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- Coast, J, et al.
(författare)
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Preferences for aspects of a dermatology consultation.
- 2006
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 155:2, s. 387-92
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: General practitioners with special interests (GPSIs) are increasingly being used to provide dermatology services in the U.K. Little is known about U.K. dermatology patient attitudes to proposed variations in secondary care service delivery or the values they attach to aspects of the care they receive.OBJECTIVES: To quantify preferences for different attributes of care within dermatology secondary care services.METHODS: Attributes of care that are important to dermatology patients were derived using in-depth qualitative interviews with 19 patients at different points in the care pathway. A discrete choice experiment using 'best-worst scaling' was sent by post to 119 patients referred to secondary care dermatology services and suitable for GPSI care who had agreed to participate in research.RESULTS: Four attributes were derived from the qualitative work: waiting, expertise, thorough care and convenience. For the discrete choice experiment, 99 patients returned questionnaires, 93 of which contained sufficient data for analysis. All attributes were found to be quantitatively important. The attribute of greatest importance was expertise of the doctor, while waiting time was of least importance. Respondents were willing to wait longer than the current 3 months maximum to receive care that was thorough, 2.1 months to see a team led by an expert and 1.3 months to attend a consultation that is easy to get to.CONCLUSIONS: Although the need to reduce outpatient waiting times is a key policy driver behind the expansion of GPSI services, this does not appear to be the most important issue for patients. The thoroughness with which the consultation is provided and the expertise of the clinician seen are higher priorities.
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- Mähring, Magnus, et al.
(författare)
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De-escalating IT Projects: The DMM Model
- 2009
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Ingår i: Communications- ACM. - : ACM Association for Computing Machinery. - 0001-0782. ; 52:10, s. 131-134
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Tidskriftsartikel (refereegranskat)abstract
- Taming runaway Information Technology (IT) projects is a challenge that most organizations have faced and that managers continue to wrestle with. These are projects that grossly exceed their planned budgets and schedules, often by a factor of 2--3 fold or greater. Many end in failure; failure not only in the sense of budget or schedule, but in terms of delivered functionality as well. Runaway projects are frequently the result of escalating commitment to a failing course of action, a phenomenon that occurs when investments fail to work out as envisioned and decision-makers compound the problem by persisting irrationally. Keil, Mann, and Rai reported that 30--40% of IT projects exhibit some degree of escalation. To break the escalation cycle, de-escalation of commitment to the failing course of action must occur so that valuable resources can be channeled into more productive use. But, making de-escalation happen is neither easy nor intuitive. This article briefly examines three approaches that have been suggested for managing de-escalation. By combining elements from the three approaches, we introduce a de-escalation management maturity (DMM) model that provides a useful framework for improving practice.
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