David Birnbaum and William Scheckler
Patient safety and medical error have become prominent issues following publication of Institute of Medicine reports in the USA. The USA, Australia, and now Canada have followed a…
Abstract
Patient safety and medical error have become prominent issues following publication of Institute of Medicine reports in the USA. The USA, Australia, and now Canada have followed a national “medical error” studies path that uses language rejected by the interdisciplinary group of experts described previously in this column, and continues using methods considered seriously flawed as well as incomplete by noteworthy hospital epidemiologists. Preliminary review of British hospitals by similar methods also has been published. Proven and more cost‐effective surveillance methods are pertinent methods developed over the past several decades by hospital epidemiology and infection control professionals who have more experience, but this heritage has been ignored in recent patient safety juggernauts. It is time to question why retrospective physician chart review approaches remain in vogue with national bodies to enumerate adverse patient outcomes and attribute them with “medical error” when better alternatives exist.
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Eric S. Williams, Thomas R. Konrad, William E. Scheckler, Donald E. Pathman, Mark Linzer, Julia E. McMurray, Martha Gerrity and Mark Schwartz
Health care organizations may incur high costs due to a stressed, dissatisfied physician workforce. This study proposes and tests a model relating job stress to four intentions to…
Abstract
Health care organizations may incur high costs due to a stressed, dissatisfied physician workforce. This study proposes and tests a model relating job stress to four intentions to withdraw from practice mediated by job satisfaction and perceptions of physical and mental health. The test used a sample of 1735 physicians and generally supported the model. Given the movement of physicians into increasingly bureaucratic structures, the clinical work environment must be effectively managed.
David William Stoten, Stanley Oliver, Jim O’Brien and Callum Garland Swain
The purpose of this paper is to explore how students interact with discussion boards, given different cultural backgrounds. The paper draws from the literature on activity theory…
Abstract
Purpose
The purpose of this paper is to explore how students interact with discussion boards, given different cultural backgrounds. The paper draws from the literature on activity theory, communities of practice, as well as learning theory to inform a discussion on students use of discussion boards.
Design/methodology/approach
Students from a range of nationalities studying in London were issued with a five-point Likert scale questionnaire that was supplemented with opportunities for students to elaborate on their thoughts through the use of open response comment boxes. In addition to qualitative analysis, statistical analysis using the Kruskal-Wallis test was undertaken to investigate the degree to which national background influenced the use of discussion boards. Students were divided into four groups (British, European, Asian and African) for the purpose of analysis.
Findings
The findings tentatively echo earlier work (Hofstede) on how cultural/national factors impact on how people approach work/study. In this case, differences between African and Asian students were most apparent in a number of interesting areas.
Research limitations/implications
This study is limited by the sample size and time constraints involved. The data were drawn from 70 students. Future student intake will be added to this cohort to build up the sample and test preliminary findings.
Practical implications
This paper infers that teachers should be actively aware of how nationality/cultural background may impact on how students learn and engage with information technology during the learning process.
Originality/value
This paper contributes to the work on learning in diverse learning communities and how information technology can contribute to a learning community.
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Mehmet Tolga Taner and Bulent Sezen
The purpose of this study is to show how the principles of Six Sigma can be applied to the high turnover problem of doctors in medical emergency services and paramedic backup.
Abstract
Purpose
The purpose of this study is to show how the principles of Six Sigma can be applied to the high turnover problem of doctors in medical emergency services and paramedic backup.
Design/methodology/approach
Six Sigma's define‐measure‐analyse‐improve‐control (DMAIC) is applied for reducing the turnover rate of doctors in an organisation operating in emergency services. Variables of the model are determined. Explanatory factor analysis, multiple regression, analysis of variance (ANOVA) and Gage R&R are employed for the analysis.
Findings
Personal burnout/stress and dissatisfaction from salary were found to be the “vital few” variables. The organisation took a new approach by improving its initiatives to doctors' working conditions. Sigma level of the process is increased. New policy and process changes have been found to effectively decrease the incidence of turnover intentions. The improved process is gained, standardised and institutionalised.
Originality/value
This study is one of the few papers in the literature that elaborates the turnover problem of doctors working in the emergency and paramedic backup services.