The effect on managers of the introduction of a balenced scorecard at a local level in a large network organisation.

The purpose of the research is to understand how unit managers react to and are able to engage with a newly devised centralised performance measurement system(PMS) based on the balanced scorecard(BSC). The theoretical contribution of this study is to establish the behaviours which may contributeto or hinder the way in which the BSC is accepted and used at a unit level. The knowledge gained and tested in actual practice will prove invaluable.This will not only allow managers to identify and therefore react to areas of probable negativity, but also allow them to encourage and endorse the more positive aspects. The observed research which adopts a process of collaborative inquiry covers a period of 10 months and adopts a longitudinal case study approach. During this time, emphasisis paid upon the role of the reviewing senior manager and those managers responsible for the unit score cards, examining their initial exposure to and deployment of the scorecard, along with its use in eight of the seventeen delivery units. The findings identify that three core elements exist within a performance environment.These consist of the performance strategy, its PMS and the performance encounter where performance improvement are ultimately realised. Within the centre core there exists both an emotional and behavioural reaction determining either the success or demise of the overall performance management and its measurement system. The research concludes by evaluating the lessons derived from the interactions within the performance environment.The study focuses on how considerations such as personal control and influence,when linked to understanding, knowledge and contribution impact on the level of perceived ownership and accountability felt by individuals. By addressing these areas organisations are able to ensure a more successful use of a centrally devised BSC approach across its exposure,deployment and usage

The effect on managers of the introduction of a balenced scorecard at a local level in a large network organisation

The purpose of the research is to understand how unit managers react to and are able to engage with a newly devised centralised performance measurement system(PMS) based on the balanced scorecard(BSC). The theoretical contribution of this study is to establish the behaviours which may contributeto or hinder the way in which the BSC is accepted and used at a unit level. The knowledge gained and tested in actual practice will prove invaluable.This will not only allow managers to identify and therefore react to areas of probable negativity, but also allow them to encourage and endorse the more positive aspects. The observed research which adopts a process of collaborative inquiry covers a period of 10 months and adopts a longitudinal case study approach. During this time, emphasisis paid upon the role of the reviewing senior manager and those managers responsible for the unit score cards, examining their initial exposure to and deployment of the scorecard, along with its use in eight of the seventeen delivery units. The findings identify that three core elements exist within a performance environment.These consist of the performance strategy, its PMS and the performance encounter where performance improvement are ultimately realised. Within the centre core there exists both an emotional and behavioural reaction determining either the success or demise of the overall performance management and its measurement system. The research concludes by evaluating the lessons derived from the interactions within the performance environment.The study focuses on how considerations such as personal control and influence,when linked to understanding, knowledge and contribution impact on the level of perceived ownership and accountability felt by individuals. By addressing these areas organisations are able to ensure a more successful use of a centrally devised BSC approach across its exposure,deployment and usage.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Knowledge or noise? Making sense of General Practitioners’ and Consultant use of two-week-wait referrals for suspected cancer

This work was funded by the National Awareness & Early Diagnosis Initiative. It was undertaken in the secure environment of the Northern Ireland Cancer Registry, which is funded by the Northern Ireland Public Health Agency. We are grateful to the staff in the Health & Social Care Board for their advice and guidance on this study.Peer reviewedPostprin

Does emergency presentation of cancer represent poor performance in primary care? Insights from a novel analysis of linked primary and secondary care data

The study was funded by the Chief Scientist’s Office of the Scottish Government. Twelve months after publication in British Journal of Cancer, the Contribution, as published on the BJC website, will be offered for reuse under the terms of the Creative Commons Attribution-NonCommercial-Share-Alike 3.0 licencePeer reviewedPostprintPostprintPostprintPostprintPostprintPostprintPostprintPostprintPostprin