guidelines, the authors developed were produced by consensus involving several stakeholders. Service users involved as research partners in the project experienced unanticipated personal benefits.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 2
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 August 1933

THE recruitment, training and payment of librarians are matters of import, not only to the youngest entrant into this work, but also to established librarians and to the public…

36

Abstract

THE recruitment, training and payment of librarians are matters of import, not only to the youngest entrant into this work, but also to established librarians and to the public. Although training was initiated forty years ago by the then chief librarians of libraries, it has in recent years become a very intimate concern of library assistants and of parents and others in charge of young folk who are considering librarianship as their possible career. After thirty years of experiment, with minor changes, the Library Association syllabus has now been completely remodelled. We have also reached a stage when we can consider to some extent, although not adequately, the effect upon the profession of our whole‐time library school of university rank. The various phases of the work must therefore be of great interest to every reader of The Library World; and this is sufficient justification for the special attention which the subject receives in this number. The first question must always be the economic and human one. Is the profession sufficiently large, and of enough importance, to justify parents in allowing lads or girls, who have gone through a secondary or even university training, to devote themselves to the somewhat protracted study which is prescribed for the work? Then, again, is the training now placed before the would‐be aspirant to library work a wise training? Is it too special, too technical, too scholarly; indeed, is the library authority, whoever and wherever it may be, asking too much for what most people regard as the very simple work of managing and distributing and exploiting books?

Details

New Library World, vol. 36 no. 4
Type: Research Article
ISSN: 0307-4803

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Article
Publication date: 22 June 2012

Dalit Yassour‐Borochowitz

Ten years have elapsed since the author was a doctoral student and conducted a study on the life stories of abusive men, about which the author writes in the present…

1116

Abstract

Purpose

Ten years have elapsed since the author was a doctoral student and conducted a study on the life stories of abusive men, about which the author writes in the present autoethnography. The research was submitted and earned the author her PhD; the findings were written in a book published in 2003, and the author also had articles published abroad. And yet, not one word of what the author relates here was reported to her supervisor, nor did it appear in any of the publications dealing with that study. This paper seeks to address these issues.

Design/methodology/approach

In this autoethnography the author describes some episodes that occurred while she was conducting this research and raises some questions regarding feminist research and the power relations between a female researcher and male participants – questions such as “Could it have been less abusive?”, “Why did I not write all this as part of my reflection on myself and my research process?”, “Why did it take me so long to be able to talk about it in a professional forum?”, “Does it happen to every researcher who studies men?”, “Can it happen again?” and “Does it lie somewhere in the seductive part of female interviewer‐male participant relationships?”.

Findings

In light of the episodes described, the paper will discuss the dilemmas of being a woman and a feminist researcher, vulnerable to some male research participants.

Originality/value

The question of a woman researcher's vulnerability is scarcely described in research methodology articles and books.

Details

Equality, Diversity and Inclusion: An International Journal, vol. 31 no. 5/6
Type: Research Article
ISSN: 2040-7149

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