In the face of an oversupplied world pig market only the most efficient producers will stay in business. By and large these will be the operations that are able to more successfully exploit the genetic potential of their animals. Similarly, only those breeders who are able to demonstrate sustained genetic improvement will sell stock to the smaller number of large producers who are left. Althoug...

This paper disseminates findings from a Lean healthcare project in a UK National Health Service (NHS) Single Point of Access; a new healthcare case study setting. Action research was applied and Lean tools used to establish current state processes, customer values and develop improvement opportunities. It was found that interface issues between primary and secondary healthcare organisations wer...

BACKGROUND Quality improvement is attracting the attention of the primary health care system as a means by which to achieve higher quality patient care. Ontario, Canada has demonstrated leadership in terms of its improvement in healthcare, but the province lacks a structured framework by which it can consistently evaluate its quality improvement initiatives specific to the primary healthcare sy...

BACKGROUND In Canada, healthcare aides (also referred to as nurse aides, personal support workers, nursing assistants) are unregulated personnel who provide 70-80% of direct care to residents living in nursing homes. Although they are an integral part of the care team their contributions to the resident care planning process are not always acknowledged in the organization. The purpose of the Sa...

BACKGROUND In healthcare change interventions, on-the-ground learning about the implementation process is often lost because of a primary focus on outcome improvements. This paper describes the Learning Evaluation, a methodological approach that blends quality improvement and implementation research methods to study healthcare innovations. METHODS Learning Evaluation is an approach to multi-o...

BACKGROUND The current profile of residents living in Canadian nursing homes includes elder persons with complex physical and social needs. High resident acuity can result in increased staff workload and decreased quality of work life. AIMS Safer Care for Older Persons [in residential] Environments is a two year (2010 to 2012) proof-of-principle pilot study conducted in seven nursing homes in...

BACKGROUND Organisational context is frequently cited as an important consideration when implementing and evaluating quality improvement interventions in healthcare, but limited guidance is available on which aspects of context are most influential or modifiable. This paper examines how internal and external contextual factors mediate organisational-level performance improvement through applyin...

PURPOSE The purpose of this paper is to present a study of how quality improvement tools and techniques are framed within healthcare settings. DESIGN/METHODOLOGY/APPROACH The paper employs an interpretive approach to understand how quality improvement tools and techniques are mobilised and legitimated. It does so using a case study of the NHS Modernisation Agency Improvement Leaders' Guides i...

In response to a weight of evidence that patients are frequently harmed as a result of their care, there have been concerted efforts to make healthcare safer, with health systems across the globe investing significant resources in policies and programmes designed to reduce adverse events. Yet, despite extensive efforts, improvements in safety have proved difficult to sustain and spread, with st...