Search results

The purpose of this paper is to examine England’s Accident and Emergency (A&E) arm of the National Health Service (NHS). It considers the positive impact that Lean has had and Six-Sigma can have in A&E departments to improve the quality and reliability of the service offered, in an area that is facing performance challenges.

Independent variables average monthly temperature data (degrees Celsius) obtained from the Met Office and weekly A&E data, patient volume is analysed alongside the dependent variable, the percentage of patients seen in 4 h or less.

The model produced a robust positive impact when Lean Six-Sigma is adopted, increasing the likelihood of A&E dependents meeting their performance objective to see and treat patients in 4 h or less.

Further variables such as staffing levels, A&E admission type should be considered in future studies. Additionally, it would add further clarity to analyse hospitals and trusts individually, to gauge which are struggling.

Should the NHS further its understanding and adoption of Lean Six-Sigma, it is believed this could have significant improvements in productivity, patient care and cost reduction.

Productivity improvements will allow the NHS to do more with an equal amount of funding, therefore improving capacity and patient care.

Through observing A&E and its ability to treat patients in a timely fashion it is clear the NHS is struggling to meet its performance objectives, the recommendation of Six-Sigma in A&E should improve the reliability and quality of care offered to patients.

The purpose of this paper is to investigate England’s Accident and Emergency (A&E) portion of the National Health Service (NHS). This paper is based upon weekly published data from A&E trusts across England, spanning from November 2010 to December 2014.

Emphasis is placed on a number of variables; month (time of year), performance (patients seen in less than four hours), patient volume and exploring the relationship between these variables. A deductive approach has been selected as the most appropriate for this paper and the format of a correlational study. Lean will be discussed as a philosophy throughout this paper, as a means to improve the NHS.

The NHS’s success in reaching its 95 per cent performance objective has in a gradual downwards trend since the data started being published and the volume of patients seen in A&E is trending upwards. However, there is only a weak relationship between these variables, suggesting that peak in demand are effectively foretasted by the NHS and appropriate resources deployed to combat this. Additionally, there is a clear relationship between the time of year (month) and volume.

The data used are not broken down and are aggregated from A&E departments across the NHS in England. Therefore, outliers could be present that impact the data and results. Should outliers exist, these should be targeted for improvement or to be learnt from, depending on their ranking.

Should the NHS continue with their Lean transformation, it is believed that efficiency will improvement throughout the organisation.

Through the identification of volume trends better care and efficiency can be provided to patients visiting the A&E departments of the NHS.

This paper analyses data over the past four years which can be used to spot past trends and predict future trends, therefore smoothing the reliability and quality of the care offered to patients. This can be achieved through a Lean transformation and a flexible resourcing approach.

This chapter covers three main concepts: it provides an overview of supply chain management (SCM), introduces the concepts of procurement and what is entailed within this function, and explains how inventory is managed. In the first section, SCM is considered broadly but also in the context of hospitality. The key roles and objectives of SCM as well as the significance of supply chain risk and disruption are considered. In the second section, the concept of sourcing is discussed. Sourcing is a critical function in any organization: without this, an organization would cease to operate. The importance of supplier selection is explored, with methods to make the most appropriate selection and for subsequently managing suppliers. Finally, the third section focuses on how inventory management can be optimized. Concepts such as economic order quantity (EOQ) and ABC analysis are explored, along with alternatives to traditional inventory management methods.

Outlines a new method of discovering original documents related to management history. Uses seemingly insignificant statements in books, articles or original documents to locate documents not listed on any computer database or public archive records, but which are undiscovered in attics or basements. The method involves the use of sources not commonly used by management scholars: obituaries, wills, cemetery records, deeds, land‐ownership maps, city directories and court records. Provides two examples to illustrate the discovery of actual documents: (1) the discovery of ten years of correspondence between F.W. Taylor and S. Thompson on the time required to do work, and (2) new evidence on F.W. Taylor’s interest in high‐heat treatment of tool steel leading to high‐speed steel and in shovels and shovelling. Finally presents new evidence on Taylor’s secret agreement with Bethlehem Steel to give favourable testimony in a patent case in exchange for a free licence for the high‐speed steel process Taylor had sold to Bethlehem for more than $50,000 in 1901.

The purpose of this paper is to analyze the ethics of a specific communication strategy to support the contention that ethics needs to be an integrated operational consideration in the corporate communication planning process rather than an afterthought.

Using the marketing communication strategy referred to as disease branding as a case‐in‐point, the “Five Pillars of Ethics for Public Communication” provide a framework for analysis of the need for making ethics an operational consideration in planning.

Communication strategies attempted by organizations today are subject to public criticism. Disease branding, a prime example, is paradoxically a “non‐branded” approach to marketing pharmaceuticals directly to consumers. Pejoratively referred to as disease‐mongering, this promotion of diseases rather than drugs neatly side‐steps the increasing criticism and even legal obstacles that face or threaten to face direct‐to‐consumer advertising of branded, prescription drugs. It is an innovative, non‐traditional tactic that has been enormously successful in widening markets for specific drug preparations. Application of the “Five Pillars” for ethical analysis finds that this strategy fails to meet the acceptable ethical standard in four out of five.

This study is limited to the application of one approach to ethical evaluation, although it is one that encompasses a number of widely accepted standards for practice.

An ethical analysis using the “Five Pillars” can be implemented by any corporate communication professional as a litmus test for determining the ethics of strategies under development during the operational planning process.

This paper fills a gap in the information available to corporate communication professionals about how to operationalize ethics.

On March 1, 2001, Jessica Gallinelli, managing director of Bancroft Capital Management, heard surprising and somewhat disturbing news about the proposed bid by General Electric Company (GE) for Honeywell International Inc. Despite recent public assurances about the deal from GE's chairman and chief executive officer (CEO), John F. “Jack” Welch Jr., the antitrust regulatory authority of the European Commission (EC) announced it had initiated a review of the proposed merger. Gallinelli, whose fund owned a large stake in Honeywell, considered this major development and wondered whether Bancroft should alter its investment. Immediately, Gallinelli instructed her associate to provide background material on the merger, an assessment of the probability the merger would be approved by antitrust regulators in the U.S. and Europe, and valuation analyses to assist Gallinelli in assessing Bancroft's investment in Honeywell. She would need to decide quickly whether to hold or sell her fund's 10 million shares in Honeywell and short position of 10 million shares in GE. As a risk arbitrageur, she thought prices would respond rapidly to the EC's announcement. She remembered Jack Welch's confidence of five months earlier that this was the “cleanest deal you'll ever see,” and she wondered whether that was still the case.

Each year approximately 3,200 women have a stillbirth in the UK. Although national evidence-based guidance has existed since 2010, case reviews continue to identify suboptimal clinical care and communication with parents. Inconsistencies in management include induction and management of labour and the frequency of investigation after stillbirth. The paper aims to discuss these issues.

An audit of stillbirths was performed in 2014 in 13 maternity units in the North West of England, this confirmed variation in practice described nationally. An integrated care pathway (ICP) was developed from national guidelines to enable optimal care for the management of stillbirth, reduce variation, standardise investigations and coordinate patient-focussed care. This was launched in 2015 and updated in 2016 to resolve the issues that were apparent after implementation.

Each participating unit had commenced using the ICP by May 2015. Following implementation there were changes in care, most notably from diverse methods for the induction of labour to guideline-directed induction of labour. There were trends towards better care in terms of information given, choices offered, more appropriate analgesia in labour and improved post-delivery investigation for cause. Staff feedback about the ICP was positive.

The use of this ICP improved care for women who had a stillbirth and their families. Issues with implementing a changed care pathway meant that further iterations were required, ongoing improvement is expected following the refinement of the ICP.

ICPs have been used for various clinical conditions. However, this is the first example of their use in women who had a stillbirth.