Naomi Ward and Jonathan Broadhurst
Describes the approach developed by the authors in using total quality management philosophies and techniques to address the issues and problems arising from IT service provision…
Abstract
Describes the approach developed by the authors in using total quality management philosophies and techniques to address the issues and problems arising from IT service provision. Outlines IT service quality issues and discusses MARQUIS (Managing Requirements and Quality in Services), which can be used to specify users′ requirements and develop service products to fulfil these requirements. Provides a Service Code of Practice (SCOP), and suggests that both it and MARQUIS will be of great benefit to the IT industry and its customers in years to come.
Details
Keywords
Ebba Sjögren and Karin Fernler
The paper problematizes previous research on accountingisation, where the role of accounting in determining the scope of professional work is understood in relation to a…
Abstract
Purpose
The paper problematizes previous research on accountingisation, where the role of accounting in determining the scope of professional work is understood in relation to a professional/economic dichotomy and a model of episodic change. The purpose of this paper is to investigate everyday professional work in established new public management (NPM) settings, and proposes a new conceptual framework to analyze the role of accounting therein. The aim is to enable future investigations into how, when and where a situated “bottom line” emerges, by conceptualizing professional work as a process of calculation.
Design/methodology/approach
Qualitative data from case studies of two tertiary level geriatric organizations using observations of 33 employees and four interviews. Data related to patient discharge, and the management of the discharge processes, were analyzed.
Findings
Few visible trade-offs between distinctly professional or economic considerations were observed. Rather, the qualification of patients’ status and evaluation of their dischargeability centered on debates over treatment time. Time therefore operated as a situated “bottom line,” to which various other concerns were emergently linked in a process of calculation. Professional practitioners seldom explicitly evoke accounting concepts and technologies, but these were implicated in the ongoing translation of each patient into something temporarily stable, calculable and thus actionable for the professionals involved in their care. The study’s findings have implications for the conceptual understanding of professional work in established NPM settings.
Research limitations/implications
Case study research is context-specific and the role of accounting in professional work will vary due to the professional groups and accounting technologies involved.
Practical implications
The study’s findings have implications for how to influence professional behavior through interventions in the existing landscape of accounting technologies. The possibility to change behavior through the introduction or removal of individual accounting technologies is questioned.
Originality/value
To date, research on the role of accounting in determining the scope of professional work has assumed a professional/economic dichotomy and studied episodic change linked to accounting-oriented reforms. This paper analyses the role of accounting as an on-going process with emergent boundaries between professional and economic considerations.
Details
Keywords
Naomi Boyle, Diane Seddon and Gill Toms
Demand for care at home is growing because of the increase in life expectancy, an ageing population and the chronic conditions that often accompany longevity. Daytime care at home…
Abstract
Purpose
Demand for care at home is growing because of the increase in life expectancy, an ageing population and the chronic conditions that often accompany longevity. Daytime care at home services have been widely reported on, but less is known about overnight care at home. This paper aims to gather evidence about overnight social care for older adults in their homes.
Design/methodology/approach
Recent studies were identified through searches in three electronic databases. Studies published in English between January 2016 and June 2022 exploring overnight care at home for older adults were eligible for inclusion. An additional Google search identified home care services within the UK currently providing overnight support.
Findings
The review retrieved five relevant papers, highlighting the paucity of research in this area. A narrative review of the literature identified common themes that suggested domiciliary night care staff play an integral role in meeting the overnight care and support needs of older adults who wish to be cared for at home. Despite the limited evidence base in this area, the Google search for UK domiciliary services who provide overnight support identified several active programmes.
Originality/value
To the best of our knowledge, this is the first scoping review exploring the provision of overnight social care to older adults in their own homes. The review highlights the need for further research to inform commissioning and practice development.
Details
Keywords
Simon Turner, Angus Ramsay and Naomi Fulop
Using the example of medication safety, this paper aims to explore the impact of three managerial interventions (adverse incident reporting, ward‐level support by pharmacists, and…
Abstract
Purpose
Using the example of medication safety, this paper aims to explore the impact of three managerial interventions (adverse incident reporting, ward‐level support by pharmacists, and a medication safety subcommittee) on different professional communities situated in the English National Health Service (NHS).
Design/methodology/approach
Semi‐structured interviews were conducted with clinical and managerial staff from two English NHS acute trusts, supplemented with meeting observations and documentary analysis.
Findings
Attitudes toward managerial intervention differ by professional community (between doctors, nurses and pharmacists) according to their existing norms of safety and perceptions of formal governance processes.
Practical implications
The heterogeneity of social norms across different professional communities and medical specialties has implications for the design of organisational learning mechanisms in the field of patient safety.
Originality/value
The paper shows that theorisation of professional “resistance” to managerialism privileges the study of doctors' reactions to management with the consequent neglect of the perceptions of other professional communities.
Details
Keywords
Iain Snelling, Lawrence Adrian Benson and Naomi Chambers
The purpose of this study is to explore how trainee hospital doctors led work-based projects undertaken on an accredited development programme in England.
Abstract
Purpose
The purpose of this study is to explore how trainee hospital doctors led work-based projects undertaken on an accredited development programme in England.
Design/methodology/approach
This is a case study of a leadership programme for hospital-based specialty trainees. The programme included participants leading work-based projects which were submitted for academic accreditation. Accounts of 35 work-based projects were thematically analysed to explore how participants led their projects.
Findings
Leadership was often informal and based on a series of individual face-to-face conversations. The establishment of project teams and the use of existing communication processes were often avoided. The reasons for this approach included lack of opportunities to arrange meetings, fear of conflict in meetings and the personal preferences of the participants. The authors discuss these findings with reference to theory and evidence about conversations and informal leadership, highlighting the relevance of complexity theory.
Research limitations/implications
The data are limited and drawn from the best accounts written for a specific educational context. There is therefore limited transferability to the leadership work of hospital-based specialty trainees in general. Future research into medical leadership might explore the micro practices of leadership and change, particularly in informal settings.
Practical implications
Leadership development programmes for trainee hospital doctors might concentrate on developing skills of conversation, particularly where there are or may be perceived power imbalances. Exploring conversations within the theory of complex responsive processes should be considered for inclusion in programmes.
Originality/value
This paper adds some detail to the general understanding of learning leadership in practice.
Details
Keywords
Naomi Burns, Zina Alkaisy and Elaine Sharp
The purpose of this paper is to explore the attitudes and beliefs of doctors towards medication error reporting following 15 years of a national patient safety agenda.
Abstract
Purpose
The purpose of this paper is to explore the attitudes and beliefs of doctors towards medication error reporting following 15 years of a national patient safety agenda.
Design/methodology/approach
This is a qualitative descriptive study utilising semi-structured interviews. A group of ten doctors of different disciplines shared their attitudes and beliefs about medication error reporting. Using thematic content analysis, findings were reflected upon those collected by the same author of a similar study 13 years before (2002).
Findings
Five key themes were identified: lack of incident feedback, non-user-friendly incident reporting systems, supportive cultures, electronic prescribing and time pressures. Despite more positive responses to the benefits of medication error reporting in 2015 compared to 2002, doctors at both times expressed a reluctance to use the hospital’s incident reporting system, labelling it time consuming and non-user-friendly. A more supportive environment, however, where error had been made was thought to exist compared to 2002. The role of the pharmacist was highlighted as critical in reducing medication error with the introduction of electronic prescribing being pivotal in 2015.
Originality/value
To the authors’ knowledge, this is the first study to compare doctors’ attitudes on medication errors following a period of time of increased patient safety awareness. The results suggest that error reporting today is largely more positive and organisations are more supportive than in 2002. Despite a change from paper to electronic methods, there is a continuing need to improve the efficacy of incident reporting systems and ensure an open, supportive environment for clinicians.
Details
Keywords
Naomi Smith, Marianne Clark and Clare Southerton
The ‘fit healthy’ body has been invoked in popular discourse as far less vulnerable to communicable diseases like the novel coronavirus both in mainstream accounts of the pandemic…
Abstract
The ‘fit healthy’ body has been invoked in popular discourse as far less vulnerable to communicable diseases like the novel coronavirus both in mainstream accounts of the pandemic and in more fringe anti-vaccine discourse. Those opposed to vaccination argue the management of the body through diet and exercise allows for natural immune processes to manage COVID-19. This chapter interrogates anti-vaccine sentiment in Western countries such as Australia, Canada, the United Kingdom and the United States to demonstrate the pervasiveness of discourses that position the maintenance of a ‘fit healthy’ ideal body as an alternative to preventative medicine such as vaccines. Drawing on several key examples, this conceptual chapter explores the ways bodily ‘wellness’ became a part of vaccine hesitancy discourse during the pandemic, as risk is balanced through calculations of what vaccines might ‘do’ to a body and the body’s capacity to respond to illness.
Details
Keywords
Research suggests that the majority of forensic clients have significant personality difficulties. Providing quality nursing care to this client group is identified as…
Abstract
Research suggests that the majority of forensic clients have significant personality difficulties. Providing quality nursing care to this client group is identified as particularly difficult. This paper outlines how schema‐focused therapy has been introduced to nursing staff working with personality disordered clients in an in‐patient setting in order to enhance their practice with this client group. A brief overview is given of Young's (1994) schema‐focused therapy model and a detailed description of how this model has been incorporated into in‐house training and used to guide nursing treatment plans and individual nursing interventions. Although this strategy has not been formally evaluated, feedback suggests that both staff and patients believe that the quality of care provided since its introduction has improved significantly.
Lise Elliott and Naomi Chambers
This paper uses data from an ethnographic study of a group of NHS community nurses in England, to analyse their work using labour process theory. A theory influenced by Marxist…
Abstract
Purpose
This paper uses data from an ethnographic study of a group of NHS community nurses in England, to analyse their work using labour process theory. A theory influenced by Marxist thinking, which is concerned with the examination of the labour process. This study of the nurses’ work provides insights into their labour process, as well as proposing theoretical development relating to labour process theory.
Design/methodology/approach
The paper has been developed using data from an ethnographically oriented study of a group of community nurses. Data was produced from 140 h of field observations and also semi-structured interviews with six, community nurses. The data produced from field observations and interview transcripts were analysed thematically and theory building was developed inductively.
Findings
The analysis within this paper highlights two areas of the nurses’ work and both illustrate the theoretical difficulties raised, when using labour process as a tool for analysis, as well as its usefulness. These two areas of work are aspects of invisible work and feelings of joy and sorrow; analysis of both these areas supports a theorising of a distinct relationship between nurse and patient. That is, a relationship between worker and human product, which the paper argues should be accommodated within labour process theory.
Research limitations/implications
More research is required to understand the nature of the proposed social relation in production, particularly with reference to other types of worker, in other caregiving settings. As the demands on healthcare workers and other public sector workers are likely to remain consistently high, improved analytical tools to support research into the nature of caregiving work seem both prudent and timely.
Originality/value
Labour process theory is a useful (but often under-used and rather unfashionable) tool in the analysis of service-based, public sector work. This paper proposes a theoretical development within labour process theory, which would recognise a social relation in production between a worker and their human product, based on empirical data from a study of community nurses. This theoretical development has the potential to improve the usefulness of labour process theory in the analysis of caregiving labour.
Details
Keywords
Presents a special issue, enlisting the help of the author’s students and colleagues, focusing on age, sex, colour and disability discrimination in America. Breaks the evidence…
Abstract
Presents a special issue, enlisting the help of the author’s students and colleagues, focusing on age, sex, colour and disability discrimination in America. Breaks the evidence down into manageable chunks, covering: age discrimination in the workplace; discrimination against African‐Americans; sex discrimination in the workplace; same sex sexual harassment; how to investigate and prove disability discrimination; sexual harassment in the military; when the main US job‐discrimination law applies to small companies; how to investigate and prove racial discrimination; developments concerning race discrimination in the workplace; developments concerning the Equal Pay Act; developments concerning discrimination against workers with HIV or AIDS; developments concerning discrimination based on refusal of family care leave; developments concerning discrimination against gay or lesbian employees; developments concerning discrimination based on colour; how to investigate and prove discrimination concerning based on colour; developments concerning the Equal Pay Act; using statistics in employment discrimination cases; race discrimination in the workplace; developments concerning gender discrimination in the workplace; discrimination in Japanese organizations in America; discrimination in the entertainment industry; discrimination in the utility industry; understanding and effectively managing national origin discrimination; how to investigate and prove hiring discrimination based on colour; and, finally, how to investigate sexual harassment in the workplace.