Using concept mapping to design an indicator framework for addiction treatment centers.

Objective. The objective of this study is to determine an indicator framework for addiction treatment centres based on the demands of stakeholders and in alignment with the European Foundation for Quality Management (EFQM) Excellence Model. Setting. The setting is the Jellinek Centre based in Amsterdam, the Netherlands, which serves as a prototype for an addiction treatment centre. Method. Concept mapping was used in the construction of the indicator framework. During the 1-day workshop, 16 stake-holders generated, prioritized and sorted 73 items concerning quality and performance. Multidimensional scaling and cluster analysis was applied in constructing a framework consisting of two dimensions and eight clusters. Results. The horizontal axis of the indicator framework is named 'Organization' and has two poles, namely, 'Processes' and 'Results'. The vertical axis is named 'Task' and the poles are named 'Efficient treatment' and 'Prevention programs'. The eight clusters in the two-dimensional framework are arranged in the following, prioritized sequence: 'Efficient treatment network', 'Effective service', 'Target group', 'Quality of life', 'Efficient service', 'Knowledge transfer', 'Reducing addiction related problems', and 'Prevention programs'. The most important items in the framework are: 'patients are satisfied with their treatment', 'early interventions', and 'efficient treatment chain'. Conclusion. The indicator framework aligns with three clusters of the results criteria of the EFQM Excellence Model. It is based on the stakeholders' perspectives and is believed to be specific for addiction treatment centres. The study demonstrates that concept mapping is a suitable strategy for generating indicator frameworks. © The Author 2005. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved

Psychosocial work conditions and work stress in an innovating addition treatment centre. Consequences for the EFQM excellence model

In the Job Demand Control Model (JDCM) and the EFQM Excellence Model, psychosocial work conditions are regarded as critical factors for the functioning of the personnel and the organisation. In order to gain insight into the role of work conditions for the development of work strain and well-being, an empirical study was conducted in an innovating addiction treatment centre in Amsterdam, the Netherlands. The Work Stress Monitor on Mental Health (WSMMH) was used as a measure of the JDCM. A cohort of 209 employees of an addiction treatment centre, in which a far-reaching innovation programme was carried out, participated in this study. With the exception of physical demands, job demands, were high, whereas job controls and the organisational supports were low. Seven out of the 18 work condition scales significantly predicted work strain and well-being. Age and educational level were positive related to well-being. Compared with other health care sectors, work in this addiction treatment centre can be characterised as high-demand low-control and thus as a high strain job. Seven important predictors for this undesirable situation were identified. These predictors can be translated into criteria for the EFQM Excellence Model and can be used to enhance the overall quality of addiction treatment service

An Evaluative Model to Assess the Organizational Efficiency in Training Corporations

In an organisation any optimization process of its issues faces increasing challenges and requires new approaches to the organizational phenomenon. Indeed, in this work it is addressed the problematic of efficiency dynamics through intangible variables that may support a different view of the corporations. It focuses on the challenges that information management and the incorporation of context brings to competitiveness. Thus, in this work it is presented the analysis and development of an intelligent decision support system in terms of a formal agenda built on a Logic Programming based methodology to problem solving, complemented with an attitude to computing grounded on Artificial Neural Networks. The proposed model is in itself fairly precise, with an overall accuracy, sensitivity and specificity with values higher than 90 %. The proposed solution is indeed unique, catering for the explicit treatment of incomplete, unknown, or even self-contradictory information, either in a quantitative or qualitative arrangement

Effect of coercive measures on treatment outcome in involuntarily admitted patients in Amsterdam

ObjectiveThe prevalence of involuntary admissions rose the last forty years in European countries, including the Netherlands. Involuntary admissions result in seclusion, physical restraint and forced medication in approximately 40% of patients. We looked at whether treatment outcomes differ in patients with and without coercive measures.MethodsUsing The Health of the Nation Outcome Scales (HoNOS) to measure treatment outcomes, we studied the files of 786 patients admitted involuntarily to an Amsterdam clinic. We applied Generalised Linear Models to determine whether the use, or not, of coercive measures during treatment was associated with a difference in outcomes.Results19% of the cohort were secluded in a High Security Room (HSR); 24% were secluded in their own room and/or received forced medication. After adjustment for the influence of diagnosis, disorder severity (initial HoNOS score) and treatment duration, the HSR group had, on average, a HoNOS difference score that was 2.4 points lower than patients without coercive measures (CI −4.0 to −0.8.; p 0.003). In the seclusion in own room group, this score was 2.6 points lower (CI −4.0 to −1.1; p 0.001), corresponding to an effect size of 0.35 and 0.40, respectively.ConclusionSeclusion, whether or not in combination with forced medication, was applied to two-fifths of patients. The HoNOS scores of the group without coercion improved by nearly two and a half points more on average than those of the two groups with coercion. A causal relationship between coercion and treatment outcome could neither be confirmed nor excluded on the basis of our results

Quality management: reduction of waiting time and efficiency enhancement in an ENT-university outpatients' department

Background Public health systems are confronted with constantly rising costs. Furthermore, diagnostic as well as treatment services become more and more specialized. These are the reasons for an interdisciplinary project on the one hand aiming at simplification of planning and scheduling patient appointments, on the other hand at fulfilling all requirements of efficiency and treatment quality. Methods As to understanding procedure and problem solving activities, the responsible project group strictly proceeded with four methodical steps: actual state analysis, analysis of causes, correcting measures, and examination of effectiveness. Various methods of quality management, as for instance opinion polls, data collections, and several procedures of problem identification as well as of solution proposals were applied. All activities were realized according to the requirements of the clinic's ISO 9001:2000 certified quality management system. The development of this project is described step by step from planning phase to inauguration into the daily routine of the clinic and subsequent control of effectiveness. Results Five significant problem fields could be identified. After an analysis of causes the major remedial measures were: installation of a patient telephone hotline, standardization of appointment arrangements for all patients, modification of the appointments book considering the reason for coming in planning defined working periods for certain symptoms and treatments, improvement of telephonic counselling, and transition to flexible time planning by daily updates of the appointments book. After implementation of these changes into the clinic's routine success could be demonstrated by significantly reduced waiting times and resulting increased patient satisfaction. Conclusion Systematic scrutiny of the existing organizational structures of the outpatients' department of our clinic by means of actual state analysis and analysis of causes revealed the necessity of improvement. According to rules of quality management correcting measures and subsequent examination of effectiveness were performed. These changes resulted in higher satisfaction of patients, referring colleagues and clinic staff the like. Additionally the clinic is able to cope with an increasing demand for appointments in outpatients' departments, and the clinic's human resources are employed more effectively

Evaluation of physical activity programmes for the elderly - exploring the lessons from other sectors and examining the general characteristics of the programmes

<p>Abstract</p> <p>Background</p> <p>In Portugal, there are several physical activity (PA) programmes for elderly people developed by the local government. The importance of these programmes has been increasing since the evidence has shown that this type of health promotion interventions may reduce the deleterious effects of the ageing process. However, no study has already identified the general characteristics of these programmes nor if they use any scheme to assess the quality of the service provided. A widely-used scheme is the EFQM Excellence Model, which will be in the core of our present work. Thus, the main aims of this preliminary study were 1) to identify the general characteristics of the PA programmes developed by the Portuguese Local Public Administration 2) to determine the extent of implementation of quality initiatives in these programmes.</p> <p>Methods</p> <p>Data were collected by an on-line questionnaire sent to all Continental Municipalities (n = 278). Categorical data were expressed as absolute counts and percentages. Continuous data were expressed as the mean and SD. An open-ended question was analysed using qualitative content analysis with QSR NVivo software. Associations between categorical variables were tested by the use of contingency tables and the calculation of chi-square tests. Significance level was set at p ≤ 0.05.</p> <p>Results</p> <p>Results showed: i) a total of 125 PA programmes were identified in the 18 districts of the Portugal mainland; ii) the main goal of the majority (95.2%) was the participants' health promotion; iii) different characteristics of the programmes were found according to different regions of the country; iv) certain characteristics of the programmes were associated to the existence of other features; v) only one PA programme developed quality initiatives.</p> <p>Conclusions</p> <p>In conclusion, although there are many PA programmes for elderly people spread throughout the country, aiming at improving the health of participants, the overwhelming majority does not adopt quality control initiatives. Considering that the quality of a service increases customer satisfaction, the continuous quality improvement of the PA programmes for elderly people should therefore be implemented since they can be useful and critical for elderly satisfaction and adherence.</p

Relationship between inpatient satisfaction and nurse absenteeism: an exploratory study using WHO-PATH performance indicators in France

<p>Abstract</p> <p>Background</p> <p>Indicators describing results of care are widely explored in term of patient satisfaction (PS). Among factors explaining PS, human resources indicators have been studied in terms of burnout or job satisfaction among healthcare professionals. No research work has set out to explore the effect of absenteeism on PS scores. The objective of this study was to explore interaction between rate of absenteeism among nurses and PS results.</p> <p>Methods</p> <p>France has taken part in a project named PATH (Performance Assessment Tool for Hospitals) of the World Health Organization, aiming to develop a tool for the assessment of hospital performance. In the first semester 2008, 25 volunteering short-stay hospitals (teaching, general and private) provide complete data on nurse short-absenteeism (periods of up to 7 consecutive days of sick leave) and on PS (a cross-sectional postal survey using a standardized validated French-language scale EQS-H exploring "quality of medical information" (MI) and "relationships with staff and daily routine" (RS)). A multi-level model was used to take into account of the hierarchical nature of the data.</p> <p>Results</p> <p>Two thousand and sixty-five patients responded to the satisfaction questionnaire (participation rate: 40.9%). The mean age of respondents was 58 yrs (± 19), 41% were men. The mean duration of hospitalisation was 7.5 days (± 11.1). The mean absenteeism rate for nurses was 0.24% (± 0.14).</p> <p>All the PS scores were significantly and negatively correlated with rate of short-absenteeism among nurses (MI score: <it>ρ </it>= -0.55, <it>p </it>< 0.01), RS score <it>ρ </it>= -0.47, <it>p </it>= 0.02). The mixed model found a significant relationship between rate of absenteeism among nurses and PS scores (MI: <it>p </it>= 0.027; RS: <it>p </it>= 0.017).</p> <p>Conclusion</p> <p>Results obtained in this study show that short-term absenteeism among nurses seems to be significantly and negatively correlated with PS. Our findings are an invitation to deepen our understanding of the impact of human resources on PS and to develop more specific projects.</p

A model of collaborative innovation between local government and tourism operators

[EN] This research proposes a framework for collaborative innovation in a public private partnership by applying techniques that combine quantitative data collection and qualitative depth. It proposes a collaborative model that looks to provide competitive advantage by improving tourist services from two perspectives: from the core of public administration, and from the private tourist sector perspective.Pons Morera, C.; Canós Darós, L.; Gil Pechuán, I. (2017). A model of collaborative innovation between local government and tourism operators. SERVICE BUSINESS. AN INTERNATIONAL JOURNAL. 1-26. doi:10.1007/s11628-017-0341-xS126Anderberg MR (1973) Cluster analysis for applications. Academic Press, New YorkAugustyn K (2000) Performance of tourism partnerships: a focus on York. Tour Manag 2:341–351Aziri B, Nedelea A (2013) Business strategies in tourism. Ecoforum 2(1):9Baglieri D, Consoli R (2009) Collaborative innovation in tourism: managing virtual communities. TQM J 21(4):353–364Barbero MI (2009) Métodos de elaboración de escalas. UNED, MadridBeaumont N, Dredge D (2010) Local tourism governance: a comparison of three network approaches. J Sustain Tourism 18(1):7–28Beritelli P, Bieger T, Laesser C (2007) Destination governance: Using corporate governance theories as a foundation for effective destination management. J Travel Res 46:96–107Bigné JE, Aldás J, Küster I, Vila N (2002) Estableciendo los determinantes de la fidelidad del cliente: Un estudio basado en técnicas cualitativas. Investigación y Mark 77:58–62Bruntland GH (1987) Our common future. http://www.un-documents.net/our-common-future.pdf . Consulted in 2016Buch EB, Cabaleiro R (2011) Hacia la determinación de la condición financiera de la administración publica local. Aplicación a los municipios de la comunidad autónoma de Galicia. Academia, Revista latinoamericana de administración, No. 47, pp. 43–60Burke JG, O’Campo P, Peak GL, Gielen AC, McDonnell KA, Trochim WM (2005) An introduction to concept mapping as a participatory public health research method. Qual Health Res 15(10):1392–1410Bustelo C, García-Morales E (2008) Administración electrónica y gestión documental. Consideraciones a la luz de la ley para el acceso electrónico de los ciudadanos a los servicios públicos. El profesional de la información. Enero-febrero 17(1):106–111Caffyn A, Jobbins G (2003) Governance capacity and stakeholder interactions in the development and management of coastal tourism: examples from Morocco and Tunisia. J Sustain Tourism 11(2):224–245Carlisle S, Kunc M, Jones E, Tiffin S (2013) Supporting innovation for tourism development through multi-stakeholder approaches: experiences from Africa. Tour Manag 35:59–69Clavero J, Codina M, Pérez A, Serrat-Brustenga M (2009) Estudio de caso de servicio de préstamo de libros electrónicos. El profesional de la información. Marzo-abril 18(2):237–241Czernek K (2013) Determinants of cooperation in a tourist region. Ann Tourism Res 40:83–104Dinica V (2009) Governance for sustainable tourism: a comparison of international and dutch visions. Journal of Sustainable Tourism. 17(5):583–603Dredge D, Whitford M (2011) Event tourism governance and the public sphere. J Sustain Tourism 19(4-5):479–499European Directive 2006/7/EC. Bathing Water. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2006:064:0037:0051:EN:PDF . Consulted in 2016Everitt B (1980) Cluster analysis. New York, NY, Halsted Press, a Division of John Wiley and SonsFernández O (1991) El análisis de Cluster: Aplicación, interpretación y validación. Papers 37:65–76Foundation for Environmental Quality of the European Union. http://www.blueflag.org/menu/awarded-sites/2014/northern-hemisphere/spain-2/List/Beaches . Consulted in 2016Freeman RE, McVea J (1984) A stakeholder approach to strategic management. Pitman, BostonGil-Lafuente AM, Kyun-Oh Y (2012) Incidencia de las inversiones de la administración pública sobre el desarrollo turístico de una ciudad. Revista Venezolana de Gestión Pública. Enero-Diciembre 3(3):81–109Gil-Pechuán I, Conesa-García M, Navarro-García A (2014) Concept mapping to improve higher education. Innovation and Teaching Technologies. ISBN: 978-3-319-04824-6. pp. 61–73Granovetter M (1985) Economic action and social structure: the problem of embeddedness. Am J Sociol 91(3):481Greenwood J (1993) Business interest groups in tourism governance. Tourism Manag 14:335–348Gulati R (1995) Social structure and alliance formation patterns: a longitudinal analysis. Adm Sci Q 40:619–653Henao-Betancur PA, Echeverri-Farley OM, Zartha-Sossa JW (2013) Metodología web para la formulación e implementación de estrategias de innovación en empresas. Rev Gestión de las Personas y Tecnol 16:6Hodge GA, Greve C (2017) On public-private partnership performance: a contemporary review. Public Works Manag Policy 22(1):55–78Hultman J, Hall CM (2012) Tourism place-Making governance of locality in Sweden. Ann Tourism Res 39(2):547–570Khattri N, Miles MB (1994) Cognitive mapping: a review and working guide. Center Policy Res, SparkhillKlodiana G, Dorina K, Engjellushe Z (2012) The role of local government in sustainable development. AUDOE. 8(2):139–155León JA, Zapico F (2003) Usos prácticos sobre la política electrónica en los servicios públicos: el caso de Extremadura. El profesional de la información. Mayo-junio 12(3):232–236Marinao E, Chasco C (2012) Trust in tourist destinations. the role of local inhabitants and institutions. Academia, Revista latinoamericana de administración 51:27–47Marzo-Roselló R, Peris-Pérez P, Ferris-Oñate, Sánchez-Lacuesta J, Matínez-Gómez L, Olaso-Melis J, Garcés-Pérez L, Primo-Capella VJ (2013) La experiencia turística en la ciudad de Valencia. Rev de Biomec 59:63–66Menon S, Manoj E (2014) Public private partnerships in tourism- a case study of Kerala Travel Mart. Afr J Hosp Tour Leisure 3(2):1–7Miranda-Gumucio L, Gil-Pechuán I, Palacios-Marqués D (2013) An exploratory study of the determinants of switching and loyalty in prepaid cell phone users. An application of concept mapping. Serv Bus 7(4):603–622Miret-Pastor L, Segarra-Oña MV (2011) Estudio del clúster turístico de Benidorm a través de indicadores de aglomeración y especialización. Renovación de destinos turísticos consolidados, pp 69–86Miret-Pastor L, Segarra-Oña MV, Hervás-Oliver JL (2009) Un análisis sobre la concentración espacial en el turismo valenciano. Congreso de la Asociación Española de Ciencia Regional. XXXV Reunión de estudios regionales, ValenciaMoscardo G (2011) Exploring social representations of tourism planning: issues for governance. J Sustain Tour 19(4-5):423–436Muñoz-Cañavate A, Chaín Navarro C (2004) La administración local española en internet: estudio cuantitativo de la evolución de los sistemas de información web de los ayuntamientos (1997–2002). Ciencias de la Inf 35(1):43–55Nabitz U, Severens P, Brink WVD, Jansen P (2007) Improving the EFQM model: an empirical study on model development and theory building using concept mapping. Total Qual Manag 12(1):69–81National and Integral Tourism Plan (2012–2015) http://www.minetur.gob.es/turismo/es-ES/PNIT/Documents/Plan%20Nacional%20e%20Integral%20de%20Turismo%20(PNIT)%202012-2015.pdf . Consulted in 2016Nicholson J, Orr K (2016) Local government partnership working: a space odyssey. Or, journeys through the dilemmas of public and private sector boundary-spanning actors. Policy Politics 44(2):269–287Nordin S, Svensson B (2007) Innovative destination governance: the Swedish ski resort of Åre. Entrepr Innov 8(1):53–66Nunkoo R (2015) Tourism development and trust in local government. Tour Manag 46:623–634Pechlaner H, Tschurtschenthaler P (2003) Tourism policy, tourism organisations and change management in Alpine regions and destinations: a european perspective. Curr Issues Tour 6(6):508–539Pfeffer J, Salancik G (1978) The external control of organizations: a resource-dependence perspective. Harper and Row, New YorkPorter ME (1990) The competitive advantage of nations. Harv Bus Rev 68(2):73–93Prahalad CK, Hamel G (1990) The core competence of the corporation. Harv Bus Rev 68(3):79–91Queiroz F, Rastrollo-Horrillo MA (2015) State of art in tourist destination governance. Tour Manag Stud 11(2):47–55. doi: 10.18089/tms.2015.11206Rodríguez MP, López AM, Ortiz D (2010) Implementing the balanced scorecard in public sector agencies: An experience in municipal sport services. Acad Rev latinoam de adm 45:116–139Rooter report (2010) La innovación en servicios en España. www.rooter.es . Consulted in 2016Rosas SR (2005) Concept mapping as a technique for program theory development: an illustration using family support programs. Am J Eval 26(3):389–401Rosas SR, Camphausen LC (2007) The use of concept mapping for scale development and validation in evaluation. Eval Progr Plann 30:125–135Santos M, Ferreira AM, Costa C (2014) Influential factors in the competitiveness of mature tourism destinations. Tour Manag Stud 10(1):73–81Selin S, Chavez D (1994) Characteristics of successful tourism partnerships: a multiple case study design. J Park Recreat Adm 12(2):51–61Selin S, Chavez D (1995) Developing an evolutionary tourism partnership model. Ann Tour Res 22(4):844–856Simpson B (1994) How do women scientists perceive their own career development? Int J Career Manag 6(1):19–27Soler-López MC (2013) Calidad y Rendimiento de Sitios Web de e-Government. Aplicación a la Administración Local. Doctoral thesis. Murcia UniversitySpanish Tourism Plan Horizon (2020) pp. 24 and 43. http://static.hosteltur.com/web/uploads/2011/10/Plan_de_Turismo_Espaol_Horizonte_2020.pdf . Consulted in 2016Toral SL, Barrero F, Martínez MR, Gallardo S, Cortés FJ (2006) Determinación de las variables de diseño en el desarrollo de una herramienta de e-learning. Pixel-Bit, Rev de medios y edu 27:99–113Torres L, Pina V (2001) Public–private partnership and private finance initiatives in the EU and Spanish local governments. Eur Account Rev 10:601–619Trochim WMK (1989) An introduction to concept mapping for planning and evaluation. Eval Progr Plann 12(1):1–16Trochim WMK, Linton R (1986) Conceptualization for planning and evaluation. Eval Progr Plann 9(4):289–308United Nations World Tourism Organization (2005) Making tourism more sustainable. A guide for policy makers, UNEP and UNWTO, pp 11–12. http://sdt.unwto.org/content/about-us-5United Nations World Tourism Organization (2015) UNWTO tourism highlights, p 6. http://www.e-unwto.org/doi/pdf/10.18111/9789284416899Velasco GM (2007) Gestión de destinos: ¿Gobernabilidad del turismo o gobernanza del destino?. Ministerio de educación y ciencia de España. Plan nacional de I + D + I (2004–2007)Wang Y (2008) Collaborative destination marketing: understanding the dynamic process. J Travel Res 47(2):151–166Wang Y, Fesenmaier RD (2007) Collaborative destination marketing: a case study of Elkhart county, Indiana. Tour Manag 28:863–875Wang C, Honggang X (2014) The role of local government and the private sector in China’s tourism industry. Tour Manag 45:95–105Williamson OE (1975) Markets and hierarchies: analysis and antitrust implications. The Free Press, New YorkWood DJ, Gray B (1991) Towards a comprehensive theory of collaboration. J Appl Behav Sci 27:139–162World Travel & Tourism Council (2016) Economic Impact 2016 Spain, p 3. http://www.wttc.org/-/media/files/reports/economic%20impact%20research/countries%202016/spain2016.pdf . Consulted in 2016Zapata MJ, Hall CM (2012) Public–private collaboration in the tourist sector: balancing legitimacy and effectiveness in local tourism partnerships. The Spanish case. J Policy Res Tour Leisure Events 4(1):61–8

Investigating organizational quality improvement systems, patient empowerment, organizational culture, professional involvement and the quality of care in European hospitals: the 'Deepening our Understanding of Quality Improvement in Europe (DUQuE)' project

BACKGROUND: Hospitals in European countries apply a wide range of quality improvement strategies. Knowledge of the effectiveness of these strategies, implemented as part of an overall hospital quality improvement system, is limited. METHODS/DESIGN: We propose to study the relationships among organisational quality improvement systems, patient empowerment, organisational culture, professionals' involvement with the quality of hospital care, including clinical effectiveness, patient safety and patient involvement. We will employ a cross-sectional, multi-level study design in which patient-level measurements are nested in hospital departments, which are in turn nested in hospitals in different EU countries. Mixed methods will be used for data collection, measurement and analysis. Hospital/care pathway level constructs that will be assessed include external pressure, hospital governance, quality improvement system, patient empowerment in quality improvement, organisational culture and professional involvement. These constructs will be assessed using questionnaires. Patient-level constructs include clinical effectiveness, patient safety and patient involvement, and will be assessed using audit of patient records, routine data and patient surveys. For the assessment of hospital and pathway level constructs we will collect data from randomly selected hospitals in eight countries. For a sample of hospitals in each country we will carry out additional data collection at patient-level related to four conditions (stroke, acute myocardial infarction, hip fracture and delivery). In addition, structural components of quality improvement systems will be assessed using visits by experienced external assessors. Data analysis will include descriptive statistics and graphical representations and methods for data reduction, classification techniques and psychometric analysis, before moving to bi-variate and multivariate analysis. The latter will be conducted at hospital and multilevel. In addition, we will apply sophisticated methodological elements such as the use of causal diagrams, outcome modelling, double robust estimation and detailed sensitivity analysis or multiple bias analyses to assess the impact of the various sources of bias. DISCUSSION: Products of the project will include a catalogue of instruments and tools that can be used to build departmental or hospital quality and safety programme and an appraisal scheme to assess the maturity of the quality improvement system for use by hospitals and by purchasers to contract hospitals