Stuart Barson, Robin Gauld, Jonathon Gray, Goran Henriks, Christina Krause, Peter Lachman, Lynne Maher, M. Rashad Massoud, Lee Mathias, Mike Wagner and Luis Villa
The purpose of this paper is to identify five quality improvement initiatives for healthcare system leaders, produced by such leaders themselves, and to provide some guidance on…
Abstract
Purpose
The purpose of this paper is to identify five quality improvement initiatives for healthcare system leaders, produced by such leaders themselves, and to provide some guidance on how these could be implemented.
Design/methodology/approach
A multi-stage modified-Delphi process was used, blending the Delphi approach of iterative information collection, analysis and feedback, with the option for participants to revise their judgments.
Findings
The process reached consensus on five initiatives: change information privacy laws; overhaul professional training and work in the workplace; use co-design methods; contract for value and outcomes across health and social care; and use data from across the public and private sectors to improve equity for vulnerable populations and the sickest people.
Research limitations/implications
Information could not be gathered from all participants at each stage of the modified-Delphi process, and the participants did not include patients and families, potentially limiting the scope and nature of input.
Practical implications
The practical implications are a set of findings based on what leaders would bring to a decision-making table in an ideal world if given broad scope and capacity to make policy and organisational changes to improve healthcare systems.
Originality/value
This study adds to the literature a suite of recommendations for healthcare quality improvement, produced by a group of experienced healthcare system leaders from a range of contexts.
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John Pickles, Elaine Hide and Lynne Maher
The purpose of this paper is to describe a study which aims to provide an alternative approach to clinical governance. This involves patients in redesigning services based on…
Abstract
Purpose
The purpose of this paper is to describe a study which aims to provide an alternative approach to clinical governance. This involves patients in redesigning services based on their actual experiences of health services. This will be of interest to front line health care staff and public and patient involvement leads.
Design/methodology/approach
The paper illustrates Experience Based Design (EBD) as a structured, formal methodology with clearly defined roles, actions and timescales. A case study approach is used to describe the implementation of this model in a District General Hospital.
Findings
This study demonstrates how three theoretical components of good design: functionality, engineering and aesthetics can be used as a framework to improve performance, safety and governance and in addition, actual experience of the service for patients and staff.
Research limitations/implications
The case study approach used has provided a good range of learning and transferable information; however, the results are currently based on a single site.
Practical implications
The use of the EBD approach will ensure that healthcare services truly reflect the needs of patients and carers based on their specific experience. It provides a mechanism whereby patients' views contribute fully to the change process leading to safer, more effective and reliable care. This approach will require the application of the non‐clinical competencies included in the Medical Leadership Competency Framework and specific health and wellbeing dimensions in the Knowledge and Skills Framework.
Originality/value
This paper offers a new model that can be incorporated into service redesign. The model enables greater understanding of clinical governance as described by patients through narrative of their actual experiences.
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Mark Mugglestone, Lynne Maher, Nick Manson and Helen Baxter
The purpose of this paper is to provide an overview of a structured improvement process that is used in all programmes of work of the NHS Institute for Innovation and Improvement…
Abstract
Purpose
The purpose of this paper is to provide an overview of a structured improvement process that is used in all programmes of work of the NHS Institute for Innovation and Improvement (NHS Institute).
Design/methodology/approach
This paper outlines the background to the development of the improvement process, specifically how learning from the domains of new product development, user centred design and innovation and creativity have been incorporated into the process.
Findings
There are key elements of evidence and experience that can be taken from other domains and incorporated into a structured approach to healthcare improvement.
Practical implications
An improvement process is outlined that could be used as a basis for any healthcare improvement effort, and will help to ensure the development of better solutions more quickly.
Originality/value
This paper introduces a process that will help anyone interested in improving healthcare create better solutions to the challenges they face in shorter timescales.
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Abstract
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John C. Cross and Bruce D. Johnson
Attempts to theorize the relationship between the informal and the illegal sectors of the economy. States that there are significant behavioural similarities. Proposes an emergent…
Abstract
Attempts to theorize the relationship between the informal and the illegal sectors of the economy. States that there are significant behavioural similarities. Proposes an emergent paradigm based on dual labour market theory to explain the similarites and differences in order to guide future research in each area. Applies the theory to the production and marketing of crack cocaine and shows how the model helps us to understand issues of exploitation and risk makagement within the drug market.
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The purpose of this paper is to explain how student‐written diaries and journals serve as a specifically feminist pedagogy for teaching feminist economics, thereby challenging the…
Abstract
Purpose
The purpose of this paper is to explain how student‐written diaries and journals serve as a specifically feminist pedagogy for teaching feminist economics, thereby challenging the lecture‐based techniques used to teach and uphold the mainstream, market‐fundamentalist paradigm.
Design/methodology/approach
The approach involves the author's observations and experiences using student‐written diaries to teach a feminist economics course.
Findings
Student‐written diaries have the potential to dislodge both the market‐fundamentalist economics paradigm and the lecture‐based teaching method that dominate the undergraduate economics curriculum. Student‐written diaries are especially useful in teaching feminist economics courses which strive to elevate women's economic status and/or to reduce the androcentric bias in economics. The paper describes how student‐written diaries are used to achieve both of these goals and to create a more inclusive classroom culture, while simultaneously challenging market fundamentalism.
Originality/value
The paper offers a new pedagogical technique to be used for teaching feminist economics courses and for countering lecture‐based courses that focus on market fundamentalism.