Peter Littlejohns, Katharina Kieslich, Albert Weale, Emma Tumilty, Georgina Richardson, Tim Stokes, Robin Gauld and Paul Scuffham
In order to create sustainable health systems, many countries are introducing ways to prioritise health services underpinned by a process of health technology assessment. While…
Abstract
Purpose
In order to create sustainable health systems, many countries are introducing ways to prioritise health services underpinned by a process of health technology assessment. While this approach requires technical judgements of clinical effectiveness and cost effectiveness, these are embedded in a wider set of social (societal) value judgements, including fairness, responsiveness to need, non-discrimination and obligations of accountability and transparency. Implementing controversial decisions faces legal, political and public challenge. To help generate acceptance for the need for health prioritisation and the resulting decisions, the purpose of this paper is to develop a novel way of encouraging key stakeholders, especially patients and the public, to become involved in the prioritisation process.
Design/methodology/approach
Through a multidisciplinary collaboration involving a series of international workshops, ethical and political theory (including accountability for reasonableness) have been applied to develop a practical way forward through the creation of a values framework. The authors have tested this framework in England and in New Zealand using a mixed-methods approach.
Findings
A social values framework that consists of content and process values has been developed and converted into an online decision-making audit tool.
Research limitations/implications
The authors have developed an easy to use method to help stakeholders (including the public) to understand the need for prioritisation of health services and to encourage their involvement. It provides a pragmatic way of harmonising different perspectives aimed at maximising health experience.
Practical implications
All health care systems are facing increasing demands within finite resources. Although many countries are introducing ways to prioritise health services, the decisions often face legal, political, commercial and ethical challenge. The research will help health systems to respond to these challenges.
Social implications
This study helps in increasing public involvement in complex health challenges.
Originality/value
No other groups have used this combination of approaches to address this issue.
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Gagan Gurung, Carol Atmore, Robin Gauld and Tim Stokes
The purpose of this paper is to identify and describe the international and New Zealand (NZ) evidence for models of integrated ambulatory care and describe key implementation…
Abstract
Purpose
The purpose of this paper is to identify and describe the international and New Zealand (NZ) evidence for models of integrated ambulatory care and describe key implementation issues and lessons learnt.
Design/methodology/approach
A scoping review was conducted for published and grey literature on integrated care. Publications from 2000 to February 2019 that described integrated ambulatory care were included.
Findings
A total of 34 articles were included. Internationally and in NZ, the most common models of integrated care found were: transfer, relocation and joint working. The international literature showed that transferring care from hospitals to community and other integrated models of care between the primary–specialist interface increased access and convenience for patients. However, there was insufficient evidence of clinical and economic outcomes. Very few NZ-based studies reported on effectiveness of models of care. Key implementation issues were: no viable and sustainable funding, lack of infrastructure, lack of confidence, trust and communication between providers, increased workload and time and knowledge and skills gap to perform new roles. The NZ literature highlighted the need for an appropriate location for services, committed leadership, development of a governance group representing different provider groups, strong communication mechanisms, new workforce skills and overall change management.
Originality/value
The review provides an overview of key components of integrated care models in ambulatory settings and identifies some common elements across the models of care. The findings can inform the design and implementation of integrated ambulatory care in health systems.
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Adeel Akmal, Nataliya Podgorodnichenko, Richard Greatbanks, Jeff Foote, Tim Stokes and Robin Gauld
The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims…
Abstract
Purpose
The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.
Design/methodology/approach
A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).
Findings
The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.
Practical implications
The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.
Originality/value
This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.
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This chapter offers a brief overview of the ways in which death has been addressed in children’s picture books in a playful or light-hearted manner. The books here are a small…
Abstract
This chapter offers a brief overview of the ways in which death has been addressed in children’s picture books in a playful or light-hearted manner. The books here are a small purposive sample showing the ‘ordinary’ way, in which death can be dealt with in picture books rather than looking at books with a specific therapeutic intent. The concepts of ‘playfulness’ and also ‘carnival’ are explored before four books are analysed.
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This paper identifies and examine a divergence of philosophies and practice between corporate/traditional marketing (CTM) and entrepreneurial marketing (EM). The paper examines…
Abstract
Purpose
This paper identifies and examine a divergence of philosophies and practice between corporate/traditional marketing (CTM) and entrepreneurial marketing (EM). The paper examines the case of an entrepreneur who also possesses a deep understanding of CTM practices. The purpose of this paper is to learn which set of marketing practices entrepreneurs are likely to privilege.
Design/methodology/approach
This paper is an ethnographic investigation of a marketing entrepreneur: one who possesses a deep understanding of CTM and who is also a successful entrepreneur. Data collection and analysis included participant observation, multiple interviews, and interpretation of textual and video data.
Findings
Entrepreneurs with CTM expertise privilege elements of EM. Rather than relying on the traditional four Ps (product, price, place, and promotion), their marketing strategy and practice is reminiscent of the entrepreneurial four P's (purpose, practices, process, and people). Communication competency is foundational to successful EM.
Practical implications
Entrepreneurs are encouraged to assess their personal situations and identify ways to improve their organizational and interpersonal communication skills and personal contact network processes.
Originality/value
This paper provides a provocative look at how CTM theory and practice are superseded by the creativity, flexibility, and innovation of day‐to‐day entrepreneurship. The paper validates a framework for analysis of marketing practices specific to entrepreneurs.
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This paper examines events management as a Community of Practice (CoP) and to demonstrate that knowledge management and practice within events operate as a CoP. The paper adds to…
Abstract
Purpose
This paper examines events management as a Community of Practice (CoP) and to demonstrate that knowledge management and practice within events operate as a CoP. The paper adds to the events management literature which is currently superficial in considering events conceptually as a CoP.
Design/methodology/approach
An interpretive and inductive approach was adopted for the research which incorporated quantitative and qualitative methods undertaken in a United Kingdom setting. Twenty-five in-depth semi-structured interviews with event professionals were conducted and this was complemented by a survey of 215 event professionals.
Findings
The findings demonstrate that within the evolving events industry, as well as reflected in aspects of the academic literature, events can be depicted as a “domain” which connects event professionals to a “community”. The themes emerging revealed that there are modes of working, shared values and practices, a shared identity and a desire to work as a wider collective in order to maintain and enhance knowledge and practice, which are in keeping with a CoP framework.
Research limitations/implications
This study provides new insight on an under-researched area concerning knowledge and practice development within events management.
Originality/value
This is a novel study that considers how the emergent field of events management should be considered as a CoP. It addresses a gap in the literature pertaining to knowledge and practice creation within events management from a CoP perspective.
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P. Tim Martindell, Cheryl J. Craig and Chestin T. Auzenne-Curl
This chapter revolves around a Zoom conversation between Tim Martindell and Cheryl Craig to which Chestin T. Auzenne-Curl added field-based evidence and reflective comments. The…
Abstract
This chapter revolves around a Zoom conversation between Tim Martindell and Cheryl Craig to which Chestin T. Auzenne-Curl added field-based evidence and reflective comments. The exchange between Martindell and Craig had to do with how Tim facilitated the Writers in the Schools (WITS) writers in conjunction with Tina and Maryann who led the WITS Collaborative. The embedded snapshots and excerpts stemmed from the field notes we accumulated during the life of the project. The conversation discusses some of the fine points of facilitation as well as the boundary areas where what unfolds fringes on the unknown. Near the end, hope for the future is discussed.
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Ali Karakus, Tim Warburton, Mehmet Haluk Aksel and Cuneyt Sert
This study aims to focus on the development of a high-order discontinuous Galerkin method for the solution of unsteady, incompressible, multiphase flows with level set interface…
Abstract
Purpose
This study aims to focus on the development of a high-order discontinuous Galerkin method for the solution of unsteady, incompressible, multiphase flows with level set interface formulation.
Design/methodology/approach
Nodal discontinuous Galerkin discretization is used for incompressible Navier–Stokes, level set advection and reinitialization equations on adaptive unstructured elements. Implicit systems arising from the semi-explicit time discretization of the flow equations are solved with a p-multigrid preconditioned conjugate gradient method, which minimizes the memory requirements and increases overall run-time performance. Computations are localized mostly near the interface location to reduce computational cost without sacrificing the accuracy.
Findings
The proposed method allows to capture interface topology accurately in simulating wide range of flow regimes with high density/viscosity ratios and offers good mass conservation even in relatively coarse grids, while keeping the simplicity of the level set interface modeling. Efficiency, local high-order accuracy and mass conservation of the method are confirmed through distinct numerical test cases of sloshing, dam break and Rayleigh–Taylor instability.
Originality/value
A fully discontinuous Galerkin, high-order, adaptive method on unstructured grids is introduced where flow and interface equations are solved in discontinuous space.
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ZY Chen, Yahui Meng, Ruei-Yuan Wang and Timothy Chen
To prove the effectiveness of the proposed design method, this study aims to propose the Fisher equation and temperature cooling fins that control high-speed aerospace vehicles.
Abstract
Purpose
To prove the effectiveness of the proposed design method, this study aims to propose the Fisher equation and temperature cooling fins that control high-speed aerospace vehicles.
Design/methodology/approach
A new approach whereby the control of aerospace vehicles can be achieved by fuzzy controller and appropriate Navier–Stokes equations in this article. The design of the controller based on models of Navier–Stokes equations simplified complex mathematical simulations and approximations.
Findings
If the fuzzy controller cannot stabilize the system, the Navier–Stokes fuzzy function is injected into the system as a controller tool, and the system is asymptotically stabilized by adjusting the fuzzy parameters.
Originality/value
The simulation results show that if the tuning frequency is high enough, the fuzzy controller and fuzzy observer can create chaotic movements by adjusting the dither amplitude appropriately. The demonstration of the Fisher equation and the temperature-cooled fin control problem for high-speed aerospace vehicles has displayed the benefits of combining fuzzy control with the Navier–Stokes equation.