Service Improvement Strategies Research Articles

G176 The National Cancer Survivorship Initiative: A National Approach to Improve the Quality of Aftercare For Survivors of Childhood Cancer

AimsThe National Cancer Survivorship Initiative [NCSI] (a partnership between the Department of Health, NHS Improvement, third sector organisations and user representatives) was established to improve the care provided for patients...

Respiratory illness healthcare-seeking behavior assessment in the Lao People’s Democratic Republic (Laos)

BackgroundRespiratory illness (RI) remains a public health problem in Laos, but little is known about the overall burden and people’s healthcare-seeking behavior for RI. Understanding the burden of RI and community patterns of healthcare-seeking behavior would provide better guidance for Lao public health program and policy planners to improve RI public health practice, surveillance systems, and prevention strategies.MethodsA quantitative and qualitative survey was conducted in 14 randomly selected villages of two purposively selected peri-urban and two rural provinces in Laos. A pre-designed and pre-tested questionnaire was used to collect information on RI in household members (defined as new fever with cough and/or sore-throat in the absence of other diagnoses during the preceding 30 days) from all heads of household in each village. Sixteen focus group discussions were conducted to obtain more information to support the quantitative survey.ResultsAmong 1,751 households (9,114 people) studied, 3.5% (317/9,114) had experienced RI (fever, cough, and/or sore-throat) in the 30 days before the survey [6.2% in rural and 2.4% in peri-urban areas (p<0.001)]. The percentage of RI among persons aged ≥15 years was 2.7%, 3.7% for those aged 5 – 14 years, and 8.2% for children < 5 years (p<0.001). Of all sick persons, 71% sought treatment [94% in peri-urban and 48% in rural areas (p<0.001)] and 31.5% of them self-medicated [55.5% in peri-urban and 29% in rural areas (p<0.001)]. Sick people in peri-urban areas preferred to chose private clinics and pharmacies as their first treatment option while in rural areas they frequently consulted with village health volunteers and visited health centres as their first choice. The qualitative study suggests that distance, costs of care, and service availability are the most important determinants of seeking healthcare.ConclusionsThe RI burden and healthcare-seeking behavior are different between rural and peri-urban areas of Laos and this is probably due to the differences in environmental and hygienic conditions, health service availability and socio-economic status between the two areas. Therefore strategies for healthcare service improvement may also need to differ between the two areas.

Exploring factors influencing non‐attendance at the diabetes clinic and service improvement strategies from patients' perspectives

AbstractA significant number of people with type 1 diabetes do not attend their clinic appointments. This study investigated the reasons underlying this decision and explored possible service improvement strategies.This was a cross‐sectional telephone survey among all patients with type 1 diabetes missing at least one appointment at a diabetes clinic between 1 October 2009 and 30 September 2010. Patients were asked two questions: why they did not attend the appointment and how attendance could be improved.The initial ‘did not attend’ (DNA) rate for all appointments was 17.6% (808/4595 appointments). Of these, the largest number were missed by patients (n=252) with type 1 diabetes. After excluding 79 patients no longer under the service, 126/173 (72.8%) were able to be contacted and answered the questions. Forgetting the appointment was the most frequent response (34.9%). Many patients advised not to send appointment reminder letters too far ahead of appointments (12.7%, 16) and to send a text message reminder (26.2%, 33) two weeks before the appointment.The findings suggest that there is a role for improving the administrative approach to patients' appointments, reminding patients in advance and improving communication between hospital staff and patients. Copyright © 2012 John Wiley &amp; Sons.

Understanding the impacts of a combination of service improvement strategies on bus running time and passenger’s perception

Transit agencies implement many strategies in order to provide an attractive transportation service. This article aims to evaluate the impacts of implementing a combination of strategies, designed to improve the bus transit service, on running time and passenger satisfaction. These strategies include using smart card fare collection, introducing limited-stop bus service, implementing reserved bus lanes, using articulated buses, and implementing transit signal priority (TSP). This study uses stop-level data collected from the Société de transport de Montréal (STM)’s automatic vehicle location (AVL) and automatic passenger count (APC) systems, in Montréal, Canada. The combination of these strategies has lead to a 10.5% decline in running time along the limited stop service compared to the regular service. The regular route running time has increased by 1% on average compared to the initial time period. The study also shows that riders are generally satisfied with the service improvements. They tend to overestimate the savings associated with the implementation of this combination of strategies by 3.5–6.0 min and by 2.5–4.1 min for both the regular route and the limited stop service, respectively. This study helps transit planners and policy makers to better understand the effects of implementing a combination of strategies to improve running time and passenger’s perception of these changes in service.

Public administration and service delivery reforms: a post-1994 South African case

This paper is an analysis of South Africa's public service improvement strategies since 1994. It first describes the historical factors that underpinned South Africa's service delivery initiatives before 1994. It is argued that the pre-1994 public service sector was racialised and highly politicised, as opposed to being people-centred and service delivery oriented. The transition to democracy in 1994 necessitated a complete revision of South Africa's public administrative system in order to meet the developmental challenges of service delivery needs. However, this transition also coincided with global reform initiatives that were taking place in the public sector, as informed by the new public management (NPM) paradigm with its emphasis on cost effectiveness, accountability and transparency. The primary argument of the paper is that commendable legislative reforms have been enacted in South Africa's public administration system in the post-1994 period, based on the NPM, but the fragility of the state bureaucracy as manifested in the silo approach characterising the South African government operations, as well as capacity limitations, encumbers the success of these reforms. The Community Development Worker (CDW) programme, operating in South Africa's Eastern and Western Cape Provinces, is used as a case study to illustrate this argument. A brief look at India's experience of the NPM also informs the discussion. The significance of the case study lies in the fact that it was conceived in the interest of increased responsiveness and accessibility to government services, a vital pillar of the NPM framework.

Service Improvement Strategy for The Insertion of Suprapubic Catheters

Service Improvement Strategy for The Insertion of Suprapubic Catheters

How can we improve outcomes for patients and families under palliative care? implementing clinical audit for quality improvement in resource limited settings

Palliative care in India has made enormous advances in providing better care for patients and families living with progressive disease, and many clinical services are well placed to begin quality improvement initiatives, including clinical audit. Clinical audit is recognized globally to be essential in all healthcare, as a way of monitoring and improving quality of care. However, it is not common in developing country settings, including India. Clinical audit is a cyclical activity involving: identification of areas of care in need of improvement, through data collection and analysis utilizing an appropriate questionnaire; setting measurable quality of care targets in specific areas; designing and implementing service improvement strategies; and then re-evaluating quality of care to assess progress towards meeting the targets. Outcome measurement is an important component of clinical audit that has additional advantages; for example, establishing an evidence base for the effectiveness of services. In resource limited contexts, outcome measurement in clinical audit is particularly important as it enables service development to be evidence-based and ensures resources are allocated effectively. Key success factors in conducting clinical audit are identified (shared ownership, training, managerial support, inclusion of all members of staff and a positive approach). The choice of outcome measurement tool is discussed, including the need for a culturally appropriate and validated measure which is brief and simple enough to incorporate into clinical practice and reflects the holistic nature of palliative care. Support for clinical audit is needed at a national level, and development and validation of an outcome measurement tool in the Indian context is a crucial next step.

공동주택 상품의 고객서비스 개선 전략 연구

As customers are becoming increasingly important in corporate management, there is a growing demand for migration to customer-focused organizational structures. Unlike the manufacturing industry, the construction industry is non-iterative and non-standardized. As a result, a wide variety of materials, human resources, technologies and equipment must be mobilized in complex work activities to complete a structure. Consequently, surprises are bound to occur as such work activities progress. This paper intends to study a strategy that is designed to improve customer services for apartment building units. It aims primarily to focus on cost control and brand management. Housing tenants and industry experts are surveyed to collect input for issue analysis. In addition, the external circumstances and internal capabilities of major builders in Korea are analyzed, and a SWOT analysis is performed regarding market conditions related to customer service. These analysis results are utilized to develop a strategy implementation plan over different time frames, and the operational resources available for such strategy implementation are analyzed in order to forecast its performance. This research will facilitate communication between construction companies in Korea and their customers by proposing a customer service improvement strategy for apartment building units, and is expected to provide resource material for a strategic analysis of efforts to fully incorporate customer requirements

ANALYZING AIRLINE SERVICE IMPROVEMENT STRATEGY THROUGH IMPORTANCE AND PERFORMANCE ANALYSIS

The main purpose of this study is to present an evaluation method that employs the well-established Importance-Performance Analysis (IPA) for understanding airline passengers' degree of care, degree of satisfaction and priority list on some critical service items. The analysis results will serve as the basis for airlines to improve their service strategies in response to customer needs. The proposed method has been applied in the Taiwan UNI AIR market analysis through a comprehensive passenger survey. The application results clearly indicate that the proposed IPA method can effectively identify critical airline service items to be improved, and serve as a valuable tool to assist airline managers in developing airline service improvement strategies.

A6 How do service improvement strategies relate to nuclear medicine?

A6 How do service improvement strategies relate to nuclear medicine?

Public management reform and organizational performance: An empirical assessment of the U.K. Labour government's public service improvement strategy

AbstractWe present the first empirical assessment of the U.K. Labour government's program of public management reform. This reform program is based on rational planning, devolution and delegation, flexibility and incentives, and enhanced choice. Measures of these variables are tested against external and internal indicators of organizational performance. The setting for the study is upper tier English local governments, and data are drawn from a multiple informant survey of 117 authorities. The statistical results indicate that planning, organizational flexibility, and user choice are associated with higher performance. Conclusions are drawn for the theory and practice of public management reform. © 2006 by the Association for Public Policy Analysis and Management

The Comparative Evaluation of Hotel Service Quality from a Managerial Perspective

ABSTRACT Total customer satisfaction is one of the most important strategic weapons of best-practice hotel organizations, because it reflects the effectiveness and efficiency of the hotel's service delivery system. To achieve total customer satisfaction, a hotel needs to build and sustain a loyal customer relationship. The establishment of a loyal customer relationship often starts with the monitoring of hotel employees who represent “internal customers” as a front-line, initial contact with hotel guests. With this in mind, this paper analyzes feedback of both hotel employees (internal customers) and guests (external customers), compares their perceived differences in the importance of service attributes to overall hotel service quality, identifies service gaps, and takes corrective action to reduce such gaps. Based on the longitudinal surveys of both hotel employees and guests who have stayed at first-class hotels in Korea, this paper develops customer retention and continuous service improvement strategies.

Initiatives in primary health care: evaluation of a South Australian program.

In 1994 the Primary Health Care Initiatives Program was established as part of the South Australian government's hospital service improvement strategy. In its first year, the program funded 34 demonstration projects, of which half were concerned with improving continuity of care and discharge planning, and half with health promotion or illness prevention. Evaluation of the program has shown that it achieved significant improvements in links and communication between the services involved, in the development of systems and procedures for facilitating discharge-planning and continuity of care, and in enhancing the capacity of organizations to undertake health promotion and illness prevention. Overall, it was not possible to determine whether the program had shortened or avoided hospital stays due to a range of factors, including the many changes occurring in the health system at the time. The program's strong emphasis on evaluation has produced a rich source of information and helped to develop the evaluation skills of project staff.

Benchmarking the quality of hotel services: managerial perspectives

With escalating competition in the hotel industry, a growing number of hotels have considered service quality their top priority in maintaining competitiveness. To maintain competitiveness, the hotel management often needs to develop reliable service quality standards. Perhaps one of the best ways of developing such standards is to compare the hotel’s service performance with that of the service leader and reassess its service performance continuously through competitive benchmarking. In an effort to establish practical guidelines for competitive benchmarking, proposes the use of an analytic hierarchy process and a competitive gap analysis. These methods can help the hotel manager formulate viable service improvement strategies in the increasingly competitive hotel industry. Illustrates the usefulness of the proposed benchmarking methodology using the case of Korean luxury hotels.

Competitive benchmarking of health care quality using the analytic hierarchy process: an example from Korean cancer Clinics

Faced with mounting competitive pressures and continued health care reforms, a growing number of health care providers have begun to realize that their future success rests on the ability to undertake a continuous improvement of health care quality. The process of continuous improvement of health care quality is facilitated by health care providers developing reliable quality measures through competitive benchmarking. In an effort to develop a meaningful set of guidelines for competitive benchmarking, and determine comparative measures of health care quality of medical clinics, this paper proposes an analytic hierarchy process (AHP) that can help medical clinics formulate viable service improvement strategies in the increasingly competitive health care industry. This paper also illustrates the usefulness of the proposed health care quality measures using the case of prominent Korean cancer clinics.

Comparison of analytical and simulation planning models of seaport container terminals

This paper discusses the major factors influencing the transfer efficiency of seaport container terminals. The objective is to utilise queuing techniques to draw inferences regarding strategies for a container terminal's service improvement by using analytical expressions. The model developed here is referred to as a batch‐arrival multi server queuing system and designated as a stochastic model. Later the model is compared with another analytical model and a simulation approach. A comparative analysis is performed on these models and results show that the analytical model can take the place of the simulation model.

Competitive benchmarking of Korean luxury hotels using the analytic hierarchy process and competitive gap analysis

As quality and profitability have become inseparable concepts, a growing number of service firms have considered quality their top priority in maintaining competitiveness. Commitment to service quality, however, is nothing more than lip service, unless management develops reliable service quality standards. Perhaps one of the best ways of developing such standards is to compare the firm’s service performance with that of the service leader and reassess its service performance continuously through competitive benchmarking. In an effort to establish practical guidelines for competitive benchmarking, proposes the use of an analytic hierarchy process and a competitive gap analysis. These methods can help the service manager to formulate viable service improvement strategies in the increasingly competitive service industry. Illustrates the usefulness of the proposed benchmarking methodology using the case of Korean luxury hotels.

Motivating employees

Outlines the policies of the Canadian Imperial Bank of Commerce in creating an organization in which its 48,000 employees are “customer obsessed”. Discusses participation in service/quality teams, highlighting their structure and practices, leadership and commitment to the scheme, communication and training, measurement and tracking and reward and recognition. Suggests four priority areas which emerge as critical requirements to building a sustained service improvement strategy through teams ‐ ownership, leadership, employee satisfaction and focus.

Governmental policies to reduce tax evasion: coerced behavior versus services and values development

Governments generally have at their disposal two types of tax compliance policies. One set of policy options coerces tax compliance by increasing risks for practicing tax evasion, while a second set of policies emphasizes development of supportive taxpaying values among citizens through service improvement and informational strategies. Tax agencies tend to favor coercive policies, but empirical research suggests that such policies are not in themselves fully adequate to fight tax evasion. Four hypotheses are offered which suggest the utility of service and values based policies and the need for increased investment in those areas of tax administration.