Dissertations / Theses on the topic 'Quality in public administration'

This thesis emerged as a result from the desire to know how the Public Service of Malaysia is coping up with the demands of quality services from the public. The Public Service, in meeting the aspirations of the Government, on providing quality services to the public, has introduced a number of quality programmes. In spite of this positive move to inculcate a quality work culture among the Public Service employees, the public is said to be still complaining about public services. In this situation, investigations are required to determine the true status of the level of quality of services delivered by the Public Service. These investigations involved measuring service quality and the SERVQUAL instrument of measuring service quality, which has been tested for its reliability, has been introduced. After obtaining the measurements, shown in the form of service quality gaps, further investigations was carried out to identify the cause of the service quality gaps. It was discovered that service quality can be affected by the internal service gaps and in this case, the service performance gap is the main cause of the service quality gap. Further investigations narrowed down the cause of the service quality gap to performance appraisal. Therefore insight was gained about the improper implementation of performance appraisal which can affect quality. The invaluable findings obtained from the thesis about the Public Service prompted suggestions to be made about ways of improving quality services delivered by the Public Service.

This dissertation examines the effect of regulations, resource and referral agencies, and subsidies on price and quality of care in child care centers. This research is based on a carefully developed conceptual framework that incorporates the factors affecting the demand and supply of child care. The first step in developing this framework is sketching out the structural equations. The structural equations help us understand the underlying behavior of individuals and firms making a decision. The exogenous variables are vector of attributes relating to family characteristics, child characteristics, regulations, subsidy, community characteristics and prices of inputs. Based on the structural equations, reduced form equations are estimated to find the effect of each of the exogenous variables on each of the endogenous variables. Reduced form equations help us answer public policy questions. The sample for this study is from the 1990 Profile of Child Care Settings (PCCS) data in which 2,089 center based programs were interviewed. Child/Staff Ratio (Group Level): Results indicate that among subsidies, only the state subsidy per child in poverty has a significant effect on the child/staff ratio at the group level. Presence of resource and referral agencies also increase the child/staff ratio at the group level. Also when the maximum center group size regulation for 25-36 months becomes more stringent, the child/staff ratio at the group level decreases. Child/Staff Ratio (Center Level): When the regulations for the maximum child/staff ratio for age groups 13-24 months and 37-60 months become lax, the child/staff ratio for the center increases. As the regulation for maximum group size for infants becomes stringent, the child/staff ratio decreases. An interesting finding is that as the regulations for maximum group size for age groups 13-24 months and 25-36 months become stringent, the child/staff ratio for the center increases. Another significant finding is that when a center is located in a rural area the child/staff ratio is significantly lower. Center Weighted Average Hourly Fees: Maximum group size regulations for age groups 25-36 months and 37-60 months have a negative effect on center hourly fee. Maximum child staff regulations for age groups 13-24 months and 37-60 months have a negative effect on center hourly fee. Maximum child staff regulations for age groups 0-12 months and 25-36 months have a positive effect on center hourly fee. Findings also indicate that the center average hourly price is lower when there is a resource and referral agency present. Cost adjusted prekindergarten funds and JOBS child care subsidies have a negative effect on average hourly fee. Cost adjusted social services block grant and state subsidy per child in poverty have a positive effect on the average hourly price. A major finding of this dissertation is the interaction of subsidy and regulatory variables. Another major finding is that child/staff ratio at the group level is lower when there is an interaction between geographic location and nature of center sponsorship.

Previous research shows that a good balance between focus on development of existing processes with development of new and innovative products, processes or services has a positive effect on organizational excellence. However, the relationship between these two quality perspectives is not easy to maintain and it is a challenge for every organization to find an appropriate balance between them. Previous research shows also that there is often a striking overemphasis on continuous improvement and stepwise refinement at the expense of working with innovations. Consequently, it has become necessary to find forms for development of the balance between improvement of existing processes and innovations. It is a question of how to manage both exploitation (improvement of existing processes) and exploration (innovations). Being able to manage both exploitation and exploration and maintain a good balance is known as organizational ambidexterity. The purpose of this thesis is to develop existing knowledge of how organisational ambidexterity and innovation can be understood and developed as an approach to increasing customer value in the context of the public sector. In order to meet the purpose, the research behind this thesis was conducted through six studies. The results have been presented in six scientific articles. The analytical focus in the research has been on management of public organization. Thus, the unit of analysis has been public sector management both at national, regional and municipal level. The studies have been conducted with a qualitative approach and data collection has primarily been done through semi- structured interviews. Most of the data has been collected in Sweden. Through the studies, it appears that the current quality practice in the Swedish public sector to a large extent relates to and supports exploitation, but not exploration. The empirical findings give examples of organizations that have a large focus on systematic measurement and control of the work process. An inhibition of increased customer value is indicated in the studied organizations’ current emphasis on exploitation at the expense of exploration. The research also shows that there are a number of impediments for the public organizations studied to combine their current quality practice with an improved ability to explore. It appears that there is a need for development of the leeway for exploration in order to increase the ability to be ambidextrous. The research behind this thesis empirically identifies a number of enablers the public organization may need to work actively with in order to develop organizational ambidexterity. Some of these enabling factors harmonize with quality movement core values. This applies to core values like committed leadership, focus on customers and a holistic system perspective. In addition, the following factors are perceived to be enabling factors for organizational ambidexterity: specific budgets for both exploration and exploitation; development of a culture in which employees feel that they are allowed to make mistakes; a good dialogue both internally and with external stake holders; focusing on the implementation of innovations and clear incentives for work on exploration as well as for work on exploitation. Finally, the empirical data also shows that an enabling factor is to get different professions involved in explorative processes. This can be achieved by working through ambassadors who can promote the explorative processes. The enablers, which have been empirically identified in this research as important for organizational ambidexterity, have also previously been identified by scholars as enablers for innovations. The research behind this thesis contributes to the empirical sorting out which - out of a wide range of factors - may be the most important factors for organizational ambidexterity.<br><p>Vid tidpunkten för disputationen var följande delarbeten opublicerade: delarbete 6 accepterat.</p><p>At the time of the doctoral defence the following papers were unpublished: paper 6 accepted.</p>

<p> From 2017 to 2019, the primary strategy to improve public schools in the U.S. was increasing competition through the expansion of charter schools and the promotion of vouchers to send public school students to private schools. The problem this presented was that key education leaders had not provided adequate input and feedback into this strategy. The purpose of this qualitative study was to gather the perspectives of accomplished education leaders on how Tiebout&rsquo;s theory of competition and the concept of the Ontario K-12 School Effectiveness Framework impacted quality, trust, and capacity. Data were collected using semistructured interviews with a purposeful sample of 15 accomplished education leaders from the charter/school choice community and traditional public schools. Data were analyzed using Bernauer&rsquo;s modified three-phase method. School and classroom leadership, meaningful and informative assessment that guides instruction, substantive student engagement, and a focus on a strong curriculum and effective teaching were the key themes that aligned with quality, trust, and capacity. Education leaders did not see Tiebout education as a key driver that would alone improve the quality of public education. Leaders believed that some schools improved in response to Tiebout competition but also shared cautions on the diminishing returns, collateral damage, and equity concerns because Tiebout competition created winners and losers. Social change may be impacted by the results of this study in that the results define and share examples of healthy and unhealthy competition in public education. The results of this study can help inform policy makers and educators as they create opportunities that will enhance the long term personal and economic success of all U.S. students.</p><p>

Despite a large body of literature addressing the issue, questions remain about whether nonprofit hospitals provide more community benefit than do for-profit hospitals. This lack of information impacts governments, hospitals, and the healthcare industry, as stakeholders attempt to generate requirements to which hospitals should adhere to maintain nonprofit status, and thus tax exemption. This study addressed this lack of information by examining U.S. hospitals through the lens of stewardship theory to determine whether nonprofits are better stewards of the public good than for-profits, and thus likely to provide higher quality and access. The study applied logistic regression to Centers for Medicare and Medicaid Services (CMS) data indicating levels of perceived quality, or patient satisfaction, and American Hospital Association data identifying service mix profitability, an indicator of access. The sample included all 2,701 U.S. hospitals receiving CMS funding. Findings indicated that high quality hospitals were more likely to be nonprofit than for-profit (b = 0.07; Exp(B) = 1.07; p = .000). Neutral access hospitals, those with mid-range service mix profitability, were more likely to be nonprofit than for-profit (b = 1.73; Exp(B) = 5.63; p = .000) as were high access hospitals, those with low service mix profitability (b = .276; Exp(B) = 1.32; p = .04). The R_L^2 for the models was .06 and .03, respectively. Given this limited predictive power, it seems unlikely the added value (access and quality) nonprofits are likely to provide justifies tax exemption. If further research supports this argument for other potentially relevant variables such as technical quality of care, governments could remove nonprofit hospitals' tax exemptions and apply the resulting tax revenue to other policy areas to realize positive social change.

Recent studies conducted by oversight agencies show that improvements are needed in Federal personnel office (FPO) operations. The existing literature and research in the field of public personnel administration provides little guidance as to what types of changes or interventions will improve service quality. The purpose of this study is to identify organizational variables that influence FPO service quality. This study is based on the multiple-constituency model of organizational effectiveness and the body of literature pertaining to service quality research conducted in private sector service industries. The investigator developed a conceptual model of FPO service quality based on the findings from service quality research and from various Federal personnel studies. Using the conceptual model as a guide, the statement of the problem became: How do the organizational dimensions of FPO access, human resource management (HRM) program design, FPO staff qualifications, FPO staff attitudes, Federal manager status, and Federal manager support influence the quality of FPO service as perceived by Federal managers? Within these six dimensions, sixteen variables were identified for testing. The research design was based on determining the association of sixteen predictor variables to the criterion variable of perceived service quality, using analytical surveys randomly administered to 72 personnel specialists and 269 Federal managers in six Federal government organizations. Of the sixteen variables tested, six had a significant relationship to managers' perceptions of service quality. These were FPO proximity, HRM program responsiveness, FPO staff training, FPO service standards, and a managers' supervisory level and authority for HRM actions. The primary significance of the study is that it extends service quality theory to Federal personnel administration, it provides an additional dimension to the current multiple constituency models of personnel office effectiveness, and it provides guidance on how to improve FPO service quality.

Total quality management [TQM] is an approach to improving the competitiveness, effectiveness and flexibility of the whole organization through the improvement of the organizational processes and those who perform them. There has been a rising interest among public sector professionals in examining the applicability and usefulness of TQM methods to public organizations. This research provides descriptive information about the experience of three health care organizations that vary in terms of ownership, whether being publicly or privately owned, with implementing TQM. Participants at these organizations were interviewed, and/or surveyed and observed. The study provides a narrative description of each organization's experience with TQM (their Quality Story) and it compares the implementation of TQM in the three organizations. Moreover, the study explores what role, if any, does ownership have on the implementation of TQM. Finally, the study presents some lessons that could be derived from the experience of these organizations. Conclusions are drawn that TQM could be successfully implemented in both sectors, provided that the process of implementation follows the specific guidelines and principles established in the field. Moreover, difference in ownership between public and private organizations, though important, is not the major factor influencing the implementation and any possible outcomes of a TQM innovation effort. It is rather the involvement and commitment of top management that seem to have the upper hand in influencing the implementation and any possible outcomes of TQM, in public as well as private organizations. However, the research suggests that public sector organizations are more challenged in implementing TQM, due to the multiplicity of their customers and more scrutiny of the tax payer and the media.

Thesis (MTech (Quality))--Cape Peninsula University of Technology, 2009<br>The Department of the Premier: Orgnisational Development is mandated to coordinate provincial intervention that will assist the provincial departments of the Western Cape to improve the efficiency of their service delivery. Increasing customer demand for quality services have virtually forced the Department of the Premier: Orgnisational Development to adopt the concept of quality in every aspect of the business. The Department of the Premier: Orgnisational Development is the center of government focussed on strategically guiding the province and centrally coordinating the strategic functions in order to deliver seamless and holistic governance towards realising the iKapa Growth and Development strategies and transforming the Western Cape into a home for all. The Department of the Premier, through holistic governance, deliver strategic leadership, outcome based management, needs-based services and efficient and effective corporate government to the Provincial Government and the citizens of the Western Cape at large. The primary research objectives of this study are the following: _ To identify mechanisms to continuously improve the level of service delivery within the department in accordance with set standards. _ To identify mechanisms to continuously measure, analyse and improve processes within the department in order to meets and exceed customer expectations. _ To create a culture and platform for continuous improvement within the Government Sector. _ To create an enablement mechanisms for staff to execute their duties effectively. It is anticipated that the research will lead to an improvement in the current state of service delivery at the Department of the Premier: Directorate Organisational Development, by identifying and providing possible solutions that impedes service delivery.

Audit quality plays an important role in the public sector, especially in an emerging market. However, there is no specific concept that defines and measures the term audit quality.  There is a gap of conceptual framework in the public sector the public sector that explains the need for audit and the attributes of audit quality. Thus, the purpose of this study is to explore the need for audit and the attributes of audit quality perceived by middle and senior management staff in public Corporation in Liberia. This study employs a qualitatitive research methodology. We collected primary data through email interviews that consisted of 8 participants from 5 different public Corporations in Liberia. we used Thematic (Template) analysis to summarize the data collected. The findings show that auditing in Public Corporation in Liberia is needed to ensure transparency and  accountability, agency/monitoring improved internal control, and business processes, as well as confidence and assurance for stakeholders. Furthermore, middle and senior management staff perceived that auditor's independence, auditors' competence, and audit partner or manager's attention to the audit, as well as audit personnel salaries, are important attributes that influence audit quality in public corporations in Liberia.Our findings form the basis for a conceptual framework for public sector auditing in a developing country.

Thesis submitted in fulfilment of the requirements for the degree Magister of Technologiae: PUBLIC MANAGEMENT in the Faculty of BUSINESS at the CAPE PENINSULA UNIVERSITY OF TECHNOLOGY 2013<br>Investment Promotion Agencies act as economic development conduits which seek not only just to undertake promotion, but also to improve the wider environment for investors by liaising and initiating change. As a result, worldwide governments have set up Investment Promotion Agencies (IPAs) to advance investment goals and by extension economic development in the context of a dynamic and competitive environment. Yet, little empirical research is done, especially in the developing world with a view to enhance the working practices of IPAs. This study investigated the effectiveness and quality of services provided by Mozambique’s Centre for the Promotion of Investment (CPI) from the perspective of both local and foreign investors. A quantitative approach by way of an online questionnaire was employed in the study. The data generated was analysed with the assistance of a registered statistician. The study found that most of the participants (local and foreign investors in Mozambique) do not make use of the services which the CPI is mandated to offer such as company registration; registration with the Fiscal Department and the publishing of company constitution in the government gazette, to name but a few. Furthermore, investors who have accessed the above services indicated a lack of service quality by the CPI. In the wider environment, the study found areas of concern such as an inadequate accounting system and a lack of proper coordination among the stakeholders involved in the process of setting up a business in Mozambique.

Expression du recentrage de l'action publique sur la satisfaction des usagers, l'exigence de qualité est devenue incontournable pour les services publics. Au départ introduite sous la forme de démarches participatives, la qualité est aujourd'hui au cœur des démarches d'assurance qualité et de responsabilisation. Si l'emprunt au secteur privé est indéniable, les ajustements auxquels la transposition de ce précepte a donné lieu témoignent de l'émergence d'une conception spécifique de la qualité, propre aux services publics et ayant des répercussions juridiques inattendues. Aussi, les composantes de la qualité administrative, telles la transparence, la simplicité, la réceptivité ou encore la célérité, sont des exigences, spécifiques au service public, largement juridicisées. L'exigence de qualité est donc saisie par le droit et tout porte à croire qu'elle est même devenue un principe du régime de service public, complétant le triptyque originel<br>The demand for quality has become inevitable for public utility, as an expression of the will of public action to satisfy users' needs. At first introduced in the form of participative approaches, quality is currently at the center of quality assurance and responsabilisation approaches. This managerial precept has adjusted itself and reflects the emergence of a distinctive notion of quality, specific to public utilities. Therefore, it has had unexpected legal repercussions. Moreover, administrative quality's components, such as transparence, simplicity, receptivity or promptness are requirements widely included in the field of Law. The demand for quality is thus seized by Law and everything leads to believing that it has become a principle of public utility regulations, completing the original triptyque

From 2017 to 2019, the primary strategy to improve public schools in the U.S. was increasing competition through the expansion of charter schools and the promotion of vouchers to send public school students to private schools. The problem this presented was that key education leaders had not provided adequate input and feedback into this strategy. The purpose of this qualitative study was to gather the perspectives of accomplished education leaders on how Tiebout's theory of competition and the concept of the Ontario K-12 School Effectiveness Framework impacted quality, trust, and capacity. Data were collected using semistructured interviews with a purposeful sample of 15 accomplished education leaders from the charter/school choice community and traditional public schools. Data were analyzed using Bernauer's modified three-phase method. School and classroom leadership, meaningful and informative assessment that guides instruction, substantive student engagement, and a focus on a strong curriculum and effective teaching were the key themes that aligned with quality, trust, and capacity. Education leaders did not see Tiebout education as a key driver that would alone improve the quality of public education. Leaders believed that some schools improved in response to Tiebout competition but also shared cautions on the diminishing returns, collateral damage, and equity concerns because Tiebout competition created winners and losers. Social change may be impacted by the results of this study in that the results define and share examples of healthy and unhealthy competition in public education. The results of this study can help inform policy makers and educators as they create opportunities that will enhance the long term personal and economic success of all U.S. students.

Thesis (MBA (Business Management))--University of Stellenbosch, 2009.<br>ENGLISH ABSTRACT: Purpose – The health care industry is faced with numerous challenges ranging from rising medical costs, poor state of hospitals, deteriorating health care services and an increasing number of hospital deaths. All these disparities present tremendous challenges for the health care managers in charge of the health care services. As a result, they are forced to try new management methods that will assist their organizations to remain cost effective and efficient. Total Quality Management (TQM) constitutes an appropriate response to these challenges and it has become the strategy of choice to improve organization’s performance and patient satisfaction. However, in practice the implementation of TQM is often unsuccessful. Certain barriers have been identified which prevent the successful implementation of TQM in other industries as well as in the health care industry. The main aim of this research is to investigate the barriers to the successful implementation of Total Quality Management in Kraaifontein health care service organization in the Western Cape Province, 2008. Design/methodology/approach – The study employed a quasi-qualitative and quantitative case study. For the quantitative section a questionnaire with a 5–point Likert style scale was used to quantify the response (strongly disagree=1; strongly agree=5). For the qualitative section a focus group discussion was conducted to verify the results obtained from the questionnaire which addressed the challenges of TQM implementation. The statistical population of this research consisted of all health care workers working the pharmacy department who were involved in the implementation of TQM in their organization. Data was analyzed using appropriate statistical procedures. The mean score of each of the dimensions was used as a representative performance indicator and the coefficient of variation (CV) was used as a general measure of standardized skewness on the performance of each dimension. A high means score indicated desired outcomes while low scores indicated poor outcomes. Findings – Major barriers that were encountered during the implementation of TQM in this case study included the lack of top management active involvement and full commitment in the initiative, rigid organizational structure, culture towards quality changes that inhibited communication between management and employees which in turn hindered employee empowerment. Other obstacles that were encountered were lack of continuous improvement processes and initiative, improper evaluation, the lack of a recognition and reward system for team work, poor collection and analysis of data that resulted in difficulty to convert this data into meaningful information to improve quality. The absence of an integrated performance measurement system also exhibited a problem as employees were not aware what was being assessed during performance appraisals. Lack of evidence based decision making, poor communication and inflexible organizational structure and culture were also viewed as barriers. Research limitations/implications – Although conducted in Kraaifontein health care facility, it is expected that the results of the study may be relevant on a broader scale to other health care departments and facilities. The results could assist the health care managers to develop a plan that addresses the barriers and challenges faced during the implementation of TQM, yielding fruitful results which allow TQM to be implemented easily, effectively, efficiently and successfully in health care facilities.<br>AFRIKAANSE OPSOMMING: Doel – Die gesondheidsorg sektor het vele uitdagings wat wissel van stygende mediese kostes, lae standaarde in hospitale, die agteruitgang van gesondheidsorg dienste, en die toename in sterftes in hospitale. Hierdie en ander probleme stel groot uitdagings aan diegene verantwoordelik vir die lewering van gesondheidsorg, met die gevolg dat diesulkes nuwe bestuursmetodes moet vind om te verseker dat hulle organisasies steeds koste-effektief en doeltreffend funksioneer. Totale Gehalte Bestuur (TGB) is ‘n geskikte en toepaslike alternatief om genoemde probleme aan te spreek, en word toenemend as oplossing gesien om organisasies se dienslewering te verbeter, en pasiënt-tevredenheid te verseker. Die implementering van TGB blyk egter nie altyd suksesvol te wees nie. Daar is spesifieke struikelblokke geidentifiseer wat as redes aangevoer word vir die onsuksesvolle implementering van TGB in verskeie sektore, insluitend die van gesondheidsorg. Die hoof doel van hierdie navorsing was om die struikelblokke te ondersoek wat verhoed dat TGB suskesvol toegepas word in Kraaifontein gesondheidsdienste in die Weskaap, 2008. Ontwerp/Metode/Benadering – Die studie was ‘n kwasi kwalitatiewe en kwantitatiewe gevallestudie; vir die kwantitatiewe komponent is ‘n 5 punt Likert tipe skaal gebruik om die response (verskil beslis = 1; stem beslis saam = 5) te kwantifiseer. Die kwalitatiewe komponent het ‘n fokusgroep bespreking behels, waartydends die resultate van die vraelys geverifiëer is, wat die uitdagings van die implementering van TGB uitgewys het. Die statistiese populasie vir hierdie navorsing was al die gesondheidsorg werknemers in diens van die aptekers-departement, wat betrokke was in die implemetering van TGB in hulle organisasie. Die data is geanaliseer met toepaslike statistiese metodes. Die gemiddelde telling van elkeen van die dimensies was gebruik as ‘n verteenwoordigende aanduiding van prestasie, en die koëfisiënt van veranderlikheid was gebruik as ‘n algemene maatstaf van die gestandardiseerde skeefheid soos gemeet op elkeen van die dimensies. ‘n Hoë gemiddelde telling was ‘n aanduiding van die beoogde uitkomste, en lae tellings aanduidend van swak uitkomste. Bevindinge – Belangrike uitdagings wat ondervind is tydens die implementering van die TGB in hierdie gevallestudie sluit in, die gebrek aan aktiewe betrokkenheid en toewyding van die topbestuur vir hierdie inisiatief, rigiede organisatoriese strukture, die kultuur teenoor gehalte veranderinge wat kommunikasie tussen bestuur en werknemers belemmer, wat op sy beurt werknemer-bemagtiging verhoed. Ander struikelblokke wat geidentifiseer is, was ‘n afwesigheid van voortdurende verbeteringsprosesse en inisiatief, swak evaluering, ‘n gebrek aan ‘n sisteem vir erkenning en vergoeding vir spanwerk, swak data insameling en ontleding, wat tot probleme gelei het om die data in betekenisvolle inligting te verwerk wat kon lei tot ‘n verbetering in gehalte. Die afwesigheid van ‘n geintegreerde prestasie-beoordeling sisteem is ook as probleem geidentifiseer omdat werknemers nie ingelig was oor wat die prestasie-beoordelings behels nie. Die gebrek aan navorsingsgesteunde besluitneming, swak kommunikasie, en onbuigsame organisatoriese strukture en kultuur, was ook gesien as struikelblokke. Navorsing-beperkinge/implikasies – Alhoewel die studie in Kraaifontein gesondheidsorgfasiliteit gedoen is, word dit aanvaar dat die bevindinge van hierdie studie ook van toepassing is op ander gesondheidsorg departmente en fasiliteite. Die resultate kan gesondheidsorgbestuurders help om die uitdagings en struikelblokke te identifiseer in die implementering van TGB. Hierdie identifikasie kan lei tot ’n meer effektiewe en suksesvolle implementering van TGB in gesondheidsorgfasiliteite.

This study utilizes the Longitudinal Study of the Vocational Rehabilitation Program to examine the impact of state-federal vocational rehabilitation services on the quality of life of consumers. The theory that guides this study is an amalgam of theories of Allardt, Halpern, Campbell, and Cummins which indicate that quality of life is made up of various domains which parallel Maslow’s Hierarchy of Needs. The study followed the theory that improvement in the individual domains of life would improve its overall quality. The domains of physical functioning, self-esteem, community integration and productivity were assessed prior to and after the receipt of vocational rehabilitation services. Results indicate that consumers who obtain an employment outcome obtain higher scores on measurements of self-esteem, physical functioning and activities of daily living and productivity than do consumers who do not obtain an employment outcome. The linkages that specific VR services have on individual life domains were also explored. Consumers who receive more education and training services show an increase in community integration scores. Suggestions for state-vocational rehabilitation services change are provided based on a socio-ecological model.

States have historically used Certificate of Need (CON) regulations to regulate cost, quality, and access to healthcare services. Federally mandated in 1974, the regulation required the states to review requests for new healthcare construction and services. In theory, community-level planning backed by the state-level CON review and health planning process would prevent unnecessary duplication of services and the accompanying costs (Smith-Mellot, 2004). However, none of the published studies have examined the association of CON regulation on volume and outcomes of solid organ transplants. In 1984, the federal mandate ended, and each state was allowed to determine whether or not to maintain its CON programs; more than one-third of the states eliminated them (Altman & Ostby, 1991). Currently, 37 states including the District of Columbia have CON programs (American Health Planning, 2010). Of those states, 21 include organ transplant as a reviewable, regulated service. Although several studies have investigated whether CON regulation has affected healthcare cost, to date very little has been written about the impact of CON on volume and quality of care; the data that does exist is contradictory. In 1988, investigators studied the effects of CON regulation on mortality and observed that greater regulatory stringency was a positive and significant predictor of hospital mortality rates (Shortell & Hughes, 1988). In contrast, DiSesa et al (2006) found no significant difference in risk-adjusted mortality for cardiac surgery patients in states with and without CON regulations. The gap between evidence and decision-making and the large number of states that use CON to regulate healthcare services indicate a need for a study on the quality of healthcare services. Solid organ transplantation is a complex, high-cost treatment that was performed over 27,000 times in 2008. The purpose of this study is to assess the association of solid organ transplant CON regulations using clinically rich data available from the Scientific Registry of Transplant Recipients (SRTR). This study tests the hypotheses that states with solid organ transplant CON regulations have fewer transplant centers, higher volumes of heart and kidney transplants per center, lower graft failure rates and lower patient mortality rates per center. In addition, this study assesses these hypotheses using two different transplant procedures (heart and kidney). This study provides additional information for transplant centers to use in their strategic decision making. Moreover, with the presence of minimum volume standards for transplant procedures mandated by the Centers for Medicare and Medicaid (CMS) now, the policy implications of continuing or repealing CON regulations should be examined.

The purpose of this study was to develop and validate a risk-adjustment index for one year healthcare resource use specific to diabetic patients, based on severity of illness measures; and to profile quality of diabetes care between outpatient clinics. The data for this study was collected from four outpatient clinics within the Southern Arizona Veterans Affairs Healthcare System, Tucson, AZ. The DRCI was developed using a sample size of 367 diabetic subjects that had complete information on diabetes-specific variables. Individual DRCI weights, based on the magnitude of one year healthcare resource use and socio-demographic characteristics, ranged from -471.5 to 3,081.2 for total healthcare costs, from -304.3 to 1,582.1 for outpatient costs, and -0.19 to 0.93 for risk of hospitalization. The DRCI was better than or equivalent to the Chronic Disease Score in predicting health care costs. Diabetics in the second cohort were predominantly elderly (mean = 66yrs ± 11.1), married (61%), white (73%), males (96%), had a high BMI (31 ± 6.3 kg/m²), and mean comorbidity score of 4.2 ± 1.8 conditions. Screening for HbA1c and microalbuminuria was frequently performed in all clinics. Overall, 61% and 36% of study patients did not have evidence of foot or eye examinations during the entire study period, respectively. Approximately, 27% (n = 408), 41% (n = 643), and 26% (n = 515) of the study patients had poor glycemic, renal function, and lipid control, respectively. Significant differences (p < .05) in HbA1c and creatinine clearance rates between the clinics were observed after adjusting for patient case-mix. However, differences between the clinics in cardiovascular outcome were not observed after adjusting for patient case-mix. This study demonstrated an association between diabetes severity with healthcare resource and costs. The DRCI, using laboratory data, is a diabetes-specific severity measure for prediction of one year healthcare resource use. Future studies are needed to validate this index in other settings. Finally, the results from this study emphasize the need to adjust for case-mix variable when comparing quality of diabetic care outcomes between outpatient clinics.

Práce se snaží reagovat na aktuální otázku, týkající se modernizace veřejné správy a s ní spojenou aplikaci metod managementu kvality ve veřejné správě. Zvláštní pozornost je věnována Modelu CAF (Common Assessment Framework), který byl vyvinut jako nástroj sebehodnocení speciálně pro veřejný sektor. V České republice byl tento model doposud aplikován především na úrovni samosprávných a ústředních správních úřadů. Vzhledem k možnosti implementovat tento model v nejrůznějších částech veřejného sektoru, se práce snaží upozornit na vhodnost využití Modelu CAF i v oblasti vzdělávání. Pro jeho snazší aplikaci ve školách jsou uvedeny i praktické příklady důkazů, které jsou důležitým podkladem pro hodnocení v Modelu.

To ascertain the purpose and value of audit in the public-sector corporations, this study was done to explore the needs and perception of audit value likewise to analyse the perception of stakeholders like auditees and the society on the value of the audit conducted by the external auditors in Liberia. A qualitative method was used to collect and analyse the empirical data used in this study. The findings of this study have proven that the need of audit in the public-sector corporations is for accountability and transparency but mainly for legitimacy as government must work along with other stakeholders like public entities to respond to the needs of its citizen. Furthermore, this studying has proven that, indeed audit can add value in the public sectors. In Liberia, the audit conducted by GAC is of great value to all stakeholder as auditors are identifying and reporting on the exact performance of the resource allocation and program implemented in the public corporations.

The collapse of Enron and several other companies, such as Global Crossing and the more recent scandal of Tesco, raised concerns worldwide about auditor independence and audit quality. The scandals have proven that particularly the joint-provision of auditing and nonaudit services (NAS) along with a long-term auditor-client relationship tend to adversely impact auditor independence thus audit quality, triggering the need for a new regulation. In order to solve this problem, the European Union implemented a new regulation requiring public listed entities (PIEs), which are defined as listed companies, credit institutions and insurance undertakings, to rotate their audit firm after a period of 10 financial years. The primary purpose of my master thesis is to gain a deeper understanding of audit firms’ and public listed firms’ perceptions of auditor rotation, meant in the sense of audit firm rotation, and its impact on audit quality. More specifically, I aim to investigate whether audit firm rotation enhances audit quality due to a fresh view brought to the company audited by a new auditor or lowers it because of a new auditor’s lack of knowledge about the client’s industry. Current literature regarding the new EU regulation, audit firm rotation and its impact on audit quality as well as the early stage of implementation of the new EU Directive in Sweden helped me to recognize a research gap. Existing studies similar to mine have not been concerned with getting a deeper understanding about the perception of this topic by audit companies and public listed companies located in Sweden. The research philosophy of my study is based on the constructivist ontological view and interpretivist epistemological perspective. In addition, the deductive approach is used to study the research question, while applying the qualitative research method by carrying out multiple semi-structured interviews with auditors and CEOs (Chief Executive Officers) and CFOs (Chief Financial Officers) of public listed companies based in Sweden. The final results are gained through the combination of primary data gathered from the interviews, and secondary data collected during my literature search. My findings demonstrate that the auditors asked are in favour of audit partner rotation since according to their opinion it positively impacts audit quality because of the prevention of a too close relationship between auditor and client. Nevertheless, they do not see an additional advantage from audit firm rotation as they believe that audit partner rotation has already fulfilled the same purpose. CEOs and CFOs of public listed companies have diverse views regarding this topic. Three from five perceive auditor rotation is increasing audit quality due to the fresh look brought by a new auditor and enhanced auditor independence, while the two others think that the new regulation is reducing audit quality caused by the new auditor´s lack of industry knowledge of the client. Other factors positive influencing audit quality are the separation of NAS and audit, joint-audits, expertise and experience of the auditor, a detailed audit plan, providing of full information by the client and the appointment of the auditor by the client itself. Keywords: auditor rotation, audit firm rotation, EU regulation 2016, audit quality, long-term auditor-client relationship, auditing in Sweden, International Standards on Auditing (ISA), role of auditor, audit firm size, non-audit services and auditor independence.

Réforme du secteur public a été entrepris dans les différentes régions du monde depuis 1980 dans le Nom du New Public Management et avec l'objectif de changer public traditionnel l'administration. Le but ultime de la réforme est d'améliorer l'efficacité, performance et la qualité des services publics fournis aux citoyens et à améliorer la capacité à exercer les fonctions de base du gouvernement. Les partisans de la NGP insister pour que le pratiques et les principes du secteur privé peuvent être adoptées par le secteur public à améliorer les activités du gouvernement. NPM a été considérée comme une meilleure pratique mondiale pour être adoptée généralement sous diverses pressions internationales. Néanmoins, en réalité, il n'ya pas de seule meilleure approche, chaque gouvernement réformateur aurait à examiner dans quellecaractéristiques degré et comment les principaux peuvent être incorporés dans leurs systèmes de gestion publiqueet les contextes. En raison de différences contextuelles, des résultats d'application de la réforme varie d'un endroit à et même d'une organisation à l'intérieur d'un pays. Dans une tentative pour améliorer la prestation des services dans le secteur public, le gouvernement de l'Ethiopie a lancé un programme de service civil en 1996 et la politique de prestation de services et la mise en œuvre instruments en 2001. L'objectif global de la réforme est de permettre aux institutions publiques pour fournir leurs services au public en efficiente, efficace, transparent et réceptif manière. Sur la base des objectifs de la politique et les paramètres tirés de la prestation des services la littérature, cette étude vise à évaluer la performance de la prestation des services mise en œuvre à Addis-Abeba gouvernement de la ville en utilisant la qualité, la quantité, le coût et le temps que indicateurs de performance. Un échantillon de trois agences sélectionnées intentionnellement et de bureaux qui sont impliqués dans la vie quotidienne prestation de services sont les principales sources d'information primaire de cette étude. 600 clients, 78 employés, 13 membres des groupes de discussion et les gestionnaires de la respective bureaux présenté leurs vues et des réponses aux questionnaires et d'entretiens transmispendant la période de collecte des données. L'étude montre que des trois bureaux, RICSRS (identité des résidents et l'état civil l'inscription au service) fait mieux que d'autres bureaux dans la plupart des clients de qualité liés dimensions et de services à offrir la vitesse. Vitesse de prestation de services a été améliorée pour la satisfaction des utilisateurs du service et que le résultat du nombre de clients ont utilisé le service considérablement augmenté au cours de la période d'étude.Au contraire, la prestation de services à l'Autorité l'administration des terres est classé dans la plupart des pauvresaspects des paramètres de performance. Les causes de la mauvaise qualité comprennent très faible niveau detransparence, la réactivité, la fiabilité, la vitesse, le mécanisme de traitement des griefs, employés de motivation, de courtoisie et d'autres dimensions de la qualité. Le nombre de services les utilisateurs n'ont pas augmenté au cours de la période d'étude. Les clients témoin de prestation de services processus prend longue période de temps à l'encontre de l'heure indiquée dans les normes de service. Les contacts sont ennuyeux, trop long et inutile menant à l'insatisfaction.La prestation de services à l'Agence du revenu peut être considérée comme modérée si elle ne répond pas au certains aspects. Il réalisées en moyenne dans les délais, la facilité processus, la transparence, l'équité, la réactivité, le grief de manipulation et de compétence. Il effectuées sous la moyenne dans dimensions telles que la consultation avec les clients, l'accès aux fournisseurs de services, du respect et de courtoisie. Le nombre de clients a augmenté la tubulure sur la période d'étude. Coût induit par client a montré des tendances variables plus élevées dans lequel chaque habitant est enregistré initialement et le plus bas en 2006. Il a bondi en 2007 et légèrement diminué en 2008. Enfin, l'amélioration de la prestation de services avec de nouvelles lois fiscales a entraîné une augmentation de la collecte des recettes. Le revenu total a augmenté de 729,47 millions de Birr en 2001-2600000000 Birr en 2006 (2,6 milliards de Birr est d'environ 260 millions de dollars dans l'année 2006). Globalement, la recherche montre que certains progrès ont été accomplis dans la mise en œuvre du réforme, mais il ya beaucoup à faire pour atteindre les objectifs aspirait à la prestation de servicesla politique. Le document de politique du service de livraison est bien écrit contenant plusieurs importants instruments de prestation des services qui répondent à d'importants aspects de la prestation de services efficace dans le secteur public. Cependant, leur mise en œuvre est retardée par une série de problèmes: La résistance au changement, une mauvaise planification et d'évaluation, le faible engagement, le manque d'objectifs l'évaluation du rendement des employés, et l'incapacité à comprendre pleinement la mise en œuvre la réforme techniques composés avec le moral du personnel bas en raison de bas salaires, absence d'incitations et de bon environnement de travail. Dans tous les trois secteurs, les employés ont des plaintes similaires concernant l'environnement de travail et des incitations. Les employés ont également indiqué qu'il n'y a pas été employé objectif évaluation du rendement qui pourrait lier la performance individuelle avec rémunération et de récompenses. Cette a créé une situation où les employés travaillent dur sont traités avec des non-travailleuse de de manière égale. La rentabilité est également plus facile à dire qu'à faire dans le nouveau service public éthiopien et la choix de l'approche service de livraison alternative n'est pas encore adopté en raison de idéologiquesabonnement à l'Etat développementaliste guidé par la démocratie révolutionnaire<br>Public sector reform has been undertaken in different parts of the world since 1980s in the name of New Public Management and with the objective to change traditional public administration. The ultimate purpose of the reform is to improve the effectiveness, performance and quality of public services delivered to the citizenry and to enhance thecapacity to carry out core government functions. The advocates of NPM insist that the practices and principles of the private sector can be adopted by the public sector to improve the business of government. NPM has been seen as a global best practice to be adopted usually under various international pressures. Nevertheless, in reality there is no single best approach, every reform-oriented government would have to consider to what degree and how key features can be incorporated into their public management systems and contexts. Because of contextual differences, results of reform implementation varies from place to place and even from organization to organization within a country. In an attempt to improve service delivery in the public sector, the government of Ethiopia launched civil service program in 1996 and service delivery policy and implementation instruments in 2001. The overall objective of the reform is to enable public institutions toprovide their services to the public in efficient, effective, transparent and responsive manner. Based on the objectives of the policy and parameters drawn from service delivery literature, this study aims at evaluating the performance of the service delivery implementation in Addis Ababa City Government using quality, quantity, cost and time as performance indicators. A sample of three purposely selected agencies and offices which are involved in daily provision of services are the major sources of primary information of this study. 600 customers, 78 employees, 13 focus group members and managers from the respective offices provided their views and answers to the questionnaires and interviews forwarded during the data collection period. The study shows that of the three offices, RICSRS( resident identification and civil status registration service) performed better than other offices in most customer related quality dimensions and service deliver speed. Service delivery speed has been improved to the satisfaction of the service users and as the result the number of customers used the service significantly increased over the study period. On the contrary, service delivery at Land Administration Authority is rated poor in most aspects of performance parameters. The causes of poor quality include very low level of transparency, responsiveness, reliability, speed, grievance handling mechanism, employees’ motivation, courtesy and other quality dimensions. The number of service users did not increase over the study period. Customers witnessed that service deliveryprocess takes long period of time contrary to the time indicated in service standards. The contacts are boring, too long and unnecessary leading to dissatisfaction. Service delivery at Revenue Agency can be viewed as moderate though it falls short in some aspects. It performed average in timeliness, process easiness, transparency, fairness, responsiveness, grievance handling and competence. It performed below average in dimensions such as consultation with customers, access to service providers, respectfulness and courtesy. The number of customers has increased manifold over thestudy period. Cost incurred per customer has shown varying trends in which highest per capita is recorded initially and the lowest in 2006. It surged in 2007 and slightly declined in 2008. Finally, service delivery improvement together with new tax laws resulted in an increase of revenue collection. The total revenue increased from 729.47 million Birr in 2001 to 2.6 billion Birr in 2006(2.6 billion Birr is about 260 million USD in the year 2006). Overall, the research shows that some progress has been made in the implementation of the reform but there are a lot to be done to achieve the goals aspired in the service delivery policy. The service delivery policy document is well written containing many important service delivery instruments that address important aspects of effective service delivery in the public sector. However, their implementation is retarded by a range of problems: Resistance to change, weak planning and evaluation, weak commitment, lack of objectiveemployee performance evaluation, and failure to fully understand reform implementation techniques compounded with low staff morale due to low salary, absence of incentives and good working environment. In all the three sectors, employees have similar complaints regarding working environment and incentives. The employees also indicated that there has not been objective employee performance evaluation that could link individual performance with pay and rewards. This has created a situation where hardworking employees are treated with non-hardworking in equal way. Cost effectiveness is also easier said than done in the new Ethiopian public service and the choice of alternative service delivery approach is not yet adopted because of ideological subscription to developmentalist state guided by revolutionary democracy

The primary purpose of this study is to examine professional city management in San Bernardino County cities functioning under the council-manager form of government, and to determine whether they are using the fundamental principals of "Managing for Results" as set by the criteria in the GPP report.

En codifiant le droit administratif en 1965, le législateur sénégalais a retenu une définition essentiellement organique de la notion de service public, qui consiste à confier la gestion du service public exclusivement aux personnes morales de droit public. Ce critère principalement organique a été largement dénoncé par la doctrine, qui relève l'absence d'une définition rigoureuse de la notion de service public, qui n'associe pas les personnes privées à la gestion publique et qui ne tient pas compte de ses développements en France.Cette conception sénégalaise de la notion de service public a été remise en cause par des circonstances endogènes et exogènes. Dans un premier temps, le critère organique du service public a été affecté par la crise de l'État interventionniste, favorisant ainsi l'avènement du « moins d'État, mieux d'État ».Ensuite, le critère organique de la notion de service public a subi les effets du droit communautaire de l'UEMOA et de l'OHADA puisqu'ils mettent en avant un critère fonctionnel ou matériel pour régir l'activité des organismes publics intervenant dans l'économie. De surcroît, l'UEMOA recommande des obligations de performance aux services publics sénégalais, qui impactent la conception classique du service public.En outre, Ces mutations ont justifié des réformes du service public et de renouveau de la gestion publique, favorisées par l’émergence des instruments de l’Union Africaine, à travers la charte africaine du service public. Il s'agit donc de confronter la conception organique du service public devenue insuffisante et inopérante à l'épreuve des mutations subies par le droit administratif et les services publics sous l'influence de la nouvelle gestion publique<br>In essence, by codifying administrative law, the Senegalese legislator adopted an essentially organic definition of the concept of public service, which consists in entrusting the management of the public service exclusively to legal persons governed by public law. This mainly organic criterion has been widely denounced by legal writers, who note the absence of a rigorous definition of the concept of public service, which does not associate private individuals with public management and which does not take account of its developments in France.This Senegalese concept of public service has been called into question by endogenous and exogenous circumstances. Initially, the organic criterion of public service was affected by the crisis of the interventionist state, which resulted in "less state, better state". Then, the organic criterion of the concept of public service has suffered the effects of community law of the WAEMU and OHADA since they put forward a functional or material criterion to govern the activity of public bodies involved in the economy. In addition, the UEMOA recommends performance obligations to Senegalese public services, which impact on the traditional conception of public service. These changes have also justified public service reforms and the renewal of public management favored by the emergence of African Union instruments, through the African charter of public service. It is therefore a question of confronting the organic conception of the public service with the test of the changes undergone by the administrative law and the public services

The objective of the research has been to determine which internal characteristics of municipal government agencies and which environmental factors of the municipalities across the U.S. affect the quality and the scope of adoption of municipal electronic government (e-government) initiatives. To accomplish this objective, an integrated approach was developed. The approach combined theoretical methodologies of three frameworks applied to the public sector agencies: innovation theory, information and communication technology, and e-government. It was hypothesized that theoretical premises of these frameworks complement each other in their ability to explain municipal e-government initiatives and their combination would help to address the drawbacks that characterize the present research on municipal e-government. The dependent variable in the present research is municipal e-government score. The dependent variable measures the scope and quality of municipal e-government initiatives. The research concentrates on two sets of predictor variables: internal municipal government agency characteristics and external environmental factors of municipalities. Correlation/regression analyses were performed to explore bivariate and multivariate relationships between the dependent and predictor variables and to accomplish the following goals: (1) describe the relationship between the dependent variable and the two sets of predictors (internal municipal agency characteristics and external environmental factors); (2) determine the effects of individual predictors in explaining the rate and the scope of adoption of e-government initiatives; and (3) compare the two sets of predictors in their power to explain the rate and the scope of adoption of e-government initiatives. The results of these analyses demonstrated that external environmental factors are significantly better predictors of the quality and the scope of local e-government initiatives, as measured by the e-government score, both individually and as a set.

<p> This project presents a theory and an application for using the integrated systems of Total Quality Management (TQM) and Six Sigma (SS) for the American Samoa Lyndon B Johnson (LBJ) Tropical Medical Center to improve results for the random survey and recertification process for Medicare and Medicaid. Identified aspects of the project include roles, responsibilities, and measurement requirements of the TQM framework, using the Juran Quality Trilogy, cost of quality, and investment training in SS. The basis of the research that forms the foundation of the project comes from a review of related literature. Methods are presented in order to clarify where improvement processes are required. This project provides the LBJ center with a proven approach that has found success for implementing TQM and an SS foundation to ensure efficient compliance with The Center of Medicare and Medicaid Services (CMS) and other regulatory government agencies.</p>

This study is about the employee perceptions of the effect of the Quality Management System intervention that was implemented at one of South Africa’s government departments. This organisation’s Quality Management System being one of the first in the government or public sector in South Africa to be implemented, creates the possibility for this Quality Management System model to be used to develop Quality Management Systems in other departments or organisations belonging to the government or the public sector in South Africa and the Southern African region. According to Madu & Kuei (1995), Quality Management System describes a situation where all business functions are involved in a process of continuous quality improvement. This implies that the development and implementation of Quality Management Systems in government departments and the public sector will improve the quality of services delivery. The findings of this study indicated that a Quality Management System can be used to improve the level of service delivery in the public sector. The Quality Management System should be planned developed and implemented over a period of time in five phases (i) Phase 1 - Determination of the scope of Quality Management System implementation (ii) Phase 2 – Training (iii) Phase 3 – Development of Procedures (iv) Phase 4 – Pilot implementation of procedures (v) Phase 5 – Evaluation of Quality Management System and rollout. It usually takes three or more years to establish an organisation-wide Quality Management System, although technical improvement to the workflow can be as quickly as six to eight months. And finally, for the Quality Management System to be developed, implemented and maintained successfully, Maximisation of Performance objectives, Good Leadership, Motivation of staff, Implementation of Change Management, Employee Involvement, Long-term Top Management Commitment, Provision of Training, Introduction of Quality Improvement Projects, Measuring Quality Management System Progress and Reward Accomplishment, are the fundamental concepts or principles that should be considered.

Public K-12 education is a large enterprise in the United States. Through local, state and federal sources, the U.S. allocated over $610 billion to K-12 public education in 2009 (NCES). Not only is the commitment of public funds for education substantial, the provision of K-12 education is primarily administered by the government in non-market settings through local school districts. It is this institutional environment that generates the impetus for evaluating how those in education make choices in the absence of markets. Like traditional markets, non-market solutions often fail because the incentives facing individuals and agencies elicit choices which produce outcomes that are divergent from those which could be considered Pareto optimal. Examining these incentives and the resulting choices allows researchers to identify unintended consequences of policy and better inform policy design and reform. This dissertation endeavors to identify some of these incentives and to empirically examine their effects on the choices made by teachers and administrators. Chapter two recognizes that teaching effectiveness may motivate teacher choice into relatively more rigorous professional development. The empirical results suggest that teachers with a past history of relative ineffectiveness are selecting into the professional development program examined. The subsequent effectiveness of the in-service training is mixed. High stakes testing and school accountability are an increasing part of our K-12 education system. Chapter three acknowledges it is plausible that administrators may choose to place more students into class rooms of more effective teachers to maximize school performance. However, because of tenure and salary constraints they may choose to place fewer students into the class rooms of more effective teachers to reward their performance. Results overall indicate that more effective teachers have larger classes. Chapter four examines school district budget uncertainty and its relation to contingency funds. The institutional ambiguity of the definition of contingency funds allows a significant amount of choice for administrators to determine fund size and use. This chapter finds that administrators may be less sensitive to budget uncertainty and more responsive to the desire for budget fungibility. This dissertation concludes by addressing implications and future research.

By 2040, 79.7 million older adults will live in the US, and nearly 40% will need nursing home services that are primarily funded by Medicare and Medicaid. Researchers have underscored the importance of leadership in quality healthcare care delivery, suggesting that nursing home administrator turnover could influence resident quality of life, causing ill-health for the residents and preventable medical costs for taxpayers. In spite of the suggested association, little research has specifically examined the role of administrator turnover on resident quality of life. As such, the purpose and central research questions of this case study were designed specifically to address the relationship between nursing home administrator turnover and resident quality of life. The Donabedian health services quality model was the framework for the study. Data were collected from 14 nursing homes, and included semistructured interview data with 7 nursing home administrators, and a review of other documents related to quality of care including site visit reports and surveys. An iterative process of coding and constant comparison was used to identify themes and categories from the data. The findings indicate that turnover likely caused an adverse impact on the nursing home overall, which was expected. The study also determined, however, that high turnover itself was not perceived to be associated to low resident quality of life. The implication for social change is that nursing home stakeholders may develop processes to retain competent administrators which in turn could reduce absent leadership presence in nursing homes. Consistent leadership presence may lead to improvement in quality of life regulatory compliance and reduction in unnecessary Medicare and Medicaid spending by nursing home residents.

The purpose of this case study was to explore faculty members’ perceptions of the QEP in a public doctoral university with highest research activity. Particularly, the study explored how faculty members perceive the role of the QEP in student learning and institutional effectiveness, the relevance of the QEP activities in student learning and institutional effectiveness, and how faculty members’ involvement with the accreditation process associated with their perceptions of the QEP. The study design was a qualitative single case study and data were collected from the Quality Enhancement Plan Questionnaire (QEPQ), face-to-face interviews, and documents. Findings revealed that faculty members perceived the QEP as an ambitious and important, necessity-driven process that is focused on globalization. Faculty members’ perceptions of the QEP’s role in institutional effectiveness included: (a) emphasizing the university identity, (b) increased reputation, (c) promoting international research collaboration, (d) bureaucracy, (e) cost-effectiveness, and (f) need for institutional conversation. In regards to their perceptions of the QEP’s role in student learning, faculty members believed that the QEP enhanced the curriculum and helped globally oriented students to compete in the workplace. The study findings also indicated that the QEP activities were relevant to student global experiences such as study abroad program and second language learning programs. Faculty members indicated that the QEP is more relevant to their focus on teaching and learning and that their involvement with the accreditation process contributed to a better awareness of the QEP. The findings from this study have implications for higher education quality practice and research.

Orientador: Olívio Novaski<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecânica<br>Made available in DSpace on 2018-08-28T23:59:47Z (GMT). No. of bitstreams: 1 Soares_MauriCesar_M.pdf: 2098606 bytes, checksum: 1dbe256030430a926cf144dfbdc20422 (MD5) Previous issue date: 2015<br>Resumo: Este trabalho de pesquisa tem como objetivo principal aplicar o Modelo SERVQUAL em uma instituição pública de ensino superior para avaliar a Qualidade dos Serviços Administrativos. Para tanto foi utilizado o Modelo SERVQUAL, desenvolvido por Parasuraman, Zeithaml e Berry; que avalia tanto a expectativa quanto a percepção dos pesquisados ao fazer uso destes serviços, resultando com isso a Qualidade Percebida. Os resultados globais sugerem que entre as cinco Dimensões propostas e avaliadas no Modelo, a Tangibilidade é a única que apresenta resultados positivos, podendo sofrer variações quanto aos resultados individuais observados nos cursos oferecidos pela Instituição. A pesquisa limitou-se a estudar e a usar como estudo de caso a FATEC Tatuí ¿ Faculdade de Tecnologia "Prof. Wilson Roberto Ribeiro de Camargo". Os dados foram levantados junto ao corpo discente, único público a ser consultado uma vez que a ele são prestados os serviços analisados nesta unidade de ensino. A presente pesquisa é inédita dentro da instituição de ensino superior e através da análise dos seus resultados, essa poderá colaborar com os gestores dessa instituição para a elaboração do planejamento estratégico da unidade, bem como ser extensiva às outras unidades que fazem parte do conjunto de faculdades que integram o CEETPS ¿ Centro Estadual de Ensino Tecnológico Paula Souza<br>Abstract: This work aims to apply the SERVQUAL Model in a public institution of higher education to evaluate the Quality of Administrative Services. So that, the SERVQUAL Model, developed by Parasuraman, Zeithaml and Berry, evaluate the expectative and the perception of the sample which uses the service, resulting in a Perceived Quality. The global result suggest that in the five proposed and evaluated dimensions on the model, the tangibility is the only one which presents positive results, which might vary in the individual courses offered by the institution. The research was limited to use the FATEC Tatuí ¿ College of Technology "Prof. Wilson Roberto Ribeiro de Camargo" as the case of study; whose research data have been raised by the school students; the only one be consulted since it is provided the services analysed in this teaching unit. The present research is inedited in the higher education institution and by the analysis of its results, it can collaborate with the managers of the institution to elaborate the strategic planning of the unit, also, it can be extended to the other college units which comprise the CEETPS ¿ Paula Souza State Center of Technological Education<br>Mestrado<br>Materiais e Processos de Fabricação<br>Mestre em Engenharia Mecânica

The public sector is today based on the reform, New Public Management, which was created to increase quality. The reform has forced the possibility of measurability in the public occupation. Measurability has also created marketing competition, which has also resulted in the emergence of privatization in the public sector. This market competition has resulted in a change in the professional role of preschool teachers that has become more market oriented. The operations work is aimed at a customer satisfaction oriented purpose. The purpose of this study was to investigate whether New Public Management hasaffected the employment situation in both municipal and independent preschool activities. The study was conducted with the help of semi-structured interviews. The conclusion of this study is that deprofessionalization in the profession has not been experienced, one experiences a commonality indecision-making about goals. The administrative part is of great importance for the activities and the children; however, the staff is affected by lack of time to be able to complete the administration. In addition to this, a lack of staff is a negativity for achieving a good working environment for bothchildren and staff. The study also shows a desire for a more suitable balance between resources andwork activities.<br>Den offentliga sektorn finner sig idag inom reformen, New Public Management, som skapats för att öka kvalitet. Reformen har framtvingat mätbarhet hos de offentliga verksamheterna. Mätbarheten har vidareskapat en marknadskonkurrens, vilket också resulterat i uppkomsten utav privatisering inom de offentliga verksamheterna. Denna marknadskonkurrens har omvandlat förskolelärarnas yrkesroll till ett allt mer marknadsfokuserat yrke. Där ändamålet för verksamheterna styrs av kundnöjdhet. Syftet med denna studie var att undersöka huruvida New Public Management har påverkat arbetssituationen i både kommunala- och fristående förskoleverksamheter. Studien har genomförts med hjälp utav semistrukturerade intervjuer. Slutsatsen av denna studie är att en deprofessionalitet i yrket inte har upplevts, man upplever en gemensamhet i beslutsfattning om mål. Den administrativa delen anses varaav stor vikt för verksamheterna och barnen, däremot påverkas personalen av tidsbrist för att kunna fullfölja administrationen. Utöver detta utgör brist på personal en negativitet för att uppnå en bra arbetsmiljö för både barn och personal. I studien framgår vidare en önskan om en mer lämplig balans mellan resurser och arbetssysslor.

Orientador: Ettore Bresciani Filho<br>Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecanica<br>Made available in DSpace on 2018-08-04T09:26:30Z (GMT). No. of bitstreams: 1 Freitas_JosedasDores_M.pdf: 1032716 bytes, checksum: 9bd363743698bdbe70a0bb3a455ec841 (MD5) Previous issue date: 2005<br>Resumo: Este trabalho teve por objetivo identificar e analisar os principais elementos que fazem com que os gerentes públicos representem um dos principais fatores presentes no processo de implementação da gestão pela qualidade no setor público estadual em Goiás. Ele está ancorado em uma pesquisa bibliográfica, que reuniu os fundamentos teóricos da gestão da qualidade; pesquisas documentais e de campo direcionadas para uma amostra dentre as organizações adesas ao Programa da Qualidade no Setor Público do Estado de Goiás. Foi desenvolvido estudo de um caso onde foram levantados dados acerca da situação atual do processo de implementação da gestão da qualidade total nos órgãos/entidades da administração pública estadual. Com base nos estudos pode-se inferir que os resultados atualmente apresentados na implementação da gestão pela qualidade no setor público estadual em Goiás trazem os reflexos diretos da atuação daqueles investidos dos cargos de dirigentes superiores: secretários de estado, presidentes de agências e equivalentes hierárquicos. O quadro constatado está abaixo dos padrões esperados pela Gerência do Programa Qualidade Goiás, que traduz a expectativa do Governo. As conclusões do estudo oferecem elementos para reflexão sobre a implementação dos conceitos da qualidade no ambiente da administração pública e são apresentadas sugestões ao final<br>Abstract: This Thesis¿ objective is to identify and analyze the main elements that make public managers one of the main factors in the process of implementing the management quality in the state department in Goias. It is based on a bibliographic research that gathered the theoretical fundaments of quality management; document and field research were directed towards a sample among the organizations that joined the quality program in the state department of Goias. A case study where data related to the situation of the actual process of implementing the quality management in the agencies/entities of the state administration was developed. Based on the studies it can be inferred that the results presented today in the implementation of the management quality in the state of Goias reflect directly on the actions of those in the top posts: State Secretaries, Agency Presidents, hierarchical equivalents. The verified situation is under the standards expected by the Quality Program Executive Management Agency of Goias which translates the expectations of the government. The conclusions of the study offer elements to reflect about the implementation of quality concepts in the public administration environment, and suggestions are presented at the end<br>Mestrado<br>Gestão da Qualidade Total<br>Mestre em Engenharia Mecânica

Thesis (MPA)--University of Stellenbosch, 2011.<br>ENGLISH ABSTRACT: Public sector organisations have to deliver quality services to the people amid budgetary cuts and public disenchantment with the public sector. Delivering these services in the face of dwindling resources has led public sector organisations to introduce performance improvement initiatives in an endeavour to do more with less. The government of Botswana introduced a raft of performance improvement initiatives such as WITS, O & M and Job Evaluation in the public sector with the sole objective of improving performance and driving public service delivery. However, despite the implementation of these initiatives, there was increasing concern that the quality of the delivery of public services was declining. These performance improvement initiatives were criticised for failing to make any meaningful impact on organisational performance, as the problems of poor service delivery remained unchanged. The failure of these earlier public sector reforms to improve organisational performance led the government to introduce a more comprehensive and holistic reform programme, PMS, guided by the national vision – Vision 2016 – in 1999. PMS was seen as the overall framework within which all previous reform initiatives could be integrated. This research sought to determine whether the objectives of PMS of DTA were being realised, given that previous public sector reforms had been deemed to have failed to actually raise organisational performance. A case study of DTA was therefore undertaken to describe the extent to which PMS had delivered on its objectives. Data collection was through structured self-administered questionnaires, comprising 14 closed-ended questions, one ranked question and one open-ended question. This was also augmented by documentary analysis of official reports such as the Annual Statements of Accounts (ASA). The research found that PMS had succeeded only in so far as communicating DTA’s vision, mission and values across the department. There was awareness of PMS within DTA. However, the system had not succeeded in improving DTA’s organisational performance, as it was hampered by various challenges such as lack of leadership commitment, the difficulty in implementing the system and lack of feedback on organisational performance. Recommendations are also made for enhancing DTA’s PMS to actually realise its objectives of improving organisational performance.<br>AFRIKAANSE OPSOMMING: Daar word van openbare sektor organisasies verwag om kwaliteit dienste aan die publiek te lewer te midde van ingekorte begrotings en openbare ontnugtering rakende die openbaresektor. In ‘n poging om hierdie dienste te lewer ten spyte van beperkte hulpbronne stel openbaresektor organisasies inisiatiewe in om werkverrigting te verbeter en sodoende meer koste-doeltreffend te werk. Die regering van Botswana het ‘n aantal inisiatiewe, byvoorbeeld Werk Verbetering Spanne (WITS), Organisering en Metodes (O&M) en Posevaluering, in die openbaresektor geïmplementeer met die uitsluitlike doel om werkverrigting te verbeter en openbare dienslewering te dryf. Ten spyte hiervan was daar egter toenemende kommer dat die kwaliteit van dienslewering toenemend verswak. Bogenoemde inisiatiewe is gekritiseer dat hulle gefaal het om enige noemenswaardige impak op organisatoriese prestasie te toon, aangesien probleme rakende swak dienslewering onveranderd was. Die versuim van hierdie aanvanklike hervormings in die openbaresektor om organisatoriese prestasie te verbeter, het daartoe aanleiding gegee dat die regering in 1999 ‘n meer omvattende en holistiese hervormingsprogram, die Prestasie Bestuur Stelsel (PMS), ingestel het, gelei deur die nasionale visie – ‘Vision 2016’. Die PMS is gesien as die omvattende raamwerk waarbinne al die vorige hervormingsinisiatiewe geïntegreer kon word. Hierdie navorsing het gepoog om vas te stel of die doelstellings van die PMS in die Departement van Stam Administrasie realiseer, siende vorige openbaresektor hervormings nie geslaag het om organisatoriese prestasie te verbeter nie. ‘n Gevallestudie van die departement is onderneem om die mate waarin die PMS se doelstellings bereik is te beskryf. Dataversameling is gedoen deur gestruktureerde, selfgeadministreerde vraelyste, bestaande uit 14 geslote vrae, een ranglysvraag en een oopvraag. Dit is aangevul deur dokumentêre analise van amptelike verslae soos Jaarlikse Rekeningstate. Die navorsing het gevind dat die PMS slegs in dié mate geslaag het dat mense dwarsdeur die departement bewusgemaak is van die departement se visie, missie en waardes. Hoewel mense bewus was van die prestasiebestuurstelsel, bevind die navorsing geen daadwerklike verbetering in organisatoriese prestasie nie, aangesien dit belemmer word deur verskeie uitdagings, soos gebrekkige toewyding deur leiers, probleme met die implementering van die sisteem en die tekort aan terugvoer rakende organisatoriese prestasie. Die navorsing stel sekere aanbevelings voor om die departement se prestasiebestuursisteem te verbeter om die doelstelling om organisatoriese prestasie te verwesenlik.

La question centrale de cette thèse sur le Programme de Management par la Qualité Totale dans le service public brésilien est de répondre aux interrogations sociales, politiques et économiques des fonctions de l'introduction de ce modèle administratif et son rôle dans la légitimation du processus de reforme de l'état. Fi s'agit d'étudier les répercussions de telles modifications au sein des institutions publiques et l'impact qu'elles provoquent pour la société en tant qu'usager du service public. Prenant comme base la recherche bibliographique et documentaire, complétée par une recherche de terrain et par une étape de recherche participative, cette thèse présente un historique de l'implantation et du développement de la Management par la Qualité Totale, qui a débuté dans les années 1980, et signale quelques caractéristiques spécifiques que ce modèle va adopter dans le pays. Son application du privé vers le public, dans les années 1990, va marquer un changement d'un modèle d'administration pour une idéologie qui répond aux intérêts politiques et économiques de l'état. L'analyse se poursuit par l' étude des cas de trois entreprises gagnante du Prix Qualité du gouvernement fédéral, présentées comme exemples du succès du programme. L'analyse de la situation réelle des entreprises et des attitudes des principaux protagonistes a été indispensable à la compréhension de la manière dont le programme proposé par le gouvernement fédéral a été effectivement appliqué Cette étude démontre que, avant de chercher une réelle amélioration des services offerts par l'état, l'introduction des réformes administratives basées sur la Management par la Qualité Totale va revêtir un double rôle: celui de promouvoir la réorganisation des activités pour pallier la réduction du personnel de manière non conflictuelle, et celui d'un programme de "maquillage" du service rendu au public, lui donnant une apparence plus rapide et plus efficace.

The administration of the public service of health, historically organized for the state, passes for transformations that search the improvement of the service offered to its public, the using citizen. The state of São Paulo implemented from 1998 a management system that uses recognized entities socially (SOH - Social Organization of Health) to execute the planned and controlled actions of health for the government. In agreement to this trend of opening and development of the public politics, the federal government search to improve the quality of relationship in its sectors of attendance. The presented research evaluated questions organizations of a clinic of specialties of the city of São Paulo that functions operated for a SOH. Using the perspective of the user, it searched to verify with are the administrative questions that are perceived and valued for the citizen. The results had evidenced low the capacity of perception and evaluation of the users of the clinic. The analysis perceived in the data of the research with superficial characteristics and without criteria technician, can be related with the low educational level of the layers poor of main the Brazilian population that are user public system of health. (National system of health). The research proved the development of the public management in the health area, as well as the viability of application of research correlated to the applied model.<br>A administração do serviço público de saúde, historicamente organizada pelo Estado, passa por transformações que buscam a melhoria do serviço oferecido ao seu público alvo, o cidadão usuário. O estado de São Paulo implementou a partir de 1998 um sistema de gestão que utiliza entidades reconhecidas socialmente (OSS Organização Social de Saúde) para executar as ações de saúde planejadas e controladas pelo governo. Em concordância à essa tendência de abertura e remodelamento das políticas públicas, o Governo Federal busca melhorar a qualidade de relacionamento em seus setores de atendimento. A pesquisa avaliou questões organizacionais de um ambulatório de especialidades da cidade de São Paulo que funciona operacionalizado por uma OSS. Usando a perspectiva do usuário, buscou verificar quais são os quesitos administrativos que são percebidos e valorizados pelo cidadão. Os resultados evidenciaram a baixa capacidade de percepção e avaliação dos usuários do ambulatório. A análise percebida nos dados da pesquisa, com características superficiais, emotivas e sem critérios técnicos, pode estar relacionada com o baixo nível educacional das camadas mais pobres da população brasileira que são os principais usuários do sistema público de saúde (SUS Sistema Único de Saúde). A pesquisa provou o desenvolvimento do gerenciamento público na área de saúde, assim como a viabilidade de aplicação de pesquisas correlacionadas ao modelo aplicado.

Este estudo apresenta um diagnóstico de situação das Bibliotecas Públicas portuguesas face aos Sistemas de Gestão de Qualidade (SGQ) e a avaliação de indícios de emergência de qualidade neste tipo de bibliotecas, tipificando os diferentes tipos de emergência diagnosticados, identificando os factores que impulsionam a implementação dos SGQ, os motivos de recuo e/ou avanço para uma gestão de qualidade. É estabelecida a ligação ao percurso da qualidade na Administração Pública em Portugal, com vista a contextualizar o presente trabalho e entender o aparecimento de Sistemas de Gestão de Qualidade. Apresentam-se razões que justificam a lentidão da prevista e anunciada proliferação de Sistemas de Gestão de Qualidade nas Bibliotecas Públicas portuguesas (como se previa há uma década atrás), referenciando de forma sucinta alguns dos diferentes modelos de gestão de qualidade validados que se encontram implementados tanto no nosso país como no estrangeiro. ABSTRACT: This study presents a diagnostic explanation on the situation of the Portuguese Public Libraries, taking into consideration the system of Managenent Quality Control (SGC) and the evaluation of the emergence of quality in these types of libraries, typifying the different types of forthcoming diagnostics, identifying the factors that started the implementation of the SGC and the reasons of the withdrawal and advancement towards quality management. A synopsis of the quality of Public Administration in Portugal has also been made, with the idea of putting into context the current work and understanding up to what point this forced the arrival of the system of Management Quality Control and, in a way, try to find the reasons that justify the slowness of the arrival of the system of Management Quality Control in the Portuguese Public Libraries (as was predicted almost a decade ago). Throughout this document references and explanations will be made, in a succinct way, of some of the different forms of validated Quality Management Control that are to be found in our country, as well as abroad.

The purpose of this quantitative cross-sectional study was to examine the association between African Americans' (AA) self-reported sleep quality and health problems in a community sample of adult AAs. This study was grounded in McEwen's theory that brief and long-term sleep deprivation triggers a stress response that increases allostatic load, which leads to ill health and poor sleep quality. The sample of volunteer participants for this study (N =121) was drawn from a community base of AA adults, aged 20 -70, who resided in the suburbs of Atlanta, Georgia and attended 1 of 3 local churches. Participants completed a self-administered survey consisting of structured standardized scales that covered the perception of stress, racism, sleep quality, social support, and perceived burden from physical and psychological symptoms. Multiple regression and correlation analyses were used to test hypothesized relationships among study variables and poor sleep quality. The results of this study found that health problems were positively correlated with poor sleep quality. The mediating and moderating role of social support, psychological stress, and racism on health and sleep quality were assessed. Psychological stress and perceived racism were found to mediate the relationship between poor sleep quality and health problems; however, social support did not. Psychological stress, perceived racism, and social support were not found to moderate the relationship between health problems and sleep quality. The results of this study contribute to knowledge and can inform health practice about the relationship of health problems and sleep quality among African Americans, as well as the role of stress and racism in exacerbating both health problems and sleep quality in this population.

The natural reefs of the world are experiencing higher use and pressures, resulting in anthropogenic impacts that are deteriorating many coral stands and creating poor water quality. The Florida Keys rely primarily on the reef system that surrounds the archipelago for their socioeconomic health and successful future. The Florida Keys shares the symbiotic relationship of the terrestrial and marine realms with many other states and countries and the experience of higher demand on the resource. Artificial reefs could provide a substitute to the natural reefs for commercial and recreational users. An increased demand for derelict vessels of the U.S. Navy and Maritime Administration has illustrated the popularity of their use as artificial reefs.Local decision-makers do not have the experience to apply to an artificial reef proposal and many rely on existing anecdotal data and "expert" testimony. A lack of evaluation criteria adds to the difficulties of determining if an artificial reef proposal is appropriate for their community. With little empirical data available in the literature and a lack of comprehensive pre and post deployment data completed, how does the decision-maker decide? This study seeks to determine if a method exists that provides criteria and best practices for evaluation of artificial reef projects. Although the study's focus is on artificial reefs, this matrix could be modified to apply to any project where similar dynamics apply. The matrix uses a disaggregate method modeled after the Goeller scorecard. The model provides a best practice's matrix developed through a meta-analysis of three existing artificial reef projects, a comprehensive literature review, and interviews with three decision-makers at different levels of participation. The matrix applies identified best practices and provides a scoring method that can assist the decision-making process. This study acknowledges the limitations of a research project such as this and realizes that many decisions in a political realm have variables not covered in a study of this scope. However, an identified lack of decision-making continuity demonstrates the need for such a study and the research provided within this study is an important first step.

Magistro darbo tikslas – įvertinti UAB „Busturas“ miesto viešojo transporto paslaugų kokybę. Darbe išanalizuota ir susisteminta įvairių Lietuvos ir užsienio autorių teorinė ir praktinė medžiaga, atskleidžiamas mokslinis požiūris į paslaugas, jų savybes, paslaugų kokybės esmę, jos matavimo būdus. Taip pat pateikiamas paslaugų kokybės vertinimas bei viešojo transporto paslaugų kokybės vertinimo kriterijai.<br>The aim of the master work – to evaluate the quality of JSC „Busturas“ urban public transport service. The theoretical and practical material of various Lithuania’s and foreign authors are analyzed and systematized in the work, also the scientific view to the services, their properties, the essence of the service quality, the ways to measure the quality. What is more, the evaluation of the services quality and the criteria of the public transport service is submitted in the master’s work.