Using action research to implement a career development framework in facilities

Purpose – The purpose of this paper is to present findings from a research study to implement a career development framework within a large acute district general hospital facilities directorate. The findings of this study will provide points of interest in terms of the implementation of a career development framework and also a wider, more generalisable analysis relating to the use of action research (AR) in this context. The efficacy of career development frameworks and alternate recruitment strategies will also be considered. Design/methodology/approach – AR was utilised as the primary research methodology, with focus groups and semi-structured interviews employed as the main sources of data collection. NVivo qualitative analysis software was used to analyse the data. Interventions within the AR cycles have been categorised as micro and macro in terms of the complexity and level of personal and organisational involvement. Although micro interventions will be briefly referred to, macro interventions have been evaluated within this paper in terms of both efficacy and transferability.Findings – There were two main findings from this research project originating from AR interventions that may prove beneficial to other organisations in terms of both organisational and staff development: development of bespoke career development pathways; and creation of a fast track employability scheme within hotel services.Research limitations/implications – Some of the more longitudinal interventions will require further analysis to gauge long-term efficacy.Originality/value – This paper should prove beneficial to those involved with implementing organisational change and the potential use of AR within the facilities environment. The paper should also provide useful alternatives in the recruitment of staff and the use of career development interventions

Facilities management in the NHS: overlapping authority and demarcation disputes

Purpose The research aimed to investigate the implementation of the new ward housekeeper role a hospital setting. The outcome was to propose a model to demonstrate how FM departments and clinical ward teams work effectively together to deliver catering and cleaning services. Methodology The context of the implementation of the role was deemed a necessary feature, particularly to understand the organisation structures. In this case the context being a hospital and the underlying mechanisms in place such as local recruitment and retention issues. Therefore an interpretive approach was taken and a series of semi-structured interviews were the primary method to collect data, supplemented by some non-participant observation and document analysis. Findings The findings from the two themes enabled the development of a model to illustrate the working relationships between FM departments and clinical ward teams. Practical implications The findings from the study are of significance for hospital facilities and estates departments and clinical stakeholders who have a responsibility for ward catering, cleaning and the environment. Originality/value The significance of this study emerges through the advancement of methodology within the context of facilities in healthcare and through the contribution to knowledge and practice as a result of the proposed mode. This was the first type of study to look in detail at ward housekeeping models, using an interpretive approach over a relatively long period of time

Excellent patient environments within acute NHS trusts: external influences and trust characteristics

Purpose – The purpose of this paper is to investigate the possible common factors in 15 Acute Hospital Trusts in the UK that achieved excellent scores at all their sites in four years of national Patient Environment audits. Design/methodology/approach – A desk-based study tested for external factors, organisational commonalities or particular contractual arrangements which the sample might have in common. A second piece of work was then undertaken; an ethnographic study that examined the behaviours exhibited by 22 managers in six of the trusts. The second phase of research will be described in a separate paper. Findings – The research found that no external, organisational or contractual commonalities could be identified as shared by the trusts that formed the Research Group. This led the researchers to ask further questions as to the management/leadership of the FM Managers who had achieved consistantly high standards of Patient Environment over the four year period. Practical implications – The research reveals that the trusts which achieved high standards of Patient Environment had no shared advantage in terms of external, organisational or contract characteristics. Thus, it should be possible for all trusts to achieve consistently high standards. Originality/value – This is believed to be the only study looking at influences and characteristics that are outside the FM Managers’ control and impact on the FMs’ ability to deliver consistantly high standards.</p

Environmental cleaning in the NHS since the NHS Plan: a policy and evidence based context

Purpose This paper examines the policy and guidance that was issued, either as a direct result of the NHS Plan, or part of a subsequent initiative, surrounding cleaning in the NHS. Design/methodology A literature review of the Department of Health and related agency websites was completed. In addition there was a literature of the relevant academic journals. Findings There is a growing evidence base on environmental cleaning in the NHS and more specifically the relationship between environmental cleaning and infection control. This paper has examined the contradiction in the evidence in the suspected correlation between infection control and environmental cleaning. However, one thing does appear to be consistent, is that a performance measure based on an observation (visual) assessment is not a sufficient tool to evaluate the environmental cleanliness of a hospital ward. Practical implications Whilst the clinical community recognise the contribution of environmental cleaning and the impact on healthcare, there needs to be more to be done to have the relevant studies published in the FM domain. Conversely there also needs to be work done to allow the FM community to have a "voice" in the infection control journals. The literature reviewed suggests that a usable technological solution is required to confirm satisfactory cleaning standards in healthcare facilities. Originality/value There is relatively little published work on the importance of cleaning to operations in the NHS, particularly in the FM domain

Realising benefits in primary healthcare infrastructures

Purpose: This paper focuses upon the requirements to manage change, tangible and intangible benefits in a joint approach to deliver outputs on time, to quality and cost without failing to realise the benefits of the change. The aim of the paper is to demonstrate the need for benefits driven programme/project management as well as the importance of identifying the stakeholders’ level of involvement and contribution throughout the process, and manage their expectations. Design/methodology/approach: The methodology used is based on an action research approach, combining findings from a literature review and case studies within UK’s primary healthcare sector. Findings: Findings demonstrate development of a Benefits Realisation (BeReal) approach in healthcare through looking at case studies taking place within UK’s primary and acute healthcare sector Research limitations/implications: The framework development is based upon theoretical evidence and further research is needed to test and validate its robustness. Originality/value: The application of Benefits Realisation and Management in developing and delivering primary healthcare facilities. Keywords: Benefits management, Benefits realisation, healthcare infrastructures, process and LIF

A study of spectator emotions at the Tour de France

Research question: This paper contributes to the canon of literature on spectator emotions by examining spectator emotions at a major hallmark event. Research methods: Spectator experience emotions were surveyed via an online questionnaire resulting in 188 valid responses. This resulted in three groups of spectators being surveyed: i) those who watched live from the roadside ii) those watching via a spectator viewing hub and iii) those watching on television. Variables tested were via PANAS scale emotions. They included the positive emotions of interested, excited, strong, enthusiastic, proud, alert, inspired, determined, attentive and active. The negative emotions were distressed, upset, hostile, irritable, scared, nervous, afraid, guilty, ashamed and jittery. There are also nine categories within the model which are (1) attentive, (2) excited, (3) proud, (4) strong, (5) distressed, (6) angry, (7) fearful, (8) guilty and (9) nervous. Results and findings: The highest positive value feelings of ‘Interested, Excited and Enthusiastic’ occurred during the live action by those watching on the roadside. Negative feelings were more variable but a highest rating for ‘Afraid’ increased during the event, suggesting feelings of not wanting to miss anything (action). Further exploration of the emotions experienced before, during and after an event is required in order to more fully understand the complexity of the factors. Implications: For those planning and staging cycling and similar multi-stage or multi-site events the mapping (route) and layout of the active spectator and participant arena can be carefully constructed to provide potential emotional hot spots. Emotions vary across time and this appears to be related to mode and location of spectating. It implies that event organisers can utilise different ‘experiential components’ within an event setting to create conditions that would be conducive to an optimal viewing environment

Facilities management help desks

Abstract Purpose The purpose of the study is to provide an exploratory look at facilities and estates management help desks in four different case study organisations. Methodology A case study methodology was adopted, with semi structured interviews and observations as the principal methods to collect data. Findings The findings suggest that the key factors for the success of a FM help desk include mapping the out all customer requirements, recruiting the correct operating staff, ensuring an appropriate working environment and client communication once the help desk is operational. Originality/value At the time of the study there had been relatively little research completed focusing specifically on FM help desks. The paper will be of value to facilities and property managers who are considering implementing a help desk service

An open-label trial of tomoxetine in pediatric attention deficit hyperactivity disorder.

OBJECTIVE: To collect pilot data assessing the safety, tolerability, and efficacy of tomoxetine, a nonstimulant norepinephrine enhancer, in pediatric attention deficit hyperactivity disorder (ADHD). METHODS: An open-label trial of tomoxetine in pediatric ADHD was conducted as part of a multisite clinical trial. Following a baseline assessment, an ascending dose titration was completed during 10 weekly visits. RESULTS: Ten subjects were enrolled at baseline, with eight completing the study. Seven of the eight remaining subjects met efficacy criteria. Significant decreases in symptom severity ratings by parents and study investigators were found. The medication was well tolerated, with transient appetite suppression the most frequently reported side effect. However, subjects\u27 weights remained stable across study visits. DISCUSSION: These preliminary findings suggest that tomoxetine may hold promise as a treatment for pediatric ADHD

Symbols of Power: The Firearm Paintings of Madjedbebe (Malakunanja II)

Depictions of firearms in Australian Aboriginal rock art provide a unique opportunity to archaeologically explore the roles that this type of material culture played in times of culture contact. From the earliest interactions with explorers to the buffalo shooting enterprises of the twentieth century—firearms played complex and shifting roles in western Arnhem Land Aboriginal societies. The site of Madjedbebe (sometimes referred to as Malakunanja II in earlier academic literature) in Jabiluka (Mirarr Country), offers the opportunity to explore these shifting roles over time with an unprecedented 16 paintings of firearms spanning the nineteenth and twentieth centuries. This rock art provides evidence for early firearms as objects of curiosity and threat to local groups, as well as evidence for later personal ownership and use of such weaponry. Moreover, we argue that the rock art suggests increasing incorporation of firearms into traditional cultural belief and artistic systems over time with Madjedbebe playing a key role in the communication of the cultural meanings behind this new subject matter