Internal Service Research Articles

Profiling referrals to a trauma support service: needs and outcomes for staff working in a secure adult developmental disorder pathway

PurposeForensic health-care workers are frequently exposed to behaviours that challenge and traumatic material, with notably high levels in developmental disorder (DD) services. The provision of support is key in alleviating distress and improving work functioning. This paper aims to incite clarity on whether staff in DD services are more likely to access trauma support. The prevailing needs and outcomes for this population are also explored.Design/methodology/approachData was extracted retrospectively from a database held by an internal trauma support service (TSS) for staff working in a secure psychiatric hospital. Overall, 278 permanent clinical staff accessed the TSS between 2018 and 2020, 102 (36.7%) of whom worked in an adult DD forensic inpatient service.FindingsStaff working in DD services were over-represented in referrals to the TSS with a greater number of referrals per bed in DD services than in non-DD services (0.94 vs 0.33). DD staff were comparatively more likely to access support for non-physical, psychologically traumatic experiences. Psychological needs and outcomes following support were comparable between staff across services.Practical implicationsThe findings highlight the more frequent need for trauma support of staff in forensic inpatient DD settings. Embedding a culture of safety and openness, and establishing appropriate and responsive models of staff support reflect key priorities for inpatient DD health-care providers, for the universal benefit of the organisation, workforce and service users.Originality/valueThis study offers novel insight into levels of access to support for staff working with people with DDs.

Believe to go the extra mile: the influence of internal CSR initiatives on service employee organizational citizenship behaviors

PurposeLeveraging the power of corporate social responsibility (CSR) is strategically important to corporations. Although various studies have explored the positive effects of CSR, few have been devoted to the investigation of CSR related to service employees from the internal marketing perspective. Therefore, this study fills this research gap by developing a conceptual model based on social influence theory to explain how internal CSR initiatives affect service employees' attitudes and behaviors.Design/methodology/approachThis study develops and empirically tests a theoretical model examining the impact of internal CSR initiatives (i.e. internal dissemination of and management support for CSR) on service employees' attitudes toward an organization (i.e. employee–company identification and value congruence), which ultimately enhance their organizational citizenship behaviors (OCBs) toward customers, other employees and the organization. Survey data from 271 frontline employees of service firms actively involved in CSR-related activities were examined with structural equation modeling.FindingsThe results suggest that perceived internal dissemination of and management support for CSR affect service employees' citizenship behaviors toward customers, other employees and the organization through the mediation of employee–company identification and value congruence.Practical implicationsInternal CSR initiatives are highly related to service employees' various OCBs that are beneficial to improving the service performance of firms. Therefore, it is imperative for companies to devote attention to internal marketing dissemination while promoting CSR. In addition, as managers' attitudes and behaviors trickle down to employees, service supervisors' support of CSR activities plays a significant role in forming employee perceptions of a firm's CSR dedication.Originality/valueThis study represents one of the first to view internal CSR initiatives as an effective internal marketing lever. Moreover, the relationship between internal CSR initiatives and service employees' OCBs – OCB toward customers, other employees and the organization – is proposed and tested with an empirical model, providing significant contributions.

Adapt to not just survive but thrive: resilience strategies of five-star hotels at difficult times

Purpose This research aims to explore the strategies and tactics taken by five-star hotels to create and sustain competitiveness at difficult times, the role of innovation among the initiatives taken and the factors that influence managers’ decision in selection of coping measures. Design/methodology/approach The research was conducted in two stages. The first stage focused on textual analysis of online news reports on luxury hotels’ coping strategies taken between 2013 and 2018. At the second stage, expert interviews were carried out with 25 managers of five-star hotels to obtain richer information of hotels’ responsive measures. The qualitative data were analyzed by thematic analysis. Findings The results revealed that five-star hotels in China made adjustment in physical resource management, human resource management, marketing mix, operation process and external relations to maintain competitiveness during difficult times. A model of hotel resilience was developed based on the findings. Innovation was imbedded in the responsive measures throughout these areas. Managers’ selection of coping measures was affected by the hotel’s organizational culture, location, brand image and competitors. Practical implications The model of hotel resilience serves as a useful reference to plan and select strategies and tactics to respond to similar external challenges. Hotel managers are recommended to embrace a variety of innovations directed at both internal management and customer service during challenging times. Originality/value To the best of the authors’ knowledge, this study is the first empirical research that systematically examines the measures taken by hotels during critical times to maintain competitiveness, linking these to contemporary post-Fordist operational trends.

How Does Employee Infusion Use of CRM Systems Drive Customer Satisfaction? Mechanism Differences Between Face-to-Face and Virtual Channels

To attain customer satisfaction, service firms invest significant resources to implement customer relationship management (CRM) systems to support internal customer service (CS) employees who provide service to external customers in both face-to-face and virtual channels. How CS employees apply sophisticated CRM systems to interact with customers and how the mechanisms through which their CRM usage affects customer satisfaction vary across service channels and bear important implications. We approach these issues by investigating the concept of infusion use, defined as CS employees’ assessment of the extent to which they use a CRM system to its fullest potential to best support their work in the CRM-enabled service interaction context. Drawing on the IS success framework and expectation confirmation theory, we first formulate a baseline model that explains the direct and indirect mechanisms through which CS employees’ infusion use of CRM systems leads to customers’ expectation confirmation, which in turn affects customers’ satisfaction. We then draw on the lenses of media richness and communication adaptation to theorize why these two mechanisms exert differential influence in face-to-face and virtual channels. We test the hypotheses by collecting multiwave data from CS employees, customers, and firm archives of a Fortune 500 telecom service firm. We find that (1) CS employee infusion use can directly contribute to customer expectation confirmation and indirectly do so through CS employees’ satisfaction with the system (i.e., user satisfaction), and (2) the direct mechanism plays a more critical role in the face-to-face channel, whereas the indirect mechanism is more important in the virtual channel. Our findings inform managers of the avenues through which employees’ infusion use promotes CRM-enabled service success across face-to-face and virtual service channels.

Australian public hospital inpatient satisfaction related to early patient involvement and shared decision-making in discharge planning.

BackgroundSurveys of hospital inpatient satisfaction may help develop actionable plans for quality improvement, and patients have preferred to give feedback during admission at the point of service compared to after discharge. However, patient satisfaction measurement has often been done by questionnaires post‐discharge, and without focussing on an Australian general internal medicine setting.AimsTo understand patients' perceptions of their admission experiences in an Australian public teaching hospital's general internal medicine unit, and to understand the opportunities for quality improvement.MethodsA prospective study of 50 inpatients of a general internal medicine unit at an Australian public teaching hospital was carried out using a patient satisfaction questionnaire given to patients on the day of discharge.ResultsPatients perceived deficits in early communication about discharge destination planning, and provision of written discharge instructions. Responses highlighted the importance of checking with patients to elicit further information that was not previously captured during initial history‐taking, patient‐centred communication to enable informed consent and decision making, use of language readily understandable to laypersons, and checking for patients' understanding of messages as communicated by the treating clinician.ConclusionsIn an Australian general internal medicine service, early involvement and shared decision‐making in discharge planning are valued by patients. Incorporating checking of patients' understanding of diagnoses, management, discharge instructions, and follow‐up plans into ward round routines may benefit patient satisfaction. This study stimulates further research into the use of a proforma to capture and check patients' understanding of discharge diagnoses and plans.

A Longitudinal Analysis of IT Outsourcing in Large Polish Organizations

Purpose: The purpose of the research was to determine the dynamics of the development of information technology outsourcing (ITO) in large organizations in Poland. The development of onshoring and offshoring was examined, the types and forms of services most commonly outsourced, the recipients of services within the organization, multisourcing, contract duration, method of payment, the impact of the Covid-19 pandemic on ITO, and the organization 's plans for ITO. Design/Methodology/Approach: Longitudinal methods (extracting over time, mapping, visualization) were used. A diagnostic survey was used to collect data on ITO, the research tool was a survey questionnaire. Data was collected using the CATI (Computer Added Telephone Interview) method in the periods January-February 2016 and January-February 2021. Each time, 200 large organizations in Poland participated in the research. The research problem concerned the dynamics of ITO development in Poland. The research questions included the determination of the dynamics of ITO development assessed from the client's side, the types and forms of services that are developing most dynamically, changes in the features of outsourcing contracts, the exchange of enterprises regarding ITO and the impact of the pandemic on ITO activities. Findings: The use of IT outsourcing in large organizations in Poland is growing, the rate of development dynamics by a big percent, especially in relation to offshoring. Outsourcing of more complex and business-critical activities and the use of cloud services are growing. Specialization and multi-sourcing are on the rise. Outsourcing contracts tend to be signed for a short period of time or the duration of the contract depends on the specifics of the project. However, there is a tendency to extend cooperation in outsourcing. The most common form of payment for services is a fixed price, although there is a trend towards other forms of payment. The COVID-19 pandemic had a weak but rather positive effect on the use of outsourcing. Companies plan to maintain the current relationship between internal and external services or expand ITO. These trends are expected to continue. Practical Implications: ITO suppliers may be advised to specialize their services and offer a wider range. Customers - prudent supplier selection and multi-sourcing. Originality/Value: The trends in the development of IT outsourcing in large organizations in Poland and changes occurring in outsourcing contacts were determined.

Metal-Organic Framework and Silver Nanowire Composites As Chemiresistive Gas Sensors Operating at the Percolation Threshold

The high internal service areas and consequent high numbers of sites for analyte adsorption of Metal-Organic Frameworks, MOFs, make them attractive candidates for gas sensing applications. Through synthesis of conductive MOFs we present a novel way of fabricating chemiresistive sensors able to detect NO2 gas in the low ppm range. A suspension of MOF and Ag nanowires in solution is prepared and drop cast onto paper to form the sensing medium. Sufficient conductive MOF is added to an insulating concentration of nanowires to give a conductive sample operating in the percolation region. The percolation region refers to the point before a thin film has formed where a small change in the number of conductive pathways leads to the largest change in material conductivity, as depicted in figure 1.1 By fabricating sensors operating in this region, a small interruption in the conductive network due to analyte interaction leads to a large change in measurable conductivity, allowing higher sensor sensitivities to be accessed.2 , 3 Moreover, the use of MOFs lends itself to the systematic synthesis of sensing media tailored to respond to desired gaseous analytes. Through selection of organic linkers with particular functional groups and/or particular metal nodes, the functionality and pore sizes of the resulting MOFs can be manipulated. We have synthesised MOFs with Cu, Ni and Fe metal centres linked by hexahydroxytriphenylene ligands4 and fabricated chemiresistive sensors through combination with Ag nanowires. Their different sensing responses to NO2 and NH3 gases with concentrations below 5 ppm have been recorded, and the simultaneous exposure of all three MOF sensors in an array to gaseous analytes is anticipated to further increase sensor selectivity. Figure 1: Schematic of a percolation curve, demonstrating how the conductivity between two electrodes changes as the concentration of conductive material, such as conductive polymer, between the electrodes is increased. The optimum region for sensing experiments is where the gradient is steepest; the percolation region. Image reproduced from reference 1. References Murugappan K, Castell MR. Bridging electrode gaps with conducting polymers around the electrical percolation threshold. Electrochem commun. 2018;87:40-43. doi:10.1016/j.elecom.2017.12.019Lefferts MJ, Murugappan K, Wu C, Castell MR. Electrical percolation through a discontinuous Au nanoparticle film. Appl Phys Lett. 2018;112(25):251602. doi:10.1063/1.5023163Armitage BI, Murugappan K, Lefferts MJ, Cowsik A, Castell MR. Conducting polymer percolation gas sensor on a flexible substrate. J Mater Chem C. 2020;8:12669. doi:10.1039/d0tc02856hCampbell MG, Liu SF, Swager TM, Dincə M. Chemiresistive Sensor Arrays from Conductive 2D Metal-Organic Frameworks. J Am Chem Soc. 2015;137(43):13780-13783. doi:10.1021/jacs.5b09600 Figure 1

Digital twins: artificial intelligence and the IoT cyber-physical systems in Industry 4.0

This paper presents a summary of mechanisms for the evolution of artificial intelligence in ‘internet of things’ networks. Firstly, the paper investigates how the use of new technologies in industrial systems improves organisational resilience supporting both a technical and human level. Secondly, the paper reports empirical results that correlate academic literature with Industry 4.0 interdependencies between edge components to both external and internal services and systems. The novelty of the paper is a new approach for creating a virtual representation operating as a real-time digital counterpart of a physical object or process (i.e., digital twin) outlined in a conceptual diagram. The methodology applied in this paper resembled a grounded theory analysis of complex interconnected and coupled systems. By connecting the human–computer interactions in different information knowledge management systems, this paper presents a summary of mechanisms for the evolution of artificial intelligence in internet of things networks.

Maintaining Zero Trust With Federation

Federated activity presents a challenge for enterprises with high-level security architectures. Federation involves information sharing among services and with working partners, coalition partners, first responders, and other organizations. Federation may be unilateral or bilateral with similar or dissimilar information-sharing goals. Strong internal security, including zero trust controls, often do not extend cleanly across enterprise boundaries, potentially leading to insecure shortcuts and workarounds that can become the rule instead of the exception. This paper presents methods for an enterprise to extend its zero trust security policies to include federation partners. It applies to federation partners that support the same security policies with compatible standards and services and to partners that provide a similar but incompatible security framework, a subset of required security services, or no security services. The partner organization may be fully trusted, partially trusted, or untrusted. Even for trusted partners, the services may not meet required security standards. Our solution combines selected partner security services, internal services, derived credentials, delegated authorities, and supplemental services to form the federation security architecture based on zero trust premises to the maximum extent. This paper uses the Zero Trust for Enterprise (ZTE) architecture as the starting point for a secure enterprise and addresses the challenge of extending this model to federate with different types of partners. We review the security approach, the security properties, and several options for an enterprise to maintain the ZTE security properties while enabling federated sharing with other enterprises that have different capabilities and levels of trust

A Resident-Led Intervention to Increase Initiation of Buprenorphine Maintenance for Hospitalized Patients With Opioid Use Disorder.

Hospitalized patients with opioid use disorder (OUD) are rarely started on buprenorphine or methadone maintenance despite evidence that these medications reduce all-cause mortality, overdoses, and hospital readmissions. To assess whether clinician education and a team of residents and hospitalist attendings waivered to prescribe buprenorphine increased the rate of starting patients with OUD on buprenorphine maintenance. Quality improvement study conducted at a large, urban, academic hospital in Maryland involving hospitalized patients with OUD on internal medicine resident services. We developed a protocol for initiating buprenorphine maintenance, presented an educational conference, and started the resident-led Buprenorphine Bridge Team of residents and attendings waivered to prescribe buprenorphine to bridge patients from discharge to follow-up. The percent of eligible inpatients with OUD initiated on buprenorphine maintenance, 24 weeks before and after the intervention; engagement in treatment after discharge; and resident knowledge and comfort with buprenorphine. The rate of starting buprenorphine maintenance increased from 10% (30 of 305 eligible patients) to 24% (64 of 270 eligible patients) after the intervention, with interrupted time series analysis showing a significant increase in rate (14.4%; 95% CI, 3.6%-25.3%; P = .02). Engagement in treatment after discharge was unchanged (40%-46% engaged 30 days after discharge). Of 156 internal medicine residents, 89 (57%) completed the baseline survey and 66 (42%) completed the follow-up survey. Responses demonstrated improved resident knowledge and comfort with buprenorphine. Internal medicine resident teams were more likely to start patients on buprenorphine maintenance after clinician education and implementation of a Buprenorphine Bridge Team.

Measuring the efficiency of the Portuguese public hospitals: A value modelled network data envelopment analysis with simulation

In contrast to conventional data envelopment analysis (DEA), where a system is considered as a ”black-box”, network DEA acknowledges its internal structure to generate more enlightening results. It goes without saying that putting network DEA in practice is natural- and progressively rarer as the complexity of a system’s structure increases. In particular, its employment in healthcare is no exception. Thus, we designed a slacks-based model to measure the efficiency of the Portuguese secondary healthcare providers bearing in mind their internal services. However, the absence of data regarding the connections between those services called for the additional use of a simulation method – the well-known Monte Carlo method –, modelled with the judgements of a decision-maker. This unprecedented application of static systems with a matrix-type structure found that two-thirds of those providers were inefficient and allowed the identification of target areas for future policy reforms in the Portuguese National Health Service.

Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study.

The demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents’ training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the appointment, preexisting medical conditions and presence of co-morbidities from first-visit patients to the internal medicine outpatient service of our university general hospital. We also collected information on all laboratory tests ordered by the attending medical residents. At a follow-up visit, we recorded residents’ subjective perception on the usefulness of each ordered laboratory test for the purposes of diagnosis, prognosis, treatment or screening. We observed that 17.3% of all ordered tests had no perceived utility by the attending resident. Tests were usually ordered to exclude differential diagnoses (26.7%) and to help prognosis estimation (19.1%). Age and co-morbidity influenced the chosen category to legitimate usefulness of tests ordering. This study suggests that clinical objectives (diagnosis, prognosis, treatment or prevention) as well as personalization to age and previous health conditions should be considered before test ordering to allow a more appropriate laboratory tests ordering, but further studies are necessary to examine this framework beyond this medical training scenario.

FEATURES OF MILITARY EDUCATIONAL INSTITUTIONS ACTIVITY IN YELISAVETGRAD REGION IN 1865-1917

In the article, the features of military educational institutions activity in Yelisavetgrad region in 1865–1917 have been studied. The purpose of the article is to study features of Yelisavetgrad cavalry junker school activity in Yelisavetgrad region in 1865–1917. The purpose of the Yelisavetgrad cavalry junker school was analysed as the one to prepare high-moral officers-practitions and as a military one that had the right to train officers in the rank of Cornets. It has been concluded that at a certain point of its activity Yelisavetgrad cavalry junker school became the second in the Russian Empire due to its the internal organization of the institution's life in accordance with the current charter of the internal service in the troops, the organization of the educational process and the regime in the school.Key words: military educational institutions, Yelisavetgrad region, military school, officer cavalry school, military education.

MHOMR: a prospective observational study of an automated mortality prediction model to identify patients with unmet palliative needs

ObjectiveIdentification of patients with shortened life expectancy is a major obstacle to delivering palliative/end-of-life care. We previously developed the modified Hospitalised-patient One-year Mortality Risk (mHOMR) model for the automated identification...

IMPLEMENTATION AND ORGANIZATION PROBLEMS OF INTERNAL AUDIT IN THE RUSSIAN FEDERATION AGROSECTOR

The article reveals the features of the implementation of internal audit in the companies of the agroindustrial sector of Russia, the main difficulties and current trends of its development. Today, the tasks of internal audit are diverse, depending on the industry differences of economic entities, organizational and legal forms, and the preferences of owners and managers of enterprises. To improve the well-being of the enterprise and optimize management activities, it is necessary to implement an independent internal audit system that will have all the necessary human and technical resources. Unfair and ineffective actions of the company's management can be significantly reduced by increasing the level of independence of the internal audit service, providing internal auditors with the necessary methodological tools that are aimed at reducing the likelihood of unfair actions of management and inefficient use of the company's resources. The main difficulties of the development of the internal audit system in the modern conditions of economic activity of agricultural enterprises are analyzed and development options are proposed.

At your service! The role of tax havens in international trade with services

This paper provides the first comprehensive study of profit shifting through service trade inside multinational firms. The analysis employs a unique firm-level dataset with detailed information about service trade and foreign affiliates for virtually all multinational firms in Germany. We find patterns consistent with profit shifting in service categories such as intellectual property (patents and trademarks), headquarter services(administration, management and advertizing), information services(data processing and storage) and financial services (investment, lending and money management). In these service categories, trade with affiliates in tax havens is skewed towards imports and the internal service providers in tax havens earn significant excess profits that vary strongly with the value of their internal service sales. These patterns are suggestive that multinational firms operate tax haven entities that sell overpriced services to affiliates in order to erode their taxable profits and reduce the global tax bill. While total service imports from tax havens are very large, our estimates suggest that Germany’s loss of government revenue from mispriced service imports from tax havens is relatively modest, less than € 1 billion per year.

The Municipality's Role in a Smart Internet of Things Ecosystem

This article explores how municipalities plan and utilize Internet of Things (IoT) for smart city development, as well as how they collaborate with actors in the IoT-ecosystem. To do so, in-depth interviews and secondary information are collected from municipalities in Norway. Overall, the empirical findings confirm that IoT has the potential to make municipalities smarter by improving public services, efficiency of internal management and service delivery. The findings form this study is novel and can help executives to gain practical insight into the theory-heavy subject of smart city development in small and medium sized municipalities

Managing internal service quality in hotels: Determinants and implications

While internal service quality (ISQ) preconditions organizational service quality management, the tourism and hospitality management literature largely overlooks it. This study developed and tested a comprehensive model to understand the determinants and how they influence ISQ using an exploratory sequential mixed method. In study 1, we conducted 12 focus groups involving 86 hotel employees. ISQ is determined by three primary categories of organizational and personal practice: management systems (i.e., manage process, training and compensation), social systems (i.e., collaborative culture, interdepartmental communication and servant leadership), and personal characteristics (i.e., role stress, empathetic personality and collegial relationships). In study 2, we conducted 332 pairs of employee-supervisor questionnaires and confirmed the effects of these determinants on ISQ through employee's internal service orientation and efficacy. Distinct determinants interrelate to predict employees' internal service orientation and efficacy. This study thus provides hotels with targeted measures to improve their ISQ and competitive advantages. • This study identifies three categories of determinants on internal service quality (ISQ). • Employees' internal service orientation and efficacy mediate the determinants and ISQ. • The ISQ determinants interact to predict internal service orientation and efficacy.

Analysis of Quality of Antibiotic Usage on Patient with Internal and Surgical Service

It is well-known that hospitals are health facility with the widely use of antibiotics. It is about 13-37% from the total hospitalized patients in developed countries use antibiotic, even in developing countries can reach 30-80%. There is identified correlation between antibiotic use and the development of bacterial resistance. Even though the resistance cannot be eliminated, but its development can be suppressed by the increasing of prudent use of antibiotics. The aim of this study was to determine the quality of antibiotic use on internal medicine and surgical patients in Aisiyah Hospital Bojonegoro. The study was a prospective cross sectional observational analytical study of among patients of internal and surgical who received antibiotic therapy in the period of August - September 2017. The total 50 samples were collected in this study which consists of 33 internal medicine and 17 surgical patients. From 50 samples, there were 16 types of antibiotics with the total use of 81 of antibiotic use. As the result, in internal medicine patients there were 22 (40%) of appropriate use of antibiotics, 4 (7.27%) of inappropriate use and 29 (52.73%) use of antibiotics without indication. In surgical patients, there were 12 (46.15%) of appropriate use of antibiotics, 2 (7.69%) of inappropriate use and 12 (46.15%) use of antibiotics without indication. This study showed that more than 50% of antibiotic use were inappropriate, and mainly antibiotic with no indication, among patients hospitalized in Aisyiyah Hospital Bojonegoro.

Rapid Adoption of an Interdisciplinary Care Team Model for Surgical Residents Managing Coronavirus Disease-19.

Introduction: Patients infected with SARS-Cov-2, the causative virus behind the coronavirus disease-19 (COVID-19) pandemic, have been increasing rapidly in New York City. New York City has the highest incidence in the United States and fully 45% of all deaths from COVID-19. Our medical center is located within a high-density region of cases in south Brooklyn and, in fact, three of our neighborhood zip codes are in the top seven in New York in incidence. As a result, our center has experienced a dramatic increase in hospitalizations, particularly respiratory distress secondary to COVID-19, which rapidly exceeded the capacity of our internal medicine service. This necessitated the formation of new COVID-19 units throughout the hospital, replacing all former service lines. These units employed management teams composed of residents from many medical and surgical disciplines, including general surgery residents. Methods: Our general surgery residency program established a surgical COVID-19 (SCOVID) management team. Initially, 4 surgical residents (2 senior and 2 junior), 1 attending surgeon, and 1 attending internal medicine physician were allocated to the initial SCOVID team. On day 3 of implementation, to achieve more rapid competence in the complex management of these patients, a senior medicine resident with direct experience in the care of COVID-19 patients was added in an advisory capacity. Results: The addition of an experienced senior medical resident and attending allowed for the quick adoption of uniform management protocols by surgical residents and attendings. Discussion: We describe a protocol for the establishment of COVID-19 management teams staffed with general surgical residents, as well as a strategy for the achievement of rapid increases in competency. The addition of a senior internal medicine resident and attending to our SCOVID team allowed for rapid achievement of competency in the care of COVID-19 patients in our large institution at the epicenter of the COVID-19 pandemic.