Organizational Change, Patient-Focused Care: An Australian Perspective

1995 ◽  
Vol 8 (3) ◽  
pp. 172-185 ◽  
Author(s):  
Jeffrey Braithwaite

Hospitals throughout the world are attempting to improve organizational performance through a variety of means. The focus in this paper is on a leading teaching hospital in Australia for a review of current management strategy. In a time of shrinking resources, management adopted a multi-faceted change management program including restructuring the organization, becoming more patient-focused via a product-line management approach and emphasising efficiency and cost-reduction measures. The next stage in management thinking is to place greater emphasis on patient-focused care. It is concluded this has the propensity to yield substantial further benefits, including improved financial and quality of care outcomes, in the Australian as well as the British and wider Organization for Economic Co-operation and Development (OECD) context. ‘Professionally, we have committed ourselves to creating caring environments that promote healing. We cannot meet this goal until we make a commitment to be patient-focused and give up being nurse-focused or facility-focused’ (Kerfort and LeClair, 1991). ‘In a customer-driven [organization], the distribution of roles is different. The organization is decentralized, with responsibility delegated to those who until now have comprised the order-obeying bottom level of the pyramid. The traditional, hierarchical corporate structure, in other words, is beginning to give way to a flattened, more horizontal structure’ (Carlzon, 1987).

2017 ◽  
Vol 4 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Diana Effendi

Information Product Approach (IP Approach) is an information management approach. It can be used to manage product information and data quality analysis. IP-Map can be used by organizations to facilitate the management of knowledge in collecting, storing, maintaining, and using the data in an organized. The  process of data management of academic activities in X University has not yet used the IP approach. X University has not given attention to the management of information quality of its. During this time X University just concern to system applications used to support the automation of data management in the process of academic activities. IP-Map that made in this paper can be used as a basis for analyzing the quality of data and information. By the IP-MAP, X University is expected to know which parts of the process that need improvement in the quality of data and information management.   Index term: IP Approach, IP-Map, information quality, data quality. REFERENCES[1] H. Zhu, S. Madnick, Y. Lee, and R. Wang, “Data and Information Quality Research: Its Evolution and Future,” Working Paper, MIT, USA, 2012.[2] Lee, Yang W; at al, Journey To Data Quality, MIT Press: Cambridge, 2006.[3] L. Al-Hakim, Information Quality Management: Theory and Applications. Idea Group Inc (IGI), 2007.[4] “Access : A semiotic information quality framework: development and comparative analysis : Journal ofInformation Technology.” [Online]. Available: http://www.palgravejournals.com/jit/journal/v20/n2/full/2000038a.html. [Accessed: 18-Sep-2015].[5] Effendi, Diana, Pengukuran Dan Perbaikan Kualitas Data Dan Informasi Di Perguruan Tinggi MenggunakanCALDEA Dan EVAMECAL (Studi Kasus X University), Proceeding Seminar Nasional RESASTEK, 2012, pp.TIG.1-TI-G.6.


Author(s):  
María- José Foncubierta-Rodriguez ◽  
Rafael Ravina-Ripoll ◽  
Eduardo Ahumada-Tello ◽  
Luis Bayardo Tobar-Pesantez

Since the end of the 20th century, economists have been attracted to the study of the economics of happiness (e.g., Singh, & Alexandrova, 2020; Crespo & Mesurado, 2015; Ferrer-i-Carbonell,2013). The use of the term happiness characterizes an essential volume of this bibliographical production as a synonym for the words satisfaction, well-being, or quality of life (Teixeira&Vasque, 2020; Carlquist et al., 2017). Under this umbrella, the culture of happiness management teaches us that a management model or direction oriented to the holistic search for happiness or job satisfaction of its employees is one of the essential axial pieces that organizations have to increase the commitment of their human capital, and therefore, their productivity and business performance (Ravina et al., 2019). Public administration employees are not exempt from this reality, a group that is characterized by job stability compared to private company employees. This article is dedicated to them. The era of Industry 4.0 is a period that is characterized, among other things, by the high precariousness of labor that is originated by the implementation of management models in advanced economies. This phenomenon is derived from the technological point of view by the automation and massive robotization of production processes and the supply chain. Together with the digitalization of companies, both factors are very present in the ecosystems of the Covid-19, and have come, perhaps, to stay in the future (Bragazzi, 2020; Ghadge et al., 2020). In line with the above, a more holistic examination of this issue seems likely to show that there is a keen interest among people to enter into Work mostly in public administrations, in search of a permanent contract for their entire working life. As is known, this is especially true in countries with high unemployment levels, such as Spain. Its unemployment rate is 20.1% in mid-2020. In the collective imagination of these individuals, there is the conviction that this type of Work constitutes ambrosia of eudaimonic happiness, job security, and quality of life, especially at present, in times of the Covid-19 pandemic (Fernández-Urbano, & Kulic, 2020). In this sense, it should be noted that in the last decades of the 21st century, there has been a growing interest in researching public employees' job satisfaction (e.g., Ryu&Bae, 2020; Steijn &Van der Voet, 2019; Luechinge et al., 2010). Most of the studies carried out on this scientific topic to date show empirically that public sector workers are happier than individuals in the private sphere. It's basically due to the intrinsic benefits (flexibility, vacation, or family reconciliation, among others) that this type of government entity offers concerning for-profit organizations (e.g., Lahat&Ofek, 2020; Sánchez-Sánchez, & Puente, 2020; Danzer,2019). In this context, this article aims to examine, as a priority in the era of Industry 4.0, whether there are observed differences in the levels of congratulations between human capital working in the private sector and that working in the public sector in Spain, by analyzing a set of variables that define positions: hours, salary, stability, promotion, and stress. Finally, we must indicate, on the one hand, that the choice of this spatial framework is motivated by the scarce literature investigating the happiness of Spanish public employees in an economy with high levels of youth unemployment (Núñez-Barriopedro et al., 2020). On the other hand, the results achieved in this study may be useful in the future for the implementation of public policies aimed at significantly promoting the welfare of working citizens through the happiness management approach (Ravina-Ripoll et al., 2019), or for taking this management concept to private companies to increase the motivation of their employees (Foncubierta-Rodríguez & Sánchez-Montero, 2019). Keywords: Happiness, human resources, Industry 4.0, public sector.


1995 ◽  
Vol 32 (1) ◽  
pp. 33-39
Author(s):  
E. Alfakih ◽  
S. Barraud ◽  
Y. Azzout ◽  
B. Chocat

The implementation of alternative techniques in urban stormwater management is a difficult problem in terms of choice, design, construction, and operating. We applied a quality management approach to try and have a better understanding of these techniques. The quality of an alternative technique in urban stormwater management is defined; the factors that lead to failures were identified and analysed. In order to reduce these factors, tools were developed, and measures that allow the achievement of the necessary standard of quality are suggested. In this article, all the illustrations refer to the porous pavement technique.


2021 ◽  
Vol 20 (3) ◽  
pp. 1-25
Author(s):  
Elham Shamsa ◽  
Alma Pröbstl ◽  
Nima TaheriNejad ◽  
Anil Kanduri ◽  
Samarjit Chakraborty ◽  
...  

Smartphone users require high Battery Cycle Life (BCL) and high Quality of Experience (QoE) during their usage. These two objectives can be conflicting based on the user preference at run-time. Finding the best trade-off between QoE and BCL requires an intelligent resource management approach that considers and learns user preference at run-time. Current approaches focus on one of these two objectives and neglect the other, limiting their efficiency in meeting users’ needs. In this article, we present UBAR, User- and Battery-aware Resource management, which considers dynamic workload, user preference, and user plug-in/out pattern at run-time to provide a suitable trade-off between BCL and QoE. UBAR personalizes this trade-off by learning the user’s habits and using that to satisfy QoE, while considering battery temperature and State of Charge (SOC) pattern to maximize BCL. The evaluation results show that UBAR achieves 10% to 40% improvement compared to the existing state-of-the-art approaches.


2020 ◽  
Vol 93 (6) ◽  
pp. 343-350
Author(s):  
Molly O. Regelmann ◽  
Rushika Conroy ◽  
Evgenia Gourgari ◽  
Anshu Gupta ◽  
Ines Guttmann-Bauman ◽  
...  

<b><i>Background:</i></b> Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. <b><i>Summary:</i></b> The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. <b><i>Key Messages:</i></b> With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.


Kidney Cancer ◽  
2021 ◽  
pp. 1-14
Author(s):  
Elizabeth E. Ellis ◽  
Edward Messing

Background: Our goal is to review current literature regarding active surveillance (AS) of small renal masses (SRMs) and identify trends in survival outcomes, factors that predict the need for further intervention, and quality of life (QOL). Methods: We performed a comprehensive literature search in PubMed and EMBASE and identified 194 articles. A narrative summary was performed in lieu of a meta-analysis due to the heterogeneity of selected studies. Results: Seventeen articles were chosen to be featured in this review. Growth rate (GR) was not an accurate predictor of malignancy, although it was the characteristic most commonly used to trigger delayed intervention (DI). The mean 5-year overall survival (OS) of all studies was 73.6% ±1.7% for AS groups. The combined cancer specific survival (CSS) for AS is 97.1% ±0.6% , compared to 98.6% ±0.4% for the primary intervention (PI) groups, (p = 0.038). Conclusions: Short and intermediate-term data demonstrate that AS with the option for DI is a management approach whose efficacy (in terms of CSS) approaches that of PI at 5 years, is cost effective, and prevents overtreatment, especially in patients with significant comorbidities.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Suja S Rajan ◽  
Jessica N Wise ◽  
Marquita Decker-palmer ◽  
Thanh Dao ◽  
Cynthia Salem ◽  
...  

Introduction: The American Heart Association (AHA) recently raised the bar on timely treatment of acute ischemic stroke (AIS) with intravenous (IV) alteplase, by recommending door-to-needle times of 30 minutes or less for 50% or more of the AIS patients. Our study looks at the effectiveness of this new standard, by examining the effect of varying door-to-needle times on efficiency and quality of care, and clinical outcomes. Methods: Our study examined 762 AIS patients treated with IV alteplase in a large academic health system from 2015-2018, and compared their outcomes after treatment within 30, 45 and 60 minutes of arrival. The outcomes compared were: 1) Efficiency of care outcome - Length of stay (LOS); 2) Quality of care outcomes - Inpatient mortality and Disability at discharge; 3) Clinical outcomes - Discharge and 90-day modified Rankin Scale (mRS), and Post-alteplase (24 hr) NIH Stroke Scale (NIHSS). Adjusted logistic and linear regression analyses were used, after controlling for baseline patient socio-demographic and clinical characteristics. Results: Based on the adjusted regression analyses (Table 1), being treated within 30 minutes of arrival reduced the average LOS by 1.3 days (p-value: 0.02), but did not affect the quality of care outcomes. Similarly, being treated within 45 minutes of arrival reduced LOS by 0.9 days (p-value: 0.04). Being treated within 60 minutes of arrival did not affect LOS, but reduced the odds of inpatient mortality by 68% (p-value: 0.00), and disability at discharge by 29% (p-value: 0.08). Being treated within 30 minutes of arrival was associated with better mRS and NIHSS scores as compared with being treated within 45 or 60 minutes. Conclusion: Quicker IV alteplase treatment significantly improved efficiency of care and clinical outcomes. Quality of care outcomes did not improve beyond the 60 minute door-to-needle threshold. This study provides evidence supporting AHA’s new recommendation of 30 minutes or less door-to-needle time.


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