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1 – 10 of 10David Walton and Seraphim J. Rose Patel
Whole system working is critical to improving health and social care services while using scarce resources more efficiently and this article aims to look at the urgent need to…
Abstract
Purpose
Whole system working is critical to improving health and social care services while using scarce resources more efficiently and this article aims to look at the urgent need to develop measures for it. It seeks to describe the development of a simple, practical, set of measures for benchmarking and analysing local use of key whole system resources as the basis for discussion and planning. Practical and usable tools are needed urgently as national measures are not available at present and key resource decisions need to be made now.
Design/methodology/approach
The paper looks at a simple framework for looking at integration in localities and some proposed measures as the basis for discussion. It describes the development and application of a simple, practical set of measures to use locally in the absence of a national set. It uses nationally available, comparable measures wherever possible to minimise work. It briefly describes how the comparative data enables localities to identify key differences in use of resources and outcomes and areas for improvement.
Findings
Taking a whole system, whole person approach and applying it across localities provides a useful framework to help local health and social care systems focus on improving patient outcomes while reducing unnecessary costs – particularly unnecessary use of high cost institutional care. The measures including the Audit Commission whole system measures identified key issues re different use of resources, costs and outcomes between localities. This article looks ahead to the implications of greater personalisation of services and the need to develop more effective information systems based on the individual patient which allow more rigorous measurement of service effectiveness including outcomes as well as activity.
Practical implications
In the absence of national measures of whole system integration, this paper describes how a simple, practical framework and measures were developed to analyse use of resources and identify key areas for improvement. It can be used by localities to provide a quick benchmark of use of resources and outcomes (especially whole system use of expensive institutional resources) to support value for money and service effectiveness work. It describes how it worked in practice and looks at how information systems could be further developed in line with personalisation to allow ongoing improvement based on individual outcomes, costs and service effectiveness.
Originality/value
This study describes the need to develop whole system measures to show the effectiveness of moves towards integration. In the absence of national measures, it describes the development of a simple set of local whole system outcome measures based on a framework based on recent work on whole system integration. The paper uses both health and social care evidence and summarises key elements that work. It shows how the measures have been applied in practice in localities as a first step in a local system improvement programme.
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Paul Whelan, Tresa Andrews, Seraphim Patel and Alex Lewis
In the UK there has been a shift over the last decade towards the setting of targets by commissioning or regulatory bodies so that health services provide improved levels of care…
Abstract
In the UK there has been a shift over the last decade towards the setting of targets by commissioning or regulatory bodies so that health services provide improved levels of care. For mental health services this has occurred in three phases: phase one related to simple key performance indicators (for example collection of patients' diagnostic codes); phase two placed greater emphasis on more meaningful clinical outcome data; the third and most recent phase placed prominence on patient‐focused data collection. We report the development and preliminary findings of a piloting of a patient‐related outcome measure (PROM) and patient‐related experience measure (PREM) created specifically for older adult mental health services in Central and North West London NHS Foundation Trust. PROMs/PREMs are in keeping with an increased focus on patients' experience of health care, the provision of quality services and various key policies such as the recent government white paper Equity and Excellence: Liberating the NHS.
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David Walton, Michael Fullerton and Seraphim Patel
This paper seeks to discuss the collaborative development and piloting of joint user outcome measures for older adults with mental health problems (OAMH) and their carers. Outcome…
Abstract
Purpose
This paper seeks to discuss the collaborative development and piloting of joint user outcome measures for older adults with mental health problems (OAMH) and their carers. Outcome measures are crucial to measuring the impact of services on people's lives and are central to the new NHS and Adult Social Care (ASC) Outcome Frameworks.
Design/methodology/approach
The paper describes the development of a joint user outcome measure based on ASC User Experience Surveys (UES) and User Outcome Measures, and NHS Patient Reported Outcome Measures (PROMS) and Patient Reported Experience Measures (PREMS).
Findings
The aim was to supplement existing clinical outcome measures (HONOS65+) with holistic measures of the impact of services on the lives of patients, easy to administer, covering a range of health and social care outcomes and meeting both health and social care outcome requirements.
Originality/value
As far as is known this is one of the first tests of a joint patient reported experience and outcome measure. Such measures may enable joint services to: measure wider outcomes as well as clinical outcomes; meet the new focus on outcomes; and enable more systematic collection of outcome and effectiveness/Value for Money (VFM) data. There are also lessons about collaborative working and development.
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Madhavi P. Patil, Ashraf M. Salama, Jane Arnfield and Seraphim Alvanides
This article introduces the “YouWalk-YouReclaim” mobile application as a transformative tool aimed at co-assessing and enhancing campus environments in a post-pandemic context. It…
Abstract
Purpose
This article introduces the “YouWalk-YouReclaim” mobile application as a transformative tool aimed at co-assessing and enhancing campus environments in a post-pandemic context. It seeks to address the need for inclusive, dynamic and technology-driven spaces within university settings.
Design/methodology/approach
The study employs a comprehensive assessment framework through a case study at Northumbria University, Newcastle. It involves over 100 students from diverse fields who utilised the application to evaluate significant areas on campus, such as Student Central, Northumberland Road and the Northumbria Library. The methodology places emphasis on direct user engagement and the use of the application’s inbuilt-image library and visual documentation features.
Findings
The application effectively evaluated the functionality, spatial dynamics and user experiences across various campus spaces. Key findings include the importance of adaptability, personalised spaces and enhanced wayfinding to meet the evolving needs of the university community. The study also noted the potential of the app to facilitate multidimensional assessments and support user-centric improvements.
Practical implications
The findings suggest that institutions can leverage technology like the “YouWalk-YouReclaim” app to better understand and optimise their campus spaces, fostering more responsive, user-focused and sustainable environments. The study advocates continuous technological enhancements and user-centred assessments to cultivate efficient and enriching campus experiences.
Originality/value
This study is novel in its integration of digital technology with user-centred approaches to assess and enhance campus environments. By enabling real-time feedback and inclusive participation, “YouWalk-YouReclaim” exemplifies an innovative approach to campus space management.
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Seshadev Sahoo and Rishita Raj
The academic research into underpricing of initial public offerings (IPOs) offers many explanations, i.e. signalling, financial and market hypothesis. However, another set of…
Abstract
Purpose
The academic research into underpricing of initial public offerings (IPOs) offers many explanations, i.e. signalling, financial and market hypothesis. However, another set of information, namely, “Qualitative Factors” (along with financial and others), are largely reported by the issuing firms in the prospectus. However, to the best of the authors’ knowledge no such systematic study has been carried out on how firms’ qualitative factors impact the IPO valuation. This paper aims to addresses this gap.
Design/methodology/approach
Using a sample of 82 IPOs issued from 2014 to 2020, we investigate the issuing firm’s pattern of reporting qualitative factors. These qualitative factors are subjected to factor analysis. The authors classify all reported factors across firms into a few categories using principal component analysis. The authors also investigate the impact of these factors on IPO underpricing using OLS regression.
Findings
The authors find that the qualitative information relating to market leadership, established brand image and modern scalable information technology infrastructure significantly influences underpricing. The authors also document that market leadership and brand image are the influential reported quality factors that reduce underpricing. Moreover, location advantage, good customer relationship, established relationship with a client, track record of growth and profitability, experienced promoter and management team failed to influence underpricing.
Originality/value
The outcome of this piece of research offers additional signalling as an attestation of quality for the issue. The authors further argue that the amount of qualitative information disclosed by the managers in the prospectus to support the pricing should not be ignored.
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Kudret Demirli, Abdulqader Al Kaf, Mecit Can Emre Simsekler, Raja Jayaraman, Mumtaz Jamshed Khan and E. Murat Tuzcu
Increased demand and the pressure to reduce health-care costs have led to longer waiting time for patients to make appointments and during the day of hospital visits. The purpose…
Abstract
Purpose
Increased demand and the pressure to reduce health-care costs have led to longer waiting time for patients to make appointments and during the day of hospital visits. The purpose of this study is to identify opportunities to reduce waiting time using lean techniques and discrete-event simulation (DES).
Design/methodology/approach
A five-step procedure is proposed to facilitate the effective utilization of lean and DES to improve the performance of the Otolaryngology Head and Neck Surgery Outpatient Clinic at Cleveland Clinic Abu Dhabi. While lean techniques were applied to reduce the potential sources of waste by aligning processes, a DES model was developed to validate the proposed solutions and plan patient arrivals under dynamic conditions and different scenarios.
Findings
Aligning processes resulted in an efficient patient flow reducing both waiting times. DES played a complementary role in verifying lean solutions under dynamic conditions, helping to plan the patient arrivals and striking a balance between the waiting times. The proposed solutions offered flexibility to improve the clinic capacity from the current 176 patients up to 479 (without violating the 30 min waiting time policy) or to reduce the patient waiting time during the visit from the current 33 min to 4.5 min (without violating the capacity goal of 333 patients).
Research limitations/implications
Proposing and validating lean solutions require reliable data to be collected from the clinic and such a process could be laborious as data collection require patient and resource tracing without interfering with the regular functions of the clinic.
Practical implications
The work enables health-care managers to conveniently conduct a trade-off analysis and choose a suitable inter-arrival time – for every physician – that would satisfy their objectives between resource utilization (clinic capacity) and average patient waiting time.
Social implications
Successful implementation of lean requires a supportive and cooperative culture from all stakeholders involved.
Originality/value
This study presents an original and detailed application of lean techniques with DES to reduce patient waiting times. The adopted approach in this study could be generalized to other health-care settings with similar objectives.
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Surya Prakash, Satish Kumar, Gunjan Soni, Raj V. Mahto and Nitesh Pandey
This study aims to present an overview of leading research trends in the lean six sigma domain published in the International Journal of Lean Six Sigma (IJLSS) since its inception.
Abstract
Purpose
This study aims to present an overview of leading research trends in the lean six sigma domain published in the International Journal of Lean Six Sigma (IJLSS) since its inception.
Design/methodology/approach
The study analyses articles published between 2010 and 2019 in IJLSS using the bibliometric technique. The results of data analysis identify the most prolific authors, their affiliation, citation trends and highly cited articles from the journal. Further, a graphical analysis involving bibliographic coupling and co-citation analysis of the corpus enriches the investigation.
Findings
The results of the bibliometric analysis suggest that the number of IJLSS’s publications and citations grew markedly over time (from 4 citations in 2010 to nearly 1,324 in 2019). The organizational diversity and collaboration among authors publishing in IJLSS are trending upwards. Case study and focus group are the two most common research designs in publications. In the study, three major themes emerged: implementation of lean on business, integration of lean and six sigma and the effects of lean six sigma on businesses.
Practical implications
The study finding informs and educates practitioners and scholars about various qualitative research tools, applications and methods of implementing lean six sigma tools in different industry sectors.
Originality/value
The study uses bibliometric analysis to propose a novel categorization of research published in IJLSS and to report on the utilization of various lean tools in the journal. The study provides guidance for new future research besides offering a thorough introspection of the lean and six sigma domains.
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