Sample records for facilitating organisational change

  1. The significance of 'facilitator as a change agent'--organisational learning culture in aged care home settings.

    PubMed

    Grealish, Laurie; Henderson, Amanda; Quero, Fritz; Phillips, Roslyn; Surawski, May

    2015-04-01

    To explore the impact of an educational programme focused on social behaviours and relationships on organisational learning culture in the residential aged care context. The number of aged care homes will continue to rise as the frail older elderly live longer, requiring more formal care and support. As with other small- to medium-sized health services, aged care homes are faced with the challenge of continuous development of the workforce and depend upon registered nurses to lead staff development. A mixed-method evaluation research design was used to determine the impact of an educational programme focused on social aspects of learning on organisational learning culture. One hundred and fifty-nine (pre) and 143 (post) participants from three aged care homes completed the Clinical Learning Organisational Culture survey, and three participant-researcher registered nurse clinical educators provided regular journal entries for review. While each site received the same educational programme over a six-month period, the change in organisational learning culture at each site was notably different. Two aged care homes had significant improvements in affiliation, one in accomplishment and one in recognition. The educators' journals differed in the types of learning observed and interventions undertaken, with Eucalyptus focused on organisational change, Grevillea focused on group (student) change and the Wattle focused on individual or situational change. Clinical educator activities appear to have a significant effect on organisational learning culture, with a focus on the organisational level having the greatest positive effect on learning culture and on individual or situational level having a limited effect. Clinical educator facilitation that is focused on organisational rather than individual interests may offer a key to improving organisational learning culture. © 2014 John Wiley & Sons Ltd.

  2. Readiness for organisational change among general practice staff.

    PubMed

    Christl, B; Harris, M F; Jayasinghe, U W; Proudfoot, J; Taggart, J; Tan, J

    2010-10-01

    Increasing demands on general practice to manage chronic disease may warrant organisational change at the practice level. Staff's readiness for organisational change can act as a facilitator or barrier to implementing interventions aimed at organisational change. To explore general practice staff readiness for organisational change and its association with staff and practices characteristics. This is a cross-sectional study of practices in three Australian states involved in a randomised control trial on the effectiveness of an intervention to enhance the role of non-general practitioner staff in chronic disease management. Readiness for organisational change, job satisfaction and practice characteristics were assessed using questionnaires. 502 staff from 58 practices completed questionnaires. Practice characteristics were not associated with staff readiness for change. A multilevel regression analysis showed statistically significant associations between staff readiness for organisational change (range 1 to 5) and having a non-clinical staff role (vs general practitioner; B=-0.315; 95% CI -0.47 to -0.16; p<0.001), full-time employment (vs part-time; B=0.175, 95% CI 0.06 to 0.29; p<0.01) and lower job satisfaction (B=-0.277, 95% CI -0.40 to -0.15; p<0.001). The results suggest that different approaches are needed to facilitate change which addresses the mix of practice staff. Moderately low job satisfaction may be an opportunity for organisational change.

  3. Organisational Structure & Change

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2006

    2006-01-01

    Structural change is seen as a way to meet the challenges of the future that face many organisations. While some writers agree that broad-ranging structural change may not always transform an organisation or enhance its performance, others claim that innovation will be a major source of competitive advantage to organisations, particularly when…

  4. Facilitating "Organisational Learning" in a "Learning Institution"

    ERIC Educational Resources Information Center

    Lawler, Alan; Sillitoe, James

    2013-01-01

    The term "organisational learning" was popularised by Peter Senge in "The Fifth Discipline", his seminal book from 1990. Since then, the term has become widely accepted among those interested in organisational learning and change management. However, partly due to the somewhat ambiguous situation which arises in a university…

  5. The impact of organisational change and fiscal restraint on organisational culture.

    PubMed

    Dark, Frances; Whiteford, Harvey; Ashkanasy, Neal M; Harvey, Carol; Harris, Meredith; Crompton, David; Newman, Ellie

    2017-01-01

    Strategies to implement evidence-based practice have highlighted the bidirectional relationship of organisational change on organisational culture. The present study examined changes in perceptions of organisational culture in two community mental health services implementing cognitive therapies into routine psychosis care over 3 years. During the time of the study there were a number of shared planned and unplanned changes that the mental health services had to accommodate. One service, Metro South, had the additional challenge of embarking on a major organisational restructure. A survey of organisational culture was administered to clinical staff of each service at yearly intervals over the 3 years. At baseline assessment there was no significant difference between the two services in organisational culture. At the midpoint assessment, which was conducted at the time the Metro South restructure was operationalized, there were less positive ratings of organisational culture recorded in Metro South compared to the other service. Organisational culture returned to near-baseline levels at endpoint assessment. These findings are consistent with the literature that organisational culture is relatively robust and resilient. It is also consistent with the literature that, at any one time, a service or organisation may have a finite capacity to absorb change. Consequently this limitation needs to be taken into account in the timing and planning of major service reform where possible. The results also extend the literature, insofar as external factors with a high impact on the operation of an organisation may impact upon organisational culture albeit temporarily.

  6. Trust in management, communication and organisational commitment: Factors influencing readiness for change management in organisation

    NASA Astrophysics Data System (ADS)

    Ahmad, Mohd Hafis; Ismail, Syuhaida; Rani, Wan Nurul Mardiah Wan Mohd; Wahab, Mohammad Hussaini

    2017-10-01

    Organisational change occurs when an organisation makes a transition from its current state to some desired future state in minimising employee resistance and cost to the organisation while simultaneously maximising the effectiveness of the change effort. This paper, aims at appraising the change management of organisation in Malaysia since limited research has been done to examine readiness for change by the employees in the organisation. This paper is materialising its objectives of (1) investigating the current practice of organisation and employees in the organisation towards change management and (2) assessing the factors influencing readiness of organisation and employees in the organisation towards change management. It is found via literature review that change management is a structured approach for ensuring that changes are thoroughly and smoothly implemented to transitioning individuals, teams, and organisations to a desired future state by focusing on the wider impacts of change, particularly on people, where change does not happen in isolation and it impacts the whole organisation. Furthermore, it is found that current practice of organisation and employees in the organisation towards change management involved in three main factors, namely trust in management, communication and organisational commitment; with the factor for trust in management is the positive vision for the future by management team, meanwhile for communication, it is found that there is good communication between supervisors and employees about the organisation's policy toward the changes. The factor found in organisational commitment is employees enjoying discussing about their organisation with outsiders. The findings of this paper provide a positive impact on change management planning, which ultimately help in ensuring more effective change programme implementation in the organisation in Malaysia.

  7. Facilitators for practice change in Spanish community pharmacy.

    PubMed

    Gastelurrutia, Miguel A; Benrimoj, S I Charlie; Castrillon, Carla C; de Amezua, María J Casado; Fernandez-Llimos, Fernando; Faus, Maria J

    2009-02-01

    To identify and prioritise facilitators for practice change in Spanish community pharmacy. Spanish community pharmacies. Qualitative study. Thirty-three semi-structured interviews were conducted with community pharmacists (n = 15) and pharmacy strategists (n = 18), and the results were examined using the content analysis method. In addition, two nominal groups (seven community pharmacists and seven strategists) were formed to identify and prioritise facilitators. Results of both techniques were then triangulated. Facilitators for practice change. Twelve facilitators were identified and grouped into four domains (D1: Pharmacist; D2: Pharmacy as an organisation; D3: Pharmaceutical profession; D4: Miscellaneous). Facilitators identified in D1 include: the need for more clinical education at both pre- and post-graduate levels; the need for clearer and unequivocal messages from professional leaders about the future of the professional practice; and the need for a change in pharmacists' attitudes. Facilitators in D2 are: the need to change the reimbursement system to accommodate cognitive service delivery as well as dispensing; and the need to change the front office of pharmacies. Facilitators identified in D3 are: the need for the Spanish National Professional Association to take a leadership role in the implementation of cognitive services; the need to reduce administrative workload; and the need for universities to reduce the gap between education and research. Other facilitators identified in this study include: the need to increase patients' demand for cognitive services at pharmacies; the need to improve pharmacist-physician relationships; the need for support from health care authorities; and the need for improved marketing of cognitive services and their benefits to society, including physicians and health care authorities. Twelve facilitators were identified. Strategists considered clinical education and pharmacists' attitude as the most important, and

  8. Management of organisational changes in a case of de-institutionalisation.

    PubMed

    Parlalis, Stavros K

    2011-01-01

    This paper seeks to explore the development of a discharge programme in one learning disability hospital in Scotland. The study aims to concentrate on organisational developmental changes in that institution. The model of the management during the discharge programme was investigated. The aim of the study is to explore how the discharge programme developed, as seen under the lens of organisational change, in order to find out what kind of model of management is more suitable in similar programmes. A case study was employed. Data were collected by means of interviews. The interviews followed a structured format. The sample of the study had to be a purposive sample and the method of snowball sampling was used; finally, 28 interviews were conducted. A grounded approach was adopted for the data analysis. The software program QSR "NUD*IST" (version "N6") was used as a technical tool, in order to facilitate the data analysis. The findings of this study show that various management models were adopted in the four phases of the discharge programme. These different models represent a "quest" by the institution's management regarding the most appropriate model for managing the discharge programme. This study shows that this goes on continuously in organisations under transition until they settle down to a more permanent state. It was concluded that management models, which are composed of characteristics from the organic theory of organisational management, could apply in discharge programmes. The data gathered enabled the researcher to arrive at a model of management which is suitable for managing organisational changes in discharge programmes, the named "stakeholder management model".

  9. Exploring the Interconnectedness among Strategy Development, Shared Mental Models, Organisational Learning and Organisational Change

    ERIC Educational Resources Information Center

    Malan, Renee

    2011-01-01

    The cognitive psychological processes related to learning and change behaviour are factors that impact on organisational strategy development. Strategy development is dependent on strategic thinking that is reciprocally influenced by shared mental models, organisational learning and organisational change. Although strategy development, shared…

  10. Organisational Change: A Solution-Focused Approach

    ERIC Educational Resources Information Center

    Morgan, Gavin

    2016-01-01

    This study investigates the effectiveness of a solution-focused approach to organisational change. Planning Alternative Tomorrows with Hope (PATH) is an intervention more commonly applied to individuals. In this study the intervention is used with groups of people working in educational organisations to help manage the change process. The approach…

  11. Assessing organisational readiness for change: use of diagnostic analysis prior to the implementation of a multidisciplinary assessment for acute stroke care.

    PubMed

    Hamilton, Sharon; McLaren, Susan; Mulhall, Anne

    2007-07-14

    Achieving evidence-based practice in health care is integral to the drive for quality improvement in the National Health Service in the UK. Encapsulated within this policy agenda are challenges inherent in leading and managing organisational change. Not least of these is the need to change the behaviours of individuals and groups in order to embed new practices. Such changes are set within a context of organisational culture that can present a number of barriers and facilitators to change. Diagnostic analysis has been recommended as a precursor to the implementation of change to enable such barriers and facilitators to be identified and a targeted implementation strategy developed. Although diagnostic analysis is recommended, there is a paucity of advice on appropriate methods to use. This paper addresses the paucity and builds on previous work by recommending a mixed method approach to diagnostic analysis comprising both quantitative and qualitative data. Twenty staff members with strategic accountability for stroke care were purposively sampled to take part in semi-structured interviews. Six recently discharged patients were also interviewed. Focus groups were conducted with one group of registered ward-based nurses (n = 5) and three specialist registrars (n = 3) purposively selected for their interest in stroke care. All professional staff on the study wards were sent the Team Climate Inventory questionnaire (n = 206). This elicited a response rate of 72% (n = 148). A number of facilitators for change were identified, including stakeholder support, organisational commitment to education, strong team climate in some teams, exemplars of past successful organisational change, and positive working environments. A number of barriers were also identified, including: unidisciplinary assessment/recording practices, varying in structure and evidence-base; weak team climate in some teams; negative exemplars of organisational change; and uncertainty created by impending

  12. Assessing organisational readiness for change: use of diagnostic analysis prior to the implementation of a multidisciplinary assessment for acute stroke care

    PubMed Central

    Hamilton, Sharon; McLaren, Susan; Mulhall, Anne

    2007-01-01

    Background Achieving evidence-based practice in health care is integral to the drive for quality improvement in the National Health Service in the UK. Encapsulated within this policy agenda are challenges inherent in leading and managing organisational change. Not least of these is the need to change the behaviours of individuals and groups in order to embed new practices. Such changes are set within a context of organisational culture that can present a number of barriers and facilitators to change. Diagnostic analysis has been recommended as a precursor to the implementation of change to enable such barriers and facilitators to be identified and a targeted implementation strategy developed. Although diagnostic analysis is recommended, there is a paucity of advice on appropriate methods to use. This paper addresses the paucity and builds on previous work by recommending a mixed method approach to diagnostic analysis comprising both quantitative and qualitative data. Methods Twenty staff members with strategic accountability for stroke care were purposively sampled to take part in semi-structured interviews. Six recently discharged patients were also interviewed. Focus groups were conducted with one group of registered ward-based nurses (n = 5) and three specialist registrars (n = 3) purposively selected for their interest in stroke care. All professional staff on the study wards were sent the Team Climate Inventory questionnaire (n = 206). This elicited a response rate of 72% (n = 148). Results A number of facilitators for change were identified, including stakeholder support, organisational commitment to education, strong team climate in some teams, exemplars of past successful organisational change, and positive working environments. A number of barriers were also identified, including: unidisciplinary assessment/recording practices, varying in structure and evidence-base; weak team climate in some teams; negative exemplars of organisational change; and

  13. Responses to Climate Change: Exploring Organisational Learning across Internationally Networked Organisations for Development

    ERIC Educational Resources Information Center

    Boyd, Emily; Osbahr, Henny

    2010-01-01

    Drawing from the organisational learning and governance literature, this paper assesses four internationally networked governmental and non-governmental organisations in the UK addressing climate change. We analyse how those concerned understand the climate change crisis, what mechanisms are put in place to address information flows, and what…

  14. Organisational merger and psychiatric morbidity: a prospective study in a changing work organisation.

    PubMed

    Väänänen, Ari; Ahola, Kirsi; Koskinen, Aki; Pahkin, Krista; Kouvonen, Anne

    2011-08-01

    Prospective studies on the relationship between organisational merger and mental health have been conducted using subjective health indicators. The objective of this prospective occupational cohort study was to examine whether a negative change during an organisational merger is an independent predictive factor of psychiatric morbidity. Survey data on organisational characteristics, health and other factors were collected prior to (1996) and after the merger (2000); register data on psychiatric morbidity were collected at baseline (1/1/1994-30/9/2000) and during the follow-up (1/10/2000-31/12/2005). Participants were 6511 (77% men) industrial employees aged 21-65 years with no register-based diagnosed psychiatric events prior to the follow-up (the Still Working Study). During the follow-up, 252 participants were admitted to the hospital due to psychiatric disorders, were prescribed a psychotropic drug or attempted or committed suicide. A negative self-reported change in the work organisation during the merger was associated with increased risk of postmerger psychiatric event (HR 1.60, 95% CI 1.19 to 2.14). This association was independent of mental health-related factors measured before the merger announcement, such as demographic characteristics, occupational status, personal orientation to life, self-rated health, self-reported psychiatric morbidity or chronic disease. A negative change in work organisation during an organisational merger may elevate the risk for postmerger psychiatric morbidity.

  15. Achieving Organisational Change through Values Alignment

    ERIC Educational Resources Information Center

    Branson, Christopher M.

    2008-01-01

    Purpose: The purpose of this paper is to, first, establish the interdependency between the successful achievement of organisational change and the attainment of values alignment within an organisation's culture and then, second, to describe an effective means for attaining such values alignment. Design/methodology/approach: Literature from the…

  16. How action researchers use anxiety to facilitate change in health care.

    PubMed

    Evans, Nicola; Hopkinson, Jane

    2016-06-01

    The aim of this paper is to report on the role of an action researcher in a study investigating the change process in a health service context where a new assessment clinic was developed to manage the excessive waiting list for that service. For effective organisational change in health, there is a suggestion that change agents need to be emotionally intelligent; recognising the emotional state of individuals, reconciling that with the organisational drivers and making an assessment of readiness for organisational change. Anxiety features throughout this literature and there is a suggestion that being aware of anxiety and managing anxiety is within the emotionally intelligent change agent's repertoire, but there is a gap in the literature that explains this relationship in detail. Data were generated to investigate the discrete nature of the role of the action researcher during this organisational change that spanned two years, through three methods: participant observations in the field captured in field notes (n = 72); observations of team meetings that had been recorded and transcribed (n = 13); interviews with key informants pre- and postintervention (n = 14); a reflexive diary one document of 8920 words (n = 1). The data illuminating the interaction between the action researcher and participants were synthesised into two broad themes: how the action researcher introduced anxiety into the system; how the action researcher facilitated the participants to tolerate change anxiety. The findings from this study can be applied in clinical practice where change in practice is planned. Part of the requirement of a change agent in the NHS might be to be sufficiently emotionally literate to understand anxiety in the participant system and manage it to effect change. © 2016 John Wiley & Sons Ltd.

  17. Organisational culture and change: implementing person-centred care.

    PubMed

    Carlström, Eric D; Ekman, Inger

    2012-01-01

    The purpose of this paper is to explore the connection between organisational cultures and the employee's resistance to change at five hospital wards in Western Sweden. Staff had experienced extensive change during a research project implementing person-centred care (PCC) for patients with chronic heart failure. Surveys were sent out to 170 nurses. The survey included two instruments--the Organisational Values Questionnaire (OVQ) and the Resistance to Change Scale (RTC). The results indicate that a culture with a dominating focus on social competence decreases "routine seeking behaviour", i.e. tendencies to uphold stable routines and a reluctance to give up old habits. The results indicate that a culture of flexibility, cohesion and trust negatively covariate with the overall need for a stable and well-defined framework. An instrument that pinpoints the conditions of a particular healthcare setting can improve the results of a change project. Managers can use instruments such as the ones used in this study to investigate and plan for change processes. Earlier studies of organisational culture and its impact on the performance of healthcare organisations have often investigated culture at the highest level of the organisation. In this study, the culture of the production units--i.e. the health workers in different hospital wards--was described. Hospital wards develop their own culture and the cultures of different wards are mirrored in the hospital.

  18. Delivering organisational adaptation through legislative mechanisms: Evidence from the Adaptation Reporting Power (Climate Change Act 2008).

    PubMed

    Jude, S R; Drew, G H; Pollard, S J T; Rocks, S A; Jenkinson, K; Lamb, R

    2017-01-01

    There is increasing recognition that organisations, particularly in key infrastructure sectors, are potentially vulnerable to climate change and extreme weather events, and require organisational responses to ensure they are resilient and adaptive. However, detailed evidence of how adaptation is facilitated, implemented and reported, particularly through legislative mechanisms is lacking. The United Kingdom Climate Change Act (2008), introduced the Adaptation Reporting Power, enabling the Government to direct so-called reporting authorities to report their climate change risks and adaptation plans. We describe the authors' unique role and experience supporting the Department for Environment, Food and Rural Affairs (Defra) during the Adaptation Reporting Power's first round. An evaluation framework, used to review the adaptation reports, is presented alongside evidence on how the process provides new insights into adaptation activities and triggered organisational change in 78% of reporting authorities, including the embedding of climate risk and adaptation issues. The role of legislative mechanisms and risk-based approaches in driving and delivering adaptation is discussed alongside future research needs, including the development of organisational maturity models to determine resilient and well adapting organisations. The Adaptation Reporting Power process provides a basis for similar initiatives in other countries, although a clear engagement strategy to ensure buy-in to the process and research on its long-term legacy, including the potential merits of voluntary approaches, is required. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Impact of organisational change on mental health: a systematic review.

    PubMed

    Bamberger, Simon Grandjean; Vinding, Anker Lund; Larsen, Anelia; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

    2012-08-01

    Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowledge combining MeSH search terms for exposure and outcome. The criterion for inclusion was original data on exposure to organisational change with mental health problems as outcome. Both cross-sectional and longitudinal studies were included. We found in 11 out of 17 studies, an association between organisational change and elevated risk of mental health problems was observed, with a less provident association in the longitudinal studies. Based on the current research, this review cannot provide sufficient evidence of an association between organisational change and elevated risk of mental health problems. More studies of long-term effects are required including relevant analyses of confounders.

  20. Learning about Learning: Action Learning in Times of Organisational Change

    ERIC Educational Resources Information Center

    Hill, Robyn

    2009-01-01

    This paper explores the conduct and outcomes of an action learning activity during a period of intense organisational change in a medium-sized vocational education and training organisation in Victoria, Australia. This organisation was the subject of significant change due to government-driven and statewide amalgamation, downsizing and sector…

  1. Caseload midwifery as organisational change: the interplay between professional and organisational projects in Denmark.

    PubMed

    Burau, Viola; Overgaard, Charlotte

    2015-05-27

    The large obstetric units typical of industrialised countries have come under criticism for fragmented and depersonalised care and heavy bureaucracy. Interest in midwife-led continuity models of care is growing, but knowledge about the accompanying processes of organisational change is scarce. This study focuses on midwives' role in introducing and developing caseload midwifery. Sociological studies of midwifery and organisational studies of professional groups were used to capture the strong interests of midwives in caseload midwifery and their key role together with management in negotiating organisational change. We studied three hospitals in Denmark as arenas for negotiating the introduction and development of caseload midwifery and the processes, interests and resources involved. A qualitative multi-case design was used and the selection of hospitals aimed at maximising variance. Ten individual and 14 group interviews were conducted in spring 2013. Staff were represented by caseload midwives, ward midwives, obstetricians and health visitors, management by chief midwives and their deputies. Participants were recruited to maximise the diversity of experience. The data analysis adopted a thematic approach, using within- and across-case analysis. The analysis revealed a highly interdependent interplay between organisational and professional projects in the change processes involved in the introduction and development of caseload midwifery. This was reflected in three ways: first, in the key role of negotiations in all phases; second, in midwives' and management's engagement in both types of projects (as evident from their interests and resources); and third in a high capacity for resolving tensions between the two projects. The ward midwives' role as a third party in organisational change further complicated the process. For managers tasked with the introduction and development of caseload midwifery, our study underscores the importance of understanding the

  2. The Army Learning Organisation Workshop

    DTIC Science & Technology

    2013-06-01

    realised. Facilitation was provided through external ( academic /subject matter expert) and internal (DALO Research Team) providers. The external...Learning Organisation arena ensured a common base of understanding for this discussion. The engagement of an academic with experience in facilitation, and...ways in which the learning organisation, and some of the claims made about learning organisations are presented in the ( academic , practitioner based

  3. Organisational change. Grace under fire.

    PubMed

    Dickinson, Helen; Parker, Helen

    2006-12-14

    The success of organisational change is often thwarted by leaders' failure to consider staff feelings. Managers must communicate a clear vision for the future, even though they may be facing great professional uncertainty themselves. It is important to deal with post-merger issues such as helping staff to new roles and 'unlearning' old ways.

  4. Sustainability reporting in public sector organisations: Exploring the relation between the reporting process and organisational change management for sustainability.

    PubMed

    Domingues, Ana Rita; Lozano, Rodrigo; Ceulemans, Kim; Ramos, Tomás B

    2017-05-01

    Sustainability Reporting has become a key element in different organisations. Although there have been a number of academic publications discussing the adoption of sustainability reports in the public sector, their numbers have been quite low when compared to those focussing on corporate reports. Additionally, there has been little research on the link between sustainability reporting in Public Sector Organisations (PSOs) and Organisational Change Management for Sustainability (OCMS). This paper focuses on the contribution of sustainability reporting to OCMS. A survey was sent to all PSOs that have published at least one sustainability report based on the GRI guidelines. The study provides a critical analysis of the relation between sustainability reporting and OCMS in PSOs, including the drivers for reporting, the impacts on organisation change management, and the role of stakeholders in the process. Despite still lagging in sustainability reporting journey, PSOs are starting to use sustainability reporting as a communication tool, and this could drive organisational changes for sustainability. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Leading organisational learning in health care.

    PubMed

    Carroll, J S; Edmondson, A C

    2002-03-01

    As healthcare organisations seek to enhance safety and quality in a changing environment, organisational learning practices can help to improve existing skills and knowledge and provide opportunities to discover better ways of working together. Leadership at executive, middle management, and local levels is needed to create a sense of shared purpose. This shared vision should help to build effective relationships, facilitate connections between action and reflection, and strengthen the desirable elements of the healthcare culture while modifying outdated assumptions, procedures, and structures.

  6. The Development and Evaluation of an Information Technology Support System to Facilitate Inter-Organisational Collaboration in HRD

    ERIC Educational Resources Information Center

    Ford, Norma J.

    2006-01-01

    Purpose: The purpose of this article is to evaluate the diffusion of and user response to an information technology support system (ITSS) which was designed to facilitate inter-organisational coordination and collaboration in the professional development of officers employed by local authorities (LAs). Design/methodology/approach: An action…

  7. Robustness of self-organised systems to changes in behaviour: an example from real and simulated self-organised snail aggregations.

    PubMed

    Stafford, Richard; Williams, Gray A; Davies, Mark S

    2011-01-01

    Group or population level self-organised systems comprise many individuals displaying group-level emergent properties. Current theory indicates that individual-level behaviours have an effect on the final group-level behaviour; that is, self-organised systems are sensitive to small changes in individual behaviour. Here we examine a self-organised behaviour in relation to environmentally-driven individual-level changes in behaviour, using both natural systems and computer simulations. We demonstrate that aggregations of intertidal snails slightly decrease in size when, owing to hotter and more desiccating conditions, individuals forage for shorter periods--a seemingly non-adaptive behaviour for the snails since aggregation reduces desiccation stress. This decrease, however, only occurs in simple experimental systems (and simulations of these systems). When studied in their natural and more complex environment, and simulations of such an environment, using the same reduced foraging time, no difference in aggregation behaviour was found between hot and cool days. These results give an indication of how robust self-organised systems are to changes in individual-level behaviour. The complexity of the natural environment and the interactions of individuals with this environment, therefore, can result in self-organised systems being more resilient to individual-level changes than previously assumed.

  8. Organising Communities-of-Practice: Facilitating Emergence

    ERIC Educational Resources Information Center

    Akkerman, Sanne; Petter, Christian; de Laat, Maarten

    2008-01-01

    Purpose: The notion of communities of practice (CoP) has received great attention in educational and organisational practice and research. Although the concept originally refers to collaborative practices that emerge naturally, educational and HRD practitioners are increasingly searching for ways to create these practices intentionally in order to…

  9. Organisational development in a rural hospital in Australia.

    PubMed

    Young, Suzanne; Leggat, Sandra; Stanton, Pauline; Bartram, Tim

    2015-04-01

    This paper analyses an organisational development project that aimed to change the organisational culture and improve people management systems and processes. The questions addressed were: was the change process a success; how was success defined; and what were the barriers to its progress? We examined the process of change over a 3-year period. The organisational development intervention is described and analysed. Qualitative methods, including document review, in-depth interviews and focus groups, participant observation, newsletters and diary entries were used to gather the data. A variant of competing values was used to analyse the data. We sought to build trust with all managers and encouraged reflection by conducting feedback sessions, presentations, workshops and one-on-one and group discussions. A cross-site action group was established to encourage organisation-wide participation in the project. However, it was clear that stakeholders had different understandings and perceptions of the problems facing the organisation. The project faltered when a leadership development intervention was organised. The existence of at least four different organisational 'worlds' and identities, according to different professional groupings with different goals, languages and values, was evident. The relationship between the researcher and subjects was key in terms of whether the researcher is seen as an 'expert' or as a 'facilitator'. In bringing about change, we need to work with the Chief Executive Officer in empowering others. Hence, the researchers need to engage in continual dialogue across boundaries and within groups as well as at individual levels to provide support for organisational change.

  10. The effectiveness of strategies to change organisational culture to improve healthcare performance

    PubMed Central

    Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

    2014-01-01

    Background Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Great emphasis has been placed during the last years on the need to change organisational culture in order to pursue effective improvement of healthcare performance. However, the precise nature of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted has been called into question. Objectives To determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. To examine the effectiveness of these strategies according to different patterns of organisational culture. Search methods We searched the following electronic databases for primary studies: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. Selection criteria We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITS) meeting the quality criteria used by the Cochrane Effective Practice and Organisation of Care Group (EPOC). Studies should be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. Data collection and analysis At least two review authors

  11. The effectiveness of strategies to change organisational culture to improve healthcare performance.

    PubMed

    Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

    2011-01-19

    Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Great emphasis has been placed during the last years on the need to change organisational culture in order to pursue effective improvement of healthcare performance. However, the precise nature of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted has been called into question. To determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance.To examine the effectiveness of these strategies according to different patterns of organisational culture. We searched the following electronic databases for primary studies: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITS) meeting the quality criteria used by the Cochrane Effective Practice and Organisation of Care Group (EPOC). Studies should be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. At least two review authors independently applied the criteria for inclusion and exclusion criteria to scan titles and

  12. Professional relations in sport healthcare: workplace responses to organisational change.

    PubMed

    Malcolm, Dominic; Scott, Andrea

    2011-02-01

    This article examines the impact of organisational changes in UK elite sport on the professional relations among and between different healthcare providers. The article describes the processes by which demand for elite sport healthcare has increased in the UK. It further charts the subsequent response within medicine and physiotherapy and, in particular, the institutionalisation of sport-specific sub-disciplines through the introduction of specialist qualifications. Drawing on semi-structured interviews with 14 doctors and 14 physiotherapists, the article argues that organisational changes have led to intra-professional tensions within both professional groups but in qualitatively different forms reflecting the organisational traditions and professional identities of the respective disciplines. Organisational changes promoting multi-disciplinary healthcare teams have also fostered an environment conducive to high levels of inter-professional cooperation though significant elements of inter-professional conflict remain. This study illustrates how intra-professional relations are affected by specialisation, how legitimation discourses are used by different professions, and how intra- and inter-professional conflict and cooperation should be seen as highly interdependent processes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. Building capacity for change: evaluation of an organisation-wide leadership development program.

    PubMed

    Schultz, Tim; Shoobridge, Jodie; Harvey, Gill; Carter, Libby; Kitson, Alison

    2018-05-23

    Objective. This study evaluated Leading 4 Change, a change leadership development program designed to support healthcare middle managers through a period of significant organisational change and enhance workplace resilience. Methods. A mixed methods evaluation was conducted within the program's framework of a quality improvement activity. Quantitative measures were participant responses (n=160) to online questionnaires, which were compared before and after the program, using an uncontrolled pre-post study design. Four questionnaires were used: Resilience @ Work, General Self-Efficacy, the 11-item Learning Organization Survey and organisational climate. Differences between the pre- and post-program periods were compared using linear mixed-effects models, incorporating repeated measures between 'pre' and 'post' periods. Qualitative data were obtained by interviewing four participants on three occasions during the program, and through text responses provided by participants during a presentation session after the program finished. Both interview data and textual data were subjected to thematic analysis. Results. Integration of data from quantitative and qualitative analyses generated three main findings: (1) participants were satisfied and engaged with the program, which met their learning objectives; (2) the program led to increased workplace resilience, in particular the ability to manage stress and self-efficacy for individuals; and (3) organisational learning perceptions were unchanged. Conclusion. Although conducted during a period of intense internal and external pressure, Leading 4 Change led to demonstrable effects. It effectively engaged middle managers across a health system. However, there was no evidence that the effect of the program extended beyond individual participants to their perceptions of their work environment as a learning organisation. What is known about the topic? Although much has been written about change management and change leadership

  14. Embedding effective depression care: using theory for primary care organisational and systems change.

    PubMed

    Gunn, Jane M; Palmer, Victoria J; Dowrick, Christopher F; Herrman, Helen E; Griffiths, Frances E; Kokanovic, Renata; Blashki, Grant A; Hegarty, Kelsey L; Johnson, Caroline L; Potiriadis, Maria; May, Carl R

    2010-08-06

    Depression and related disorders represent a significant part of general practitioners (GPs) daily work. Implementing the evidence about what works for depression care into routine practice presents a challenge for researchers and service designers. The emerging consensus is that the transfer of efficacious interventions into routine practice is strongly linked to how well the interventions are based upon theory and take into account the contextual factors of the setting into which they are to be transferred. We set out to develop a conceptual framework to guide change and the implementation of best practice depression care in the primary care setting. We used a mixed method, observational approach to gather data about routine depression care in a range of primary care settings via: audit of electronic health records; observation of routine clinical care; and structured, facilitated whole of organisation meetings. Audit data were summarised using simple descriptive statistics. Observational data were collected using field notes. Organisational meetings were audio taped and transcribed. All the data sets were grouped, by organisation, and considered as a whole case. Normalisation Process Theory (NPT) was identified as an analytical theory to guide the conceptual framework development. Five privately owned primary care organisations (general practices) and one community health centre took part over the course of 18 months. We successfully developed a conceptual framework for implementing an effective model of depression care based on the four constructs of NPT: coherence, which proposes that depression work requires the conceptualisation of boundaries of who is depressed and who is not depressed and techniques for dealing with diffuseness; cognitive participation, which proposes that depression work requires engagement with a shared set of techniques that deal with depression as a health problem; collective action, which proposes that agreement is reached about how

  15. Organisational adaptation in an activist network: social networks, leadership, and change in al-Muhajiroun.

    PubMed

    Kenney, Michael; Horgan, John; Horne, Cale; Vining, Peter; Carley, Kathleen M; Bigrigg, Michael W; Bloom, Mia; Braddock, Kurt

    2013-09-01

    Social networks are said to facilitate learning and adaptation by providing the connections through which network nodes (or agents) share information and experience. Yet, our understanding of how this process unfolds in real-world networks remains underdeveloped. This paper explores this gap through a case study of al-Muhajiroun, an activist network that continues to call for the establishment of an Islamic state in Britain despite being formally outlawed by British authorities. Drawing on organisation theory and social network analysis, we formulate three hypotheses regarding the learning capacity and social network properties of al-Muhajiroun (AM) and its successor groups. We then test these hypotheses using mixed methods. Our methods combine quantitative analysis of three agent-based networks in AM measured for structural properties that facilitate learning, including connectedness, betweenness centrality and eigenvector centrality, with qualitative analysis of interviews with AM activists focusing organisational adaptation and learning. The results of these analyses confirm that al-Muhajiroun activists respond to government pressure by changing their operations, including creating new platforms under different names and adjusting leadership roles among movement veterans to accommodate their spiritual leader's unwelcome exodus to Lebanon. Simple as they are effective, these adaptations have allowed al-Muhajiroun and its successor groups to continue their activism in an increasingly hostile environment. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  16. Frameworks for change in healthcare organisations: a formative evaluation of the NHS Change Model.

    PubMed

    Martin, Graham P; Sutton, Elizabeth; Willars, Janet; Dixon-Woods, Mary

    2013-08-01

    Organisational change in complex healthcare systems is a multifaceted process. The English National Health Service recently introduced a 'Change Model' that seeks to offer an evidence-based framework for guiding change. We report findings from a formative evaluation of the NHS Change Model and make recommendations for those developing the Model and its users. The evaluation involved 28 interviews with managers and clinicians making use of the Change Model in relation to a variety of projects. Interviews were fully transcribed and were analysed using an approach based on the Framework method. Participants saw the Change Model as valuable and practically useful. Fidelity to core principles of the Model was variable: participants often altered the Model, especially when using it to orchestrate the work of others. In challenging organisational contexts, the Change Model was sometimes used to delegitimise opposition rather than identify shared purpose among different interest groups. Those guiding change may benefit from frameworks, guidance and toolkits to structure and inform their planning and activities. Participants' experiences suggested the Change Model has much potential. Further work on its design and on supporting materials may optimise the approach, but its utility rests in particular on organisational cultures that support faithful application. © The Author(s) 2013 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  17. Organisational change: a methodology to uncover the business idea.

    PubMed

    Barker, J; Anderson, P

    2001-01-01

    A study was undertaken to identify the "Business Idea", as defined by van der Heijden (1996), in The Family Planning Association of WA Inc (FPWA) which is a Non-Government Organisation (NGO) in Perth, Western Australia. This organisation was chosen as, along with many other NGOs, it was undergoing major changes in its funding, role and required outcomes. A qualitative interpretivist single case study methodology employing grounded theory research principles and methods was used to study the Business Idea framework in this setting. Thirty-four members of FPWA's staff were interviewed and data was managed using NUD*IST4 and Decision Explorer data storage, data retrieval and graphical reproduction facilities. Results indicated that images of the Business Idea model within FPWA were largely consistent across all staff levels excepting members of the Board of Management. Changes within the organisation were impacting heavily on staff, who needed to be assisted over the transitional phase. Strong leadership and corporate direction were identified as essential if the FPWA was to balance the strongly held sense of social justice amongst its staff with a need for greater productivity efficiency and accountability across the organisation.

  18. Change, Technology and Higher Education: Are Universities Capable of Organisational Change?

    ERIC Educational Resources Information Center

    Marshall, Stephen

    2010-01-01

    Technology and change are so closely related that the use of the word innovation seems synonymous with technology in many contexts, including that of higher education. This paper contends that university culture and existing capability constrain such innovation and to a large extent determine the nature and extent of organisational change. In the…

  19. Change, Technology and Higher Education: Are Universities Capable of Organisational Change?

    ERIC Educational Resources Information Center

    Marshall, Stephen

    2011-01-01

    Technology and change are so closely related that the use of the word innovation seems synonymous with technology in many contexts, including that of higher education. This paper contends that university culture and existing capability constrain such innovation and to a large extent determine the nature and extent of organisational change. In the…

  20. Occupational therapists' job satisfaction in a changing hospital organisation--a time-geography-based study.

    PubMed

    Bendixen, Hans Jørgen; Ellegård, Kajsa

    2014-01-01

    To investigate occupational therapists' job satisfaction under a changing regime by using a time-geographic approach focusing on the therapists' everyday working lives. Nine occupational therapists at the Copenhagen University Hospital, Gentofte, Denmark. A mixed-method design was employed. Occupational therapists kept time-geographic diaries, and the results from them were grounded for individual, semi-structured in-depth interviews. Individual reflections on everyday working life were recorded. Transcribed statements from the interviews were analysed to determine factors influencing job satisfaction. The nine therapists kept diaries for one day a month for a total of 70 preselected days over a period of nine months; six participated in individual interviews. Four factors constraining OT job satisfaction were revealed. Economic concerns, new professional paradigms and methods in combination with a new organisational structure for the occupational therapy service caused uncertainty. In addition, decreasing possibilities for supervision by colleagues influenced job satisfaction. Opportunities for experiencing autonomy in everyday working life were described as facilitators for job satisfaction. The time-geographic and interview methods were useful in focusing on the job satisfaction of occupational therapists, who provided individual interpretations of the balance between autonomy and three types of constraints in everyday working life. The constraints related to organisation, power relations and - not least - how the organisational project of the department fitted in with OTs' individual projects. Matching of organisational and individual projects is of crucial importance, not only for OTs but for most workplaces where individuals are employed to serve patients in the healthcare sector.

  1. Coexistence or Operational Necessity: The Role of Formally Structured Organisation and Informal Networks during Deployments

    DTIC Science & Technology

    2011-06-01

    informal communication and informal networks which provide the quickest means of communication in organisations . These informal groupings develop ...promote creativity through sensemaking and self- organisation will better enable the military to respond to environmental changes (McDaniel, 2007... need to be addressed to facilitate the co-existence of formal organisation and informal networks during deployments? The military in general and

  2. Adapting to climate change by water management organisations: Enablers and barriers

    NASA Astrophysics Data System (ADS)

    Azhoni, Adani; Jude, Simon; Holman, Ian

    2018-04-01

    Climate change will be particularly experienced though the medium of water. Water organisations, that are managing societal and ecological needs for water, are therefore likely to experience the impact the most. This study reviews the current literature regarding adaptation to climate change by water management organisations and associated barriers. Literature on adaptive capacity is growing and a general consensus is emerging on the determinants of adaptive capacity, although variations exist regarding how it is to be evaluated, enhanced and applied to policy making due to its dynamic, contextual and latent nature. Since adaptive capacity is hard to measure and successful adaptation difficult to define, some studies focus on the existence of adaptation attributes of organisations. Studies reporting successful adaptation are minimal and barriers of adaptation are being discovered as adaptation research transitions into implementation. But the root causes of these barriers are often overlooked and the interconnectedness of the barriers is poorly addressed. Increasingly, combining top-down and bottom-up approaches to adaptation is being recommended due to the limitations of each. However, knowledge regarding how organisations operating at different scales can enhance adaptive capacity of other organisations operating at another scale is lacking due to the few studies of inter-organisational networks across scales. Social networks among actors are recognised as a key factor to enable adaptation. However, network studies generally focus on individual actors and rarely between public agencies/organisations. Moreover, the current literature is inadequate to understand the relationship between adaptation enabling characteristics, barriers and adaptation manifestation. The review demonstrates that research on understanding the emergence and sustenance of barriers is urgently required. Addressing these knowledge gaps will help to improve the design of adaptation strategies

  3. Effect of organisational change type and frequency on long-term sickness absence in hospitals.

    PubMed

    Bernstrøm, Vilde H; Kjekshus, Lars Erik

    2015-09-01

    The present study was conducted to investigate how the frequency of structural change and patient care-related change is related to employees' long-term sickness absence. Although a growing body of research is investigating the potentially harmful effects of organisational change on employee health, most studies have focused on single episodes of organisational change and do not differentiate among the types and frequencies of change. National registry data were collected from 2005 and 2007. A total of 34 712 health professionals from 56 hospitals were included (76% nurses, 18% physicians and 6% other health professionals) and the data were analysed using multilevel logistic regression. The research findings reveal a significantly higher probability of long-term sickness absence among employees who experienced more frequent structural changes (OR = 1.03; CI: 1.00-1.06; P < 0.05), but not among employees who experienced more frequent patient care-related changes. A higher frequency of organisational change may lead to more sickness-related absence among employees, with the effect depending on the type of change. These findings highlight the need for managers who are contemplating or are in the process of implementing organisational change to become more aware of the potentially harmful effects of frequent organisational change on employee health. © 2014 John Wiley & Sons Ltd.

  4. Management of change in health care organisations and human resource role.

    PubMed

    Carignani, V

    2000-01-01

    The paper is focused on the analysis of the most relevant factors necessary to manage change in health care organisations. The approach suggested is the Stakeholder one. According to this approach, the hospital's managers seem to be successful if they are able to satisfy people (internal and external stakeholders) that have a stake in the health care institution. The attention of the author is mainly focused on the internal forces that make the health care sector competitive and successful. In order to motivate internal human resources to accept change and to achieve the organisational targets two main methods can be suggested. The former is based on tangible variables and in particular on a fair reward system; the latter is built on intangible elements e.g. communication, negotiation, contracting, and organisational values sharing. Moreover, in order to cope with change it is important to develop the information technology management and to reengineer delivery processes, taking into consideration both the costs and benefits of these kinds of innovations.

  5. The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review.

    PubMed

    Parmelli, Elena; Flodgren, Gerd; Beyer, Fiona; Baillie, Nick; Schaafsma, Mary Ellen; Eccles, Martin P

    2011-04-03

    Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. In recent years, increasing emphasis has been placed on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. We searched the following electronic databases: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies (controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) analyses). Studies could be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. The search strategy yielded 4,239 records. After the full text assessment, two CBA studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes. Both were at high risk of

  6. The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review

    PubMed Central

    2011-01-01

    Background Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. In recent years, increasing emphasis has been placed on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. Methods We searched the following electronic databases: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies (controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) analyses). Studies could be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. Results The search strategy yielded 4,239 records. After the full text assessment, two CBA studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes

  7. Action Learning--A Process Which Supports Organisational Change Initiatives

    ERIC Educational Resources Information Center

    Joyce, Pauline

    2012-01-01

    This paper reflects on how action learning sets (ALSs) were used to support organisational change initiatives. It sets the scene with contextualising the inclusion of change projects in a masters programme. Action learning is understood to be a dynamic process where a team meets regularly to help individual members address issues through a highly…

  8. A Positive Approach to Change: The Role of Appreciative Inquiry in Library and Information Organisations

    ERIC Educational Resources Information Center

    Kelly, Tricia

    2010-01-01

    Library and information management (LIM) organisations are on an almost continual path of change driven by changes in technology, service models, staffing structures, and financial allocations. The way in which LIM organisations approach change varies, as does the success rate of change management procedures undertaken. One particular approach to…

  9. Self-Organisation and Capacity Building: Sustaining the Change

    ERIC Educational Resources Information Center

    Bain, Alan; Walker, Allan; Chan, Anissa

    2011-01-01

    Purpose: The paper aims to describe the application of theoretical principles derived from a study of self-organisation and complex systems theory and their application to school-based capacity building to support planned change. Design/methodology/approach: The paper employs a case example in a Hong Kong School to illustrate the application of…

  10. The effects of organisational culture on nurses' perceptions of their work.

    PubMed

    Garcia, Alessandra Bassalobre; Rocha, Fernanda Ludmilla Rossi; Pissinati, Paloma de Souza Cavalcante; Marziale, Maria Helena Palucci; Camelo, Silvia Helena Henriques; Haddad, Maria do Carmo Fernandez Lourenço

    2017-07-27

    This study aimed to analyse the relationship between the organisational culture and feelings of pleasure and suffering among working nursing professionals. This was a cross-sectional correlational study conducted in a tertiary hospital with 214 nursing staff over 3 months using three instruments: professional characterisation, the Brazilian Instrument for Assessment of Organisational Culture, and the Scale of Pleasure and Suffering at Work. The analysis included descriptive statistics and the Spearman correlation test. The external integration practice was the domain most frequently found in the organisational culture and the feeling of pleasure-gratification predominated among the workers. Values of cooperative professionalism and wellbeing, and practices of external integration and relationship promotion, were related to increased pleasure and decreased suffering at work. These aspects depend on the organisational culture of the institution. Investigating organisational culture facilitates the understanding of potential collective coping strategies and the organisational changes that favour good mental health in nurses.

  11. The success of the Uttarakhand Cluster: a case study of organisational change towards disability inclusive development.

    PubMed

    Grills, Nathan; Varghese, Jubin; Hughes, Nicole; Jolly, Tamara; Kumar, Robert

    2016-08-02

    Persons with disability are often marginalised and excluded from international development efforts. This case study reviews the success of Uttarakhand Cluster of development NGOs in changing organisational behaviour towards being disability inclusive in their development (DID) activities. A triangulation of qualitative research methods was used, including key informant interviews, focus group discussions and review of textual data. The results synthesise data into Kotter's framework for organisational change, explaining the different stages of change experienced by the Cluster as it moved towards DID. Development of a disability mission, sharing of capacity and resources, and presence of disability champions were key in the organisations' transition towards DID. This case study demonstrates that the Cluster, a low - cost network, was able to drive organisational change and promote DID.

  12. Knowledge Creation in Construction Organisations: A Case Approach

    ERIC Educational Resources Information Center

    Eliufoo, Harriet

    2008-01-01

    Purpose: The purpose of this paper is to investigate and characterise the knowledge creation process in construction organisations and explore to what extent organisations facilitate the process. Design/methodology/approach: A case study approach is adopted using four construction organisations; a knowledge creation model is also used as the…

  13. Organisational Structure

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2006

    2006-01-01

    An understanding of organisational structure can provide guidance for organisations that want to change and innovate. Many writers agree that this understanding allows organisations to shape how their work is done to ultimately achieve their business goals--and that too often structure is given little consideration in business strategy and…

  14. Facilitators and barriers for eating behaviour changes in obstructive sleep apnoea and obesity - a qualitative content analysis.

    PubMed

    Spörndly-Nees, Søren; Igelström, Helena; Lindberg, Eva; Martin, Cathrin; Åsenlöf, Pernilla

    2014-01-01

    Obesity is a major risk factor for obstructive sleep apnoea syndrome, a condition known causing lack of sleep continuity and daytime sleepiness. Weight loss interventions are recommended, however knowledge on what facilitate and impede eating behaviour change is lacking for this particular population. The aim of this study was to identify personal conceptions of prerequisites for eating behaviour change. A qualitative study on 15 patients with obstructive sleep apnoea syndrome (OSAS; apnoea-hypopnoea index >15) and obesity (Mean body mass index 38.2). Semi-structured interviews were conducted and data were transcribed and analysed using qualitative content analysis with researcher triangulation for trustworthiness. Data were organised according to barriers and facilitators for changing eating behaviour. Identified barriers were desire and reward, cravings and emotional control, low self-confidence, insufficient support, taxing behaviours, cost, lack of knowledge about healthy eating strategies, perceived helplessness and low susceptibility. Identified facilitators were positive expectations, fear of negative consequences, experience of success, support and follow-up, accessibility, applied skills for healthy eating, personal involvement and challenged self-image. This study adds knowledge on important barriers and facilitators of eating behaviour change according to individuals with obesity and OSAS. Information used to inform a tailored behavioural medicine intervention targeting eating behaviours. Patients with obstructive sleep apnoea syndrome (OSAS) benefit from weight loss and eating behaviour changes are recommended. Patients' views on prerequisites for eating behaviour change are important to plan, conduct and tailor behaviour change interventions. These aspects have hitherto not been elaborated in patients with OSAS. Considerations on patient's self-image and perceived susceptibility along with providing strategies for controlling the desire and rewarding

  15. Organisational change, job strain and increased risk of stroke? A pilot study.

    PubMed

    Medin, Jennie; Ekberg, Kerstin; Nordlund, Anders; Eklund, Jörgen

    2008-01-01

    The objective of this pilot study was to explore whether organisational change and work-related stress, as measured by the Job Content Questionnaire, were associated with first-ever stroke among working people aged 30-65. In a case-control study a total of 65 consecutive cases, aged 30-65 years of age, with first-ever stroke were recruited from four hospitals in Sweden during 2000-2002. During the same period, 103 random population controls in the same age interval were recruited. Data on job-related stress and traditional medical risk factors were collected by a questionnaire. In the multivariate analyses, organisational change (OR 3.38) increased the likelihood of stroke, while experiencing an active job (OR 0.37) decreased the likelihood of stroke. Regarding risk factors outside work, age (OR 1.11), low physical activity (OR 5.21), low education (OR 2.48) and family history of stroke (OR 2.59) were associated with increased likelihood of stroke. This study suggests an association between organisational change, work-related stress and stroke. The likelihood of stroke was lower for people in active job situations.

  16. Organisational Blogging: The Problem of Engagement

    ERIC Educational Resources Information Center

    Baxter, Gavin J.; Connolly, Thomas; Stansfield, Mark

    2011-01-01

    This paper investigates the implementation and use of an internal organisational blog by several departments in the HR division in a large public sector financial organisation in the UK. This qualitative study adopts a case study approach and examines the experiences of staff using the blog to explore whether it can facilitate organisational…

  17. Redirecting traditional professional values to support safety: changing organisational culture in health care.

    PubMed

    Carroll, J S; Quijada, M A

    2004-12-01

    Professionals in healthcare organisations who seek to enhance safety and quality in an increasingly demanding industry environment often identify culture as a barrier to change. The cultural focus on individual autonomy, for example, seems to conflict with desired norms of teamwork, problem reporting, and learning. We offer a definition and explication of why culture is important to change efforts. A cultural analysis of health care suggests professional values that can be redirected to support change. We offer examples of organisations that drew upon cultural strengths to create new ways of working and gradually shifted the culture.

  18. Redirecting traditional professional values to support safety: changing organisational culture in health care

    PubMed Central

    Carroll, J; Quijada, M

    2004-01-01

    Professionals in healthcare organisations who seek to enhance safety and quality in an increasingly demanding industry environment often identify culture as a barrier to change. The cultural focus on individual autonomy, for example, seems to conflict with desired norms of teamwork, problem reporting, and learning. We offer a definition and explication of why culture is important to change efforts. A cultural analysis of health care suggests professional values that can be redirected to support change. We offer examples of organisations that drew upon cultural strengths to create new ways of working and gradually shifted the culture. PMID:15576686

  19. Policy interventions implemented through sporting organisations for promoting healthy behaviour change.

    PubMed

    Priest, Naomi; Armstrong, Rebecca; Doyle, Jodie; Waters, Elizabeth

    2008-07-16

    Sporting organisations provide an important setting for health promotion strategies that involve policies, communication of healthy messages and creation of health promoting environments. The introduction of policy interventions within sporting organisations is one strategy to target high risk behaviours such as smoking, alcohol consumption, excess sun exposure, unhealthy eating and discrimination. To update a review of all controlled studies evaluating policy interventions organised through sporting settings to increase healthy behaviour (related to smoking, alcohol, healthy eating, sun protection, discrimination, safety and access). We updated the original (2004) searches in May 2007. We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2 2007); MEDLINE and MEDLINE In-Process and Other Non-Indexed Citations (2004 to Week 3 April 2007); EMBASE (2004 to Week 17 2007); PsyclNFO (2004 to April Week 1 2007); CINAHL (2004 to Week 1 May 2007); SPORTDiscus (2004 to April 2007); Sociological Abstracts (2004 to 2007); Dissertation Abstracts (2004 to May 2007), ERIC (2000 to 2007), freely available online health promotion and sports-related databases hosted by leading agencies, and the internet using sport and policy-related key words. Controlled studies evaluating any policy intervention implemented through sporting organisations to instigate and/or sustain healthy behaviour change, intention to change behaviour, or changes in attitudes, knowledge or awareness of healthy behaviour, in people of all ages. Policies must address any of the following: smoking, alcohol, healthy eating, sun protection, access for disadvantaged groups, physical safety (not including injuries), and social and emotional health (e.g. anti-vilification, anti-discrimination). Uncontrolled studies which met the other inclusion criteria were to be reported in an annex to the review. We assessed whether identified citations met the inclusion criteria

  20. Learning to listen to the organisational rhetoric of primary health and social care integration.

    PubMed

    Warne, T; McAndrew, S; King, M; Holland, K

    2007-11-01

    The sustained modernisation of the UK primary health care service has resulted in individuals and organisations having to develop more integrated ways of working. This has resulted in changes to the structure and functioning of primary care organisations, changes to the traditional workforce, and an increase in scope of primary care practice. These changes have contributed to what for many staff has become a constantly turbulent organisational and practice environment. Data from a three-year project, commissioned by the North West Development Agency is used to explore how staff involved in these changes dealt with this turbulence. Three hundred and fifty staff working within primary care participated in the study. A multimethods approach was used which facilitated an iterative analysis and data collection process. Thematic analysis revealed a high degree of congruence between the perceptions of all staff groups with evidence of a generally well-articulated, but often rhetorical view of the organisational and professional factors involved in how these changes were experienced. This rhetoric was used by individuals as a way of containing both the good and bad elements of their experience. This paper discusses how these defense mechanisms need to be recognised and understood by managers so that a more supportive organisational culture is developed.

  1. Age-associated changes in rich-club organisation in autistic and neurotypical human brains

    PubMed Central

    Watanabe, Takamitsu; Rees, Geraint

    2015-01-01

    Macroscopic structural networks in the human brain have a rich-club architecture comprising both highly inter-connected central regions and sparsely connected peripheral regions. Recent studies show that disruption of this functionally efficient organisation is associated with several psychiatric disorders. However, despite increasing attention to this network property, whether age-associated changes in rich-club organisation occur during human adolescence remains unclear. Here, analysing a publicly shared diffusion tensor imaging dataset, we found that, during adolescence, brains of typically developing (TD) individuals showed increases in rich-club organisation and inferred network functionality, whereas individuals with autism spectrum disorders (ASD) did not. These differences between TD and ASD groups were statistically significant for both structural and functional properties. Moreover, this typical age-related changes in rich-club organisation were characterised by progressive involvement of the right anterior insula. In contrast, in ASD individuals, did not show typical increases in grey matter volume, and this relative anatomical immaturity was correlated with the severity of ASD social symptoms. These results provide evidence that rich-club architecture is one of the bases of functionally efficient brain networks underpinning complex cognitive functions in adult human brains. Furthermore, our findings suggest that immature rich-club organisation might be associated with some neurodevelopmental disorders. PMID:26537477

  2. Organisational Change: Communicating to Schein's Operator, Engineer and Executive Occupational Subcultures

    ERIC Educational Resources Information Center

    Chapman, Geoffrey R.; Hayes, Kathryn J.; Sloan, Terry; Fitzgerald, Janna Anneke

    2011-01-01

    There has been substantial academic interest surrounding innovation, change management and the individual attributes that permit and promote learning, organisational change and innovative behaviour. This research uses a psychometric tool known as the Instinctive Drives System[R] to measure preferred working styles in 3943 employees from a range of…

  3. Piloting a logic-based framework for understanding organisational change process for a health IT implementation.

    PubMed

    Diment, Kieren; Garrety, Karin; Yu, Ping

    2011-01-01

    This paper describes how a method for evaluating organisational change based on the theory of logical types can be used for classifying organisational change processes to understand change after the implementation of an electronic documentation system in a residential aged care facility. In this instance we assess the organisational change reflected by care staff's perceptions of the benefits of the new documentation system at one site, at pre-implementation, and at 12 months post-implementation. The results show how a coherent view from the staff as a whole of the personal benefits, the benefits for others and the benefits for the organization create a situation of positive feedback leading to embeddedness of the documentation system into the site, and a broader appreciation of the potential capabilities of the electronic documentation system.

  4. Organisational change stressors and nursing job satisfaction: the mediating effect of coping strategies.

    PubMed

    Teo, Stephen T T; Pick, David; Newton, Cameron J; Yeung, Melissa E; Chang, Esther

    2013-09-01

    To examine the mediating effect of coping strategies on the consequences of nursing and non-nursing (administrative) stressors on the job satisfaction of nurses during change management. Organisational change can result in an increase in nursing and non-nursing-related stressors, which can have a negative impact on the job satisfaction of nurses employed in health-care organisations. Matched data were collected in 2009 via an online survey at two time-points (six months apart). Partial least squares path analysis revealed a significant causal relationship between Time 1 administrative and role stressors and an increase in nursing-specific stressors in Time 2. A significant relationship was also identified between job-specific nursing stressors and the adoption of effective coping strategies to deal with increased levels of change-induced stress and strain and the likelihood of reporting higher levels of job satisfaction in Time 2. The effectiveness of coping strategies is critical in helping nurses to deal with the negative consequences of organisational change. This study shows that there is a causal relationship between change, non-nursing stressors and job satisfaction. Senior management should implement strategies aimed at reducing nursing and non-nursing stress during change in order to enhance the job satisfaction of nurses. © 2013 John Wiley & Sons Ltd.

  5. Influencing organisational change in the NHS: lessons learned from workplace wellness initiatives in practice.

    PubMed

    Blake, Holly; Lloyd, Scott

    2008-01-01

    This article presents a discussion of the key issues in influencing organisational change in NHS settings, in the development of workplace wellness interventions to improve employee health and wellbeing. To tackle poor public health and associated rising healthcare costs, there must be a focus on the root cause of many preventable diseases - unhealthy lifestyle choices. Workplace wellness initiatives are now an important prevention strategy adopted by socially responsible organisations to target the health and wellbeing of working age adults. Lessons learned from initiatives in secondary care suggest that effective implementation requires change in organisational 'health culture', through a combination of education, behaviour change intervention, needs-based facilities, and services and strategies for developing supportive and health-promoting work environments. Most of all, employers must demonstrate a commitment to health and wellness that is fully integrated with their mission, values and long-term vision, paving the way for sustainable lifestyle changes. Evaluation systems must be in place to measure the impact and outcomes of wellness schemes.

  6. Postgraduate Education to Support Organisation Change: A Reflection on Reflection

    ERIC Educational Resources Information Center

    Stewart, Jim; Keegan, Anne; Stevens, Pam

    2008-01-01

    Purpose: This paper aims to explore how teaching and assessing reflective learning skills can support postgraduate practitioners studying organisational change and explores the challenges for tutors in assessing these journals. Design/methodology/approach: Assessment criteria were developed from the literature on reflective practice and…

  7. The Role of Learner-Centred Assessment in Postsecondary Organisational Change

    ERIC Educational Resources Information Center

    Webber, Karen L.; Tschepikow, Kyle

    2013-01-01

    For postsecondary institutions, organisational change is an inevitable and ongoing process. Institutions face a growing need to assess student learning assessment as part of an institution's comprehensive assessment plan. While a growing body of literature suggests that learner-centred assessment is a best practice in higher education pedagogy, it…

  8. Inter-organisational communication networks in healthcare: centralised versus decentralised approaches.

    PubMed

    Pirnejad, Habibollah; Bal, Roland; Stoop, Arjen P; Berg, Marc

    2007-05-16

    To afford efficient and high quality care, healthcare providers increasingly need to exchange patient data. The existence of a communication network amongst care providers will help them to exchange patient data more efficiently. Information and communication technology (ICT) has much potential to facilitate the development of such a communication network. Moreover, in order to offer integrated care interoperability of healthcare organizations based upon the exchanged data is of crucial importance. However, complications around such a development are beyond technical impediments. To determine the challenges and complexities involved in building an Inter-organisational Communication network (IOCN) in healthcare and the appropriations in the strategies. Interviews, literature review, and document analysis were conducted to analyse the developments that have taken place toward building a countrywide electronic patient record and its challenges in The Netherlands. Due to the interrelated nature of technical and non-technical problems, a socio-technical approach was used to analyse the data and define the challenges. Organisational and cultural changes are necessary before technical solutions can be applied. There are organisational, financial, political, and ethicolegal challenges that have to be addressed appropriately. Two different approaches, one "centralised" and the other "decentralised" have been used by Dutch healthcare providers to adopt the necessary changes and cope with these challenges. The best solutions in building an IOCN have to be drawn from both the centralised and the decentralised approaches. Local communication initiatives have to be supervised and supported centrally and incentives at the organisations' interest level have to be created to encourage the stakeholder organisations to adopt the necessary changes.

  9. Narrative organisation at encoding facilitated children's long-term episodic memory.

    PubMed

    Wang, Qi; Bui, Van-Kim; Song, Qingfang

    2015-01-01

    This study examined the effect of narrative organisation at encoding on long-term episodic memory in a sample of five- to seven-year-old children (N = 113). At an initial interview, children were asked to narrate a story from a picture book. Six months later, they were interviewed again and asked to recall the story and answer a series of direct questions about the story. Children who initially encoded more information in narrative and produced more complete, complex, cohesive and coherent narratives remembered the story in greater detail and accuracy following the six-month interval, independent of age and verbal skills. The relation between narrative organisation and memory was consistent across culture and gender. These findings provide new insight into the critical role of narrative in episodic memory.

  10. The sideshow or the circus? The role for public interest organisations at inquests.

    PubMed

    Prictor, Megan

    2012-12-01

    Recent changes in coronial law in Australian jurisdictions have enabled inquests to adopt an expanded scope and have facilitated the participation of family members and other interested parties. Public interest bodies have increasingly sought to have input to coronial policy and practice. This article examines the involvement by public interest organisations in Australian inquests over recent years. These organisations adopt various roles in inquests, including the representation and support of family members of the deceased, and the pursuit of policy and legislative changes. A further role is that of participation in specific inquests as an "interested party", in order to provide relevant expertise, shape the scope of the inquiry, and illuminate systemic issues which may have contributed to a death. This article considers the legal framework for the involvement of public interest organisations, and critically reflects upon the main purposes and effects of such intervention.

  11. From Digital Administration to Organisational Learning

    ERIC Educational Resources Information Center

    Elkjaer, Bente

    2005-01-01

    Purpose: To explore whether deliberate organisational change of a public sector organisation (a local municipality) would create an avenue for organisational learning. Design/methodology/approach: A case study was set up to study the means by which the organisational change towards a digital administration was to come about. The organisational…

  12. On the Shortcomings of Our Organisational Forms: With Implications for Educational Change and School Improvement

    ERIC Educational Resources Information Center

    Waite, Duncan

    2010-01-01

    This article informs school improvement and educational change from a radically different perspective. Building upon work done recently in neural psychology, primatology and ethology, the article examines four common and general types of organisational form: the cell, the silo, the pyramidal, and the network types of organisational structures.…

  13. Inter-organisational communication networks in healthcare: centralised versus decentralised approaches

    PubMed Central

    Pirnejad, Habibollah; Bal, Roland; Stoop, Arjen P.; Berg, Marc

    2007-01-01

    Background To afford efficient and high quality care, healthcare providers increasingly need to exchange patient data. The existence of a communication network amongst care providers will help them to exchange patient data more efficiently. Information and communication technology (ICT) has much potential to facilitate the development of such a communication network. Moreover, in order to offer integrated care interoperability of healthcare organizations based upon the exchanged data is of crucial importance. However, complications around such a development are beyond technical impediments. Objectives To determine the challenges and complexities involved in building an Inter-organisational Communication network (IOCN) in healthcare and the appropriations in the strategies. Case study Interviews, literature review, and document analysis were conducted to analyse the developments that have taken place toward building a countrywide electronic patient record and its challenges in The Netherlands. Due to the interrelated nature of technical and non-technical problems, a socio-technical approach was used to analyse the data and define the challenges. Results Organisational and cultural changes are necessary before technical solutions can be applied. There are organisational, financial, political, and ethicolegal challenges that have to be addressed appropriately. Two different approaches, one “centralised” and the other “decentralised” have been used by Dutch healthcare providers to adopt the necessary changes and cope with these challenges. Conclusion The best solutions in building an IOCN have to be drawn from both the centralised and the decentralised approaches. Local communication initiatives have to be supervised and supported centrally and incentives at the organisations' interest level have to be created to encourage the stakeholder organisations to adopt the necessary changes. PMID:17627296

  14. Constructing professional and organisational fields.

    PubMed

    Gurney, Robert

    2016-01-01

    Purpose - The purpose of this paper is to fill an apparent gap in the literature addressing issues of leadership and change - the development and activities of constructing and leading sports sciences and medicine professions, and similarly, the construction and leadership of multidisciplinary/inter-disciplinary organisations that practice sports sciences and medicine. Design/methodology/approach - This study incorporated explorations through conducting both interviews and survey questionnaires with members of Sports Medicine Australia (SMA). The interviews (qualitative) were semi-structured and asked questions addressing what changed, why change and how change was implemented. Findings - The health sciences and medicine professions moving to specialised sports sciences and medicine disciplines and SMA, evolved through forces driving the need for change (legitimacy, resource dependency, positioning and core competencies). Practical implications - The knowledge developed from understanding activities of change that traditional professions conducted to become specialised Disciplines and parallel changes in a single Discipline organisation evolving to an umbrella organisation (SMA), comprised a membership of specialised Disciplines, can act as a catalyst for inquiry by other professional and organisational groups. Originality/value - The findings of this study contributes to the literature investigating change in professional and organisations fields. More specifically, this study promotes inquiry into leadership practices of sports sciences and medicine, as contributors to the field of health services.

  15. Organisational support, organisational identification and organisational citizenship behaviour among male nurses.

    PubMed

    Chen, Sheng-Hwang; Yu, Hsing-Yi; Hsu, Hsiu-Yueh; Lin, Fang-Chen; Lou, Jiunn-Horng

    2013-11-01

    The purpose of this study was to explore the relationship between organisational support, organisational identification, and organisational citizenship behaviour and the predictors of organisational citizenship behaviour in Taiwanese male nurses. The turnover rate among male nurses is twice that of female nurses. Organisational citizenship behaviour is the predictor of turnover intention. Little information is available on the relationship between organisational support, organisational identification and organisational citizenship behaviour, particularly for male nurses. Data were collected in 2010 from a questionnaire mailed to 167 male nurses in Taiwan. A cross-sectional survey with simple sampling was used in this study. The results showed that organisational identification and organisational support were correlated with organisational citizenship behaviour. Organisational distinctiveness, organisational support of work conditions and the type of organisation were the main predictors of organisational citizenship behaviour. Together they accounted for 40.7% of the total variation in organisational citizenship behaviour. Organisational distinctiveness was the most critical predictor, accounting for 29.6% of the variation. Organisational support and organisational identification have positive relationships with organisational behaviour. Organisational distinctiveness is an important factor in explaining organisational citizenship behaviour in male nurses. This finding provides concrete directions for managers to follow when providing organisational identification, in particular, the organisational distinctiveness will help male nurses to display increasingly more organisational citizenship behaviour. © 2012 John Wiley & Sons Ltd.

  16. Reframing implementation as an organisational behaviour problem.

    PubMed

    Clay-Williams, Robyn; Braithwaite, Jeffrey

    2015-01-01

    The purpose of this paper is to report on a process evaluation of a randomised controlled trial (RCT) intervention study that tested the effectiveness of classroom- and simulation-based crew resource management courses, alone and in combination, and identifies organisational barriers and facilitators to implementation of team training programmes in healthcare. The RCT design consisted of a before and after study with a team training intervention. Quantitative data were gathered on utility and affective reactions to training, and on teamwork knowledge, attitudes, and behaviours of the learners. A sample of participants was interviewed at the conclusion of the study. Interview responses were analysed, alongside qualitative elements of the classroom course critique, to search for evidence, context, and facilitation clues to the implementation process. The RCT method provided scientifically robust data that supported the benefits of classroom training. Qualitative data identified a number of facilitators to implementation of team training, and shed light on some of the ways that learning was diffused throughout the organisation. Barriers to successful implementation were also identified, including hospital time and resource constraints and poor organisational communication. Quantitative randomised methods have intermittently been used to evaluate team training interventions in healthcare. Despite two decades of team training trials, however, the authors do not know as well as the authors would like what goes on inside the "black box" of such RCTs. While results are usually centred on outcomes, this study also provides insight into the context and mechanisms associated with those outcomes and identifies barriers and facilitators to successful intervention implementation.

  17. Exploring Organisational Stratification and Technological Pedagogical Change: Cases of Technology Integration Specialists in Hong Kong International Schools

    ERIC Educational Resources Information Center

    Woo, David James

    2015-01-01

    An international school may make organisational choices that divide the school by curriculum, grade-level, language and location. This article explores how a school's organisational stratification impacts how the school supports changing teaching and learning practices through technology. The article draws from case data of technology integration…

  18. Facilitators and barriers to implementation of the AIDES initiative, a social innovation for participative assessment of children in need and for coordination of services.

    PubMed

    Dufour, Sarah; Lessard, Danielle; Chamberland, Claire

    2014-12-01

    As part of an implementation evaluation, this study aims to identify the conditions of practice that facilitated or hindered implementation of the AIDES initiative, a social innovation to support collaboration between partners involved with vulnerable children. Evaluators conducted qualitative telephone interviews with 36 respondents (19 practitioners and 17 managers) who participated in the AIDES initiative trial. Respondents were chosen to include all participating organisations (child protection services, prevention social services). Participants' comments were submitted to descriptive content analysis. Conditions facilitating or hindering implementation of the initiative included the following dimensions: (1) implementation quality; (2) organisational elements (organisational functioning, cooperation between organisations); (3) socio-political issues; and (4) personal and professional characteristics. The study highlights critical elements to consider in implementing and maintaining significant changes in practice in organisations providing assistance to vulnerable children and their families. Social innovations that do not consider such elements are likely to compromise their implementation and sustainability. We must prevent promising social changes from being considered unrealistic or inappropriate due to contextual barriers. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Participants' evaluation of a group-based organisational assessment tool in Danish general practice: the Maturity Matrix.

    PubMed

    Buch, Martin Sandberg; Edwards, Adrian; Eriksson, Tina

    2009-01-01

    The Maturity Matrix is a group-based formative self-evaluation tool aimed at assessing the degree of organisational development in general practice and providing a starting point for local quality improvement. Earlier studies of the Maturity Matrix have shown that participants find the method a useful way of assessing their practice's organisational development. However, little is known about participants' views on the resulting efforts to implement intended changes. To explore users' perspectives on the Maturity Matrix method, the facilitation process, and drivers and barriers for implementation of intended changes. Observation of two facilitated practice meetings, 17 semi-structured interviews with participating general practitioners (GPs) or their staff, and mapping of reasons for continuing or quitting the project. General practices in Denmark Main outcomes: Successful change was associated with: a clearly identified anchor person within the practice, a shared and regular meeting structure, and an external facilitator who provides support and counselling during the implementation process. Failure to implement change was associated with: a high patient-related workload, staff or GP turnover (that seemed to affect small practices more), no clearly identified anchor person or anchor persons who did not do anything, no continuous support from an external facilitator, and no formal commitment to working with agreed changes. Future attempts to improve the impact of the Maturity Matrix, and similar tools for quality improvement, could include: (a) attention to matters of variation caused by practice size, (b) systematic counselling on barriers to implementation and support to structure the change processes, (c) a commitment from participants that goes beyond participation in two-yearly assessments, and (d) an anchor person for each identified goal who takes on the responsibility for improvement in practice.

  20. Understanding practice change in community pharmacy: a qualitative research instrument based on organisational theory.

    PubMed

    Roberts, Alison S; Hopp, Trine; Sørensen, Ellen Westh; Benrimoj, Shalom I; Chen, Timothy F; Herborg, Hanne; Williams, Kylie; Aslani, Parisa

    2003-10-01

    The past decade has seen a notable shift in the practice of pharmacy, with a strong focus on the provision of cognitive pharmaceutical services (CPS) by community pharmacists. The benefits of these services have been well documented, yet their uptake appears to be slow. Various strategies have been developed to overcome barriers to the implementation of CPS, with varying degrees of success, and little is known about the sustainability of the practice changes they produce. Furthermore, the strategies developed are often specific to individual programs or services, and their applicability to other CPS has not been explored. There seems to be a need for a flexible change management model for the implementation and dissemination of a range of CPS, but before it can be developed, a better understanding of the change process is required. This paper describes the development of a qualitative research instrument that may be utilised to investigate practice change in community pharmacy. Specific objectives included gaining knowledge about the circumstances surrounding attempts to implement CPS, and understanding relationships that are important to the change process. Organisational theory provided the conceptual framework for development of the qualitative research instrument, within which two theories were used to give insight into the change process: Borum's theory of organisational change, which categorizes change strategies as rational, natural, political or open; and Social Network Theory, which helps identify and explain the relationships between key people involved in the change process. A semi-structured affecting practice change found in the literature that warranted further investigation with the theoretical perspectives of organisational change and social networks. To address the research objectives, the instrument covered four broad themes: roles, experiences, strategies and networks. The qualitative research instrument developed in this study provides a

  1. Leadership and transformational change in healthcare organisations: a qualitative analysis of the North East Transformation System.

    PubMed

    Erskine, Jonathan; Hunter, David J; Small, Adrian; Hicks, Chris; McGovern, Tom; Lugsden, Ed; Whitty, Paula; Steen, Nick; Eccles, Martin Paul

    2013-02-01

    The research project 'An Evaluation of Transformational Change in NHS North East' examines the progress and success of National Health Service (NHS) organisations in north east England in implementing and embedding the North East Transformation System (NETS), a region-wide programme to improve healthcare quality and safety, and to reduce waste, using a combination of Vision, Compact, and Lean-based Method. This paper concentrates on findings concerning the role of leadership in enabling tranformational change, based on semi-structured interviews with a mix of senior NHS managers and quality improvement staff in 14 study sites. Most interviewees felt that implementing the NETS requires committed, stable leadership, attention to team-building across disciplines and leadership development at many levels. We conclude that without senior leader commitment to continuous improvement over a long time scale and serious efforts to distribute leadership tasks to all levels, healthcare organisations are less likely to achieve positive changes in managerial-clinical relations, sustainable improvements to organisational culture and, ultimately, the region-wide step change in quality, safety and efficiency that the NETS was designed to deliver. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  2. Short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health: results from the Whitehall II study.

    PubMed

    Falkenberg, Helena; Fransson, Eleonor I; Westerlund, Hugo; Head, Jenny A

    2013-10-01

    To investigate short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health for women and men in different employment grades. Minor psychiatric disorder and self-rated health among 6710 British civil servants (1993 women and 4717 men) in three employment grades from the Whitehall II study were examined from 1985 to 1988 under stable employment conditions. The short-term effects of organisational change were investigated in 1991-1993 after a time of major restructuring aiming at increasing the influence of market forces in the civil service and the long-term effects were investigated in 1997-1999. Those who had experienced organisational change and those who anticipated organisational change reported more negative short-term health effects (minor psychiatric disorder and poor self-rated health) compared with those who reported no change. No major differences were found depending on employment grade or gender. The negative health effects had diminished during 1997-1999 for those who reported that a major change had happened before 1991-1993. Those who anticipated an organisational change in 1991-1993 still reported more ill-health in 1997-1999 (both minor psychiatric disorder and self-reported health) than those in the comparison group. The results indicate that organisational change affects employees' health negatively in the short term but also that it is possible to recover from such negative effects. As it was not possible to discern any definite difference between the gender and grades, the results point at the importance of working proactively to implement organisational change for women and men at all levels.

  3. Of floods, sandbags and simulations: Urban resilience to natural disasters and the performance of disaster management organisations under change.

    NASA Astrophysics Data System (ADS)

    Dressler, Gunnar; Mueller, Birgit; Frank, Karin; Kuhlicke, Christian

    2015-04-01

    Natural disasters and in particular floods have become a strong threat to urban communities in the last decades. In just eleven years (2002, 2013) two centenary river floods have hit Eastern Germany, causing damages of 9.1 billion € (2002) and 6.7 billion € (2013, first estimate), making them the most costly flood events in German history. Many cities in the Free State of Saxony that were strongly hit by both floods are additionally challenged by demographic change with an ageing society and outmigration leading to population shrinkage. This also constrains the coping capacity of disaster management services, especially those of volunteer-based disaster management organisations such as fire brigades, leading to an increased vulnerability of the community at risk. On the other hand, new technologies such as social media have led to rapid information spread and self-organisation of tremendous numbers of civil volunteers willing to help. How do responsible organisations deal with the challenges associated with demographic change, as well as with expected increases in flood frequency and intensity, and what strategies could enhance their performance in the future? To explore these questions, we developed an agent-based simulation model. It is based on socio-demographic settings of the community, communication and coordination structures of disaster management as well as transportation infrastructure for resources and emergency forces. The model is developed in exchange with relevant stakeholders including experts of local disaster management organisations and authority representatives. The goal of the model is to a) assess the performance of disaster management organisations and determine performance limits with respect to forecast lead times and respective coping times of disaster management organisations and b) use it as a discussion tool with these organisations and authorities to identify weak points as well as new options and strategies to ensure protection

  4. Linking Shared Organisational Context and Relational Capital through Unlearning: An Initial Empirical Investigation in SMEs

    ERIC Educational Resources Information Center

    Cegarra-Navarro, Juan G.; Dewhurst, Frank W.

    2006-01-01

    Purpose: The environment provided by an organisation to facilitate learning and create knowledge has been defined as the shared organisational context. The value to an organisation of knowledge created by the shared organisational context is called intellectual capital, of which one key component is relational capital. The purpose of this paper is…

  5. Facilitating organisational development using a group-based formative assessment and benchmarking method: design and implementation of the International Family Practice Maturity Matrix.

    PubMed

    Elwyn, Glyn; Bekkers, Marie-Jet; Tapp, Laura; Edwards, Adrian; Newcombe, Robert; Eriksson, Tina; Braspenning, Jozé; Kuch, Christine; Adzic, Zlata Ozvacic; Ayankogbe, Olayinka; Cvetko, Tatjana; In 't Veld, Kees; Karotsis, Antonis; Kersnik, Janko; Lefebvre, Luc; Mecini, Ilir; Petricek, Goranka; Pisco, Luis; Thesen, Janecke; Turón, José María; van Rossen, Edward; Grol, Richard

    2010-12-01

    Well-organised practices deliver higher-quality care. Yet there has been very little effort so far to help primary care organisations achieve higher levels of team performance and to help them identify and prioritise areas where quality improvement efforts should be concentrated. No attempt at all has been made to achieve a method which would be capable of providing comparisons--and the stimulus for further improvement--at an international level. The development of the International Family Practice Maturity Matrix took place in three phases: (1) selection and refinement of organisational dimensions; (2) development of incremental scales based on a recognised theoretical framework; and (3) testing the feasibility of the approach on an international basis, including generation of an automated web-based benchmarking system. This work has demonstrated the feasibility of developing an organisational assessment tool for primary care organisations that is sufficiently generic to cross international borders and is applicable across a diverse range of health settings, from state-organised systems to insurer-based health economies. It proved possible to introduce this assessment method in 11 countries in Europe and one in Africa, and to generate comparison benchmarks based on the data collected. The evaluation of the assessment process was uniformly positive with the view that the approach efficiently enables the identification of priorities for organisational development and quality improvement at the same time as motivating change by virtue of the group dynamics. We are not aware of any other organisational assessment method for primary care which has been 'born international,' and that has involved attention to theory, dimension selection and item refinement. The principal aims were to achieve an organisational assessment which gains added value by using interaction, engagement comparative benchmarks: aims which have been achieved. The next step is to achieve wider

  6. The Impact of a Learning Culture on Organisational Change in Regional SMEs

    ERIC Educational Resources Information Center

    Bamberry, Goff; Sabri-Matanagh, Saeed; Duncan, Glen

    2015-01-01

    This paper explores the impact of a learning culture on organisational change in small to medium-sized regional manufacturing enterprises following a review of the related literature, and a qualitative study of 10 manufacturing SMEs in the Riverina region of New South Wales. The research confirmed that key learning culture factors as identified in…

  7. How to change organisational culture: Action research in a South African public sector primary care facility.

    PubMed

    Mash, Robert; De Sa, Angela; Christodoulou, Maria

    2016-08-31

    Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. To explore how to transform the organisational culture in line with the desired values. Retreat Community Health Centre, Cape Town, South Africa. Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA) survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA) and had 6 months of coaching. Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.

  8. Development of a Framework and Measure for Assessing Principal Change Facilitator Style.

    ERIC Educational Resources Information Center

    Hall, Gene E.; George, Archie

    A framework is proposed for describing the underlying dimensions of different styles that principals have as facilitators of change. A measure, the Change Facilitator Style Questionnaire, was developed to assess these dimensions and change facilitator styles. A review of the literature suggested an organizing framework of the following dimensions:…

  9. Lesbian workers: personal strategies amid changing organisational responses to 'sexual minorities' in UK workplaces.

    PubMed

    Colgan, Fiona; Creegan, Chris; McKearney, Aidan; Wright, Tessa

    2008-01-01

    This article reports emerging findings from a qualitative research study about lesbian, gay and bisexual (LGB) people at work in the UK. The research focuses on the personal experiences and strategies of LGB people amidst changing organisational responses to sexuality within a new legal and political landscape following the introduction of the Employment Equality (Sexual Orientation) Regulations 2003. The article draws specifically on the perceptions of lesbian respondents about a range of issues concerning social inclusion and exclusion in the workplace including coming out at work, treatment by managers and colleagues, workplace and organisational culture and participation in LGBT groups and networks.

  10. Human Resource Development in Construction Organisations: An Example of a "Chaordic" Learning Organisation?

    ERIC Educational Resources Information Center

    Raiden, Ani B.; Dainty, Andrew R. J.

    2006-01-01

    Purpose: The concept of the learning organisation (LO) is associated with an advanced approach to human resource development (HRD) characterised by an ethos of self-responsibility and self-development. The learning climate that this engenders is supported by temporary organisational structures responsive to environmental change. The purpose of his…

  11. Improving care coordination using organisational routines.

    PubMed

    Prætorius, Thim

    2016-01-01

    The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change and can be replicated, the way they are influenced by the organisation and the way they influence health care professionals. Theory of routines is systematically applied to care pathways in order to develop theoretically derived propositions. Care pathways mirror routines by being recurrent, collective and embedded and specific to an organisation. In particular, care pathways resemble standard operating procedures that can give rise to recurrent collective action patterns. In all, 11 propositions related to five categories are proposed by building on these insights: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications - The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research. The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality/value - Theory on organisational routines offers fundamental, yet unexplored, insights into hospital processes, including in particular care coordination.

  12. Organisational justice and change in justice as predictors of employee health: the Whitehall II study.

    PubMed

    Kivimäki, Mika; Ferrie, Jane E; Head, Jenny; Shipley, Martin J; Vahtera, Jussi; Marmot, Michael G

    2004-11-01

    Organisational justice has been proposed as a new way to examine the impact of psychosocial work environment on employee health. This article studied the justice of interpersonal treatment by supervisors (the relational component of organisational justice) as a predictor of health. Prospective cohort study. Phase 1 (1985-88) measured relational justice, job demands, job control, social support at work, effort-reward imbalance, and self rated health. Relational justice was assessed again at phase 2 (1989-90) and self rated health at phase 2 and phase 3 (1991-93). 20 civil service departments originally located in London. 10 308 civil servants (6895 men, 3413 women) aged 35-55. Self rated health. Men exposed to low justice at phase 1 or adverse change in justice between phase 1 and phase 2 were at higher risk of poor health at phase 2 and phase 3. A favourable change in justice was associated with reduced risk. Adjustment for other stress indicators had little effect on results. In women, low justice at phase 1 predicted poor health at phase 2 and phase 3 before but not after adjustment for other stress indicators. Adverse change in justice was associated with worse health prospects irrespective of adjustments. The extent to which people are treated with justice in workplaces seems to predict their health independently of established stressors at work. Evidence on reduced health risk after favourable change in organisational justice implies a promising area for health interventions at workplace.

  13. What are the barriers and facilitators for third sector organisations (non-profits) to evaluate their services? A systematic review.

    PubMed

    Bach-Mortensen, Anders Malthe; Montgomery, Paul

    2018-01-22

    The third sector is becoming a more common provider of social and health services, but little is known about how third sector organisations (TSOs) evaluate their activities. Past research has reported that the third sector is under increasing pressure to evaluate its impact and performance by government and other commissioning bodies. However, in responding to this increased pressure to undertake evaluation, research suggests that many TSOs struggle to evaluate their activities following the principles of evidence-based practice (EBP). Yet, there has been no systematic effort to investigate why the third sector is struggling to provide good quality evidence of its effects. This systematic review is reported following the PRISMA guidelines. Ten interdisciplinary databases were searched using a search string developed following best practice and in consultation with an information systems expert. Included studies were primary research of any research design investigating barriers to and facilitators of the evaluation process of TSOs as identified by practitioners. All studies were quality appraised, and the results were synthesised as a thematic summary. Twenty-four studies were included, which mainly investigated TSOs working within health and social services. The thematic summary identified the main barriers for TSOs to undertake evaluation to be related to the (1) lack of financial resources, (2) lack of technical capability and evaluation literacy and (3) challenges around identifying relevant evaluation systems and outcome indicators. Key facilitating factors involved (1) getting the appropriate support, (2) having an organisational culture that supports evaluation and (3) the motivation to be accountable to stakeholders. These findings were robust to study quality. This review constitutes the first systematic effort to synthesise existing literature on factors supporting and preventing evaluation by TSOs. The prevalence of factors revolving around the lack of

  14. How to change organisational culture: Action research in a South African public sector primary care facility

    PubMed Central

    De Sa, Angela; Christodoulou, Maria

    2016-01-01

    Background Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. Aim To explore how to transform the organisational culture in line with the desired values. Setting Retreat Community Health Centre, Cape Town, South Africa. Methods Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA) survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA) and had 6 months of coaching. Results Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Conclusion Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group. PMID:27608671

  15. Mental health service changes, organisational factors, and patient suicide in England in 1997-2012: a before-and-after study.

    PubMed

    Kapur, Nav; Ibrahim, Saied; While, David; Baird, Alison; Rodway, Cathryn; Hunt, Isabelle M; Windfuhr, Kirsten; Moreton, Adam; Shaw, Jenny; Appleby, Louis

    2016-06-01

    Research into which aspects of service provision in mental health are most effective in preventing suicide is sparse. We examined the association between service changes, organisational factors, and suicide rates in a national sample. We did a before-and-after analysis of service delivery data and an ecological analysis of organisational characteristics, in relation to suicide rates, in providers of mental health care in England. We also investigated whether the effect of service changes varied according to markers of organisational functioning. Overall, 19 248 individuals who died by suicide within 12 months of contact with mental health services were included (1997-2012). Various service changes related to ward safety, improved community services, staff training, and implementation of policy and guidance were associated with a lower suicide rate after the introduction of these changes (incidence rate ratios ranged from 0·71 to 0·79, p<0·0001). Some wider organisational factors, such as non-medical staff turnover (Spearman's r=0·34, p=0·01) and incident reporting (0·46, 0·0004), were also related to suicide rates but others, such as staff sickness (-0·12, 0·37) and patient satisfaction (-0·06, 0·64), were not. Service changes had more effect in organisations that had low rates of staff turnover but high rates of overall event reporting. Aspects of mental health service provision might have an effect on suicide rates in clinical populations but the wider organisational context in which service changes are made are likely to be important too. System-wide change implemented across the patient care pathway could be a key strategy for improving patient safety in mental health care. The Healthcare Quality Improvement Partnership commissions the Mental Health Clinical Outcome Review Programme, National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, on behalf of NHS England, NHS Wales, the Scottish Government Health and Social

  16. Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK

    PubMed Central

    Viney, Rowena; Jayaweera, Hirosha; Griffin, Ann

    2018-01-01

    Objectives To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Design Qualitative semistructured individual and group interview study. Setting Postgraduate medical education in the UK. Participants Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Results Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Conclusions Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic

  17. Organisational systems and services for children of parents with mental illness and their families: processes of change and sustainability.

    PubMed

    Owen, Susanne

    2010-09-01

    Adult mental illness in the community including depression and anxiety has achieved greater public awareness and visibility in recent years and this has also resulted in increased recognition about the widespread impact on dependent children. During the past decade in Australia, policies and specific programs for infants, children and youth in terms of prevention, early intervention and promotion in relation to children of parents with a mental illness ('copmi') have been devised. However, these have generally been disconnected projects, essentially supported only by non-recurrent funding. In more recent years, systematic and interconnected responses involving a wider range of government, non-government and consumer and carer organisations to build sustainability have become the focus. However, little research about change processes affecting the organisational systems serving children of parents with mental illness and their families has been undertaken. This aim of the current study is to describe the enablers and barriers that contribute to change in systems and government and non-government organisations in relation to children of parents with a mental illness in Australia over the past decade, within the context of sustainability. The study involved interviews, focus groups and website and literature searches regarding systems change across Australian states and territories and nationally in relation to the enablers, barriers and future directions. Strategic and intentional processes within organisations, more evolutionary ongoing cross-agency processes and links to sustained changes are key systems change findings. Relevance for change in other health services is highlighted.

  18. Agri-environmental collaboratives as bridging organisations in landscape management.

    PubMed

    Prager, Katrin

    2015-09-15

    In recent years, landscape and its management has become a focus of policies and academic conceptualisation. Landscape is understood as a concept of interconnected natural and human systems. Its management must take into account the dynamic interdependencies and diverging interests of various stakeholders at different levels. Bridging organisations can provide an arena for trust-building, conflict resolution, learning and collaboration between relevant stakeholders. This paper draws on two strands of literature - landscape governance and co-management of social-ecological systems - to investigate the contributions of agri-environmental collaboratives (AEC) to sustainable landscape management. Based on data from 41 interviews with key informants and AEC members in Germany and the Netherlands, six fields of contributions were identified: policy implementation and service provision; coordination and mediation; awareness raising and behaviour change; care for 'everyday' landscapes; maintenance and protection of landscapes (including species and habitats); and income generation and economic benefits. Some of the contributions evolve around the specific role of AEC as bridging organisations, but other contributions such as economic benefits emerge beyond this analytical lens. The paper therefore emphasises holistic, bottom up assessment of AEC contributions and argues that governments should support such organisations through i) funding for facilitators and ii) funding for impact monitoring and data management. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Rethinking capacity building for knowledge mobilisation: developing multilevel capabilities in healthcare organisations.

    PubMed

    Kislov, Roman; Waterman, Heather; Harvey, Gill; Boaden, Ruth

    2014-11-15

    Knowledge mobilisation in healthcare organisations is often carried out through relatively short-term projects dependent on limited funding, which raises concerns about the long-term sustainability of implementation and improvement. It is becoming increasingly recognised that the translation of research evidence into practice has to be supported by developing the internal capacity of healthcare organisations to engage with and apply research. This process can be supported by external knowledge mobilisation initiatives represented, for instance, by professional associations, collaborative research partnerships and implementation networks. This conceptual paper uses empirical and theoretical literature on organisational learning and dynamic capabilities to enhance our understanding of intentional capacity building for knowledge mobilisation in healthcare organisations. The discussion is structured around the following three themes: (1) defining and classifying capacity building for knowledge mobilisation; (2) mechanisms of capability development in organisational context; and (3) individual, group and organisational levels of capability development. Capacity building is presented as a practice-based process of developing multiple skills, or capabilities, belonging to different knowledge domains and levels of complexity. It requires an integration of acquisitive learning, through which healthcare organisations acquire knowledge and skills from knowledge mobilisation experts, and experience-based learning, through which healthcare organisations adapt, absorb and modify their knowledge and capabilities through repeated practice. Although the starting point for capability development may be individual-, team- or organisation-centred, facilitation of the transitions between individual, group and organisational levels of learning within healthcare organisations will be needed. Any initiative designed to build capacity for knowledge mobilisation should consider the

  20. Exploring Employee Perceptions of Six Sigma as a Change Management Program in Higher Education

    ERIC Educational Resources Information Center

    Davis, Monica; Fifolt, Matthew

    2018-01-01

    Change initiatives in higher education are frequently guided by an institutional change management program which provides employees with a framework and set of skills to better understand problems and facilitate change at the organisational level. In this paper, we explore employee perceptions of Six Sigma as a tool for facilitating change at one…

  1. Measuring organisational readiness for patient engagement (MORE): an international online Delphi consensus study.

    PubMed

    Oostendorp, Linda J M; Durand, Marie-Anne; Lloyd, Amy; Elwyn, Glyn

    2015-02-14

    Widespread implementation of patient engagement by organisations and clinical teams is not a reality yet. The aim of this study is to develop a measure of organisational readiness for patient engagement designed to monitor and facilitate a healthcare organisation's willingness and ability to effectively implement patient engagement in healthcare. The development of the MORE (Measuring Organisational Readiness for patient Engagement) scale was guided by Weiner's theory of organisational readiness for change. Weiner postulates that an organisation's readiness is determined by both the willingness and ability to implement the change (i.e. in this context: patient engagement). A first version of the scale was developed based on a literature search and evaluation of pre-existing tools. We invited multi-disciplinary stakeholders to participate in a two-round online Delphi survey. Respondents were asked to rate the importance of each proposed item, and to comment on the proposed domains and items. Second round participants received feedback from the first round and were asked to re-rate the importance of the revised, new and unchanged items, and to provide comments. The first version of the scale contained 51 items divided into three domains: (1) Respondents' characteristics; (2) the organisation's willingness to implement patient engagement; and (3) the organisation's ability to implement patient engagement. 131 respondents from 16 countries (health care managers, policy makers, clinicians, patients and patient representatives, researchers, and other stakeholders) completed the first survey, and 72 of them also completed the second survey. During the Delphi process, 34 items were reworded, 8 new items were added, 5 items were removed, and 18 were combined. The scale's instructions were revised. The final version of MORE totalled 38 items; 5 on stakeholders, 13 on an organisation's willingness to implement, and 20 on an organisation's ability to implement patient

  2. Organisational justice and change in justice as predictors of employee health: the Whitehall II study

    PubMed Central

    Kivimaki, M.; Ferrie, J.; Head, J.; Shipley, M.; Vahtera, J.; Marmot, M.

    2004-01-01

    Objective: Organisational justice has been proposed as a new way to examine the impact of psychosocial work environment on employee health. This article studied the justice of interpersonal treatment by supervisors (the relational component of organisational justice) as a predictor of health. Design: Prospective cohort study. Phase 1 (1985–88) measured relational justice, job demands, job control, social support at work, effort-reward imbalance, and self rated health. Relational justice was assessed again at phase 2 (1989–90) and self rated health at phase 2 and phase 3 (1991–93). Setting: 20 civil service departments originally located in London. Participants: 10 308 civil servants (6895 men, 3413 women) aged 35–55. Outcome measure: Self rated health. Main results: Men exposed to low justice at phase 1 or adverse change in justice between phase 1 and phase 2 were at higher risk of poor health at phase 2 and phase 3. A favourable change in justice was associated with reduced risk. Adjustment for other stress indicators had little effect on results. In women, low justice at phase 1 predicted poor health at phase 2 and phase 3 before but not after adjustment for other stress indicators. Adverse change in justice was associated with worse health prospects irrespective of adjustments. Conclusions: The extent to which people are treated with justice in workplaces seems to predict their health independently of established stressors at work. Evidence on reduced health risk after favourable change in organisational justice implies a promising area for health interventions at workplace. PMID:15483310

  3. Managing workplace stress in community pharmacy organisations: lessons from a review of the wider stress management and prevention literature.

    PubMed

    Jacobs, Sally; Johnson, Sheena; Hassell, Karen

    2018-02-01

    Workplace stress in community pharmacy is increasing internationally due, in part, to pharmacists' expanding roles and escalating workloads. Whilst the business case for preventing and managing workplace stress by employers is strong, there is little evidence for the effectiveness of organisational stress management interventions in community pharmacy settings. To identify and synthesise existing evidence for the effectiveness of organisational solutions to workplace stress from the wider organisational literature which may be adaptable to community pharmacies. A secondary synthesis of existing reviews. Publications were identified through keyword searches of electronic databases and the internet; inclusion and exclusion criteria were applied; data about setting, intervention, method of evaluation, effectiveness and conclusions (including factors for success) were extracted and synthesised. Eighteen reviews of the stress management and prevention literature were identified. A comprehensive list of organisational interventions to prevent or manage workplace stress, ordered by prevalence of evidence of effectiveness, was produced, together with an ordered list of the benefits both to the individual and employing organisation. An evidence-based model of best practice was derived specifying eight factors for success: top management support, context-specific interventions, combined organisational and individual interventions, a participative approach, clearly delineated tasks and responsibilities, buy-in from middle management, change agents as facilitators and change in organisational culture. This literature review provides community pharmacy organisations with evidence from which to develop effective and successful stress management strategies to support pharmacists and pharmacy staff. Well-designed trials of stress management interventions in community pharmacy organisations are still required. © 2017 Royal Pharmaceutical Society.

  4. Organisational development in general practice: lessons from practice and professional development plans (PPDPs)

    PubMed Central

    Elwyn, Glyn; Hocking, Paul

    2000-01-01

    facilitation were clear: evaluations of internal group processes were possible, strategic issues could be raised and explored and financial probity ensured. These areas are much more difficult to examine when only internal stakeholders are engaged in a planning process. Conclusions It is not possible to introduce practice and professional development plans (organisational development and organisational learning projects) in a publicly funded health care system without first addressing existing educational and management structures. Existing systems are based on educational credits for attendance and emerging accountability frameworks (criteria checklists) for clinical governance. Moving to systems that are less summative and more formative, and based on the philosophies of continual quality improvement, require changes to be made in the relevant support systems in order achieve policy proposals. PMID:11178111

  5. Advancing knowledge on practice change: linking facilitation to the senses framework.

    PubMed

    Cooper, Julie; Meyer, Julienne; Holman, Cheryl

    2013-06-01

    To explore the facilitating factors that enabled staff on a rehabilitation ward for older people engage in change activities. The importance of facilitation in practice change is widely acknowledged; however, little nursing research has taken place in relation to its nature. Following identification in the early phases of an action research study that learned helplessness states and the use of socially structured defence techniques were preventing staff on a rehabilitation ward for older people from engaging in practice development, some change was achieved. What facilitated this to take place needed to be explored. An action research approach was used. Data gained from 13 in-depth interviews with staff and managers together with three years of researcher field notes were analysed using thematic analysis. The continuous presence and neutrality of the researcher who worked together with staff on their issues of concern using a flexible ward-based approach, combined with giving staff the opportunity to explore what it was like for them working in this area, were considered key in helping staff to engage with change. Analysis of findings suggests that the senses framework presents a theoretical approach to facilitation that can help staff move out of learned helplessness states and reduce the need for the use of socially structured defence techniques. This study identifies a facilitation approach that enabled staff to engage with practice change. Although carried out in the UK, its findings have wider relevance through the application of a theoretical perspective for practice change facilitation that has not before been considered in this literature, and which is likely to be of interest to those involved in practice change internationally. © 2013 Blackwell Publishing Ltd.

  6. Foucauldian Iterative Learning Conversations--An Example of Organisational Change: Developing Conjoint-Work between EPS and Social Workers

    ERIC Educational Resources Information Center

    Apter, Brian

    2014-01-01

    An organisational change-process in a UK local authority (LA) over two years is examined using transcribed excerpts from three meetings. The change-process is analysed using a Foucauldian analytical tool--Iterative Learning Conversations (ILCS). An Educational Psychology Service was changed from being primarily an education-focussed…

  7. Restoring the order: gender segregation as an obstacle to organisational development.

    PubMed

    Abrahamsson, Lena

    2002-11-01

    This paper raises questions about the links between gender and organisational changes. The empirical base for the discussion is a qualitative study of the effects of organisational changes in the pulp and paper industry, the electronics industry, the food industry and the laundry industry in Sweden during the mid-1990s. At the studied companies, restoration responses in the work organisations brought the organisation back into its original form and function. The study shows that gender exerts an influence both on the existing work organisation and in the organisational change. The modern organisation, with its focus on integration and decentralisation, challenges the gender order, which is a strong system, built on segregation and hierarchy. The conclusion from the study is that gender segregating and stereotypic gender-coding of workplaces and work tasks were strong restoring mechanisms and obstacles to strategic organisational changes.

  8. A Multi-organisational Approach to Service Delivery

    NASA Astrophysics Data System (ADS)

    Purchase, Valerie; Mills, John; Parry, Glenn

    Who is involved in delivering a service? There has been growing recognition in a wide variety of contexts that service is increasingly being delivered by multi-rather than single-organisational entities. Such recognition is evident not only in our experience but in a number of areas of literature including strategy development, core competence analysis, operations and supply chain management, and is reflected in and further facilitated by ICT developments. Customers have always been involved in some degree in the process of value delivery and such involvement is increasing to include complex co-creation of value. Such interactions are challenging when they involve individual customers, however, this becomes ever more challenging when the 'customer' is another organisation or when there are multiple 'customers'. Within this chapter we will consider some of the key drivers for a multi-organisational approach to service delivery; examine the ways in which the parties involved in service co-creation have expanded to include multiple service providers and customers; and finally, identify some of the challenges created by a multi-organisational approach to service delivery.

  9. Implementing medical revalidation in the United Kingdom: Findings about organisational changes and impacts from a survey of Responsible Officers.

    PubMed

    Walshe, Kieran; Boyd, Alan; Bryce, Marie; Luscombe, Kayleigh; Tazzyman, Abigail; Tredinnick-Rowe, John; Archer, Julian

    2017-01-01

    Objective To describe the implementation of medical revalidation in healthcare organisations in the United Kingdom and to examine reported changes and impacts on the quality of care. Design A cross-sectional online survey gathering both quantitative and qualitative data about structures and processes for medical revalidation and wider quality management in the organisations which employ or contract with doctors (termed 'designated bodies') from the senior doctor in each organisation with statutory responsibility for medical revalidation (termed the 'Responsible Officer'). Setting United Kingdom Participants Responsible Officers in designated bodies in the United Kingdom. Five hundred and ninety-five survey invitations were sent and 374 completed surveys were returned (63%). Main outcome measures The role of Responsible Officers, the development of organisational mechanisms for quality assurance or improvement, decision-making on revalidation recommendations, impact of revalidation and mechanisms for quality assurance or improvement on clinical practice and suggested improvements to revalidation arrangements. Results Responsible Officers report that revalidation has had some impacts on the way medical performance is assured and improved, particularly strengthening appraisal and oversight of quality within organisations and having some impact on clinical practice. They suggest changes to make revalidation less 'one size fits all' and more responsive to individual, organisational and professional contexts. Conclusions Revalidation appears primarily to have improved systems for quality improvement and the management of poor performance to date. There is more to be done to ensure it produces wider benefits, particularly in relation to doctors who already perform well.

  10. The evaluation of a mental health facilitator in general practice: effects on recognition, management, and outcome of mental illness.

    PubMed

    Bashir, K; Blizard, B; Bosanquet, A; Bosanquet, N; Mann, A; Jenkins, R

    2000-08-01

    Facilitation uses personal contact between the facilitator and the professional to encourage good practice and better service organisation. The model has been applied to physical illness but not to psychiatric disorders. To determine if a non-specialist facilitator can improve the recognition, management, and outcome of psychiatric illness presenting to general practitioners (GPs). Six practices were visited over an 18-month period by a facilitator whose activities included providing guidelines and organising training initiatives. Six other practices acted as controls. Recognition (identification index of family doctors), management (psychotropic prescribing, psychological consultations with the GP, specialist mental health treatment, and the use of medical interventions and investigations), and patient outcome at four months were assessed before and after intervention. The mean identification index of facilitator GPs rose from 0.51 to 0.64 following intervention, while that of the control GPs fell from 0.67 to 0.59 (P = 0.046). The facilitator had no detectable effect on management or patient outcome. The facilitator improved recognition of psychiatric illness by GPs. Generic facilitators can be trained to take on a mental health role; however, the failure to achieve more fundamental changes in treatment and outcome implies that facilitator intervention requires development.

  11. What can organisational theory offer knowledge translation in healthcare? A thematic and lexical analysis.

    PubMed

    Dadich, Ann; Doloswala, Navin

    2018-05-10

    Despite the relative abundance of frameworks and models to guide implementation science, the explicit use of theory is limited. Bringing together two seemingly disparate fields of research, this article asks, what can organisational theory offer implementation science? This is examined by applying a theoretical lens that incorporates agency, institutional, and situated change theories to understand the implementation of healthcare knowledge into practice. Interviews were conducted with 20 general practitioners (GPs) before and after using a resource to facilitate evidence-based sexual healthcare. Research material was analysed using two approaches - researcher-driven thematic coding and lexical analysis, which was relatively less researcher-driven. The theoretical lens elucidated the complex pathways of knowledge translation. More specifically, agency theory revealed tensions between the GP as agent and their organisations and patients as principals. Institutional theory highlighted the importance of GP-embeddedness within their chosen specialty of general practice; their medical profession; and the practice in which they worked. Situated change theory exposed the role of localised adaptations over time - a metamorphosis. This study has theoretical, methodological, and practical implications. Theoretically, it is the first to examine knowledge translation using a lens premised on agency, institutional, and situated change theories. Methodologically, the study highlights the complementary value of researcher-driven and researcher-guided analysis of qualitative research material. Practically, this study signposts opportunities to facilitate knowledge translation - more specifically, it suggests that efforts to shape clinician practices should accommodate the interrelated influence of the agent and the institution, and recognise that change can be ever so subtle.

  12. Public release of performance data in changing the behaviour of healthcare consumers, professionals or organisations

    PubMed Central

    Ketelaar, Nicole ABM; Faber, Marjan J; Flottorp, Signe; Rygh, Liv Helen; Deane, Katherine HO; Eccles, Martin P

    2014-01-01

    Background It is becoming increasingly common to release information about the performance of hospitals, health professionals or providers, and healthcare organisations into the public domain. However, we do not know how this information is used and to what extent such reporting leads to quality improvement by changing the behaviour of healthcare consumers, providers and purchasers, or to what extent the performance of professionals and providers can be affected. Objectives To determine the effectiveness of the public release of performance data in changing the behaviour of healthcare consumers, professionals and organisations. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, MEDLINE Ovid (from 1966), EMBASE Ovid (from 1979), CINAHL, PsycINFO Ovid (from 1806) and DARE up to 2011. Selection criteria We searched for randomised or quasi-randomised trials, interrupted time series and controlled before-after studies of the effects of publicly releasing data regarding any aspect of the performance of healthcare organisations or individuals. The papers had to report at least one main outcome related to selecting or changing care. Other outcome measures were awareness, attitude, views and knowledge of performance data and costs. Data collection and analysis Two review authors independently screened studies for eligibility and extracted data. For each study, we extracted data about the target groups (healthcare consumers, healthcare providers and healthcare purchasers), performance data, main outcomes (choice of healthcare provider and improvement by means of changes in care) and other outcomes (awareness, attitude, views, knowledge of performance data and costs). Main results We included four studies containing more than 35,000 consumers, and 1560 hospitals. Three studies were conducted in the USA and examined consumer behaviour after the public release of

  13. Practice change in community pharmacy: quantification of facilitators.

    PubMed

    Roberts, Alison S; Benrimoj, Shalom I; Chen, Timothy F; Williams, Kylie A; Aslani, Parisa

    2008-06-01

    There has been an increasing international trend toward the delivery of cognitive pharmaceutical services (CPS) in community pharmacy. CPS have been developed and disseminated individually, without a framework underpinning their implementation and with limited knowledge of factors that might assist practice change. The implementation process is complex, involving a range of internal and external factors. To quantify facilitators of practice change in Australian community pharmacies. We employed a literature review and qualitative study to facilitate the design of a 43-item "facilitators of practice change" scale as part of a quantitative survey instrument, using a framework of organizational theory. The questionnaire was pilot-tested (n = 100), then mailed to a random sample of 2000 community pharmacies, with a copy each for the pharmacy owner, employed pharmacist, and pharmacy assistant. The construct validity and reliability of the scale were established using exploratory factor analysis and Cronbach's alpha, respectively. A total of 735 (37%) pharmacies responded, with 1303 individual questionnaires. Factor analysis of the scale yielded 7 factors, explaining 48.8% of the total variance. The factors were: relationship with physicians (item loading range 0.59-0.85; Cronbach's alpha 0.90), remuneration (0.52-0.74; 0.82), pharmacy layout (0.52-0.79; 0.81), patient expectation (0.52-0.85; 0.82), manpower/staff (0.49-0.66; 0.80), communication and teamwork (0.37-0.65; 0.77), and external support/assistance (0.47-0.69; 0.74). All of the factors demonstrated good reliability and construct validity and explained approximately half of the variance. Implementing CPS requires support not only with the clinical aspects of service delivery, but also for the process of implementation itself, and remuneration models must reflect this. The identified facilitators should be used in a multilevel strategy to integrate professional services into the community pharmacy business

  14. Implementing medical revalidation in the United Kingdom: Findings about organisational changes and impacts from a survey of Responsible Officers

    PubMed Central

    Boyd, Alan; Bryce, Marie; Luscombe, Kayleigh; Tazzyman, Abigail; Tredinnick-Rowe, John; Archer, Julian

    2017-01-01

    Objective To describe the implementation of medical revalidation in healthcare organisations in the United Kingdom and to examine reported changes and impacts on the quality of care. Design A cross-sectional online survey gathering both quantitative and qualitative data about structures and processes for medical revalidation and wider quality management in the organisations which employ or contract with doctors (termed ‘designated bodies’) from the senior doctor in each organisation with statutory responsibility for medical revalidation (termed the ‘Responsible Officer’). Setting United Kingdom Participants Responsible Officers in designated bodies in the United Kingdom. Five hundred and ninety-five survey invitations were sent and 374 completed surveys were returned (63%). Main outcome measures The role of Responsible Officers, the development of organisational mechanisms for quality assurance or improvement, decision-making on revalidation recommendations, impact of revalidation and mechanisms for quality assurance or improvement on clinical practice and suggested improvements to revalidation arrangements. Results Responsible Officers report that revalidation has had some impacts on the way medical performance is assured and improved, particularly strengthening appraisal and oversight of quality within organisations and having some impact on clinical practice. They suggest changes to make revalidation less ‘one size fits all’ and more responsive to individual, organisational and professional contexts. Conclusions Revalidation appears primarily to have improved systems for quality improvement and the management of poor performance to date. There is more to be done to ensure it produces wider benefits, particularly in relation to doctors who already perform well. PMID:28084166

  15. Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK.

    PubMed

    Woolf, Katherine; Viney, Rowena; Rich, Antonia; Jayaweera, Hirosha; Griffin, Ann

    2018-03-09

    To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Qualitative semistructured individual and group interview study. Postgraduate medical education in the UK. Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of

  16. Barriers and facilitators to integrating care: experiences from the English Integrated Care Pilots

    PubMed Central

    Ling, Tom; Brereton, Laura; Conklin, Annalijn; Newbould, Jennifer; Roland, Martin

    2012-01-01

    Background: In 2008, the English Department of Health appointed 16 ‘Integrated Care Pilots’ which used a range of approaches to provide better integrated care. We report qualitative analyses from a three-year multi-method evaluation to identify barriers and facilitators to successful integration of care. Theory and methods: Data were analysed from transcripts of 213 in-depth staff interviews, and from semi-structured questionnaires (the ‘Living Document’) completed by staff in pilot sites at six points over a two-year period. Emerging findings were therefore built from ‘bottom up’ and grounded in the data. However, we were then interested in how these findings compared and contrasted with more generic analyses. Therefore after our analyses were complete we then systematically compared and contrasted the findings with the analysis of barriers and facilitators to quality improvement identified in a systematic review by Kaplan et al. (2010) and the analysis of more micro-level shapers of behaviour found in Normalisation Process Theory (May et al. 2007). Neither of these approaches claims to be full blown theories but both claim to provide mid-range theoretical arguments which may be used to structure existing data and which can be undercut or reinforced by new data. Results and discussion: Many barriers and facilitators to integrating care are those of any large-scale organisational change. These include issues relating to leadership, organisational culture, information technology, physician involvement, and availability of resources. However, activities which appear particularly important for delivering integrated care include personal relationships between leaders in different organisations, the scale of planned activities, governance and finance arrangements, support for staff in new roles, and organisational and staff stability. We illustrate our analyses with a ‘routemap’ which identifies questions that providers may wish to consider when planning

  17. Individual influences on lifestyle change to reduce vascular risk: a qualitative literature review

    PubMed Central

    Murray, Jenni; Honey, Stephanie; Hill, Kate; Craigs, Cheryl; House, Allan

    2012-01-01

    Background Management of cardiovascular risk includes adoption of healthy lifestyles. Uptake and completion rates for lifestyle programmes are low and many barriers and facilitators to lifestyle behaviour change have been reported in the literature. Clarity on which barriers and facilitators to target during consultations in primary care may support a more systematic approach to lifestyle behaviour change in those at high risk of cardiovascular events. Aim To identify the main barriers and facilitators to lifestyle behaviour change in individuals at high risk of cardiovascular events. Design A content synthesis of the qualitative literature reporting patient-level influences on lifestyle change. Method Qualitative studies involving patients at high risk of cardiovascular events were identified through electronic searching and screening against predefined selection criteria. Factors (reported influences) were extracted and, using a clustering technique, organised into categories that were then linked to key themes through relationship mapping. Results A total of 348 factors were extracted from 33 studies. Factors were organised into 20 categories and from these categories five key themes were identified: emotions, beliefs, information and communication, friends and family support, and cost/transport. Conclusion It is possible to organise the large number of self-reported individual influences on lifestyle behaviours into a small number of themes. Further research is needed to clarify which of these patient-level barriers and facilitators are the best predictors of uptake and participation in programmes aimed at helping people to change lifestyle. PMID:22687232

  18. The Role of International Non-Governmental Organisations in Promoting Adult Education for Social Change: A Research Agenda

    ERIC Educational Resources Information Center

    Hoff, Lutz; Hickling-Hudson, Anne

    2011-01-01

    This paper explores the role of International Non-Governmental Organisations (INGOs) in adult education as one instrument of global civil society to effect social change. Postcolonial theory is utilized to explore the complex relationships between the concepts of "globalisation", "global civil, society", and "adult education for social change". In…

  19. Using enterprise architecture to analyse how organisational structure impact motivation and learning

    NASA Astrophysics Data System (ADS)

    Närman, Pia; Johnson, Pontus; Gingnell, Liv

    2016-06-01

    When technology, environment, or strategies change, organisations need to adjust their structures accordingly. These structural changes do not always enhance the organisational performance as intended partly because organisational developers do not understand the consequences of structural changes in performance. This article presents a model-based analysis framework for quantitative analysis of the effect of organisational structure on organisation performance in terms of employee motivation and learning. The model is based on Mintzberg's work on organisational structure. The quantitative analysis is formalised using the Object Constraint Language (OCL) and the Unified Modelling Language (UML) and implemented in an enterprise architecture tool.

  20. Facilitating change from a distance - a story of success? A discussion on leaders' styles in facilitating change in four nursing homes in Norway.

    PubMed

    Øye, Christine; Mekki, Tone Elin; Jacobsen, Frode Fadnes; Førland, Oddvar

    2016-09-01

    To examine the influence of leadership when facilitating change in nursing homes. The study is a part of an education intervention for care staff to prevent the use of restraint in nursing home residents with dementia in 24 nursing homes (NHs) in Norway. Leadership is known to be a fundamental factor for success of evidence-based practice (EBP) implementation in health services. However, the type of leadership that strengthens the processes of change remains to be clarified. A multi-site comparative ethnography was performed in four nursing homes to investigate how contextual factors influenced the implementation. The analysis was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework, and in particular the sub-element of leadership. Different leadership styles to facilitate change were identified. Paradoxically, a strong collective and collaborative leadership style was found to hamper change in one particular home, whereas a remote leadership style combined with almost no cooperation with staff proved successful in another setting. The study indicates that leadership cannot be understood on a low-high continuum as suggested by the PARIHS framework, but rather as a factor characterised by diversity. Our study indicates, as a minimum, that a leader's presence is necessary to facilitate the internal processes in order more successfully to implement EBP. © 2016 John Wiley & Sons Ltd.

  1. Managing resources in NHS dentistry: the views of decision-makers in primary care organisations.

    PubMed

    Holmes, R D; Donaldson, C; Exley, C; Steele, J G

    2008-09-27

    To investigate priority setting and decision-making in primary care organisations and to determine how resources are managed in order to meet the oral health needs of local populations. This is a qualitative study. The purposive sample comprised twelve dental public health consultants and six senior finance representatives from contrasting care systems across the United Kingdom. Participants completed a written information sheet followed by a recorded semi-structured telephone interview. Conversations were professionally transcribed verbatim and analysed independently by two investigators using the constant comparative method. The emergent themes focused upon: the role of participants in decision-making; professional relationships; managing change; information needs; and identifying and managing priorities. There was wide interpretation with respect to participants' roles and perceived information needs for decision-making and commissioning. A unifying factor was the importance placed by participants upon trust and the influence of individuals on the success of relationships forged between primary care organisations and general dental practitioners. To facilitate decision-making in primary care organisations, commissioners and managers could engage further with practitioners and incorporate them into commissioning and resource allocation processes. Greater clarity is required regarding the role of dental public health consultants within primary care organisations and commissioning decisions.

  2. Barriers of inter-organisational integration in vocational rehabilitation.

    PubMed

    Wihlman, Ulla; Lundborg, Cecilia Stålsby; Axelsson, Runo; Holmström, Inger

    2008-06-19

    A project of vocational rehabilitation was studied in Sweden between 1999 and 2002. The project included four public organisations: the social insurance office, the local health services, the municipal social service and the office of the state employment service. The aim of this paper was to analyse perceived barriers in the development of inter-organisational integration. Theories of inter-professional and inter-organisational integration, and theories on organisational change. In total, 51 semi-structured interviews and 14 focus group discussions were performed with actors within the project between 1999 and 2002. A thematic approach was used for the analysis of the data. THREE DIFFERENT MAIN THEMES OF BARRIERS EMERGED FROM THE DATA: A Uncertainty, B Prioritising own organisation and C Lack of communication. The themes are interconnected in an intricate web and hence not mutually exclusive. The barriers found are all related partly to organisational change in general and partly to the specific development of organisational integration. Prioritising of own organisation led to flaws in communication, which in turn led to a high degree of uncertainty within the project. This can be seen as a circular relationship, since uncertainty might increase focus on own organisation and lack of communication. A way to overcome these barriers would be to take the needs of the clients as a point of departure in the development of joint services and to also involve them in the development of inter-organisational integration.

  3. Revenue Generation and Organisational Change in Higher Education: Insights from Canada

    ERIC Educational Resources Information Center

    Eastman, Julia Antonia

    2006-01-01

    This paper reports on a study of four major Canadian universities' strategies for generating revenue in the face of prolonged cutbacks. The universities are placed on a continuum of higher education funding, institutional types and organisational attributes. The study produced new hypotheses about how universities' organisational attributes change…

  4. Facilitating Conceptual Change in Students' Understanding of Electrochemistry.

    ERIC Educational Resources Information Center

    Niaz, Mansoor

    2002-01-01

    Constructs a teaching strategy to facilitate conceptual change in freshman students' understanding of electrochemistry. Provides students with the correct response along with alternative responses (teaching experiments), producing a conflicting situation that is conducive to an equilibration of their cognitive structures. Concludes that the…

  5. Facilitation among plants in alpine environments in the face of climate change.

    PubMed

    Anthelme, Fabien; Cavieres, Lohengrin A; Dangles, Olivier

    2014-01-01

    While there is a large consensus that plant-plant interactions are a crucial component of the response of plant communities to the effects of climate change, available data remain scarce, particularly in alpine systems. This represents an important obstacle to making consistent predictions about the future of plant communities. Here, we review current knowledge on the effects of climate change on facilitation among alpine plant communities and propose directions for future research. In established alpine communities, while warming seemingly generates a net facilitation release, earlier snowmelt may increase facilitation. Some nurse plants are able to buffer microenvironmental changes in the long term and may ensure the persistence of other alpine plants through local migration events. For communities migrating to higher elevations, facilitation should play an important role in their reorganization because of the harsher environmental conditions. In particular, the absence of efficient nurse plants might slow down upward migration, possibly generating chains of extinction. Facilitation-climate change relationships are expected to shift along latitudinal gradients because (1) the magnitude of warming is predicted to vary along these gradients, and (2) alpine environments are significantly different at low vs. high latitudes. Data on these expected patterns are preliminary and thus need to be tested with further studies on facilitation among plants in alpine environments that have thus far not been considered. From a methodological standpoint, future studies will benefit from the spatial representation of the microclimatic environment of plants to predict their response to climate change. Moreover, the acquisition of long-term data on the dynamics of plant-plant interactions, either through permanent plots or chronosequences of glacial recession, may represent powerful approaches to clarify the relationship between plant interactions and climate change.

  6. Self-organisation after embryonic kidney dissociation is driven via selective adhesion of ureteric epithelial cells.

    PubMed

    Lefevre, James G; Chiu, Han S; Combes, Alexander N; Vanslambrouck, Jessica M; Ju, Ali; Hamilton, Nicholas A; Little, Melissa H

    2017-03-15

    Human pluripotent stem cells, after directed differentiation in vitro , can spontaneously generate complex tissues via self-organisation of the component cells. Self-organisation can also reform embryonic organ structure after tissue disruption. It has previously been demonstrated that dissociated embryonic kidneys can recreate component epithelial and mesenchymal relationships sufficient to allow continued kidney morphogenesis. Here, we investigate the timing and underlying mechanisms driving self-organisation after dissociation of the embryonic kidney using time-lapse imaging, high-resolution confocal analyses and mathematical modelling. Organotypic self-organisation sufficient for nephron initiation was observed within a 24 h period. This involved cell movement, with structure emerging after the clustering of ureteric epithelial cells, a process consistent with models of random cell movement with preferential cell adhesion. Ureteric epithelialisation rapidly followed the formation of ureteric cell clusters with the reformation of nephron-forming niches representing a later event. Disruption of P-cadherin interactions was seen to impair this ureteric epithelial cell clustering without affecting epithelial maturation. This understanding could facilitate improved regulation of patterning within organoids and facilitate kidney engineering approaches guided by cell-cell self-organisation. © 2017. Published by The Company of Biologists Ltd.

  7. Organisational culture: an important concept for pharmacy practice research.

    PubMed

    Scahill, Shane; Harrison, Jeff; Carswell, Peter; Babar, Zaheer-Ud-Din

    2009-10-01

    Throughout the developed world, community pharmacy is under considerable pressure to play a greater part in delivering effective primary health care. The requirement to adopt new roles continues to challenge community pharmacy and drive change. The factors that determine the ability of community pharmacy to effectively deliver services for health gain are complex and include; policy, professional, financial and structural elements. There is also evidence to suggest that organisational culture may influence the effectiveness of an organisation. In order to address this there is a need to understand the dimensions of organisational culture that lead to successful implementation of the change necessary for community pharmacy to become a more effective primary health care organisation. In this commentary, we introduce the concept of organisational culture, outline two frameworks for studying culture, and argue the benefits of pursuing an organisational culture research agenda for the evolution of pharmacy practice and research.

  8. Temporal context and the organisational impairment of memory search in schizophrenia.

    PubMed

    Polyn, Sean M; McCluey, Joshua D; Morton, Neal W; Woolard, Austin A; Luksik, Andrew S; Heckers, Stephan

    2015-01-01

    An influential theory of schizophrenic deficits in executive function suggests that patients have difficulty maintaining and utilising an internal contextual representation, whose function is to ensure that stimuli are processed in a task-appropriate manner. In basic research on episodic memory, retrieved-context theories propose that an internal contextual representation is critically involved in memory search, facilitating the retrieval of task-appropriate memories. This contextual machinery is thought to give rise to temporal organisation during free recall: the tendency for successive recall responses to correspond to items from nearby positions on the study list. If patients with schizophrenia have a generalised contextual deficit, then this leads to the prediction that these patients will exhibit reduced temporal organisation in free recall. Using a combination of classic and recently developed organisational measures, we characterised recall organisation in 75 patients with schizophrenia and 72 nondisordered control participants performing a multi-trial free-recall task. Patients with schizophrenia showed diminished temporal organisation, as well as diminished subjective organisation of their recall sequences relative to control participants. The two groups showed similar amounts of semantic organisation during recall. The observation of reduced temporal organisation in the patient group is consistent with the proposal that the memory deficit in schizophrenia can be characterised as a deficit in contextual processing.

  9. Organisational support for evidence-based practice: occupational therapists perceptions.

    PubMed

    Bennett, Sally; Allen, Shelley; Caldwell, Elizabeth; Whitehead, Mary; Turpin, Merrill; Fleming, Jennifer; Cox, Ruth

    2016-02-01

    Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice. © 2016 Occupational Therapy Australia.

  10. Organisational values and organisational commitment: do nurses' ethno-cultural differences matter?

    PubMed

    Hendel, Tova; Kagan, Ilya

    2014-05-01

    To examine the association between perceived organisational values and organisational commitment among Israeli nurses in relation to their ethno-cultural background. Differences and the discrepancy between individuals' organisational values and those of their organisational culture are a potential source of adjustment difficulties. Organisational values are considered to be the bond of the individual to their organisation. In multicultural societies, such as Israel, the differences in perception of organisational values and organisational commitment may be reflected within workgroups. Data were collected using a questionnaire among 106 hospital nurses. About 59.8% of the sample were Israeli-born. A positive correlation was found between organisational values and organisational commitment. Significant differences were found in organisational values and organisational commitment between Israeli-born-, USSR-born- and Ethiopian-born nurses. The socio-demographic profile modified the effect of organisational values on organisational commitment: when the nurse was male, Muslim, religiously orthodox and without academic education, the effect of organisational values on organisational commitment was higher. Findings confirm the role of culture and ethnicity in the perception of organisational values and the level of organisational commitment among nurses. Assessing ethno-cultural differences in organisational values and organisational commitment provides a fuller understanding of nurses' ability to adjust to their work environment and helps nurse managers devise means to increase nurses' commitment. © 2012 John Wiley & Sons Ltd.

  11. Protocol for development and validation of a context-appropriate tool for assessing organisational readiness for change in primary health clinics in South Africa

    PubMed Central

    Sorsdahl, Katherine; Lombard, Carl; Petersen-Williams, Petal; Myers, Bronwyn

    2018-01-01

    Introduction A large treatment gap for common mental disorders (such as depression) exists in South Africa. Comorbidity with other chronic diseases, including HIV and diseases of lifestyle, is an increasing public health concern globally. Currently, primary health facilities as points of care for those with chronic disease provide limited services for common mental disorders. Assessing organisational readiness for change (ORC) towards adopting health innovations (such as mental health services) using contextually appropriate measures is needed to facilitate implementation of these services. This study aims to investigate the validity of the Texas Christian University Organisational Readiness for Change (TCU-ORC) scale in the South African context. Subsequently, we will develop a shortened version of this scale. This study is nested within Project MIND, a multiyear randomised controlled trial that is testing two different approaches for integrating counselling for common mental disorders into chronic disease care. Although the modified, contextually appropriate ORC measure resulting from the proposed study will be developed in the context of integrating mental health into primary healthcare services, the potential for the tool to be generalised to further understanding barriers to any change being implemented in primary care settings is high. Methods and analysis We will establish internal consistency (Cronbach’s alpha coefficients), test-retest reliability (intraclass correlation coefficient) and construct validity of the long-form TCU-ORC questionnaire. Survey data will be collected from 288 clinical, management and operational staff from 24 primary health facilities where the Project MIND trial is implemented. A modified Delphi approach will assess the content validity of the TCU-ORC items and identify areas for potential adaptation and item reduction. Ethics and dissemination Ethical approval has been granted by the South African Medical Research Council

  12. A Longitudinal Study on Newcomers' Perception of Organisational Culture

    ERIC Educational Resources Information Center

    Turker, Duygu; Altuntas, Ceren

    2015-01-01

    Purpose: The purpose of this paper is to analyse how newcomers' perceptions of organisational culture can change over time. The study tries to address whether initial working experience changes newcomers' perceptions about the ideal organisational culture, and whether these perceptions converge with those of their supervisors.…

  13. Qualification and assessment of work organisation in livestock farms.

    PubMed

    Madelrieux, S; Dedieu, B

    2008-03-01

    Farmers have to cope with both society and market pressures in their working practices, as well as with the enlargement of farms, off-farm opportunities and profound changes in the workforce. Expectations in terms of working duration and rhythms are increasingly expressed by farmers, meaning that working conditions and the efficiency of work organisation are critical issues nowadays. The bibliography shows that work organisation is mainly discussed by social scientists, but that livestock scientists make a significant contribution to the debate. Indeed, technical changes modify working calendars, priorities between tasks and interchangeability among workers; technical adaptations are levers to solving problems of work with equipment, buildings and the workforce. We present here French approaches to work organisation that take into account livestock management and its implications in work organisation. The 'Work Assessment' method represents the work organisation and evaluates work durations and time flexibility for farmers. The ATELAGE model describes and qualifies work organisation with its various regulations and time scales, integrating the other activities - economic or private - that farmers can carry on. Three principles underpin them: not all workers are interchangeable; tasks have different temporal characteristics (rhythms, postponement, etc.); and the year is a succession of work periods that differ in their daily form of organisation. We illustrate with concrete examples how these approaches contribute to helping and guiding farmers in their thoughts about change.

  14. Challenging the Post-Fordist/Flexible Organisation Thesis: The Case of Reformed Educational Organisations

    ERIC Educational Resources Information Center

    Brehony, Kevin J.; Deem, Rosemary

    2005-01-01

    This paper examines claims that recent reforms to UK education have led to significant organisational changes in primary school and higher education. It also examines two main theoretical explanations for these, namely post-Fordism and New Managerialism. Examples of changes in both schools and universities, including flexibility and teamwork, are…

  15. Co-ordinated action between youth-care and sports: facilitators and barriers.

    PubMed

    Hermens, Niels; de Langen, Lisanne; Verkooijen, Kirsten T; Koelen, Maria A

    2017-07-01

    In the Netherlands, youth-care organisations and community sports clubs are collaborating to increase socially vulnerable youths' participation in sport. This is rooted in the idea that sports clubs are settings for youth development. As not much is known about co-ordinated action involving professional care organisations and community sports clubs, this study aims to generate insight into facilitators of and barriers to successful co-ordinated action between these two organisations. A cross-sectional study was conducted using in-depth semi-structured qualitative interview data. In total, 23 interviews were held at five locations where co-ordinated action between youth-care and sports takes place. Interviewees were youth-care workers, representatives from community sports clubs, and Care Sport Connectors who were assigned to encourage and manage the co-ordinated action. Using inductive coding procedures, this study shows that existing and good relationships, a boundary spanner, care workers' attitudes, knowledge and competences of the participants, organisational policies and ambitions, and some elements external to the co-ordinated action were reported to be facilitators or barriers. In addition, the participants reported that the different facilitators and barriers influenced the success of the co-ordinated action at different stages of the co-ordinated action. Future research is recommended to further explore the role of boundary spanners in co-ordinated action involving social care organisations and community sports clubs, and to identify what external elements (e.g. events, processes, national policies) are turning points in the formation, implementation and continuation of such co-ordinated action. © 2017 John Wiley & Sons Ltd.

  16. Locally Based Research and Development Units as Knowledge Brokers and Change Facilitators in Health and Social Care of Older People in Sweden

    ERIC Educational Resources Information Center

    Nyström, Monica Elisabeth; Hansson, Johan; Garvare, Rickard; Andersson-Bäck, Monica

    2015-01-01

    This article investigates the role of locally based research and development units (R&Ds) focusing on health and social services. Nearly 300 local R&Ds are funded by the Swedish government with the intention to facilitate knowledge transfer and development of high quality and effective health and social care organisations. Based on…

  17. The organisation of the Department of Veterinary Services in Malaysia.

    PubMed

    Mohd Nor, M N; Abu Mustapa, A J; Abu Hassan, M A; Chang, K W

    2003-08-01

    The Department of Veterinary Services (DVS) in Malaysia was established in 1888 as an agency to control exotic and domestic animal diseases. Over the years, the structure and functions of the organisation have evolved to meet the growing demand for veterinary services. The responsibilities of the Veterinary Services are enshrined in the Constitution of Malaysia. The current organisation of the DVS is structured to achieve the following objectives:---to prevent, control and eradicate animal and zoonotic diseases--to facilitate the growth and development of a strong animal industry--to ensure that animal products for human consumption are wholesome, clean, safe and suitable to be consumed--to facilitate the growth and development of the animal feed industry--to ensure the welfare and well-being of all animals. To meet these objectives the DVS has nine different divisions, as follows: Planning and Evaluation, Epidemiology and Veterinary Medicine, Veterinary Public Health, Research and Development, Industry Development, Production and Development of Genetic Resources, Human Resource Development (HRD), Enforcement, and Administration. The development of the animal industry is managed through national development policies, including the Third National Agriculture Policy. The basis for current programmes for disease control and animal industry development is the Eighth Development Plan (2001-2005). Over the period of this Plan, Malaysia will address the need for sanitary and phytosanitary measures by developing specific programmes covering all fields of the animal industry. This is just one way in which Malaysia is meeting the challenges of the increased liberalisation of trade created by the World Trade Organization and the Association of Southeast Asian Nations Free Trade Area. The development of the industry is focused on the major commodities, namely, beef, mutton, poultry meat, eggs, pork and milk. Other commodities receive support if it is considered economically

  18. How Batterer Intervention Programs Work: Participant and Facilitator Accounts of Processes of Change

    ERIC Educational Resources Information Center

    Silvergleid, Courtenay S.; Mankowski, Eric S.

    2006-01-01

    Understanding what facilitates change in men who perpetrate domestic violence can aid the development of more effective batterer intervention programs (BIPs). To identify and describe key change processes, in-depth interviews were conducted with nine successful BIP completers and with 10 intervention group facilitators. The accounts described a…

  19. Breaking through the Glass Ceiling: Consumers in Mental Health Organisations' Hierarchies.

    PubMed

    Scholz, Brett; Bocking, Julia; Happell, Brenda

    2017-05-01

    Contemporary mental health policies call for consumers to be engaged in all levels of mental health service planning, implementation, and delivery. Critical approaches to traditional healthcare hierarchies can effectively challenge barriers to better engagement with consumers in mental health organisations. This qualitative exploratory study analyses how particular strategies for consumer leadership facilitate or hinder relationships between consumers and mental health services, and how these strategies influence hierarchical structures. Fourteen participants from a range of mental health organisations were interviewed. These interviews were analysed using thematic analytic and discursive psychological techniques. The findings highlight several benefits of having consumers within mental health organisational hierarchies, and elaborate on ways that employees within mental health services can support integration of consumers into existing hierarchies. Specific barriers to consumers in hierarchies are discussed, including a lack of clarity of structures and roles within hierarchies, and resistance to consumers reaching the highest levels of leadership within organisations. Alternative hierarchical models which privilege consumers' control over resources and power are also discussed. Mental health organisations are encouraged to integrate consumer leaders into their hierarchical structures to improve their organisational offerings, their reputation, and their service innovation.

  20. Transformations? Skilled Change Agents Influencing Organisational Sustainability Culture

    ERIC Educational Resources Information Center

    Davis, Keith; Boulet, Mark

    2016-01-01

    Training employees in sustainability knowledge and skills is considered a vital element in creating a sustainability culture within an organisation. Yet, the particular types of training programs that are effective for this task are still relatively unknown. This case study describes an innovative workplace training program using a "head,…

  1. Perceptions of barriers and facilitators to health behavior change among veteran cancer survivors.

    PubMed

    Beehler, Gregory P; Rodrigues, Amy E; Kay, Morgan A; Kiviniemi, Marc T; Steinbrenner, Lynn

    2014-09-01

    This study aimed to identify barriers and facilitators to health behavior change related to body size in a sample of veteran cancer survivors. A qualitative study was conducted with a sample of 35 male and female cancer survivors receiving care at a Veterans Administration comprehensive cancer center. Participants completed individual interviews regarding barriers and facilitators to lifestyle change and responded to a brief questionnaire regarding current health behaviors. Participants reported suboptimal adherence to recommended health behavior goals and the majority were overweight or obese (80%). Qualitative analysis revealed numerous barriers and facilitators to health behavior change across six broad categories: environmental factors, health services delivery factors, health-related factors, factors related to attitudes toward change, factors related to enacting change, and motivational factors. Veteran cancer survivors were impacted by common barriers to change affecting the general population, cancer-specific factors related to personal diagnosis and treatment history, and health service delivery factors related to the Veterans Administration health care system. There are many barriers and facilitators that exist in diverse domains for veteran cancer survivors, each of which offers unique challenges and opportunities for improving engagement in behavior change following cancer diagnosis and treatment. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  2. Academic Professional Development Strategies to Facilitate Educational Changes in Universities

    ERIC Educational Resources Information Center

    Gonzalez Alonso, Gloria Amparo

    2009-01-01

    This qualitative within-case study explored how planned educational change in universities can be facilitated through academic professional development strategies. Thus this study attempted to shed some light on the dynamics of educational planned change in universities and their implications for academic professional development of faculty. The…

  3. Facilitation among plants in alpine environments in the face of climate change

    PubMed Central

    Anthelme, Fabien; Cavieres, Lohengrin A.; Dangles, Olivier

    2014-01-01

    While there is a large consensus that plant–plant interactions are a crucial component of the response of plant communities to the effects of climate change, available data remain scarce, particularly in alpine systems. This represents an important obstacle to making consistent predictions about the future of plant communities. Here, we review current knowledge on the effects of climate change on facilitation among alpine plant communities and propose directions for future research. In established alpine communities, while warming seemingly generates a net facilitation release, earlier snowmelt may increase facilitation. Some nurse plants are able to buffer microenvironmental changes in the long term and may ensure the persistence of other alpine plants through local migration events. For communities migrating to higher elevations, facilitation should play an important role in their reorganization because of the harsher environmental conditions. In particular, the absence of efficient nurse plants might slow down upward migration, possibly generating chains of extinction. Facilitation–climate change relationships are expected to shift along latitudinal gradients because (1) the magnitude of warming is predicted to vary along these gradients, and (2) alpine environments are significantly different at low vs. high latitudes. Data on these expected patterns are preliminary and thus need to be tested with further studies on facilitation among plants in alpine environments that have thus far not been considered. From a methodological standpoint, future studies will benefit from the spatial representation of the microclimatic environment of plants to predict their response to climate change. Moreover, the acquisition of long-term data on the dynamics of plant–plant interactions, either through permanent plots or chronosequences of glacial recession, may represent powerful approaches to clarify the relationship between plant interactions and climate change. PMID

  4. Successful clinical and organisational change in endodontic practice: a qualitative study.

    PubMed

    Koch, M; Englander, M; Tegelberg, Å; Wolf, E

    2014-08-01

    The aim of this study was to explicate and describe the qualitative meaning of successful clinical and organizational change in endodontic practice, following a comprehensive implementation program, including the integration of the nickel-titanium-rotary-technique. After an educational intervention in the Public Dental Service in a Swedish county, thematic in-depth interviews were conducted, with special reference to the participants' experience of the successful change. Interviews with four participants, were purposively selected on the basis of occupation (dentist, dental assistant, receptionist, clinical manager), for a phenomenological human scientific analysis. Four constituents were identified as necessary for the invariant, general structure of the phenomenon: 1) disclosed motivation, 2) allowance for individual learning processes, 3) continuous professional collaboration, and 4) a facilitating educator. The perceived requirements for achieving successful clinical and organizational change in endodontic practice were clinical relevance, an atmosphere which facilitated discussion and allowance for individual learning patterns. The qualities required in the educator were acknowledged competence with respect to scientific knowledge and clinical expertise, as well as familiarity with conditions at the dental clinics. The results indicate a complex interelationship among various aspects of the successful change process. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Influencing organisational culture: a leadership challenge.

    PubMed

    Muls, Ann; Dougherty, Lisa; Doyle, Natalie; Shaw, Clare; Soanes, Louise; Stevens, Anna-Marie

    In the wake of the Francis report, the need for NHS trusts and hospitals to adopt a culture of learning, safety and transparency has been highlighted. This article considers different aspects of culture in health care, and hones in on the link between culture and safety for patients in putting the patient first, embedding the 6Cs and considering the options to measure and influence organisational culture. The article reflects more deeply on how leadership across all levels can influence and inspire change in organisational culture, ensuring that the patient remains the focus of any changes in care delivery.

  6. Revisiting Organisational Learning in Integrated Care.

    PubMed

    Nuño-Solinís, Roberto

    2017-08-11

    Progress in health care integration is largely linked to changes in processes and ways of doing. These changes have knowledge management and learning implications. For this reason, the use of the concept of organisational learning is explored in the field of integrated care. There are very limited contributions that have connected the fields of organisational learning and care integration in a systematic way, both at the theoretical and empirical level. For this reason, hybridization of both perspectives still provides opportunities for understanding care integration initiatives from a research perspective as well as potential applications in health care management and planning.

  7. Revisiting Organisational Learning in Integrated Care

    PubMed Central

    2017-01-01

    Progress in health care integration is largely linked to changes in processes and ways of doing. These changes have knowledge management and learning implications. For this reason, the use of the concept of organisational learning is explored in the field of integrated care. There are very limited contributions that have connected the fields of organisational learning and care integration in a systematic way, both at the theoretical and empirical level. For this reason, hybridization of both perspectives still provides opportunities for understanding care integration initiatives from a research perspective as well as potential applications in health care management and planning. PMID:28970762

  8. Franchisees in Crisis: Using Action Learning to Self-Organise

    ERIC Educational Resources Information Center

    O'Donoghue, Carol

    2011-01-01

    The present article describes the use of action learning by a group of 30 franchisees to organise themselves and work through a period of upheaval and uncertainty when their parent company faced liquidation. Written from the perspective of one of the franchisees who found herself adopting action learning principles to facilitate the group, it…

  9. The role of global public health strategy in non-profit organisational change at country level: lessons from the joining of Save the Children and Merlin in Myanmar.

    PubMed

    Campbell, Fiona M; Balabanova, Dina; Howard, Natasha

    2018-01-01

    The paper presents a case study that critically assesses the role of global strategy 'Public Health on the Frontline 2014-2015' ('the Strategy') in supporting Merlin and Save the Children's organisational change and future programme of the combined organisation in Myanmar. Research was undertaken in 2014 in Myanmar. Twenty-six individual and three group interviews were conducted with stakeholders, and 10 meetings relevant to the country organisational transition process were observed. A conceptual framework was developed to assess the role of the global strategy in supporting the country change process. Several positive aspects of the global strategy were found, as well as critical shortcomings in its support to the organisational change process at country level. The strategy was useful in signalling Save the Children's intention to scale up humanitarian health provision. However, it had only limited influence on the early change process and outcomes in Myanmar. Results highlight several aspects that would enhance the role of a global strategy at country level. Lessons can be applied by organisations undertaking a similar process. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Strategies facilitating practice change in pediatric cancer: a systematic review.

    PubMed

    Robinson, Paula D; Dupuis, Lee L; Tomlinson, George; Phillips, Bob; Greenberg, Mark; Sung, Lillian

    2016-09-01

    By conducting a systematic review, we describe strategies to actively disseminate knowledge or facilitate practice change among healthcare providers caring for children with cancer and we evaluate the effectiveness of these strategies. We searched Ovid Medline, EMBASE and PsychINFO. Fully published primary studies were included if they evaluated one or more professional intervention strategies to actively disseminate knowledge or facilitate practice change in pediatric cancer or hematopoietic stem cell transplantation. Data extracted included study characteristics and strategies evaluated. In studies with a quantitative analysis of patient outcomes, the relationship between study-level characteristics and statistically significant primary analyses was evaluated. Of 20 644 titles and abstracts screened, 146 studies were retrieved in full and 60 were included. In 20 studies, quantitative evaluation of patient outcomes was examined and a primary outcome was stated. Eighteen studies were 'before and after' design; there were no randomized studies. All studies were at risk for bias. Interrupted time series was never the primary analytic approach. No specific strategy type was successful at improving patient outcomes. Literature describing strategies to facilitate practice change in pediatric cancer is emerging. However, major methodological limitations exist. Studies with robust designs are required to identify effective strategies to effect practice change. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Developing facilitation skills--a narrative.

    PubMed

    Newton, Jennifer M

    2003-07-01

    Effective facilitation has been identified in the literature as one of three elements, along with context and evidence, that have a dynamic and coexisting relationship to enable the successful uptake of evidence into practice. This paper presents an overview of the concept of facilitation within the context of practice development, ahead of a personal and professional reflective account of a 'developing facilitator'. In the summer of 2001, the author was instrumental in organising the first Practice Development School in Melbourne. Thrown in at the deep end, she found herself co-facilitating with an experienced practice developer from the United Kingdom. Having never facilitated in the arena of an action learning group, nor worked in the field of practice development, there was initially a sense of impending overload and drowning in the new knowledge and skills that needed to be acquired. Drawing upon the work of narrative inquiry the author shares her experiences in the anticipation that in telling her story it will assist others in their journey of becoming a facilitator.

  12. Different intra- and interspecific facilitation mechanisms between two Mediterranean trees under a climate change scenario.

    PubMed

    Gimeno, Teresa E; Escudero, Adrián; Valladares, Fernando

    2015-01-01

    In harsh environments facilitation alleviates biotic and abiotic constraints on tree recruitment. Under ongoing drier climate change, we expect facilitation to increase as a driver of coexistence. However, this might not hold under extreme abiotic stress and when the outcome depends on the interaction with other drivers such as altered herbivore pressure due to land use change. We performed a field water-manipulation experiment to quantify the importance of facilitation in two coexisting Mediterranean trees (dominant Juniperus thurifera and coexisting Quercus ilex subsp. ballota) under a climate change scenario. Shifts in canopy dominance favouring Q. ilex could be based on the extension of heterospecific facilitation to the detriment of conspecific alleviation. We found that saplings of both species transplanted under the canopy of nurse trees had greater survival probability, growth and photochemical efficiency. Intra- and interspecific facilitation mechanisms differed: alleviation of abiotic stress benefited both species during summer and J. thurifera during winter, whereas browsing protection was relevant only for Q. ilex. Facilitation was greater under the dry treatment only for Q. ilex, which partially agreed with the predictions of the stress gradient hypothesis. We conclude that present rainfall availability limits neither J. thurifera nor Q. ilex establishment. Nevertheless, under current global change scenarios, imposing increasing abiotic stress together with altered herbivore browsing, nurse trees could differentially facilitate the establishment of Q. ilex due to species-specific traits, i.e. palatability; drought, heat and cold tolerance, underlying species differences in the facilitation mechanisms and eventually triggering a change from pure juniper woodlands to mixed formations.

  13. Development of a taxonomy of interventions to organise the evidence on consumers' medicines use.

    PubMed

    Lowe, Dianne; Ryan, Rebecca; Santesso, Nancy; Hill, Sophie

    2011-11-01

    Safe, effective (quality) medicines use remains problematic worldwide, yet consumers' medicines use research is not well organised. This creates difficulties for decision makers in identifying evidence or research gaps and in understanding how or why interventions work. Developing a conceptual framework for this evidence helps to organise the evidence for application and raise awareness of the range of possible interventions. To scope the aims of interventions to improve consumers' medicines use we searched for and iteratively analysed policy documents, systematic reviews, and an existing consumer-oriented communication intervention taxonomy. We identified eight recurrent themes associated with the purpose of the interventions: to inform and educate; to support behaviour change; to teach skills; to facilitate communication and/or decision making; to support; to minimise risk and harms; to involve consumers at the system level; and to improve health care quality. The taxonomy accommodates the complexity and diversity of interventions in this field, by focussing on the purposes of interventions, rather than the intervention type. Currently used to organise the evidence on consumers' medicines use, the taxonomy provides a conceptual and practical map of the evidence which will aid decision making and future research investment in the area. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  14. Voluntary Organisation

    ERIC Educational Resources Information Center

    Williams, Shirley; Spiret, Claire; Dimitriadi, Yota; McCrindle, Rachel

    2013-01-01

    The World Association of Girl Guides and Girl Scouts (WAGGGS) is the umbrella organisation for Member Organisations from 145 countries, with a total membership of 10 million. While Member Organisations offer training and development within their own countries, WAGGGS offers international opportunities, such as leadership development at…

  15. A Developmental Guide to the Organisation of Close Relationships

    PubMed Central

    Laursen, Brett; Bukowski, William M.

    2009-01-01

    A developmental guide to close relationships is presented. Parent-child, sibling, friend, and romantic relationships are described along dimensions that address permanence, power, and gender. These dimensions describe relationship differences in organisational principles that encompass internal representations, social understanding, and interpersonal experiences. The concept of domain specificity is borrowed from cognitive development to address the shifting developmental dynamics of close relationships. Distinct relationships are organised around distinct socialisation tasks, so each relationship requires its own organisational system. As a consequence, different principles guide different relationships, and these organisational principles change with development. PMID:20090927

  16. Implementing family involvement in the treatment of patients with psychosis: a systematic review of facilitating and hindering factors

    PubMed Central

    Eassom, Erica; Giacco, Domenico; Dirik, Aysegul; Priebe, Stefan

    2014-01-01

    Objective To synthesise the evidence on implementing family involvement in the treatment of patients with psychosis with a focus on barriers, problems and facilitating factors. Design Systematic review of studies evaluating the involvement of families in tripartite communication between health professionals, ‘families’ (or other unpaid carers) and adult patients, in a single-family context. A theoretical thematic analysis approach and thematic synthesis were used. Data sources A systematic electronic search was carried out in seven databases, using database-specific search strategies and controlled vocabulary. A secondary manual search of grey literature was performed as well as using forwards and backwards snowballing techniques. Results A total of 43 studies were included. The majority featured qualitative data (n=42), focused solely on staff perspectives (n=32) and were carried out in the UK (n=23). Facilitating the training and ongoing supervision needs of staff are necessary but not sufficient conditions for a consistent involvement of families. Organisational cultures and paradigms can work to limit family involvement, and effective implementation appears to operate via a whole team coordinated effort at every level of the organisation, supported by strong leadership. Reservations about family involvement regarding power relations, fear of negative outcomes and the need for an exclusive patient–professional relationship may be explored and addressed through mutually trusting relationships. Conclusions Implementing family involvement carries additional challenges beyond those generally associated with translating research to practice. Implementation may require a cultural and organisational shift towards working with families. Family work can only be implemented if this is considered a shared goal of all members of a clinical team and/or mental health service, including the leaders of the organisation. This may imply a change in the ethos and practices

  17. The NHS and market forces in healthcare: the need for organisational ethics.

    PubMed

    Frith, Lucy

    2013-01-01

    The NHS in England is an organisation undergoing substantial change. The passage of the Health and Social Care Act 2012, consolidates and builds on previous health policies and introduces further 'market-style' reforms of the NHS. One of the main aspects of these reforms is to encourage private and third sector providers to deliver NHS services. The rationale for this is to foster a more competitive market in healthcare to encourage greater efficiency and innovation. This changing healthcare environment in the English NHS sharpens the need for attention to be paid to the ethical operation of healthcare organisations. All healthcare organisations need to consider the ethical aspects of their operation, whether state or privately run. However, the changes in the type of organisations used to provide healthcare (such as commercial companies) can create new relationships and ethical tensions. This paper will chart the development of organisational ethics as a concern in applied ethics and how it arose in the USA largely owing to changes in the organisation of healthcare financing and provision. It will be argued that an analogous transition is happening in the NHS in England. The paper will conclude with suggestions for the development of organisational ethics programmes to address some of the possible ethical issues raised by this new healthcare environment that incorporates both private and public sector providers.

  18. Navigating change: how outreach facilitators can help clinicians improve patient outcomes.

    PubMed

    Laferriere, Dianne; Liddy, Clare; Nash, Kate; Hogg, William

    2012-01-01

    The objective of this study was to describe outreach facilitation as an effective method of assisting and supporting primary care practices to improve processes and delivery of care. We spent 4 years working with 83 practices in Eastern Ontario, Canada, on the Improved Delivery of Cardiovascular Care through the Outreach Facilitation program. Primary care practices, even if highly motivated, face multiple challenges when providing quality patient care. Outreach facilitation can be an effective method of assisting and supporting practices to make the changes necessary to improve processes and delivery of care. Multiple jurisdictions use outreach facilitation for system redesign, improved efficiencies, and advanced access. The development and implementation of quality improvement programs using practice facilitation can be challenging. Our research team has learned valuable lessons in developing tools, finding resources, and assisting practices to reach their quality improvement goals. These lessons can lead to improved experiences for the practices and overall improved outcomes for the patients they serve.

  19. Protocol for development and validation of a context-appropriate tool for assessing organisational readiness for change in primary health clinics in South Africa.

    PubMed

    Brooke-Sumner, Carrie; Sorsdahl, Katherine; Lombard, Carl; Petersen-Williams, Petal; Myers, Bronwyn

    2018-04-09

    A large treatment gap for common mental disorders (such as depression) exists in South Africa. Comorbidity with other chronic diseases, including HIV and diseases of lifestyle, is an increasing public health concern globally. Currently, primary health facilities as points of care for those with chronic disease provide limited services for common mental disorders. Assessing organisational readiness for change (ORC) towards adopting health innovations (such as mental health services) using contextually appropriate measures is needed to facilitate implementation of these services. This study aims to investigate the validity of the Texas Christian University Organisational Readiness for Change (TCU-ORC) scale in the South African context. Subsequently, we will develop a shortened version of this scale. This study is nested within Project MIND, a multiyear randomised controlled trial that is testing two different approaches for integrating counselling for common mental disorders into chronic disease care. Although the modified, contextually appropriate ORC measure resulting from the proposed study will be developed in the context of integrating mental health into primary healthcare services, the potential for the tool to be generalised to further understanding barriers to any change being implemented in primary care settings is high. We will establish internal consistency (Cronbach's alpha coefficients), test-retest reliability (intraclass correlation coefficient) and construct validity of the long-form TCU-ORC questionnaire. Survey data will be collected from 288 clinical, management and operational staff from 24 primary health facilities where the Project MIND trial is implemented. A modified Delphi approach will assess the content validity of the TCU-ORC items and identify areas for potential adaptation and item reduction. Ethical approval has been granted by the South African Medical Research Council (Protocol ID EC004-2-2015, amendment of 20 August 2017). Results

  20. Major transcriptome re-organisation and abrupt changes in signalling, cell cycle and chromatin regulation at neural differentiation in vivo.

    PubMed

    Olivera-Martinez, Isabel; Schurch, Nick; Li, Roman A; Song, Junfang; Halley, Pamela A; Das, Raman M; Burt, Dave W; Barton, Geoffrey J; Storey, Kate G

    2014-08-01

    Here, we exploit the spatial separation of temporal events of neural differentiation in the elongating chick body axis to provide the first analysis of transcriptome change in progressively more differentiated neural cell populations in vivo. Microarray data, validated against direct RNA sequencing, identified: (1) a gene cohort characteristic of the multi-potent stem zone epiblast, which contains neuro-mesodermal progenitors that progressively generate the spinal cord; (2) a major transcriptome re-organisation as cells then adopt a neural fate; and (3) increasing diversity as neural patterning and neuron production begin. Focussing on the transition from multi-potent to neural state cells, we capture changes in major signalling pathways, uncover novel Wnt and Notch signalling dynamics, and implicate new pathways (mevalonate pathway/steroid biogenesis and TGFβ). This analysis further predicts changes in cellular processes, cell cycle, RNA-processing and protein turnover as cells acquire neural fate. We show that these changes are conserved across species and provide biological evidence for reduced proteasome efficiency and a novel lengthening of S phase. This latter step may provide time for epigenetic events to mediate large-scale transcriptome re-organisation; consistent with this, we uncover simultaneous downregulation of major chromatin modifiers as the neural programme is established. We further demonstrate that transcription of one such gene, HDAC1, is dependent on FGF signalling, making a novel link between signals that control neural differentiation and transcription of a core regulator of chromatin organisation. Our work implicates new signalling pathways and dynamics, cellular processes and epigenetic modifiers in neural differentiation in vivo, identifying multiple new potential cellular and molecular mechanisms that direct differentiation. © 2014. Published by The Company of Biologists Ltd.

  1. Questioning skills of clinical facilitators supporting undergraduate nursing students.

    PubMed

    Phillips, Nicole M; Duke, Maxine M; Weerasuriya, Rona

    2017-12-01

    To report on a study investigating questioning skills of clinical facilitators who support the learning of undergraduate nursing students. The ability to think critically is integral to decision-making and the provision of safe and quality patient care. Developing students' critical thinking skills is expected of those who supervise and facilitate student learning in the clinical setting. Models used to facilitate student learning in the clinical setting have changed over the years with clinicians having dual responsibility for patient care and facilitating student learning. Many of these nurses have no preparation for the educative role. This study adapted a comparative study conducted over fifteen years ago. Descriptive online survey including three acute care patient scenarios involving an undergraduate nursing student. Participants were required to identify the questions they would ask the student in relation to the scenario. A total of 133 clinical facilitators including clinical teachers, clinical educators and preceptors from five large partner healthcare organisations of one Australian university participated. The majority of questions asked were knowledge questions, the lowest category in the cognitive domain requiring only simple recall of information. Facilitators who had undertaken an education-related course/workshop or formal qualification asked significantly more questions from the higher cognitive level. The study provides some evidence that nursing facilitators in the clinical setting ask students predominantly low-level questions. Further research is needed to identify strategies that develop the capacity of facilitators to ask higher level cognitive questions. Clinical facilitators should undertake targeted education that focuses on how to frame questions for students that demand application, analysis, synthesis and evaluation. © 2017 John Wiley & Sons Ltd.

  2. What can management theories offer evidence-based practice? A comparative analysis of measurement tools for organisational context.

    PubMed

    French, Beverley; Thomas, Lois H; Baker, Paula; Burton, Christopher R; Pennington, Lindsay; Roddam, Hazel

    2009-05-19

    Given the current emphasis on networks as vehicles for innovation and change in health service delivery, the ability to conceptualize and measure organisational enablers for the social construction of knowledge merits attention. This study aimed to develop a composite tool to measure the organisational context for evidence-based practice (EBP) in healthcare. A structured search of the major healthcare and management databases for measurement tools from four domains: research utilisation (RU), research activity (RA), knowledge management (KM), and organisational learning (OL). Included studies were reports of the development or use of measurement tools that included organisational factors. Tools were appraised for face and content validity, plus development and testing methods. Measurement tool items were extracted, merged across the four domains, and categorised within a constructed framework describing the absorptive and receptive capacities of organisations. Thirty measurement tools were identified and appraised. Eighteen tools from the four domains were selected for item extraction and analysis. The constructed framework consists of seven categories relating to three core organisational attributes of vision, leadership, and a learning culture, and four stages of knowledge need, acquisition of new knowledge, knowledge sharing, and knowledge use. Measurement tools from RA or RU domains had more items relating to the categories of leadership, and acquisition of new knowledge; while tools from KM or learning organisation domains had more items relating to vision, learning culture, knowledge need, and knowledge sharing. There was equal emphasis on knowledge use in the different domains. If the translation of evidence into knowledge is viewed as socially mediated, tools to measure the organisational context of EBP in healthcare could be enhanced by consideration of related concepts from the organisational and management sciences. Comparison of measurement tools across

  3. Can the tools of activity theory help us in advancing understanding and organisational change in undergraduate medical education?

    PubMed

    Reid, Anne-Marie; Ledger, Alison; Kilminster, Sue; Fuller, Richard

    2015-08-01

    Continued changes to healthcare delivery in the UK, and an increasing focus on patient safety and quality improvement, require a radical rethink on how we enable graduates to begin work in challenging, complex environments. Professional regulatory bodies now require undergraduate medical schools to implement an 'assistantship' period in the final year of study, where senior medical students 'shadow' the work of junior doctors, with an expectation that they will be better 'prepared' for work. However, there is little guidance about what an 'assistantship' entails and the current emphasis on preparedness of students arguably underplays the importance of contextualised learning within the workplace environment. This paper will describe a modified Development Work Research (DWR) (Engeström in Developmental work research: activity theory in practice. Lehmanns Media, Berlin, 2005) approach to organisational change, enabling academic, clinical and administrative partners to develop assistantship placements in different hospitals. Our findings indicate that a modified DWR approach can reveal factors indicating organisational readiness to support change within a locally contextualised framework. The process has significant practical applications across a range of healthcare disciplines, as all professions seek to engage with the challenge of enabling successful transitions of graduates to the workplace.

  4. Methods for the economic evaluation of changes to the organisation and delivery of health services: principal challenges and recommendations.

    PubMed

    Meacock, Rachel

    2018-04-20

    There is a requirement for economic evaluation of health technologies seeking public funding across Europe. Changes to the organisation and delivery of health services, including changes to health policy, are not covered by such appraisals. These changes also have consequences for National Health Service (NHS) funds, yet undergo no mandatory cost-effectiveness assessment. The focus on health technologies may have occurred because larger-scale service changes pose more complex challenges to evaluators. This paper discusses the principal challenges faced when performing economic evaluations of changes to the organisation and delivery of health services and provides recommendations for overcoming them. The five principal challenges identified are as follows: undertaking ex-ante evaluation; evaluating impacts in terms of quality-adjusted life years; assessing costs and opportunity costs; accounting for spillover effects; and generalisability. Of these challenges, methods for estimating the impact on costs and quality-adjusted life years are those most in need of development. Methods are available for ex-ante evaluation, assessing opportunity costs and examining generalisability. However, these are rarely applied in practice. The general principles of assessing the cost-effectiveness of interventions should be applied to all NHS spending, not just that involving health technologies. Advancements in this area have the potential to improve the allocation of scarce NHS resources.

  5. How to manage organisational change and create practice teams: experiences of a South African primary care health centre.

    PubMed

    Mash, B J; Mayers, P; Conradie, H; Orayn, A; Kuiper, M; Marais, J

    2008-07-01

    In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses. This paper is based on their experience of both unsuccessful and successful attempts to introduce practice teams and reports on their learning regarding organisational change. An emergent action research study design utilised a co-operative inquiry group. The first nine months of inquiry focused on understanding the initial unsuccessful attempt to create practice teams. This paper reports primarily on the subsequent nine months (four cycles of planning, action, observation and reflection) during which practice teams were re-introduced. The central question was how more effective practice teams of doctors and nurses could be created. The group utilised outcome mapping to assist with planning, monitoring and evaluation. Outcome mapping defined a vision, mission, boundary partners, outcome challenges, progress markers and strategies for the desired changes and supported quantitative monitoring of the process. Qualitative data were derived from the co-operative inquiry group (CIG) meetings and interviews with doctors, nurses, practice teams and patients. The CIG engaged effectively with 68% of the planned strategies, and more than 60% of the progress markers were achieved for clinical nurse practitioners, doctors, support staff and managers, but not for patients. Key themes that emerged from the inquiry group's reflection on their experience of the change process dealt with the amount of interaction, type of communication, team resilience, staff satisfaction, leadership style, reflective capacity, experimentation and evolution of new

  6. Organisational learning and self-adaptation in dynamic disaster environments.

    PubMed

    Corbacioglu, Sitki; Kapucu, Naim

    2006-06-01

    This paper examines the problems associated with inter-organisational learning and adaptation in the dynamic environments that characterise disasters. The research uses both qualitative and quantitative methods to investigate whether organisational learning took place during and in the time in between five disaster response operations in Turkey. The availability of information and its exchange and distribution within and among organisational actors determine whether self-adaptation happens in the course of a disaster response operation. Organisational flexibility supported by an appropriate information infrastructure creates conditions conducive to essential interaction and permits the flow of information. The study found that no significant organisational learning occurred within Turkish disaster management following the earthquakes in Erzincan (1992), Dinar (1995) and Ceyhan (1998). By contrast, the 'symmetry-breaking' Marmara earthquake of 1999 initiated a 'double loop' learning process that led to change in the organisational, technical and cultural aspects of Turkish disaster management, as revealed by the Duzce earthquake response operations.

  7. A cross-sectional survey of supports for evidence-informed decision-making in healthcare organisations: a research protocol.

    PubMed

    Ouimet, Mathieu; Lavis, John N; Léon, Grégory; Ellen, Moriah E; Bédard, Pierre-Olivier; Grimshaw, Jeremy M; Gagnon, Marie-Pierre

    2014-10-09

    This protocol builds on the development of a) a framework that identified the various supports (i.e. positions, activities, interventions) that a healthcare organisation or health system can implement for evidence-informed decision-making (EIDM) and b) a qualitative study that showed the current mix of supports that some Canadian healthcare organisations have in place and the ones that are perceived to facilitate the use of research evidence in decision-making. Based on these findings, we developed a web survey to collect cross-sectional data about the specific supports that regional health authorities and hospitals in two Canadian provinces (Ontario and Quebec) have in place to facilitate EIDM. This paper describes the methods for a cross-sectional web survey among 32 regional health authorities and 253 hospitals in the provinces of Quebec and Ontario (Canada) to collect data on the current mix of organisational supports that these organisations have in place to facilitate evidence-informed decision-making. The data will be obtained through a two-step survey design: a 10-min survey among CEOs to identify key units and individuals in regard to our objectives (step 1) and a 20-min survey among managers of the key units identified in step 1 to collect information about the activities performed by their unit regarding the acquisition, assessment, adaptation and/or dissemination of research evidence in decision-making (step 2). The study will target three types of informants: CEOs, library/documentation centre managers and all other key managers whose unit is involved in the acquisition, assessment, adaptation/packaging and/or dissemination of research evidence in decision-making. We developed an innovative data collection system to increase the likelihood that only the best-informed respondent available answers each survey question. The reporting of the results will be done using descriptive statistics of supports by organisation type and by province. This study will

  8. The organisation of spatial and temporal relations in memory.

    PubMed

    Rondina, Renante; Curtiss, Kaitlin; Meltzer, Jed A; Barense, Morgan D; Ryan, Jennifer D

    2017-04-01

    Episodic memories are comprised of details of "where" and "when"; spatial and temporal relations, respectively. However, evidence from behavioural, neuropsychological, and neuroimaging studies has provided mixed interpretations about how memories for spatial and temporal relations are organised-they may be hierarchical, fully interactive, or independent. In the current study, we examined the interaction of memory for spatial and temporal relations. Using explicit reports and eye-tracking, we assessed younger and older adults' memory for spatial and temporal relations of objects that were presented singly across time in unique spatial locations. Explicit change detection of spatial relations was affected by a change in temporal relations, but explicit change detection of temporal relations was not affected by a change in spatial relations. Younger and older adults showed eye movement evidence of incidental memory for temporal relations, but only younger adults showed eye movement evidence of incidental memory for spatial relations. Together, these findings point towards a hierarchical organisation of relational memory. The implications of these findings are discussed in the context of the neural mechanisms that may support such a hierarchical organisation of memory.

  9. Autonomy and Authority in Public Research Organisations: Structure and Funding Factors.

    PubMed

    Cruz-Castro, Laura; Sanz-Menéndez, Luis

    2018-01-01

    This paper establishes a structural typology of the organisational configurations of public research organisations which vary in their relative internal sharing of authority between researchers and managers; we distinguish between autonomous, heteronomous and managed research organisations. We assume that there are at least two sources of legitimate authority within research organisations, one derived from formal hierarchy (organisational leadership) and another derived from the research community (professional); the balance of authority between researchers and managers is essentially structural but is empirically mediated by the funding portfolio of organisations and the corresponding endowment of resources at the disposal of leaders or researchers. Changes in the level, sources and strings of organisational and individual research funding are expected to affect the balance of internal authority in different ways depending on the organisational configuration, and to open the door to the influence of external actors in the development of research agendas.

  10. The Many Organisational Factors Relevant to Planning Change in Emergency Care Departments: A Qualitative Study to Inform a Cluster Randomised Controlled Trial Aiming to Improve the Management of Patients with Mild Traumatic Brain Injuries.

    PubMed

    Bosch, Marije; Tavender, Emma J; Brennan, Sue E; Knott, Jonathan; Gruen, Russell L; Green, Sally E

    2016-01-01

    The Neurotrauma Evidence Translation (NET) Trial aims to design and evaluate the effectiveness of a targeted theory-and evidence-informed intervention to increase the uptake of evidence-based recommended practices for the management of patients who present to an emergency department (ED) with mild head injuries. When designing interventions to bring about change in organisational settings such as the ED, it is important to understand the impact of the context to ensure successful implementation of practice change. Few studies explicitly use organisational theory to study which factors are likely to be most important to address when planning change processes in the ED. Yet, this setting may have a unique set of organisational pressures that need to be taken into account when implementing new clinical practices. This paper aims to provide an in depth analysis of the organisational context in which ED management of mild head injuries and implementation of new practices occurs, drawing upon organisational level theory. Semi-structured interviews were conducted with ED staff in Australia. The interviews explored the organisational context in relation to change and organisational factors influencing the management of patients presenting with mild head injuries. Two researchers coded the interview transcripts using thematic content analysis. The "model of diffusion in service organisations" was used to guide analyses and organisation of the results. Nine directors, 20 doctors and 13 nurses of 13 hospitals were interviewed. With regard to characteristics of the innovation (i.e. the recommended practices) the most important factor was whether they were perceived as being in line with values and needs. Tension for change (the degree to which stakeholders perceive the current situation as intolerable or needing change) was relatively low for managing acute mild head injury symptoms, and mixed for managing longer-term symptoms (higher change commitment, but relatively low

  11. Developing the organisational culture in a healthcare setting.

    PubMed

    Nightingale, Adele

    2018-01-17

    This article aims to define organisational culture and explain why it is important to patients, carers and those working in healthcare environments. Organisational culture is not a new concept and the literature on the subject is well-established. However, because of the changing dynamics of the NHS, there has been a shift away from 'what' the NHS stands for, often relating to its history and rituals, to 'who' it functions for, including how healthcare professionals such as nurses can develop and drive the organisational culture. The article seeks to assist nurses in understanding the role of organisational culture, as well as implementing its main principles in the workplace. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  12. Implementing an organised cervical screening programme in the Republic of Moldova-Stakeholder identification and engagement.

    PubMed

    Davies, Philip; Valuta, Diana; Cojohari, Natalia; Sancho-Garnier, Helene

    2017-10-01

    Successfully implementing cervical screening programmes requires them to be adapted to the local context and have broad stakeholder support. This can be achieved by actively engaging local stakeholders in planning as well as implementing the programmes. The Moldovan government started implementing an organised cervical screening programme in 2010 with the first step being stakeholder identification and engagement. This process started by contacting easily identified stakeholders with each asked to recommend others and the process continued until no new ones were identified. Stakeholders were then involved in a series of individual and group meetings over a 2-year period to build confidence and encourage progressively greater engagement. In total, 87 individuals from 46 organisations were identified. Over the 2-year process, the individual and group meetings facilitated a change in stakeholder attitudes from disinterest, to acceptance and finally to active cooperation in designing the screening programme and preparing an implementation plan that were both well adapted to the Moldovan context. Developing the broad support needed to implement cervical screening programmes required ongoing interaction with stakeholders over an extended period. This interaction allowed stakeholder concerns to be identified and addressed, progress to be demonstrated, and stakeholders to be educated about organised screening programmes so they had the knowledge to progressively take greater responsibility and ownership. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Barriers and facilitators to learn and improve through morbidity and mortality conferences: a qualitative study.

    PubMed

    de Vos, Marit S; Hamming, Jaap F; Marang-van de Mheen, Perla J

    2017-11-12

    To explore barriers and facilitators to successful morbidity and mortality conferences (M&M), driving learning and improvement. This is a qualitative study with semistructured interviews. Inductive, thematic content analysis was used to identify barriers and facilitators, which were structured across a pre-existing framework for change in healthcare. Dutch academic surgical department with a long tradition of M&M. An interview sample of surgeons, residents and physician assistants (n=12). A total of 57 barriers and facilitators to successful M&M, covering 18 themes, varying from 'case type' to 'leadership', were perceived by surgical staff. While some factors related to M&M organisation, others concerned individual or social aspects. Eight factors, of which four were at the social level, had simultaneous positive and negative effects (eg, 'hierarchy' and 'team spirit'). Mediating pathways for M&M success were found to relate to available information , staff motivation and realisation processes. This study provides leads for improvement of M&M practice, as well as for further research on key elements of successful M&M. Various factors were perceived to affect M&M success, of which many were individual and social rather than organisational factors, affecting information and realisation processes but also staff motivation. Based on these findings, practical recommendations were formulated to guide efforts towards best practices for M&M. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Climate change collaboration among natural resource management agencies: lessons learned from two US regions

    USGS Publications Warehouse

    Lemieux, Christopher J.; Thompson, Jessica; Slocombe, D. Scott; Schuster, Rudy

    2015-01-01

    It has been argued that regional collaboration can facilitate adaptation to climate change impacts through integrated planning and management. In an attempt to understand the underlying institutional factors that either support or contest this assumption, this paper explores the institutional factors influencing adaptation to climate change at the regional scale, where multiple public land and natural resource management jurisdictions are involved. Insights from two mid-western US case studies reveal that several challenges to collaboration persist and prevent fully integrative multi-jurisdictional adaptation planning at a regional scale. We propose that some of these challenges, such as lack of adequate time, funding and communication channels, be reframed as opportunities to build interdependence, identify issue-linkages and collaboratively explore the nature and extent of organisational trade-offs with respect to regional climate change adaptation efforts. Such a reframing can better facilitate multi-jurisdictional adaptation planning and management of shared biophysical resources generally while simultaneously enhancing organisational capacity to mitigate negative effects and take advantage of potentially favourable future conditions in an era characterised by rapid climate change.

  15. Key enablers to facilitate healthy behavior change: workshop summary.

    PubMed

    Teyhen, Deydre S; Aldag, Matt; Centola, Damon; Edinborough, Elton; Ghannadian, Jason D; Haught, Andrea; Jackson, Theresa; Kinn, Julie; Kunkler, Kevin J; Levine, Betty; Martindale, Valerie E; Neal, David; Snyder, Leslie B; Styn, Mindi A; Thorndike, Frances; Trabosh, Valerie; Parramore, David J

    2014-05-01

    The increases in preventable chronic diseases and the rising costs of health care are unsustainable. The US Army Surgeon General's vision to transition from a health care system to a system of health requires the identification of key health enablers to facilitate the adoption of healthy behaviors. In support of this vision, the US Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health." Members of government and academia participated to identify key health enablers that could ultimately be leveraged by technology. The key health enablers discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior-change intervention, and (5) the role of peer and social networks on change. This report summarizes leading evidence and the group consensus on evidence-based practices with respect to the key enablers in creating healthy behavior change.

  16. Smartphone technology facilitates dietary change in healthy adults.

    PubMed

    Ipjian, Michelle L; Johnston, Carol S

    2017-01-01

    Many individuals are advised to adhere to specific diet plans for their personal health; hence, it is important that tools are available to support these behaviors. Smartphone applications (apps) may assist health care professionals in educating their clients on specific dietary modifications. This pilot study focused on a single dietary modification, reducing sodium intake, to determine whether a commercial health app is useful for promoting dietary change. Thirty healthy adults (age 34.4 ± 15.7 y; body mass index 25.6 ± 4.3 kg/m 2 ) were recruited from a university community and completed this 4-wk randomized parallel trial. Participants were instructed to reduce their sodium intake to ≤2300 mg/d by using the MyFitnessPal app to receive feedback on sodium content of foods or by paper tallying of estimated sodium intake. The predicted 24-h sodium excretion, estimated using the ratio of sodium to creatinine from the first morning urine void, and participant satisfaction were the main outcomes measured. The change in the predicted 24-h sodium excretion differed between groups: -838 ± 1093 and +236 ± 1333 mg/24 h predicted for the app and journal groups, respectively (P = 0.010). Moreover, participants in the app group reported significantly greater satisfaction with their method of diet tracking than the journal group (P = 0.001). These data suggest that smartphone apps have the potential to facilitate the implementation of dietary advice. This was a small pilot study with limited scope, and more research is necessary to determine the value of smartphone apps for facilitating dietary change. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Facilitating climate-change-induced range shifts across continental land-use barriers.

    PubMed

    Robillard, Cassandra M; Coristine, Laura E; Soares, Rosana N; Kerr, Jeremy T

    2015-12-01

    Climate changes impose requirements for many species to shift their ranges to remain within environmentally tolerable areas, but near-continuous regions of intense human land use stretching across continental extents diminish dispersal prospects for many species. We reviewed the impact of habitat loss and fragmentation on species' abilities to track changing climates and existing plans to facilitate species dispersal in response to climate change through regions of intensive land uses, drawing on examples from North America and elsewhere. We identified an emerging analytical framework that accounts for variation in species' dispersal capacities relative to both the pace of climate change and habitat availability. Habitat loss and fragmentation hinder climate change tracking, particularly for specialists, by impeding both propagule dispersal and population growth. This framework can be used to identify prospective modern-era climatic refugia, where the pace of climate change has been slower than surrounding areas, that are defined relative to individual species' needs. The framework also underscores the importance of identifying and managing dispersal pathways or corridors through semi-continental land use barriers that can benefit many species simultaneously. These emerging strategies to facilitate range shifts must account for uncertainties around population adaptation to local environmental conditions. Accounting for uncertainties in climate change and dispersal capabilities among species and expanding biological monitoring programs within an adaptive management paradigm are vital strategies that will improve species' capacities to track rapidly shifting climatic conditions across landscapes dominated by intensive human land use. © 2015 Society for Conservation Biology.

  18. Implementing family involvement in the treatment of patients with psychosis: a systematic review of facilitating and hindering factors.

    PubMed

    Eassom, Erica; Giacco, Domenico; Dirik, Aysegul; Priebe, Stefan

    2014-10-03

    To synthesise the evidence on implementing family involvement in the treatment of patients with psychosis with a focus on barriers, problems and facilitating factors. Systematic review of studies evaluating the involvement of families in tripartite communication between health professionals, 'families' (or other unpaid carers) and adult patients, in a single-family context. A theoretical thematic analysis approach and thematic synthesis were used. A systematic electronic search was carried out in seven databases, using database-specific search strategies and controlled vocabulary. A secondary manual search of grey literature was performed as well as using forwards and backwards snowballing techniques. A total of 43 studies were included. The majority featured qualitative data (n=42), focused solely on staff perspectives (n=32) and were carried out in the UK (n=23). Facilitating the training and ongoing supervision needs of staff are necessary but not sufficient conditions for a consistent involvement of families. Organisational cultures and paradigms can work to limit family involvement, and effective implementation appears to operate via a whole team coordinated effort at every level of the organisation, supported by strong leadership. Reservations about family involvement regarding power relations, fear of negative outcomes and the need for an exclusive patient-professional relationship may be explored and addressed through mutually trusting relationships. Implementing family involvement carries additional challenges beyond those generally associated with translating research to practice. Implementation may require a cultural and organisational shift towards working with families. Family work can only be implemented if this is considered a shared goal of all members of a clinical team and/or mental health service, including the leaders of the organisation. This may imply a change in the ethos and practices of clinical teams, as well as the establishment of

  19. What can management theories offer evidence-based practice? A comparative analysis of measurement tools for organisational context

    PubMed Central

    French, Beverley; Thomas, Lois H; Baker, Paula; Burton, Christopher R; Pennington, Lindsay; Roddam, Hazel

    2009-01-01

    Background Given the current emphasis on networks as vehicles for innovation and change in health service delivery, the ability to conceptualise and measure organisational enablers for the social construction of knowledge merits attention. This study aimed to develop a composite tool to measure the organisational context for evidence-based practice (EBP) in healthcare. Methods A structured search of the major healthcare and management databases for measurement tools from four domains: research utilisation (RU), research activity (RA), knowledge management (KM), and organisational learning (OL). Included studies were reports of the development or use of measurement tools that included organisational factors. Tools were appraised for face and content validity, plus development and testing methods. Measurement tool items were extracted, merged across the four domains, and categorised within a constructed framework describing the absorptive and receptive capacities of organisations. Results Thirty measurement tools were identified and appraised. Eighteen tools from the four domains were selected for item extraction and analysis. The constructed framework consists of seven categories relating to three core organisational attributes of vision, leadership, and a learning culture, and four stages of knowledge need, acquisition of new knowledge, knowledge sharing, and knowledge use. Measurement tools from RA or RU domains had more items relating to the categories of leadership, and acquisition of new knowledge; while tools from KM or learning organisation domains had more items relating to vision, learning culture, knowledge need, and knowledge sharing. There was equal emphasis on knowledge use in the different domains. Conclusion If the translation of evidence into knowledge is viewed as socially mediated, tools to measure the organisational context of EBP in healthcare could be enhanced by consideration of related concepts from the organisational and management sciences

  20. Leaders of School Technology Innovation: A Confirmatory Factor Analysis of the Change Facilitator Style Questionnaire (CFSQ)

    ERIC Educational Resources Information Center

    Liu, Feng; Ritzhaupt, Albert; Cavanaugh, Cathy

    2013-01-01

    Purpose: This paper aims to describe a construct validation study of the Change Facilitator Style Questionnaire (CFSQ), an instrument designed to measure the leadership style of school principals as change facilitators. Design/methodology/approach: Participants included 614 K-12 teachers across the state of Florida involved in the Enhancing…

  1. The relationship between organisational communication and perception.

    PubMed

    Marynissen, H M F

    2011-01-01

    Both researchers and managers search for the most appropriate form of organisational communication. The aim of such an organisational communication is to influence the receivers' perception to confirm, adapt or change behaviour according to the sender's intention. This paper argues that to influence the receivers' perception, a specific form of communication that is embedded in a specific organisational culture is required. It also demands prior knowledge of the existing organisational schemata and the current perception concerning the topic that has to be communicated. The rationale is that three obstacles hinder the objectives of traditional communication strategies to influence perception according to the sender's objectives. The first challenge is that a receiver of a certain message never garners one single, clearly pronounced message conveyed by one single person. Yet, few studies are based on multiple messages from various sources. This makes most of the communication strategies in use obsolete. The second strain is the dual mode of thinking that forms organisational members' perceptions: the heuristic and the cogitative (Taleb, 2010). Most organisational communication theories are based on the paradigm in which receivers of information process this information in a rational way, while research in the field of neurobiology (Lehrer, 2009) indicates that rationality is dominated by emotions. The third difficulty is that organisational members constrain to well-established, ingrained schemas (Labianca et al., 2000; Balogun and Johnson, 2004). Based on these existing schemas, the scattered information from multiple sources, and the inability to process that information through cognitive reasoning, organisational members construct perceptions that are not in line with the objectives of the sender's communication. This article reviews different communication theories, points out key concepts in the literature on individual and collective perceptions, and suggests

  2. How Organisational Change is Contributing to a Sustainable Bushfire Program

    ERIC Educational Resources Information Center

    Baker, Angela; Stanton, Andrew

    2004-01-01

    The Nature Conservation Council of NSW (NCC)'s Bushfire Program is unique amongst conservation organisations. The Program has been running for over ten years, focusing its campaign work mainly on government policy, legislation and commissions of inquiry. However, the Program was originally initiated to provide support to over 70 conservation…

  3. Incentives for knowledge sharing: impact of organisational culture and information technology

    NASA Astrophysics Data System (ADS)

    Lyu, Hongbo; Zhang, Zuopeng Justin

    2017-10-01

    This research presents and examines an analytical model of knowledge management in which organisational culture dynamically improves with knowledge-sharing and learning activities within organisations. We investigate the effects of organisational incentives and the level of information technology on the motivation of knowledge sharing. We derive a linear incentive reward structure for knowledge sharing under both homogeneous and heterogeneous conditions. In addition, we show how the organisational culture and the optimum linear sharing reward change with several crucial factors, and summarise three sets of methods (strong IT support, congruent organisational culture, and effective employee assessment) to complement the best linear incentive. Our research provides valuable insights for practitioners in terms of implementing knowledge-management initiatives.

  4. Organisational travel plans for improving health.

    PubMed

    Hosking, Jamie; Macmillan, Alexandra; Connor, Jennie; Bullen, Chris; Ameratunga, Shanthi

    2010-03-17

    Dependence on car use has a number of broad health implications, including contributing to physical inactivity, road traffic injury, air pollution and social severance, as well as entrenching lifestyles that require environmentally unsustainable energy use. Travel plans are interventions that aim to reduce single-occupant car use and increase the use of alternatives such as walking, cycling and public transport, with a variety of behavioural and structural components. This review focuses on organisational travel plans for schools, tertiary institutes and workplaces. These plans are closely aligned in their aims and intervention design, having emerged from a shared theoretical base. To assess the effects of organisational travel plans on health, either directly measured, or through changes in travel mode. We searched the following electronic databases; Transport (1988 to June 2008), MEDLINE (1950 to June 2008), EMBASE (1947 to June 2008), CINAHL (1982 to June 2008), ERIC (1966 to June 2008), PSYCINFO (1806 to June 2008), Sociological Abstracts (1952 to June 2008), BUILD (1989 to 2002), Social Sciences Citation Index (1900 to June 2008), Science Citation Index (1900 to June 2008), Arts & Humanities Index (1975 to June 2008), Cochrane Database of Systematic Reviews (to August 2008), CENTRAL (to August 2008), Cochrane Injuries Group Register (to December 2009), C2-RIPE (to July 2008), C2-SPECTR (to July 2008), ProQuest Dissertations & Theses (1861 to June 2008). We also searched the reference lists of relevant articles, conference proceedings and Internet sources. We did not restrict the search by date, language or publication status. We included randomised controlled trials and controlled before-after studies of travel behaviour change programmes conducted in an organisational setting, where the measured outcome was change in travel mode or health. Both positive and negative health effects were included. Two authors independently assessed eligibility, assessed trial

  5. Supporting Reflective Practices in Social Change Processes with the Dynamic Learning Agenda: An Example of Learning about the Process towards Disability Inclusive Development

    ERIC Educational Resources Information Center

    van Veen, Saskia C.; de Wildt-Liesveld, Renée; Bunders, Joske F. G.; Regeer, Barbara J.

    2014-01-01

    Change processes are increasingly seen as the solution to entrenched (social) problems. However, change is difficult to realise while dealing with multiple actors, values, and approaches. (Inter)organisational learning is seen as a way to facilitate reflective practices in social change that support emergent changes, vicarious learning, and…

  6. Reorientation of health services: enablers and barriers faced by organisations when increasing health promotion capacity.

    PubMed

    McFarlane, K; Judd, J; Devine, S; Watt, K

    2016-08-01

    Issue addressed Primary healthcare settings are important providers of health promotion approaches. However, organisational challenges can affect their capacity to deliver these approaches. This review identified the common enablers and barriers health organisations faced and it aimed to explore the experiences health organisations, in particular Aboriginal organisations, had when increasing their health promotion capacity. Methods A systematic search of peer-reviewed literature was conducted. Articles published between 1990-2014 that focused on a health care-settings approach and discussed factors that facilitated or hindered an organisation's ability to increase health promotion capacity were included. Results Twenty-five articles met the inclusion criteria. Qualitative (n=18) and quantitative (n=7) study designs were included. Only one article described the experiences of an Aboriginal health organisation. Enablers included: management support, skilled staff, provision of external support to the organisation, committed staffing and financial resources, leadership and the availability of external partners to work with. Barriers included: lack of management support, lack of dedicated health promotion staff, staff lacking skills or confidence, competing priorities and a lack of time and resources allocated to health promotion activities. Conclusions While the literature highlighted the importance of health promotion work, barriers can limit the delivery of health promotion approaches within primary healthcare organisations. A gap in the literature exists about how Aboriginal health organisations face these challenges. So what? Primary healthcare organisations wanting to increase their health promotion capacity can pre-empt the common barriers and strengthen identified enablers through the shared learnings outlined in this review.

  7. The Many Organisational Factors Relevant to Planning Change in Emergency Care Departments: A Qualitative Study to Inform a Cluster Randomised Controlled Trial Aiming to Improve the Management of Patients with Mild Traumatic Brain Injuries

    PubMed Central

    Bosch, Marije; Tavender, Emma J.; Brennan, Sue E.; Knott, Jonathan; Gruen, Russell L.; Green, Sally E.

    2016-01-01

    Background The Neurotrauma Evidence Translation (NET) Trial aims to design and evaluate the effectiveness of a targeted theory-and evidence-informed intervention to increase the uptake of evidence-based recommended practices for the management of patients who present to an emergency department (ED) with mild head injuries. When designing interventions to bring about change in organisational settings such as the ED, it is important to understand the impact of the context to ensure successful implementation of practice change. Few studies explicitly use organisational theory to study which factors are likely to be most important to address when planning change processes in the ED. Yet, this setting may have a unique set of organisational pressures that need to be taken into account when implementing new clinical practices. This paper aims to provide an in depth analysis of the organisational context in which ED management of mild head injuries and implementation of new practices occurs, drawing upon organisational level theory. Methods Semi-structured interviews were conducted with ED staff in Australia. The interviews explored the organisational context in relation to change and organisational factors influencing the management of patients presenting with mild head injuries. Two researchers coded the interview transcripts using thematic content analysis. The “model of diffusion in service organisations” was used to guide analyses and organisation of the results. Results Nine directors, 20 doctors and 13 nurses of 13 hospitals were interviewed. With regard to characteristics of the innovation (i.e. the recommended practices) the most important factor was whether they were perceived as being in line with values and needs. Tension for change (the degree to which stakeholders perceive the current situation as intolerable or needing change) was relatively low for managing acute mild head injury symptoms, and mixed for managing longer-term symptoms (higher change

  8. Birth environment facilitation by midwives assisting in non-hospital births: a qualitative interview study.

    PubMed

    Igarashi, Toshiko; Wakita, Mariko; Miyazaki, Kikuko; Nakayama, Takeo

    2014-07-01

    midwifery homes (similar to birth centres) are rich in midwifery wisdom and skills that differ from those in hospital obstetrical departments, and a certain percentage of pregnant women prefer birth in these settings. This study aimed to understand the organisation of the perinatal environment considered important by independent midwives in non-hospital settings and to clarify the processes involved. semi-structured qualitative interview study and constant comparative analysis. 14 independent midwives assisting at births in midwifery homes in Japan, and six independent midwives assisting at home births. Osaka, Kyoto, Nara, and Shiga, Japan. midwives assisting at non-hospital births organised the birth environment based on the following four categories: 'an environment where the mother and family are autonomous'; 'a physical environment that facilitates birth'; 'an environment that facilitates the movement of the mother for birth'; and 'scrupulous safety preparation'. These, along with their sub-categories, are presented in this paper. independent midwives considered it important to create a candid relationship between the midwife and the woman/family from the period of pregnancy to facilitate birth in which the woman and her family were autonomous. They also organised a distinctive environment for non-hospital birth, with preparations to guarantee safety. Experiential knowledge and skills played a major part in creating an environment to facilitate birth, and the effectiveness of this needs to be investigated objectively in future research. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Testing a model of facilitated reflection on network feedback: a mixed method study on integration of rural mental healthcare services for older people.

    PubMed

    Fuller, Jeffrey; Oster, Candice; Muir Cochrane, Eimear; Dawson, Suzanne; Lawn, Sharon; Henderson, Julie; O'Kane, Deb; Gerace, Adam; McPhail, Ruth; Sparkes, Deb; Fuller, Michelle; Reed, Richard L

    2015-11-11

    To test a management model of facilitated reflection on network feedback as a means to engage services in problem solving the delivery of integrated primary mental healthcare to older people. Participatory mixed methods case study evaluating the impact of a network management model using organisational network feedback (through social network analysis, key informant interviews and policy review). A model of facilitated network reflection using network theory and methods. A rural community in South Australia. 32 staff from 24 services and 12 senior service managers from mental health, primary care and social care services. Health and social care organisations identified that they operated in clustered self-managed networks within sectors, with no overarching purposive older people's mental healthcare network. The model of facilitated reflection revealed service goal and role conflicts. These discussions helped local services to identify as a network, and begin the problem-solving communication and referral links. A Governance Group assisted this process. Barriers to integrated servicing through a network included service funding tied to performance of direct care tasks and the lack of a clear lead network administration organisation. A model of facilitated reflection helped organisations to identify as a network, but revealed sensitivity about organisational roles and goals, which demonstrated that conflict should be expected. Networked servicing needed a neutral network administration organisation with cross-sectoral credibility, a mandate and the resources to monitor the network, to deal with conflict, negotiate commitment among the service managers, and provide opportunities for different sectors to meet and problem solve. This requires consistency and sustained intersectoral policies that include strategies and funding to facilitate and maintain health and social care networks in rural communities. Published by the BMJ Publishing Group Limited. For permission to

  10. Do mechanical forces contribute to nanoscale membrane organisation in T cells?

    PubMed

    Klotzsch, Enrico; Stiegler, Johannes; Ben-Ishay, Eldad; Gaus, Katharina

    2015-04-01

    Mechanotransduction describes how a cell senses and interacts with its environment. The concept originated in adhesion biology where adhesion receptors, integrins, facilitate force transmission between the extracellular matrix and the intracellular actin cytoskeleton. Indeed, during any adhesive contacts, cells do exert mechanical force. Hence, the probing of the local environment by cells results in mechanical cues that contribute to cellular functions and cell fate decisions such as migration, proliferation, differentiation and apoptosis. On the molecular level, mechanical forces can rearrange proteins laterally within the membrane, regulate their activity by inducing conformational changes and probe the mechanical properties and bond strength of receptor-ligands. From this point of view, it appears surprising that molecular forces have been largely overlooked in membrane organisation and ligand discrimination processes in lymphocytes. During T cell activation, the T cell receptor recognises and distinguishes antigenic from benign endogenous peptides to initiate the reorganisation of membrane proteins into signalling clusters within the immunological synapse. In this review, we asked whether characteristics of fibroblast force sensing could be applied to immune cell antigen recognition and signalling, and outline state-of-the-art experimental strategies for studying forces in the context of membrane organisation. This article is part of a Special Issue entitled: Nanoscale membrane orgainisation and signalling. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. An integrated health and social care organisation in Sweden: creation and structure of a unique local public health and social care system.

    PubMed

    Øvretveit, John; Hansson, Johan; Brommels, Mats

    2010-10-01

    Research and citizens have noted failures in coordinating health and social services and professionals, and the need to address this issue to realize benefits from increasing specialisation. Different methods have been proposed and one has been structural integration of separate services within one organisation. This paper reports an empirical longitudinal study of the development of an integrated health and social care organisation in Sweden combining service provision, purchasing and political governance for a defined population. The study found a combination of influences contributed to the development of this new organisation. The initial structural macro-integration facilitated, but did not of itself result in better clinical care coordination. Other actions were needed to modify the specialised systems and cultures which the organisation inherited. The study design was not able to establish with any degree of certainty whether better patient and cost outcomes resulted, but it did find structural and process changes which make improved outcomes likely. The study concludes that coordinated actions at different levels and of different types were needed to achieve care coordination for patients and that a phased approach was necessary where management capacity and outside expertise are limited. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Organisational Intelligence

    ERIC Educational Resources Information Center

    Yolles, Maurice

    2005-01-01

    Purpose: Seeks to explore the notion of organisational intelligence as a simple extension of the notion of the idea of collective intelligence. Design/methodology/approach: Discusses organisational intelligence using previous research, which includes the Purpose, Properties and Practice model of Dealtry, and the Viable Systems model. Findings: The…

  13. Innovation Adoption as Facilitated by a Change-Oriented Workplace

    PubMed Central

    Becan, Jennifer Edwards; Knight, Danica K.; Flynn, Patrick M.

    2011-01-01

    One of the unique contributions of the current study is a glimpse into the process by which counselors decide to try new innovations in their clinical work. Data were collected from 421 counseling staff from 71 outpatient treatment programs in 4 US regions. Using hierarchical linear modeling, results reveal that the propensity to adopt workshop-based interventions is facilitated by two important mechanisms (1) an innovative organization with creative leadership and (2) change-oriented staff attributes (i.e., seeking professional growth, efficacy, adaptability, and influence on others). Innovative leaders and a climate receptive to change also bolster the development of these change-oriented attributes. One implication of these findings is the cascading effect of leaders’ support of innovative thinking and action resulting in employees strengthening their own adaptive skills and carrying this innovative thinking into individual adoption. PMID:22154030

  14. The development of ORACLe: a measure of an organisation's capacity to engage in evidence-informed health policy.

    PubMed

    Makkar, Steve R; Turner, Tari; Williamson, Anna; Louviere, Jordan; Redman, Sally; Haynes, Abby; Green, Sally; Brennan, Sue

    2016-01-14

    Evidence-informed policymaking is more likely if organisations have cultures that promote research use and invest in resources that facilitate staff engagement with research. Measures of organisations' research use culture and capacity are needed to assess current capacity, identify opportunities for improvement, and examine the impact of capacity-building interventions. The aim of the current study was to develop a comprehensive system to measure and score organisations' capacity to engage with and use research in policymaking, which we entitled ORACLe (Organisational Research Access, Culture, and Leadership). We used a multifaceted approach to develop ORACLe. Firstly, we reviewed the available literature to identify key domains of organisational tools and systems that may facilitate research use by staff. We interviewed senior health policymakers to verify the relevance and applicability of these domains. This information was used to generate an interview schedule that focused on seven key domains of organisational capacity. The interview was pilot-tested within four Australian policy agencies. A discrete choice experiment (DCE) was then undertaken using an expert sample to establish the relative importance of these domains. This data was used to produce a scoring system for ORACLe. The ORACLe interview was developed, comprised of 23 questions addressing seven domains of organisational capacity and tools that support research use, including (1) documented processes for policymaking; (2) leadership training; (3) staff training; (4) research resources (e.g. database access); and systems to (5) generate new research, (6) undertake evaluations, and (7) strengthen relationships with researchers. From the DCE data, a conditional logit model was estimated to calculate total scores that took into account the relative importance of the seven domains. The model indicated that our expert sample placed the greatest importance on domains (2), (3) and (4). We utilised

  15. Organisation of workplace learning: a case study of paediatric residents' and consultants' beliefs and practices.

    PubMed

    Skipper, Mads; Nøhr, Susanne Backman; Jacobsen, Tine Klitgaard; Musaeus, Peter

    2016-08-01

    Several studies have examined how doctors learn in the workplace, but research is needed linking workplace learning with the organisation of doctors' daily work. This study examined residents' and consultants' attitudes and beliefs regarding workplace learning and contextual and organisational factors influencing the organisation and planning of medical specialist training. An explorative case study in three paediatric departments in Denmark including 9 days of field observations and focus group interviews with 9 consultants responsible for medical education and 16 residents. The study aimed to identify factors in work organisation facilitating and hindering residents' learning. Data were coded through an iterative process guided by thematic analysis. Findings illustrate three main themes: (1) Learning beliefs about patient care and apprenticeship learning as inseparable in medical practice. Beliefs about training and patient care expressed in terms of training versus production caused a potential conflict. (2) Learning context. Continuity over time in tasks and care for patients is important, but continuity is challenged by the organisation of daily work routines. (3) Organisational culture and regulations were found to be encouraging as well inhibiting to a successful organisation of the work in regards to learning. Our findings stress the importance of consultants' and residents' beliefs about workplace learning as these agents handle the potential conflict between patient care and training of health professionals. The structuring of daily work tasks is a key factor in workplace learning as is an understanding of underlying relations and organisational culture in the clinical departments.

  16. Change Facilitators: In Search of Understanding Their Role. Research on the Improvement Process in Schools and Colleges.

    ERIC Educational Resources Information Center

    Rutherford, William L.; And Others

    This information analysis paper examines (1) the characteristics associated with effective change facilitators and (2) the concept of "style" and its value in describing and understanding leadership performance and the role of change facilitators in particular. Three bodies of literature are highlighted and summarized in pursuit of…

  17. Managerial strategies to reorient hospitals towards health promotion: lessons from organisational theory.

    PubMed

    Röthlin, Florian

    2013-01-01

    Reorienting health services towards health promotion is one of the major health promotion strategies stipulated by the Ottawa Charter). Important contradictions, tensions and barriers to health promotion implementation associated with organisational structures have, thus far, been underexposed in the hospital health promotion discourse. This paper aims at identifying risks and the chances for hospital management to strategically and sustainably reorient their hospitals towards health promotion. The paper combines theories and findings from organisational science and management studies as well as from capacity development in the form of a narrative literature review. The aim is to focus on the conditions hospitals, as organisational systems with a highly professionalised workforce, provide for a strategically managed reorientation towards health promotion. Models and principles helping managers to navigate the difficulties and complexities of health promotion reorientation will be suggested. Hospital managers have to deal with genuine obstacles in the complexity and structural formation of hospital organisations. Against this background, continuous management support, a transformative leadership style, participative strategic management and expert governance can be considered important organisational capacities for the reorientation towards a new concept such as health promotion. This paper discusses managerial strategies, effective structural transformations and important organisational capacities that can contribute to a sustainable reorientation of hospitals towards health promotion. It supports hospital managers in exploring their chances of facilitating and effectively supporting a sustainable health promotion reorientation of their hospitals. The paper provides an innovative approach where the focus is on enhanced possibilities for hospital managers to strategically manage the reorientation towards health promotion.

  18. Processes, barriers and facilitators to implementation of a participatory ergonomics program among eldercare workers.

    PubMed

    Rasmussen, Charlotte Diana Nørregaard; Lindberg, Naja Klærke; Ravn, Marie Højbjerg; Jørgensen, Marie Birk; Søgaard, Karen; Holtermann, Andreas

    2017-01-01

    This study aimed to investigate the processes of a participatory ergonomics program among 594 eldercare workers with emphasis on identified risk factors for low back pain and solutions, and reveal barriers and facilitators for implementation. Sixty-nine per cent of the identified risk factors were physical ergonomic, 24% were organisational and 7% were psychosocial risk factors. Most solutions were organisational (55%), followed by physical (43%) and psychosocial solutions (2%). Internal factors (e.g. team or management) constituted 47% of the barriers and 75% of the facilitators. External factors (e.g. time, financial resources, collaboration with resident or relatives) constituted 53% of the barriers and 25% of the facilitators. This study revealed the processes and implementation of a participatory ergonomics program among eldercare workers. The findings can be transferred to workers, workplaces, health and safety professionals, and researchers to improve future participatory ergonomics programs. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. The Role of Leadership in Facilitating Organisational Learning and Collective Capacity Building

    ERIC Educational Resources Information Center

    Piranfar, Hosein

    2007-01-01

    The paper examines the role of leadership in facilitating collective learning and capacity building by utilising ideas from the fields of evolutionary learning, operations strategy, quality, project and risk management. Two contrasting cases are chosen to show how success and failure can depend upon collective capacity building through…

  20. Exploring the Challenges in Scaling up the Delivery of Action Learning Facilitator Training within a Global Organisation

    ERIC Educational Resources Information Center

    Antell, Sonja; Heywood, John

    2015-01-01

    Action learning is often used as an element of leadership development programmes. The intention is to support classroom learning with an experiential thread which runs throughout the life of the programme. Action Learning Associates (ALA) has been working with an international organisation for three years to deliver the global "First Line…

  1. A Wicked Problem? Whistleblowing in Healthcare Organisations

    PubMed Central

    Hyde, Paula

    2016-01-01

    Mannion and Davies’ article recognises whistleblowing as an important means of identifying quality and safety issues in healthcare organisations. While ‘voice’ is a useful lens through which to examine whistleblowing, it also obscures a shifting pattern of uncertain ‘truths.’ By contextualising cultures which support or impede whislteblowing at an organisational level, two issues are overlooked; the power of wider institutional interests to silence those who might raise the alarm and changing ideas about what constitutes adequate care. A broader contextualisation of whistleblowing might illuminate further facets of this multi-dimensional problem. PMID:27239870

  2. The organisation of federal Veterinary Services in Canada: the Canadian Food Inspection Agency.

    PubMed

    Evans, B R; Doering, R L; Clarke, R C; Ranger, C

    2003-08-01

    The organisational design of a national Veterinary Service is critical to the overall quality and integrity of its animal health and veterinary public health infrastructure. It is well recognised that the diversity of political, economic and social situations which exist in and between countries dictates that no one model of organisational structure can be applied to all circumstances. In Canada, a re-organisation of the approach of the federal government to food inspection in 1997 resulted in the transfer of the veterinary administration to a newly created agency called the Canadian Food Inspection Agency (CFIA). The authors provide a short background on the impetus for the creation of the CFIA and an overview of its organisational structure and responsibilities in animal and veterinary public health and food safety. Also included are the logic models that were developed for the federal Veterinary Services as part of their quality and performance management framework. Integrating all federally mandated food inspection systems under the CFIA has had concrete benefits in clarifying roles and responsibilities, reducing overlap and duplication of programme functions, improving service delivery and facilitating federal-provincial collaboration. Moreover, the strength of the organisation lies in the ability of the Canadian Veterinary Services to adhere to the fundamental principles of quality which are recommended by the OIE (World organisation for animal health) for the evaluation of Veterinary Services. No single organisational structure can guarantee a highly effective or competent Veterinary Service. Common challenges exist that may or may not be addressed in whole or in part by the organisational structure. The challenges highlighted in this paper provide further thoughts on the management of shared jurisdiction, meeting public health objectives, balancing science and political accountability, and defining the role and jurisdiction of veterinarians.

  3. System Constellations as a Tool Supporting Organisational Learning and Change Processes

    ERIC Educational Resources Information Center

    Birkenkrahe, Marcus

    2008-01-01

    Originally developed in the context of family therapy, system constellations are introduced using an organisational learning and system theoretical framework. Constellations are systemic group interventions using a spatial representation of the system elements. They correspond to deutero-learning processes and use higher-order systemic thinking.…

  4. School-based vaccination programmes: a systematic review of the evidence on organisation and delivery in high income countries.

    PubMed

    Perman, Sarah; Turner, Simon; Ramsay, Angus I G; Baim-Lance, Abigail; Utley, Martin; Fulop, Naomi J

    2017-03-14

    Many countries have recently expanded their childhood immunisation programmes. Schools are an increasingly attractive setting for delivery of these new immunisations because of their ability to reach large numbers of children in a short period of time. However, there are organisational challenges to delivery of large-scale vaccination programmes in schools. Understanding the facilitators and barriers is important for improving the delivery of future school-based vaccination programmes. We undertook a systematic review of evidence on school-based vaccination programmes in order to understand the influence of organisational factors on the delivery of programmes. Our eligibility criteria were studies that (1) focused on childhood or adolescent vaccination programmes delivered in schools; (2) considered organisational factors that influenced the preparation or delivery of programmes; (3) were conducted in a developed or high-income country; and (4) had been peer reviewed. We searched for articles published in English between 2000 and 2015 using MEDLINE and HMIC electronic databases. Additional studies were identified by searching the Cochrane Library and bibliographies. We extracted data from the studies, assessed quality and the risk of bias, and categorised findings using a thematic framework of eight organisational factors. We found that most of the recent published literature is from the United States and is concerned with the delivery of pandemic or seasonal flu vaccination programmes at a regional (state) or local level. We found that the literature is largely descriptive and not informed by the use of theory. Despite this, we identified common factors that influence the implementation of programmes. These factors included programme leadership and governance, organisational models and institutional relationships, workforce capacity and roles particularly concerning the school nurse, communication with parents and students, including methods for obtaining consent

  5. Work disability following major organisational change: the Whitehall II study.

    PubMed

    Virtanen, M; Kivimäki, M; Singh-Manoux, A; Gimeno, D; Shipley, M J; Vahtera, J; Akbaraly, T N; Marmot, M G; Ferrie, J E

    2010-05-01

    Privatisation and private sector practices have been increasingly applied to the public sector in many industrialised countries. Over the same period, long-term work disability has risen substantially. We examined whether a major organisational change--the transfer of public sector work to executive agencies run on private sector lines--was associated with an increased risk of work disability. The study uses self-reported data from the prospective Whitehall II cohort study. Associations between transfer to an executive agency assessed at baseline (1991-1994) and work disability ascertained over a period of approximately 8 years at three follow-up surveys (1995-1996, 1997-1999 and 2001) were examined using Cox proportional hazard models. In age- and sex-adjusted models, risk of work disability was higher among the 1263 employees who were transferred to an executive agency (HR 1.90, 95% CI 1.46 to 2.48) compared with the 3419 employees whose job was not transferred. These findings were robust to additional adjustment for physical and mental health and health behaviours at baseline. Increased work disability was observed among employees exposed to the transfer of public sector work to executive agencies run on private sector lines. This may highlight an unintentional cost for employees, employers and society.

  6. A thematic analysis of the role of the organisation in building allied health research capacity: a senior managers' perspective.

    PubMed

    Golenko, Xanthe; Pager, Susan; Holden, Libby

    2012-08-27

    Evidence-based practice aims to achieve better health outcomes in the community. It relies on high quality research to inform policy and practice; however research in primary health care continues to lag behind that of other medical professions. The literature suggests that research capacity building (RCB) functions across four levels; individual, team, organisation and external environment. Many RCB interventions are aimed at an individual or team level, yet evidence indicates that many barriers to RCB occur at an organisational or external environment level. This study asks senior managers from a large healthcare organisation to identify the barriers and enablers to RCB. The paper then describes strategies for building allied health (AH) research capacity at an organisational level from a senior managers' perspective. This qualitative study is part of a larger collaborative RCB project. Semi-structured in-depth interviews were conducted with nine allied health senior managers. Recorded interviews were transcribed and NVivo was used to analyse findings and emergent themes were defined. The dominant themes indicate that the organisation plays an integral role in building AH research capacity and is the critical link in creating synergy across the four levels of RCB. The organisation can achieve this by incorporating research into its core business with a whole of organisation approach including its mission, vision and strategic planning. Critical success factors include: developing a co-ordinated and multidisciplinary approach to attain critical mass of research-active AH and enhance learning and development; support from senior managers demonstrated through structures, processes and systems designed to facilitate research; forming partnerships to increase collaboration and sharing of resources and knowledge; and establishing in internal framework to promote recognition for research and career path opportunities. This study identifies four key themes: whole of

  7. Organisational readiness: exploring the preconditions for success in organisation-wide patient safety improvement programmes.

    PubMed

    Burnett, Susan; Benn, Jonathan; Pinto, Anna; Parand, Anam; Iskander, Sandra; Vincent, Charles

    2010-08-01

    Patient safety has been high on the agenda for more than a decade. Despite many national initiatives aimed at improving patient safety, the challenge remains to find coherent and sustainable organisation-wide safety-improvement programmes. In the UK, the Safer Patients' Initiative (SPI) was established to address this challenge. Important in the success of such an endeavour is understanding 'readiness' at the organisational level, identifying the preconditions for success in this type of programme. This article reports on a case study of the four NHS organisations participating in the first phase of SPI, examining the perceptions of organisational readiness and the relationship of these factors with impact by those actively involved in the initiative. A mixed-methods design was used, involving a survey and semistructured interviews with senior executive leads, the principal SPI programme coordinator and the four operational leads in each of the SPI clinical work areas in all four organisations taking part in the first phase of SPI. This preliminary work would suggest that prior to the start of organisation-wide quality- and safety-improvement programmes, organisations would benefit from an assessment of readiness with time spent in the preparation of the organisational infrastructure, processes and culture. Furthermore, a better understanding of the preconditions that mark an organisation as ready for improvement work would allow policymakers to set realistic expectations about the outcomes of safety campaigns.

  8. Managing Postsocialist Transitions: Politicized Sense Making as a Facilitator of Organizational Change

    ERIC Educational Resources Information Center

    Tiplic, Dijana

    2011-01-01

    This study explores what organizational strategies are employed to initiate and facilitate organizational change in higher education institutions in the increasingly complex and competitive postsocialist environment of Bosnia-Herzegovina. By studying organizations trapped between their inert socialist-era legacies and desired organizational…

  9. Factors affecting performance and productivity of nurses: professional attitude, organisational justice, organisational culture and mobbing.

    PubMed

    Terzioglu, Fusun; Temel, Safiye; Uslu Sahan, Fatma

    2016-09-01

    To identify relationships among variables affecting nurses' performance and productivity, namely professional attitudes, organisational culture, organisational justice and exposure to mobbing. The determination of the factors affecting performance and productivity is important for providing efficient nursing services. These factors have been investigated in the literature independently, but the relationship among them has not been clearly identified. This cross-sectional questionnaire study included 772 nurses working in a University Hospital accredited by Joint Commission International. The professional attitude score of the nurses was high (4.35 ± 0.63). However, their organisational justice (2.22 ± 1.26) and organisational culture (2.47 ± 0.71) scores were low. Nurses were subjected to mobbing at a high level (0.82 ± 0.78). As the organisational justice increased, the organisational culture increased and the mobbing decreased. As the organisation culture decreased, the mobbing increased. There was a positive correlation between organisation culture and organisational justice of the nurses and a negative correlation with mobbing. The results of the study are essential for improving nurses' performance and productivity. © 2016 John Wiley & Sons Ltd.

  10. The Living Cell as a Multi-agent Organisation: A Compositional Organisation Model of Intracellular Dynamics

    NASA Astrophysics Data System (ADS)

    Jonker, C. M.; Snoep, J. L.; Treur, J.; Westerhoff, H. V.; Wijngaards, W. C. A.

    Within the areas of Computational Organisation Theory and Artificial Intelligence, techniques have been developed to simulate and analyse dynamics within organisations in society. Usually these modelling techniques are applied to factories and to the internal organisation of their process flows, thus obtaining models of complex organisations at various levels of aggregation. The dynamics in living cells are often interpreted in terms of well-organised processes, a bacterium being considered a (micro)factory. This suggests that organisation modelling techniques may also benefit their analysis. Using the example of Escherichia coli it is shown how indeed agent-based organisational modelling techniques can be used to simulate and analyse E.coli's intracellular dynamics. Exploiting the abstraction levels entailed by this perspective, a concise model is obtained that is readily simulated and analysed at the various levels of aggregation, yet shows the cell's essential dynamic patterns.

  11. Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study

    PubMed Central

    2011-01-01

    Background Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. Methods A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Results Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. Conclusions A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various

  12. Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study.

    PubMed

    Barnett, Julie; Vasileiou, Konstantina; Djemil, Fayika; Brooks, Laurence; Young, Terry

    2011-12-16

    Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse

  13. Becoming organisms: the organisation of development and the development of organisation.

    PubMed

    de la Rosa, Laura Nuño

    2010-01-01

    Despite the radical importance of embryology in the development of organicism, developmental biology remains philosophically underexplored as a theoretical and empirical resource to clarify the nature of organisms. This paper discusses how embryology can help develop the organisational definition of the organism as a differentiated, functionally integrated, and autonomous system. I distinguish two conceptions of development in the organisational tradition that yield two different conceptions of the organism: the life-history view claims that organisms can be considered as such during their whole ontogeny; the constitutive view distinguishes two periods in the life history, a period of generation and a period of self-maintenance of a constitutive organisation. Arguing in favour of the constitutive view, it will be claimed that the organisational criteria for the definition of organism (i.e., differentiation, functional integration, and autonomy) can only be applied to the developmental system when it has entered the period of self-maintenance of a constitutive organisation. Under the light of current research in developmental biology, it is possible to make explicit how organisms come to be as organisms. To this end, I explore key ontogenetic events that help us clarify the core aspects of animal organisation and allow us to identify the developmental stage that marks the ontological transition between an organism in potency and an organism in actuality. The structure of this ontogenetic unfolding parallels the conceptual structure of the very notion of organism; the generation of the being of a particular organism parallels its definition.

  14. Development of an interprofessional lean facilitator assessment scale.

    PubMed

    Bravo-Sanchez, Cindy; Dorazio, Vincent; Denmark, Robert; Heuer, Albert J; Parrott, J Scott

    2018-05-01

    High reliability is important for optimising quality and safety in healthcare organisations. Reliability efforts include interprofessional collaborative practice (IPCP) and Lean quality/process improvement strategies, which require skilful facilitation. Currently, no validated Lean facilitator assessment tool for interprofessional collaboration exists. This article describes the development and pilot evaluation of such a tool; the Interprofessional Lean Facilitator Assessment Scale (ILFAS), which measures both technical and 'soft' skills, which have not been measured in other instruments. The ILFAS was developed using methodologies and principles from Lean/Shingo, IPCP, metacognition research and Bloom's Taxonomy of Learning Domains. A panel of experts confirmed the initial face validity of the instrument. Researchers independently assessed five facilitators, during six Lean sessions. Analysis included quantitative evaluation of rater agreement. Overall inter-rater agreement of the assessment of facilitator performance was high (92%), and discrepancies in the agreement statistics were analysed. Face and content validity were further established, and usability was evaluated, through primary stakeholder post-pilot feedback, uncovering minor concerns, leading to tool revision. The ILFAS appears comprehensive in the assessment of facilitator knowledge, skills, abilities, and may be useful in the discrimination between facilitators of different skill levels. Further study is needed to explore instrument performance and validity.

  15. Organised surfactant assemblies in analytical atomic spectrometry

    NASA Astrophysics Data System (ADS)

    Sanz-Medel, Alfredo; Fernandez de la Campa, Maria del Rosario; Gonzalez, Elisa Blanco; Fernandez-Sanchez, Maria Luisa

    1999-02-01

    The use of surfactant-based organised assemblies in analytical atomic spectroscopy is extensively and critically reviewed along three main lines: first, the ability of organised media to enhance detection of atomic spectroscopic methods by favourable manipulation of physical and chemical properties of the sample solution second, the extension of separation mechanisms by resorting to organised media and third a discussion of synergistic combinations of liquid chromatography separations and atomic detectors via the use of vesicular mobile phases. Changes in physical properties of sample solutions aspirated in atomic spectrometry by addition of surfactants can be advantageously used in at least four different ways: (i) to improve nebulisation efficiency; (ii) to enhance wettability of solid surfaces used for atomisation; (iii) to improve compatibility between aqueous and organic phases; and (iv) to achieve good dispersion of small particles in "slurry" techniques. Controversial results and statements published so far are critically discussed. The ability of surfactant-based organised assemblies, such as micelles and vesicles, to organise reactants at the molecular level has also been applied to enhance the characteristics of chemical generation of volalite species of metals and semi-metals (e.g., hydride or ethylide generation of As, Pb, Cd, Se, Sn, and cold vapour Hg generation) used in atomic methods. Enhancements in efficiency/transport of volatile species, increases in the reaction kinetics, stabilisation of some unstable species and changes in the selectivity of the reactions by surfactants are dealt with. Non-chromatographic cloud-point separations to design pre-concentration procedures with subsequent metal determination by atomic methods are addressed along with chromatographic separations of expanded scope by addition of surfactants to the conventional aqueous mobile phases of reversed-phase high-performance liquid chromatography. Finally, the synergistic

  16. Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program.

    PubMed

    Tappen, Ruth M; Wolf, David G; Rahemi, Zahra; Engstrom, Gabriella; Rojido, Carolina; Shutes, Jill M; Ouslander, Joseph G

    Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period. Themes related to barriers and facilitators were identified. Six major barriers to implementation were identified: the magnitude and complexity of the change (35%), instability of facility leadership (27%), competing demands (40%), stakeholder resistance (49%), scarce resources (86%), and technical problems (31%). Six facilitating strategies were also reported: organization-wide involvement (68%), leadership support (41%), use of administrative authority (14%), adequate training (66%), persistence and oversight on the part of the champion (73%), and unfolding positive results (14%). Successful introduction of a complex change such as the INTERACT® quality improvement program in a long-term care facility requires attention to the facilitators and barriers identified in this report from those at the frontline.

  17. 'Care': moral concept or merely an organisational suffix?

    PubMed

    Clapton, J

    2008-07-01

    Over recent decades, a couple of interesting trends have occurred in regard to human services practices in Australia. First, there has been a significant shift from practices that previously have intentionally responded to emerging and continuing human need within communities to practices that are now managed within a context of managerialism and influenced by market forces. Second, in such a changing context, increasingly, organisations have added the suffix 'care' to their organisational name. One is therefore left to consider why this latter change has occurred, and how is care being considered, particularly in organisations supporting people with intellectual disability (ID). A conceptual-theoretical analysis is undertaken to explore the characteristics of human services that embrace managerialism. The moral constructions of personhood in regard to people with ID within this service context are investigated; and the implications of how care is practised are considered. An immoral-amoral binary of personhood within an underpinning neo-liberal context is identified and analysed. Further analysis reveals a more insidious independent-dependent binary for people with an ID linked to a dominating Ethic of Normalcy. This latter binary suggests that care seemingly becomes neither ethically relevant nor legitimate for people with ID in managerialist service contexts. Ethical transformation in regard to care is needed for contemporary human services practice for people with ID. The underpinning Ethic of Normalcy is challenged for an Ethic of Engagement; whereby a deep understanding of care as a moral concept needs to be at the core of practice, rather than merely attached in an organisational name.

  18. The effects of perceived organisational support and span of control on the organisational commitment of novice leaders.

    PubMed

    Havaei, Farinaz; Dahinten, V Susan; MacPhee, Maura

    2015-04-01

    The purpose of this study was to examine the main and interaction effects of perceived organisational support, span of control and leadership rank on novice nurse leaders' organisational commitment. As nurse leaders' organisational commitment is eroded at times of healthcare restructuring, it is important to study factors associated with organisational commitment. Cross-sectional data from 69 novice nurse leaders, collected via mailed surveys at two time points, were analysed using hierarchical regression. The findings supported our hypotheses about the positive effect of perceived organisational support, the positive effect of leadership rank and the negative effect of span of control on novice nurse leaders' organisational commitment. In addition, perceived organisational support was shown to moderate the negative effect of span of control on novice nurse leaders' organisational commitment at time 2. Organisational strategies aimed at supporting nurse leaders, and attention to span of control, are required to enhance the organisational commitment of novice nurse leaders. Nurse leaders with a wide span of control, in particular those with little leadership experience, need to adopt leadership strategies that maximise their effectiveness, such as organising smaller work groups or teams within their wide span of control. © 2013 John Wiley & Sons Ltd.

  19. Linking climate change and biological invasions: Ocean warming facilitates nonindigenous species invasions.

    PubMed

    Stachowicz, John J; Terwin, Jeffrey R; Whitlatch, Robert B; Osman, Richard W

    2002-11-26

    The spread of exotic species and climate change are among the most serious global environmental threats. Each independently causes considerable ecological damage, yet few data are available to assess whether changing climate might facilitate invasions by favoring introduced over native species. Here, we compare our long-term record of weekly sessile marine invertebrate recruitment with interannual variation in water temperature to assess the likely effect of climate change on the success and spread of introduced species. For the three most abundant introduced species of ascidian (sea squirt), the timing of the initiation of recruitment was strongly negatively correlated with winter water temperature, indicating that invaders arrived earlier in the season in years with warmer winters. Total recruitment of introduced species during the following summer also was positively correlated with winter water temperature. In contrast, the magnitude of native ascidian recruitment was negatively correlated with winter temperature (more recruitment in colder years) and the timing of native recruitment was unaffected. In manipulative laboratory experiments, two introduced compound ascidians grew faster than a native species, but only at temperatures near the maximum observed in summer. These data suggest that the greatest effects of climate change on biotic communities may be due to changing maximum and minimum temperatures rather than annual means. By giving introduced species an earlier start, and increasing the magnitude of their growth and recruitment relative to natives, global warming may facilitate a shift to dominance by nonnative species, accelerating the homogenization of the global biota.

  20. Testosterone: from initiating change to modulating social organisation in domestic fowl ( Gallus gallus domesticus)

    NASA Astrophysics Data System (ADS)

    Kent, John P.; Murphy, Kenneth J.; Bannon, Finian J.; Hynes, Niamh M.; Hayden, Thomas J.

    2009-07-01

    Testosterone (T) concentrations in many species are sensitive to seasonal changes and to changes in social conditions. However, the effect of the natural or endogenous T increase in the juvenile on their social behaviour is not well understood. In this study, T and behaviour were measured from the pro-social juvenile to the adult stage in semi-feral domestic fowl. During the pro-social phase T levels and the distance chicks maintained between each other, i.e. inter-individual distance (IID) were low. Then, as T increased, a corresponding increase in IID occurred and continued in males until dispersal to individual adult male territories. In the new and initially stable adult social structure, T declined and IID remained high, indicating a new behavioural mechanism was in place. Males first mated as T levels were declining. They were then challenged; then T increased, and then IID increased again. Adult male T levels fluctuate, being low or declining in a socially stable environment and increasing following a challenge, suggesting a regulatory or modulating role for T. The results are consistent with T having an endogenous role: in the juvenile, driving behavioural change towards adulthood, and in adulthood, a modulating role regulating social organisation.

  1. Transition into the workplace: comparing health graduates' and organisational perspectives.

    PubMed

    Walker, Arlene; Costa, Beth M

    2017-02-01

    Health graduates face personal and work-related stressors during the graduate year. The extent to which employers and health graduates have a shared understanding of graduate stressors is unclear but may impact graduate support and transition into the health profession. Aim and design: The aim of this exploratory qualitative study was to identify factors that impact health graduates' transition and integration into the workplace, comparing the perspectives of health graduates and organisational representatives. Individual and small group semi-structured interviews were conducted with 15 medical and 26 nursing graduates and five organisational representatives from a regional health organisation in Victoria, Australia. A thematic analysis was undertaken on the data. Five main categories were identified: dealing with change, dealing with conflict, workload, taking responsibility and factors that influence performance. Similarities and differences in the perspectives of health graduates and organisational representatives were identified. These findings have implications for current graduate support programs.

  2. An exploratory study of how sports and recreation industry personnel perceive the barriers and facilitators of physical activity in children with disability.

    PubMed

    Shields, Nora; Synnot, Anneliese J

    2014-01-01

    To explore the perceived barriers and facilitators to participation in physical activity among children with disability in physical activity and community sports from the perspective of sports and recreation industry personnel. A convenient sample of 24 participants was recruited from delegates attending a symposium on physical activity for organisations in the sport and recreation sector in Victoria, Australia. The participants completed a brief questionnaire. Data were analysed by content analysis using an inductive approach. The participants reported 25 facilitators and 20 barriers to participation for children with disability. The top five reported facilitators were: welcoming providers, support and encouragement from parents or others, inclusive providers, adaptable approaches and accessibility of facilities. The top five reported barriers were: inaccessible facilities, non-inclusive providers, transport, lack of relevant opportunities and cost. Sports industry personnel share a similar perspective to families of potential barriers and facilitators to engagement by children with disability in physical activity and community sports. Policy change was not considered as a facilitator of physical activity, even though four of the top five facilitators identified could be implemented through local policy change. Implications for Rehabilitation There are multiple factors that interact with each other which influence the participation by children with disability in physical activity and community sports. The sports and recreation industry should consider policy change as a relevant way to facilitate participation by children with disability in physical activity. More professional development and disability engagement opportunities for sports and recreation industry personnel may help address some of the barriers to participation for children with disability experience.

  3. Working with Research Integrity-Guidance for Research Performing Organisations: The Bonn PRINTEGER Statement.

    PubMed

    Forsberg, Ellen-Marie; Anthun, Frank O; Bailey, Sharon; Birchley, Giles; Bout, Henriette; Casonato, Carlo; Fuster, Gloria González; Heinrichs, Bert; Horbach, Serge; Jacobsen, Ingrid Skjæggestad; Janssen, Jacques; Kaiser, Matthias; Lerouge, Inge; van der Meulen, Barend; de Rijcke, Sarah; Saretzki, Thomas; Sutrop, Margit; Tazewell, Marta; Varantola, Krista; Vie, Knut Jørgen; Zwart, Hub; Zöller, Mira

    2018-05-31

    This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity-Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on the following key issues: § 1. Providing information about research integrity § 2. Providing education, training and mentoring § 3. Strengthening a research integrity culture § 4. Facilitating open dialogue § 5. Wise incentive management § 6. Implementing quality assurance procedures § 7. Improving the work environment and work satisfaction § 8. Increasing transparency of misconduct cases § 9. Opening up research § 10. Implementing safe and effective whistle-blowing channels § 11. Protecting the alleged perpetrators § 12. Establishing a research integrity committee and appointing an ombudsperson § 13. Making explicit the applicable standards for research integrity.

  4. The influence of individual and organisational factors on nurses' behaviour to use lifting devices in healthcare.

    PubMed

    Koppelaar, E; Knibbe, J J; Miedema, H S; Burdorf, A

    2013-07-01

    This study evaluates the influence of individual and organisational factors on nurses' behaviour to use lifting devices in healthcare. Interviews among nurses were conducted to collect individual characteristics and to establish their behaviour regarding lifting devices use. Organisational factors were collected by questionnaires and walk-through-surveys, comprising technical facilities, organisation of care, and management-efforts. Generalised-Estimating-Equations for repeated measurements were used to estimate determinants of nurses' behaviour. Important determinants of nurses' behaviour to use lifting devices were knowledge of workplace procedures (OR = 5.85), strict guidance on required lifting devices use (OR = 2.91), and sufficient lifting devices (OR = 1.92). Management-support and supportive-management-climate were associated with these determinants. Since nurses' behaviour to use lifting devices is influenced by factors at different levels, studies in ergonomics should consider how multi-level factors impact each other. An integral approach, addressing individual and organisational levels, is necessary to facilitate appropriate implementation of ergonomic interventions, like lifting devices. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  5. Institutional Level Student Engagement and Organisational Cultures

    ERIC Educational Resources Information Center

    van der Velden, Gwen

    2012-01-01

    Driven by the growing presence of market forces within higher education worldwide, universities are changing the way they engage with students. This article explores how a university's internal culture relates to engagement with students and their views. It builds on wider research into student engagement and organisational cultures. The…

  6. Relative Ranking of Conditions that Facilitate Innovation Implementation in the USA

    ERIC Educational Resources Information Center

    Ensminger, David C.; Surry, Daniel W,

    2008-01-01

    This study compared how people working in three different types of organisations in the United States (K-12 schools, higher education, and business) rank the importance of eight conditions that have been shown to facilitate the implementation of innovations. The study also sought to determine if the nature of the innovation (i.e., technology or…

  7. Facilitation of an end-of-life care programme into practice within UK nursing care homes: A mixed-methods study.

    PubMed

    Kinley, Julie; Preston, Nancy; Froggatt, Katherine

    2018-06-01

    programme required an external facilitator who could mediate multi-layered learning at an individual, organisational and appreciative system level. The cost savings in the study outweighed the cost of providing a 'being present' approach to facilitation. Different types of facilitation are offered to support the implementation of end-of-life care initiatives. However, in this study 'being present' facilitation, when supported by multi-layered learning, was the only approach that initiated the change required. Copyright © 2018. Published by Elsevier Ltd.

  8. The Power of Professionally Situated Practice Analysis in Redesigning Organisations: A Psychosociological Approach

    ERIC Educational Resources Information Center

    Scaratti, Giuseppe; Gorli, Mara; Ripamonti, Silvio

    2009-01-01

    Purpose: This paper seeks to provoke thoughts around the possibility of using the lever of practices and situated knowledge to trigger organisational change and to redesign it with the involvement of the whole organisation. Design/methodology/approach: The paper presents connections between a psychosociological approach and a practice-based…

  9. A descriptive study of lexical organisation in bilingual children with language impairment: Developmental changes.

    PubMed

    Holmström, Ketty; Salameh, Eva-Kristina; Nettelbladt, Ulrika; Dahlgren Sandberg, Annika

    2016-04-01

    This study aimed to describe the development of Arabic and Swedish lexical organisation in bilingual children with language impairment (BLI). Lexical organisation was assessed through word associations in 10 BLI and 10 bilingual children with typical development (BTD), aged 6;2-8;0 years, matched for age and gender. The participants were assessed twice, with a 1-year interval. Word associations were coded as paradigmatic, syntagmatic, phonological, other and no answer. This study reports analyses of the semantically-related syntagmatic and paradigmatic associations. Using repeated measures ANOVA, main and interaction effects of Group, Time and Language were examined for paradigmatic and syntagmatic associations separately. The interaction between Group and Time was significant for both associations. The BLI group increased syntagmatic associations from time 1 to time 2, while the BTD group increased paradigmatic associations. Results showed a significant main effect of Language for both types of associations, with better performance in Swedish. Significant Group by Language interactions resulted from lower Arabic than Swedish syntagmatic and paradigmatic scores for the BLI and BTD groups, respectively. Differing developmental trajectories indicate that bilingual children with LI develop lexical organisation at a slower pace than bilingual peers with typical language development.

  10. Characteristics of value-based health and social care from organisations' perspectives (OrgValue): a mixed-methods study protocol.

    PubMed

    Ansmann, Lena; Hillen, Hendrik Ansgar; Kuntz, Ludwig; Stock, Stephanie; Vennedey, Vera; Hower, Kira Isabelle

    2018-04-27

    Health and social care systems are under pressure to organise care around patients' needs with constrained resources. Several studies reveal that care is constantly challenged by balancing economic requirements against individual patients' preferences and needs. Therefore, value-based health and social care aims to facilitate patient-centredness while taking the resources spent into consideration. The OrgValue project examines the implementation of patient-centredness while considering the health and social care organisations' resource orientation in the model region of the city of Cologne, Germany. First, the implementation status of patient-centredness as well as its facilitators and barriers-also in terms of resource orientation-will be assessed through face-to-face interviews with decision-makers (at least n=18) from health and social care organisations (HSCOs) in Cologne. Second, patients' understanding of patient-centredness and their preferences and needs will be revealed by conducting face-to-face interviews (at least n=15). Third, the qualitative results will provide the basis for a quantitative survey of decision-makers from all HSCOs in Cologne, which will include questions on patient-centredness, resource orientation and determinants of implementation. Fourth, qualitative interviews with decision-makers from different types of HSCOs will be conducted to develop a uniform measurement instrument on the cost and service structure of HSCOs. For all collected data, the relevant data protection regulations will be adhered to. Consultation and a positive vote from the ethics committee of the Medical Faculty of the University of Cologne have been obtained. All personal identifiers (eg, name, date of birth) will be pseudonymised. Dissemination strategies include a feedback report as well as research and development workshops for the organisations with the aim of initiating organisational learning and organisational development, presenting results in publications

  11. An organisational change intervention for increasing the delivery of smoking cessation support in addiction treatment centres: study protocol for a randomized controlled trial.

    PubMed

    Bonevski, Billie; Guillaumier, Ashleigh; Shakeshaft, Anthony; Farrell, Michael; Tzelepis, Flora; Walsberger, Scott; D'Este, Catherine; Paul, Chris; Dunlop, Adrian; Searles, Andrew; Kelly, Peter; Fry, Rae; Stirling, Robert; Fowlie, Carrie; Skelton, Eliza

    2016-06-14

    The provision of smoking cessation support in Australian drug and alcohol treatment services is sub-optimal. This study examines the cost-effectiveness of an organisational change intervention to reduce smoking amongst clients attending drug and alcohol treatment services. A cluster-randomised controlled trial will be conducted with drug and alcohol treatment centres as the unit of randomisation. Biochemically verified (carbon monoxide by breath analysis) client 7-day-point prevalence of smoking cessation at 6 weeks will be the primary outcome measure. The study will be conducted in 33 drug and alcohol treatment services in four mainland states and territories of Australia: New South Wales, Australian Capital Territory, Queensland, and South Australia. Eligible services are those with ongoing client contact and that include pharmacotherapy services, withdrawal management services, residential rehabilitation, counselling services, and case management services. Eligible clients are those aged over 16 years who are attending their first of a number of expected visits, are self-reported current smokers, proficient in the English language, and do not have severe untreated mental illness as identified by the service staff. Control services will continue to provide usual care to the clients. Intervention group services will receive an organisational change intervention, including assistance in developing smoke-free policies, nomination of champions, staff training and educational client and service resources, and free nicotine replacement therapy in order to integrate smoking cessation support as part of usual client care. If effective, the organisational change intervention has clear potential for implementation as part of the standard care in drug and alcohol treatment centres. Australian and New Zealand Clinical Trials Registry, ACTRN12615000204549 . Registered on 3 March 2015.

  12. Mechanisms of change of a novel weight loss programme provided by a third sector organisation: a qualitative interview study.

    PubMed

    McMahon, Naoimh E; Visram, Shelina; Connell, Louise A

    2016-05-10

    There is a need for theory-driven studies that explore the underlying mechanisms of change of complex weight loss programmes. Such studies will contribute to the existing evidence-base on how these programmes work and thus inform the future development and evaluation of tailored, effective interventions to tackle overweight and obesity. This study explored the mechanisms by which a novel weight loss programme triggered change amongst participants. The programme, delivered by a third sector organisation, addressed both diet and physical activity. Over a 26 week period participants engaged in three weekly sessions (education and exercise in a large group, exercise in a small group and a one-to-one education and exercise session). Novel aspects included the intensity and duration of the programme, a competitive selection process, milestone physical challenges (e.g. working up to a 5 K and 10 K walk/run during the programme), alumni support (face-to-face and online) and family attendance at exercise sessions. Data were collected through interviews with programme providers (n = 2) and focus groups with participants (n = 12). Discussions were audio-recorded, transcribed and analysed using NVivo10. Published behaviour change frameworks and behaviour change technique taxonomies were used to guide the coding process. Clients' interactions with components of the weight loss programme brought about a change in their commitment, knowledge, beliefs about capabilities and social and environmental contexts. Intervention components that generated these changes included the competitive selection process, group and online support, family involvement and overcoming milestone challenges over the 26 week programme. The mechanisms by which these components triggered change differed between participants. There is an urgent need to establish robust interventions that can support people who are overweight and obese to achieve a healthy weight and maintain this change. Third

  13. Improving detection and quality of assessment of child abuse and partner abuse is achievable with a formal organisational change approach.

    PubMed

    Wills, Russell; Ritchie, Miranda; Wilson, Mollie

    2008-03-01

    To improve detection and quality of assessment of child and partner abuse within a health service. A formal organisational change approach was used to implement the New Zealand Family Violence Intervention Guidelines in a mid-sized regional health service. The approach includes obtaining senior management support, community collaboration, developing resources to support practice, research, evaluation and training. Formal pre-post evaluations were conducted of the training. Barriers and enablers of practice change were assessed through 85 interviews with 60 staff. More than 6000 clinical records were audited to assess rates of questioning for partner abuse. Identifications of partner abuse and referrals made were counted through the Family Violence Accessory File. Referrals to the Department of Child, Youth and Family Services (CYFS) were recorded routinely by the CYFS. Audits assessed quality of assessment of child and partner abuse, when identified. More than 700 staff were trained in dual assessment for child and partner abuse. Evaluations demonstrate improved confidence following training, though staff still need support. Barriers and enablers to asking about partner abuse were identified. Referrals from the health service to the CYFS increased from 10 per quarter to 70 per quarter. Identification of partner abuse increased from 30 to 80 per 6-month period. Routine questioning rates for partner abuse vary between services. Achieving and sustaining improved rates of identification and quality of assessment of child and partner abuse is possible with a formal organisational change approach.

  14. Building Organisational Capability the Private Provider Way

    ERIC Educational Resources Information Center

    Guthrie, Hugh

    2008-01-01

    Organisational capability is recognised as a key to organisational success. The combination of human capital (peoples' skills and knowledge), social capital (relationships between people) and organisational capital (the organisation's processes), is central to building an organisation's capability. This paper, presented at the 2008 annual…

  15. Microtubule self-organisation by reaction-diffusion processes causes collective transport and organisation of cellular particles

    PubMed Central

    Glade, Nicolas; Demongeot, Jacques; Tabony, James

    2004-01-01

    Background The transport of intra-cellular particles by microtubules is a major biological function. Under appropriate in vitro conditions, microtubule preparations behave as a 'complex' system and show 'emergent' phenomena. In particular, they form dissipative structures that self-organise over macroscopic distances by a combination of reaction and diffusion. Results Here, we show that self-organisation also gives rise to a collective transport of colloidal particles along a specific direction. Particles, such as polystyrene beads, chromosomes, nuclei, and vesicles are carried at speeds of several microns per minute. The process also results in the macroscopic self-organisation of these particles. After self-organisation is completed, they show the same pattern of organisation as the microtubules. Numerical simulations of a population of growing and shrinking microtubules, incorporating experimentally realistic reaction dynamics, predict self-organisation. They forecast that during self-organisation, macroscopic parallel arrays of oriented microtubules form which cross the reaction space in successive waves. Such travelling waves are capable of transporting colloidal particles. The fact that in the simulations, the aligned arrays move along the same direction and at the same speed as the particles move, suggest that this process forms the underlying mechanism for the observed transport properties. Conclusions This process constitutes a novel physical chemical mechanism by which chemical energy is converted into collective transport of colloidal particles along a given direction. Self-organisation of this type provides a new mechanism by which intra cellular particles such as chromosomes and vesicles can be displaced and simultaneously organised by microtubules. It is plausible that processes of this type occur in vivo. PMID:15176973

  16. Culture in community pharmacy organisations: what can we glean from the literature?

    PubMed

    Jacobs, Sally; Ashcroft, Darren; Hassell, Karen

    2011-01-01

    The aim of this paper is to report on the findings of a systematic literature review-seeking to elicit existing evidence of the nature of organisational culture in community pharmacy organisations. This review takes a novel approach to systematically identifying and synthesising the peer-reviewed research literature pertaining to organisational culture in this setting, its antecedents and outcomes. The review provides an overview of the scope of and research methods used in the identified literature, together with a narrative synthesis of its findings, framed within five dimensions of organisational culture: the professional-business role dichotomy; workload, management style, social support and autonomy; professional culture; attitudes to change and innovation; and entrepreneurial orientation. There is a need for more detailed and holistic exploration of organisational culture in community pharmacy, using a greater diversity of research methods and a greater focus on patient-related outcomes. This paper demonstrates that, whilst little research has explicitly investigated organisational culture in this context, there exists a range of evidence describing aspects of that culture, some of the environmental and organisational factors helping to shape it, and its impact on the pharmacy workforce, services delivered and business outcomes. It highlights the importance of the business-professional role dichotomy in community pharmacy; the influence of individual pharmacists' characteristics and organisational setting; and the impact on pharmacists' wellbeing and job satisfaction and the services delivered. It provides less evidence of the impact of organisational culture on the quality and safety of service provision.

  17. Reframing professional boundaries in healthcare: a systematic review of facilitators and barriers to task reallocation from the domain of medicine to the nursing domain.

    PubMed

    Niezen, Maartje G H; Mathijssen, Jolanda J P

    2014-08-01

    To explore the main facilitators and barriers to task reallocation. One of the innovative approaches to dealing with the anticipated shortage of physicians is to reallocate tasks from the professional domain of medicine to the nursing domain. Various (cost-)effectiveness studies demonstrate that nurse practitioners can deliver as high quality care as physicians and can achieve as good outcomes. However, these studies do not examine what factors may facilitate or hinder such task reallocation. A systematic literature review of PubMed and Web of Knowledge supplemented with a snowball research method. The principles of thematic analysis were followed. The 13 identified relevant papers address a broad spectrum of task reallocation (delegation, substitution and complementary care). Thematic analysis revealed four categories of facilitators and barriers: (1) knowledge and capabilities, (2) professional boundaries, (3) organisational environment, and (4) institutional environment. Introducing nurse practitioners in healthcare requires organisational redesign and the reframing of professional boundaries. Especially the facilitators and barriers in the analytical themes of 'professional boundaries' and 'organisational environment' should be considered when reallocating tasks. If not, these factors might hamper the cost-effectiveness of task reallocation in practice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. International Organisations and the Shared Construction of Policy "Problems": Problematisation and Change in Education Governance in Europe

    ERIC Educational Resources Information Center

    Grek, Sotiria

    2010-01-01

    Over recent years, research has shown the ways that national governments have seemingly ceded some of their autonomy in education policy development to international organisations (IOs) in the context of globalisation and one of its conduits, Europeanisation. This article develops the idea that IOs, and particularly the Organisation for Economic…

  19. Facilitation drives 65 years of vegetation change in the Sonoran Desert

    USGS Publications Warehouse

    Butterfield, Bradley J.; Betancourt, Julio L.; Turner, Raymond M.; Briggs, John M.

    2010-01-01

    Ecological processes of low-productivity ecosystems have long been considered to be driven by abiotic controls with biotic interactions playing an insignificant role. However, existing studies present conflicting evidence concerning the roles of these factors, in part due to the short temporal extent of most data sets and inability to test indirect effects of environmental variables modulated by biotic interactions. Using structural equation modeling to analyze 65 years of perennial vegetation change in the Sonoran Desert, we found that precipitation had a stronger positive effect on recruitment beneath existing canopies than in open microsites due to reduced evaporation rates. Variation in perennial canopy cover had additional facilitative effects on juvenile recruitment, which was indirectly driven by effects of density and precipitation on cover. Mortality was strongly influenced by competition as indicated by negative density-dependence, whereas precipitation had no effect. The combined direct, indirect, and interactive facilitative effects of precipitation and cover on recruitment were substantial, as was the effect of competition on mortality, providing strong evidence for dual control of community dynamics by climate and biotic interactions. Through an empirically derived simulation model, we also found that the positive feedback of density on cover produces unique temporal abundance patterns, buffering changes in abundance from high frequency variation in precipitation, amplifying effects of low frequency variation, and decoupling community abundance from precipitation patterns at high abundance. Such dynamics should be generally applicable to low-productivity systems in which facilitation is important and can only be understood within the context of long-term variation in climatic patterns. This predictive model can be applied to better manage low-productivity ecosystems, in which variation in biogeochemical processes and trophic dynamics may be driven by

  20. The organisational context of nursing care in stroke units: a case study approach.

    PubMed

    Burton, Christopher R; Fisher, Andrea; Green, Theresa L

    2009-01-01

    Internationally the stroke unit is recognised as the evidence-based model for patient management, although clarity about the effective components of stroke units is lacking. Whilst skilled nursing care has been proposed as one component, the theoretical and empirical basis for stroke nursing is limited. We attempted to explore the organisational context of stroke unit nursing, to determine those features that staff perceived to be important in facilitating high quality care. A case study approach was used, that included interviews with nurses and members of the multidisciplinary teams in two Canadian acute stroke units. A total of 20 interviews were completed, transcribed and analysed thematically using the Framework Approach. Trustworthiness was established through the review of themes and their interpretation by members of the stroke units. Nine themes that comprised an organisational context that supported the delivery of high quality nursing care in acute stroke units were identified, and provide a framework for organisational development. The study highlighted the importance of an overarching service model to guide the organisation of care and the development of specialist and advanced nursing roles. Whilst multidisciplinary working appears to be a key component of stroke unit nursing, various organisational challenges to its successful implementation were highlighted. In particular the consequence of differences in the therapeutic approach of nurses and therapy staff needs to be explored in greater depth. Successful teamwork appears to depend on opportunities for the development of relationships between team members as much as the use of formal communication systems and structures. A co-ordinated approach to education and training, clinical leadership, a commitment to research, and opportunities for role and practice development also appear to be key organisational features of stroke unit nursing. Recommendations for the development of stroke nursing

  1. What are the Facilitators and Obstacles to Participation in Workplace Team Sport? A Qualitative Study

    PubMed Central

    Brinkley, Andrew; Freeman, Josie; McDermott, Hilary; Munir, Fehmidah

    2017-01-01

    Working age adults are failing to meet physical activity recommendations. Inactive behaviours are increasing costs for diminished individual and organisational health. The workplace is a priority setting to promote physical activity, however there is a lack of evidence about why some employees choose to participate in novel workplace activities, such as team sport, whilst others do not. The aim of this study was to explore the complexity of facilitators and obstacles associated with participation in workplace team sport. Twenty-nine semi-structured face-to-face and telephone interviews were conducted with office workers (58% female) (36 ± 7.71) from manufacturing, public services, and educational services. Data was analysed through template analysis. Five sub-level (i.e., intrapersonal, interpersonal, organisational, community and societal influences) facilitate participation or create obstacles for participants. Participants were challenged by a lack of competence, self-efficacy, negative sporting ideals and amotivation. Unhealthy competition, an unstable work-life balance and unsupportive colleagues created obstacles to participation. An unsupportive organisation and workplace culture placed demands on workplace champions, funding, facilities and communication. Healthy competitions, high perceptions of competence and self-efficacy, and being motivated autonomously enabled participation. Further, relatedness and social support created a physical activity culture where flexible working was encouraged and team sport was promoted in accessible locations within the organisation. Researchers should consider accounting for complexity of these influences. A participatory approach may tailor interventions to individual organisations and the employees that work within them. Interventions whereby autonomy, competence and relatedness are supported are recommended. This may be achieved by adapting sports and training workplace champions. PMID:29922705

  2. Initial investigation of organisational factors associated with the implementation of active support.

    PubMed

    Fyffe, Chris; McCubbery, Jeffrey; Reid, Katharine J

    2008-09-01

    Active support (AS) has been shown to increase the amount of time that residents in shared residential settings are involved in purposeful activities. The organisational processes required to implement AS have been less well researched. Staff in community houses answered questions about the occurrence of organisational activities and processes thought to assist AS implementation (e.g., training and teamwork), their understanding of engagement, and their experience of changes in staff practice consistent with AS (including implementation problems). Non-house-based managers were also interviewed about their role in AS implementation. Reported occurrence of organisational activities and processes (e.g., training and teamwork) and understanding of engagement were associated with more reports of changes in staff practice and fewer staff reports of implementation problems. Staff reports on the role of non-house-based managers were not associated with reports of changes in staff practice or with reports of fewer AS implementation problems. Non-house-based managers' reports overestimated their role in AS implementation when compared with reports from house-based staff groups. While there are limitations in the research design (including the reliance on staff reports), the findings support the importance of wider organisational factors (beyond training programs for direct support staff) as integral to the implementation of AS. There is a need for further research on AS implementation.

  3. Reciprocal Benefits, Legacy and Risk: Applying Ellinger and Bostrom's Model of Line Manager Role Identity as Facilitators of Learning

    ERIC Educational Resources Information Center

    Campbell, Paul; Evans, Peter

    2016-01-01

    Purpose: The purpose of this paper is to explore the beliefs held by managers about their roles as facilitators of learning with their employees in a public utilities organisation. Design/methodology/approach: The research was based on Ellinger and Bostrom's (2002) study on managers' beliefs on their role as facilitators of learning in…

  4. A case study of the changing nature of a non-government organisation: a focus on disability and development.

    PubMed

    Yoshida, Karen K; Parnes, Penny; Brooks, Dina; Cameron, Deb

    2009-01-01

    The purpose of this article is to describe the changing nature, process and structure of an international non-governmental organisation (NGO) in response to internal and external factors. This article is based on the interview data collected for the study which focussed on the experiences and perception of key informants on trends related to official development assistance, local governments' perspective of the NGO as a development partner and the NGO's perception of corporate and foundation support. Qualitative descriptive data analysis was used. Three main themes were developed with the interview data. Our analysis indicated shifts in the: (1) vision/nature (single to cross disability focus), (2) structure (building internal and external relationships) and (3) process (from ad hoc to systemic evaluations). These broader issues of vision, structure (relationships) and evaluation within and outside of the organisation, needs to be addressed to provide a foundation upon which funding initiatives can be developed. A closer relationship between funders and projects/programmes would do much to enhance the partnership and would ensure that the projects are able to measure and report results in a manner that is conducive to increasing support.

  5. Estimating costs of quality improvement for outpatient healthcare organisations: a practical methodology.

    PubMed

    Brown, Sydney E S; Chin, Marshall H; Huang, Elbert S

    2007-08-01

    Outpatient healthcare organisations worldwide participate in quality improvement (QI) programmes. Despite the importance of understanding the financial impact of such programmes, there are no established standard methods for empirically assessing QI programme costs and their consequences for small outpatient healthcare organisations. The costs and cost consequences were evaluated for a diabetes QI programme implemented throughout the USA in federally qualified community health centres. For five case study centres, survey instruments and methods for data analysis were developed. Two types of cost/revenue were evaluated. Direct costs/revenues, such as personnel time, items purchased and grants received, were evaluated using self-administered surveys. Cost/revenue consequences, which were cost/revenue changes that may have occurred due to changes in patient utilisation or physician behaviour, were evaluated using electronic billing data. Other methods for evaluating cost/revenue consequences if electronic billing data are not available are also discussed. This paper describes a practical taxonomy and method for assessing the costs and revenues of QI programmes for outpatient organisations. Results of such analyses will be useful for healthcare organisations implementing QI programmes and also for policy makers designing incentives for QI participation.

  6. The Context, Process, and Outcome Evaluation Model for Organisational Health Interventions.

    PubMed

    Fridrich, Annemarie; Jenny, Gregor J; Bauer, Georg F

    2015-01-01

    To facilitate evaluation of complex, organisational health interventions (OHIs), this paper aims at developing a context, process, and outcome (CPO) evaluation model. It builds on previous model developments in the field and advances them by clearly defining and relating generic evaluation categories for OHIs. Context is defined as the underlying frame that influences and is influenced by an OHI. It is further differentiated into the omnibus and discrete contexts. Process is differentiated into the implementation process, as the time-limited enactment of the original intervention plan, and the change process of individual and collective dynamics triggered by the implementation process. These processes lead to proximate, intermediate, and distal outcomes, as all results of the change process that are meaningful for various stakeholders. Research questions that might guide the evaluation of an OHI according to the CPO categories and a list of concrete themes/indicators and methods/sources applied within the evaluation of an OHI project at a hospital in Switzerland illustrate the model's applicability in structuring evaluations of complex OHIs. In conclusion, the model supplies a common language and a shared mental model for improving communication between researchers and company members and will improve the comparability and aggregation of evaluation study results.

  7. The Context, Process, and Outcome Evaluation Model for Organisational Health Interventions

    PubMed Central

    Fridrich, Annemarie; Jenny, Gregor J.; Bauer, Georg F.

    2015-01-01

    To facilitate evaluation of complex, organisational health interventions (OHIs), this paper aims at developing a context, process, and outcome (CPO) evaluation model. It builds on previous model developments in the field and advances them by clearly defining and relating generic evaluation categories for OHIs. Context is defined as the underlying frame that influences and is influenced by an OHI. It is further differentiated into the omnibus and discrete contexts. Process is differentiated into the implementation process, as the time-limited enactment of the original intervention plan, and the change process of individual and collective dynamics triggered by the implementation process. These processes lead to proximate, intermediate, and distal outcomes, as all results of the change process that are meaningful for various stakeholders. Research questions that might guide the evaluation of an OHI according to the CPO categories and a list of concrete themes/indicators and methods/sources applied within the evaluation of an OHI project at a hospital in Switzerland illustrate the model's applicability in structuring evaluations of complex OHIs. In conclusion, the model supplies a common language and a shared mental model for improving communication between researchers and company members and will improve the comparability and aggregation of evaluation study results. PMID:26557665

  8. Similarity as an organising principle in short-term memory.

    PubMed

    LeCompte, D C; Watkins, M J

    1993-03-01

    The role of stimulus similarity as an organising principle in short-term memory was explored in a series of seven experiments. Each experiment involved the presentation of a short sequence of items that were drawn from two distinct physical classes and arranged such that item class changed after every second item. Following presentation, one item was re-presented as a probe for the 'target' item that had directly followed it in the sequence. Memory for the sequence was considered organised by class if probability of recall was higher when the probe and target were from the same class than when they were from different classes. Such organisation was found when one class was auditory and the other was visual (spoken vs. written words, and sounds vs. pictures). It was also found when both classes were auditory (words spoken in a male voice vs. words spoken in a female voice) and when both classes were visual (digits shown in one location vs. digits shown in another). It is concluded that short-term memory can be organised on the basis of sensory modality and on the basis of certain features within both the auditory and visual modalities.

  9. Exploring the barriers to and facilitators of implementing research into practice.

    PubMed

    Johnston, Bridget; Coole, Carol; Narayanasamy, Melanie; Feakes, Ruth; Whitworth, Gillian; Tyrell, Tracy; Hardy, Beth

    2016-08-02

    District and community nursing roles have changed rapidly in recent years. Community nurses are increasingly being tasked with carrying out multiple roles, which require them to put research into practice and use evidence-based tools and interventions. The implementation of interventions and tools needs to be developed from empirical research, requiring evidence, to be translated into practice. However, this process may be compromised or enhanced by a number of factors. This exploratory, descriptive qualitative study sought to identify barriers and facilitators to community nurses implementing research into practice. Four focus groups were conducted with registered community nurses and district nurses (n=22). Analysis identified four main themes: keeping up to date with evidence; using a clinical tool; education/training and implementation. Findings suggest that there are barriers at a personal, professional and organisational level. Strategies are suggested to overcome these obstacles.

  10. Understanding the long-term influence of EIA on organisational learning and transformation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jones, Megan, E-mail: 31836179@student.murdoch.edu.au; Morrison-Saunders, Angus, E-mail: a.morrison-saunders@murdoch.edu.au

    This research is an attempt to verify the notion postulated by Robert Bartlett and Lynton Caldwell that the full benefits of environmental impact assessment (EIA) would take decades to be realized. While EIA is intended to directly influence decision-making regarding new development proposals, the process is also expected to lead to organisational learning and transformation over time. Our aim was to examine the influence of EIA on a single Western Australian proponent with sustained experience in the process to understand how EIA is used within the organisation and to seek evidence of transformation of the organisation's purpose and mission. Themore » research reviewed literature in order to identify key influences of EIA on organisations, along with semi-structured staff interviews and document analysis for the case study organisation. Ascertaining causality that involvement in EIA processes influences or effects organisational learning and transformation is a challenge in the face of other societal events. Document analysis and interviewee data indicates that the action-forcing nature of EIA did influence proponent behavior through the creation of internal processes seeking to ensure robust design of new projects that would satisfy environmental protection expectations, without the need to trigger formal EIA. Evidence of EIA values and thinking were apparent within internal documentation, including the evolving mission statement. Our research indicates that participation in the EIA process can positively influence organisational learning and transformation by guiding internal change for decision-making. - Highlights: • The long-term influence of EIA on a proponent organisation is investigated. • EIA promotes internal organisational learning and transformation. • Analysis of mission statements can indicate the influence of EIA on organisations. • Organisations aligned with EIA values can reduce the need to engage in formal EIA.« less

  11. A Wicked Problem? Whistleblowing in Healthcare Organisations Comment on "Cultures of Silence And Cultures of Voice: The Role Of Whistleblowing in Healthcare Organisations".

    PubMed

    Hyde, Paula

    2016-01-08

    Mannion and Davies' article recognises whistleblowing as an important means of identifying quality and safety issues in healthcare organisations. While 'voice' is a useful lens through which to examine whistleblowing, it also obscures a shifting pattern of uncertain 'truths.' By contextualising cultures which support or impede whislteblowing at an organisational level, two issues are overlooked; the power of wider institutional interests to silence those who might raise the alarm and changing ideas about what constitutes adequate care. A broader contextualisation of whistleblowing might illuminate further facets of this multi-dimensional problem. © 2016 by Kerman University of Medical Sciences.

  12. Crisis management teams in health organisations.

    PubMed

    Canyon, Deon V

    2012-01-01

    Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.

  13. Connecting today's climates to future climate analogs to facilitate movement of species under climate change.

    PubMed

    Littlefield, Caitlin E; McRae, Brad H; Michalak, Julia L; Lawler, Joshua J; Carroll, Carlos

    2017-12-01

    Increasing connectivity is an important strategy for facilitating species range shifts and maintaining biodiversity in the face of climate change. To date, however, few researchers have included future climate projections in efforts to prioritize areas for increasing connectivity. We identified key areas likely to facilitate climate-induced species' movement across western North America. Using historical climate data sets and future climate projections, we mapped potential species' movement routes that link current climate conditions to analogous climate conditions in the future (i.e., future climate analogs) with a novel moving-window analysis based on electrical circuit theory. In addition to tracing shifting climates, the approach accounted for landscape permeability and empirically derived species' dispersal capabilities. We compared connectivity maps generated with our climate-change-informed approach with maps of connectivity based solely on the degree of human modification of the landscape. Including future climate projections in connectivity models substantially shifted and constrained priority areas for movement to a smaller proportion of the landscape than when climate projections were not considered. Potential movement, measured as current flow, decreased in all ecoregions when climate projections were included, particularly when dispersal was limited, which made climate analogs inaccessible. Many areas emerged as important for connectivity only when climate change was modeled in 2 time steps rather than in a single time step. Our results illustrate that movement routes needed to track changing climatic conditions may differ from those that connect present-day landscapes. Incorporating future climate projections into connectivity modeling is an important step toward facilitating successful species movement and population persistence in a changing climate. © 2017 Society for Conservation Biology.

  14. Organisational participation and health among smallholder farmers: a longitudinal study in a Latin American context

    PubMed Central

    Orozco, Fadya; Mota, Eduardo; Cole, Donald C

    2014-01-01

    Objective To understand the impact of social organisation affiliation and farmers’ agricultural production practices on farmer health. Organisations facilitate the acquisition and exchange of forms of social capital which can influence the adoption of practices with potential health impacts. In countries such as Ecuador, smallholder agriculture is practised by socially vulnerable populations. Agricultural production often involves the use of extremely hazardous pesticides, while practices that reduce the use of chemicals through integrated pest management (IPM) remain uncommon. Design Longitudinal study (2007–2010). Setting 12 Ecuadorian communities, previously part of a participatory action research study. Participants 208 small-scale farmers. Inclusion criteria were: age between 18 and 65 years, literate and resident in the community for the previous 3 years. Primary outcomes The differential effects of the membership in social organisations (as an effect modifier), on the relationship between the implementation of IPM practices (main independent variable) and farmers’ health, measured by neurocognitive performance scores (better higher value; dependent variable). Results Among organisational participants, the coefficient of association between the implementation of IPM practices for the category good/very good (vs no use) and neurocognitive performance, when farmers were involved in organisations, was negative and moderate (β=−0.17, SE 0.21) though not significant (p>0.1); for the category little/moderate use, the coefficient was positive (β=0.34, SE 0.19) and significant. Among those who did not participate in organisations, both little/moderate use and good/very good use of IPM practices were associated with an increase in neurocognitive performance. Conclusions The effect of agricultural production practices on farmers’ health, transmitted through organisations, can be differentiated. Organisations as structures of social capital seem to be

  15. Business continuity management in international organisations.

    PubMed

    Adamou, Christel

    2014-01-01

    In the area of business continuity management, a preliminary review of the literature reveals extensive knowledge, expertise and experience concerning organisations in the private and public sectors. It is interesting to note, however, that there is little literature about business continuity management in international organisations, although these entities are complex and particularly prone to threats. This apparent absence of literature suggests that business continuity management has not yet hit the agenda of international organisations. In recent years, member states have encouraged senior management to design and implement business continuity strategies to minimise the mishandling of an internal crisis and build organisational resilience, but very few of them have actually been able to design and implement comprehensive business continuity programmes. Based on actual experience working in international organisations, this paper outlines some of the challenges faced by international organisations in developing and implementing business continuity activities and attempts to make suggestions for further improvement.

  16. A meta-ethnography of organisational culture in primary care medical practice.

    PubMed

    Grant, Suzanne; Guthrie, Bruce; Entwistle, Vikki; Williams, Brian

    2014-01-01

    Over the past decade, there has been growing international interest in shaping local organisational cultures in primary healthcare. However, the contextual relevance of extant culture assessment instruments to the primary care context has been questioned. The aim of this paper is to derive a new contextually appropriate understanding of the key dimensions of primary care medical practice organisational culture and their inter-relationship through a synthesis of published qualitative research. A systematic search of six electronic databases followed by a synthesis using techniques of meta-ethnography involving translation and re-interpretation. A total of 16 papers were included in the meta-ethnography from the UK, the USA, Canada, Australia and New Zealand that fell into two related groups: those focused on practice organisational characteristics and narratives of practice individuality; and those focused on sub-practice variation across professional, managerial and administrative lines. It was found that primary care organisational culture was characterised by four key dimensions, i.e. responsiveness, team hierarchy, care philosophy and communication. These dimensions are multi-level and inter-professional in nature, spanning both practice and sub-practice levels. The research contributes to organisational culture theory development. The four new cultural dimensions provide a synthesized conceptual framework for researchers to evaluate and understand primary care cultural and sub-cultural levels. The synthesised cultural dimensions present a framework for practitioners to understand and change organisational culture in primary care teams. The research uses an innovative research methodology to synthesise the existing qualitative research and is one of the first to develop systematically a qualitative conceptual framing of primary care organisational culture.

  17. Capability maturity models for offshore organisational management.

    PubMed

    Strutt, J E; Sharp, J V; Terry, E; Miles, R

    2006-12-01

    The goal setting regime imposed by the UK safety regulator has important implications for an organisation's ability to manage health and safety related risks. Existing approaches to safety assurance based on risk analysis and formal safety assessments are increasingly considered unlikely to create the step change improvement in safety to which the offshore industry aspires and alternative approaches are being considered. One approach, which addresses the important issue of organisational behaviour and which can be applied at a very early stage of design, is the capability maturity model (CMM). The paper describes the development of a design safety capability maturity model, outlining the key processes considered necessary to safety achievement, definition of maturity levels and scoring methods. The paper discusses how CMM is related to regulatory mechanisms and risk based decision making together with the potential of CMM to environmental risk management.

  18. [Creation of a complete organised care network allowing facilitated access to ophthalmological care for patients living in socially "at-risk" situations, feasibility study].

    PubMed

    Terrier de la Chaise, S; Criton, A; Berrod, J-P; Boivin, J-M

    2017-09-01

    Currently, renouncement to healthcare by socially "at-risk" patients continues to increase and access to ophthalmological care is complex. The main objective of this study is to test the feasibility of a complete organised care network allowing facilitated access to ophthalmological care for patients living in socially "at-risk" situations. A prospective interventional study was conducted within four social housing infrastructures to screen for vision problems in the "at-risk" socially population in question. Partnering with the ophthalmological department of the CHRU de Nancy, an interventional and supportive care trial for the affected population was conducted with the assistance of social workers, nursing aides, opticians, and the author. Ten screening sessions were conducted between December 2015 and April 2016 allowing a vision exam of sixty-five patients living in social housing. Twenty-five patients benefited from specialised care within a three-month time frame provided by the ophthalmological department, of which nineteen patients received corrective lenses. The remaining six patients received other types of ophthalmological care. The study allowed to demonstrate that the cooperation of willing actors makes it possible to improve access to visual healthcare for patients living in socially "at-risk" situations, in particular in the frame of ophthalmological care, often taking second place in a general medical consultation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Development and testing of the ‘Culture of Care Barometer’ (CoCB) in healthcare organisations: a mixed methods study

    PubMed Central

    Rafferty, Anne Marie; Philippou, Julia; Fitzpatrick, Joanne M; Pike, Geoff; Ball, Jane

    2017-01-01

    Objective Concerns about care quality have prompted calls to create workplace cultures conducive to high-quality, safe and compassionate care and to provide a supportive environment in which staff can operate effectively. How healthcare organisations assess their culture of care is an important first step in creating such cultures. This article reports on the development and validation of a tool, the Culture of Care Barometer, designed to assess perceptions of a caring culture among healthcare workers preliminary to culture change. Design/setting/participants An exploratory mixed methods study designed to develop and test the validity of a tool to measure ‘culture of care’ through focus groups and questionnaires. Questionnaire development was facilitated through: a literature review, experts generating items of interest and focus group discussions with healthcare staff across specialities, roles and seniority within three types of public healthcare organisations in the UK. The tool was designed to be multiprofessional and pilot tested with a sample of 467 nurses and healthcare support workers in acute care and then validated with a sample of 1698 staff working across acute, mental health and community services in England. Exploratory factor analysis was used to identify dimensions underlying the Barometer. Results Psychometric testing resulted in the development of a 30-item questionnaire linked to four domains with retained items loading to four factors: organisational values (α=0.93, valid n=1568, M=3.7), team support (α=0.93, valid n=1557, M=3.2), relationships with colleagues (α=0.84, valid n=1617, M=4.0) and job constraints (α=0.70, valid n=1616, M=3.3). Conclusions The study developed a valid and reliable instrument with which to gauge the different attributes of care culture perceived by healthcare staff with potential for organisational benchmarking. PMID:28821526

  20. Why Learning Organisations Do Not Transform

    ERIC Educational Resources Information Center

    Blackman, Deborah; Henderson, Steven

    2005-01-01

    Purpose: In this paper it is held that a transformational learning organisation could be clearly distinguished from non-learning organisations. This paper seeks to establish whether or not this is actually the case. Design/methodology/approach: Case studies were developed for two organisations considering themselves to be learning organisations…

  1. Nurse plants, tree saplings and grazing pressure: changes in facilitation along a biotic environmental gradient.

    PubMed

    Smit, Christian; Vandenberghe, Charlotte; den Ouden, Jan; Müller-Schärer, Heinz

    2007-05-01

    Current conceptual models predict that an increase in stress shifts interactions between plants from competitive to facilitative; hence, facilitation is expected to gain in ecological importance with increasing stress. Little is known about how facilitative interactions between plants change with increasing biotic stress, such as that incurred by consumer pressure or herbivory (i.e. disturbance sensu Grime). In grazed ecosystems, the presence of unpalatable plants is reported to protect tree saplings against cattle grazing and enhance tree establishment. In accordance with current conceptual facilitation-stress models, we hypothesised a positive relationship between facilitation and grazing pressure. We tested this hypothesis in a field experiment in which tree saplings of four different species (deciduous Fagus sylvatica, Acer pseudoplatanus and coniferous Abies alba, Picea abies) were planted either inside or outside of the canopy of the spiny nurse shrub Rosa rubiginosa in enclosures differing in grazing pressure (low and high) and in exclosures. During one grazing season we followed the survival of the different tree saplings and the level of browsing on these; we also estimated browsing damage to the nurse shrubs. Shrub damage was highest at the higher grazing pressure. Correspondingly, browsing increased and survival decreased in saplings located inside the canopy of the shrubs at the high grazing pressure compared to the low grazing pressure. Saplings of both deciduous species showed a higher survival than the evergreens, while sapling browsing did not differ between species. The relative facilitation of sapling browsing and sapling survival - i.e. the difference between saplings inside and outside the shrub canopy - decreased at high grazing pressure as the facilitative species became less protective. Interestingly, these findings do not agree with current conceptual facilitation-stress models predicting increasing facilitation with abiotic stress. We used

  2. Inter-organisational response to disasters.

    PubMed

    Paturas, James L; Smith, Stewart R; Albanese, Joseph; Waite, Geraldine

    2016-01-01

    Inter-organisational communication failures during times of real-world disasters impede the collaborative response of agencies responsible for ensuring the public's health and safety. In the best of circumstances, communications across jurisdictional boundaries are ineffective. In times of crisis, when communities are grappling with the impact of a disaster, communications become critically important and more complex. Important factors for improving inter-organisational communications are critical thinking and problem-solving skills; inter-organisational relationships; as well as strategic, tactical and operational communications. Improving communication, critical thinking, problem-solving and decision-making requires a review of leadership skills. This discussion begins with an analysis of the existing disaster management research and moves to an examination of the importance of inter-organisational working relationships. Before a successful resolution of a disaster by multiple levels of first responders, the group of organisations must have a foundation of trust, collegiality, flexibility, expertise, openness, relational networking and effective communications. Leaders must also be prepared to improve leadership skills through continual development in each of these foundational areas.

  3. Organisational Culture and Technology-Enhanced Innovation in Higher Education

    ERIC Educational Resources Information Center

    Zhu, Chang

    2015-01-01

    Higher education institutions are evolving and technology often plays a central role in their transformations. Educational changes benefit from a supportive environment. The study examines the relationship between organisational culture and teachers' perceptions of and responses to technology-enhanced innovation among Chinese universities. A…

  4. Towards an organisation-wide process-oriented organisation of care: A literature review

    PubMed Central

    2011-01-01

    Background Many hospitals have taken actions to make care delivery for specific patient groups more process-oriented, but struggle with the question how to deal with process orientation at hospital level. The aim of this study is to report and discuss the experiences of hospitals with implementing process-oriented organisation designs in order to derive lessons for future transitions and research. Methods A literature review of English language articles on organisation-wide process-oriented redesigns, published between January 1998 and May 2009, was performed. Results Of 329 abstracts identified, 10 articles were included in the study. These articles described process-oriented redesigns of five hospitals. Four hospitals tried to become process-oriented by the implementation of coordination measures, and one by organisational restructuring. The adoption of the coordination mechanism approach was particularly constrained by the functional structure of hospitals. Other factors that hampered the redesigns in general were the limited applicability of and unfamiliarity with process improvement techniques. Conclusions Due to the limitations of the evidence, it is not known which approach, implementation of coordination measures or organisational restructuring (with additional coordination measures), produces the best results in which situation. Therefore, more research is needed. For this research, the use of qualitative methods in addition to quantitative measures is recommended to contribute to a better understanding of preconditions and contingencies for an effective application of approaches to become process-oriented. Hospitals are advised to take the factors for failure described into account and to take suitable actions to counteract these obstacles on their way to become process-oriented organisations. PMID:21247491

  5. Towards an organisation-wide process-oriented organisation of care: a literature review.

    PubMed

    Vos, Leti; Chalmers, Sarah E; Dückers, Michel La; Groenewegen, Peter P; Wagner, Cordula; van Merode, Godefridus G

    2011-01-19

    Many hospitals have taken actions to make care delivery for specific patient groups more process-oriented, but struggle with the question how to deal with process orientation at hospital level. The aim of this study is to report and discuss the experiences of hospitals with implementing process-oriented organisation designs in order to derive lessons for future transitions and research. A literature review of English language articles on organisation-wide process-oriented redesigns, published between January 1998 and May 2009, was performed. Of 329 abstracts identified, 10 articles were included in the study. These articles described process-oriented redesigns of five hospitals. Four hospitals tried to become process-oriented by the implementation of coordination measures, and one by organisational restructuring. The adoption of the coordination mechanism approach was particularly constrained by the functional structure of hospitals. Other factors that hampered the redesigns in general were the limited applicability of and unfamiliarity with process improvement techniques. Due to the limitations of the evidence, it is not known which approach, implementation of coordination measures or organisational restructuring (with additional coordination measures), produces the best results in which situation. Therefore, more research is needed. For this research, the use of qualitative methods in addition to quantitative measures is recommended to contribute to a better understanding of preconditions and contingencies for an effective application of approaches to become process-oriented. Hospitals are advised to take the factors for failure described into account and to take suitable actions to counteract these obstacles on their way to become process-oriented organisations.

  6. Adoption of evidence into practice: can change be sustainable?

    PubMed

    Cockburn, Jill

    2004-03-15

    Few studies have monitored change in professional practice over time to determine the sustainability of change. Research from other behavioural change literature shows that initial change is difficult to maintain, with reported relapse rates as high as 80%. Interventions most likely to succeed are based on a clear understanding of target behaviours and the environmental context. Facilitators and barriers are usually multifaceted and occur at a number of interrelated levels. The issue targeted for intervention must be clearly defined at the outset, so that antecedents, determinants and supporting mechanisms can be defined, suggesting points for intervention and strategies for initial and sustainable change. The target population's readiness to change is an important factor at both an individual and organisational level. In most cases, a combination of different interventions will be needed to achieve lasting change.

  7. Adapting to Adaptations: Behavioural Strategies that are Robust to Mutations and Other Organisational-Transformations

    PubMed Central

    Egbert, Matthew D.; Pérez-Mercader, Juan

    2016-01-01

    Genetic mutations, infection by parasites or symbionts, and other events can transform the way that an organism’s internal state changes in response to a given environment. We use a minimalistic computational model to support an argument that by behaving “interoceptively,” i.e. responding to internal state rather than to the environment, organisms can be robust to these organisational-transformations. We suggest that the robustness of interoceptive behaviour is due, in part, to the asymmetrical relationship between an organism and its environment, where the latter more substantially influences the former than vice versa. This relationship means that interoceptive behaviour can respond to the environment, the internal state and the interaction between the two, while exteroceptive behaviour can only respond to the environment. We discuss the possibilities that (i) interoceptive behaviour may play an important role of facilitating adaptive evolution (especially in the early evolution of primitive life) and (ii) interoceptive mechanisms could prove useful in efforts to create more robust synthetic life-forms. PMID:26743579

  8. The relationships between organisational citizenship behaviour, job satisfaction and turnover intention.

    PubMed

    Tsai, Yafang; Wu, Shih-Wang

    2010-12-01

    This study aims to explore the relationships between organisational citizenship behaviour, job satisfaction and turnover intention. Because of the changing health policies landscape, Taiwan's hospital administrators are facing major cost reduction challenges. Specifically, the high turnover rate of nurses represents a hindrance and a human resource cost. This study focuses on ways of reducing the employee turnover rate through enhanced organisational citizenship behaviour and job satisfaction. A cross-sectional study. This study focuses on hospital nurses in Taiwan. Our research samples were obtained from one medical centre, three regional hospitals and seven district hospitals. Out of 300 questionnaires distributed among samples, 237 were completed and returned. Pearson's correlation was used to test for relationships among the main variables. One-way analysis of variance and Scheffé's post hoc analysis were employed to test the influence of demographic data on the main variables. The results reveal that the nurses' job satisfaction has a significantly positive correlation with organisational citizenship behaviour and a negative correlation with turnover intention. This study has proven that the turnover intention of clinical nurses is related to their organisational citizenship behaviour and job satisfaction. Hospital administrators can reduce the turnover intention by meeting nurses' needs and by promoting their organisational citizenship behaviour. Organisational citizenship behaviour involves behaviour that encourages staff to endeavour to voluntarily improve organisational performance without lobbying for compensation. Employees' job satisfaction includes satisfaction with the working environment or welfare programme in the context of human resource initiatives. Similarly, human resource protocols may serve as the starting point for promoting staff organisational citizenship behaviour. Administrators in clinical healthcare are encouraged to meet their

  9. Healthcare professionals' organisational barriers to health information technologies-a literature review.

    PubMed

    Lluch, Maria

    2011-12-01

    This literature review identifies and categorises, from an organisational management perspective, barriers to the use of HIT or ICT for health. Based on the review, it offers policy interventions. This systematic literature review was carried out during December 2009 and January 2010. Additional on-going reviews of updates through automated system alerts took place up until this paper was submitted. A total of thirty-one sources were searched including nine software platforms/databases, fifteen specialised websites/targeted databases, Google Scholar, ISI Science Citation Index and five journals hand-searched. The study covers seventy-nine articles on organisational barriers to ICT adoption by healthcare professionals. These are categorised under five main headings - (I) Structure of healthcare organisations; (II) Tasks; (III) People policies; (IV) Incentives; and (V) Information and decision processes. A total of ten subcategories are also identified. By adopting an organisational management approach, some recommendations to remove organisational management barriers are made. Despite their apparent promise, health information technologies (HIT) have proved difficult to implement. This systematic review reveals the implementation barriers associated to organisational management and their interrelations. Several important future directions in the field are also suggested: (1) there is a need for further research providing evidence of HIT cost-effectiveness as well as the development of optimal HIT applications; (2) more information is needed regarding organisational change, incentives, liability issues, end-users HIT competences and skills, structure and work process issues involved in realising the benefits from HIT. Future policy interventions should consider the five dimensions identified when addressing the impact of HIT in healthcare organisational systems, and how the impact of an intervention aimed at a particular dimension would interrelate with others. 2011

  10. Perceptions of job satisfaction relating to affective organisation commitment.

    PubMed

    Papinczak, Tracey

    2012-10-01

    Affective organisation commitment, which refers to a psychological attachment to, and involvement with, an employing institution, is regarded as important because of its effects on employee identification with the employer and its causal effects on work effort and staff retention. This paper explores the experiences of casual tutors facilitating problem-based learning (PBL) tutorials and aims to identify aspects of their role that strengthen and detract from employee job satisfaction and affective commitment. Qualitative data were gathered from first- and second-year tutors (N = 13) through 2 focus groups. Both clinicians and non-clinicians were recruited, including highly experienced staff and those with < 12 months of tutoring experience. Four main themes arose from inductive analysis of data: job-related factors; job-involvement characteristics; professional challenges and responsibilities, and mentoring for learning and support. The first 2 themes are congruent with previous literature on organisation commitment; novel findings include the supportive and compensatory nature of the collegial relationships formed between casual tutors. Role attenuation, a job-related factor, was a predominant perception as it related to dysfunctional groups and increasing student disengagement with PBL. Within the unique learning environment of PBL, positive factors relating to job satisfaction may have an important role to play in improving tutors' commitment to their employing organisation. Aspects of the role which are viewed most negatively and relate most significantly to affective commitment need to be addressed promptly. Attention should be directed to supporting tutors to maximise the perceived benefits and providing professional development and improved communication to better address issues associated with difficult or disengaged students as well as isolation from decision-makers. © Blackwell Publishing Ltd 2012.

  11. Transforming Universities: National Conditions of Their Varied Organisational Actorhood

    ERIC Educational Resources Information Center

    Whitley, Richard

    2012-01-01

    Despite major changes in the governance of universities overtly intended to transform them into authoritatively integrated collectivities, the extent of their organisational actorhood remains quite limited and varied between OECD countries. This is because of inherent limitations to the managerial direction and control of research and teaching…

  12. Organisational Effectiveness in Military Organisations

    DTIC Science & Technology

    1988-11-01

    socialisatlon, an eq*msis on " belongingness " goals and a desire to maintain social solidarity in an increasingly individualistic social envirment. Cohm...statistical quality control and where employees often meet in their am time and usually receive a financial bcnus for the performance of the organisation. In...companies with more than 500 employees had QC programmes. ihle QCs have no decision making powrs, managers in many cases felt pressured to accept all

  13. Eliciting behavior change in a US sexual violence and intimate partner violence prevention program through utilization of Freire and discussion facilitation.

    PubMed

    Nelson, Atiba; Lewy, Robin; Ricardo, Francine; Dovydaitis, Tiffany; Hunter, Amber; Mitchell, Ashley; Loe, Claire; Kugel, Candace

    2010-09-01

    Designed by Migrant Clinicians Network, the Hombres Unidos Contra La Violencia Familiar (Men United Against Family Violence) Project used facilitated discussion groups as the method to encourage self-reflection and behavior change. Male participants were not taught to rectify any past sexual or intimate partner violence (SV/IPV) 'tendencies', rather the discussion facilitation allowed them to reflect on the SV/IPV that was present in their lives and in the Hispanic community. Subsequently, the sessions and self-reflection, coupled with the discussions with other participating males, empowered several participants to have further interactions about SV/IPV with individuals in their community. The discussions led participants to realize that SV/IPV existed in their community, but that there were males within their community that wanted to change. The Hombres Unidos Contra La Violencia Familiar project demonstrated that behavior change does not need to be actively persuaded, but that self-reflection, which elicits behavior change, can be achieved through facilitated discussion and by permitting the facilitators to become participants. By creating sessions that allow participants to construct their own understanding of the perceived problem while reflecting on their past behavior, true behavior change that is initiated by the participant can be achieved. Through discussion facilitation, a targeted and structured behavior change intervention can assist participants in realizing that their past actions were damaging to themselves and their community, while aiding the participant in employing self-initiated responses, learned within the discussions, to alter their behaviors.

  14. Eliciting behavior change in a US sexual violence and intimate partner violence prevention program through utilization of Freire and discussion facilitation

    PubMed Central

    Nelson, Atiba; Lewy, Robin; Ricardo, Francine; Dovydaitis, Tiffany; Hunter, Amber; Mitchell, Ashley; Loe, Claire; Kugel, Candace

    2010-01-01

    Designed by Migrant Clinicians Network, the Hombres Unidos Contra La Violencia Familiar (Men United Against Family Violence) Project used facilitated discussion groups as the method to encourage self-reflection and behavior change. Male participants were not taught to rectify any past sexual or intimate partner violence (SV/IPV) ‘tendencies’, rather the discussion facilitation allowed them to reflect on the SV/IPV that was present in their lives and in the Hispanic community. Subsequently, the sessions and self-reflection, coupled with the discussions with other participating males, empowered several participants to have further interactions about SV/IPV with individuals in their community. The discussions led participants to realize that SV/IPV existed in their community, but that there were males within their community that wanted to change. The Hombres Unidos Contra La Violencia Familiar project demonstrated that behavior change does not need to be actively persuaded, but that self-reflection, which elicits behavior change, can be achieved through facilitated discussion and by permitting the facilitators to become participants. By creating sessions that allow participants to construct their own understanding of the perceived problem while reflecting on their past behavior, true behavior change that is initiated by the participant can be achieved. Through discussion facilitation, a targeted and structured behavior change intervention can assist participants in realizing that their past actions were damaging to themselves and their community, while aiding the participant in employing self-initiated responses, learned within the discussions, to alter their behaviors. PMID:20427371

  15. Strategies to overcome obstacles in the facilitation of critical thinking in nursing education.

    PubMed

    Mangena, Agnes; Chabeli, Mary M

    2005-05-01

    This paper seeks to describe strategies that can be used to overcome obstacles in the facilitation of critical thinking in nursing education. A qualitative, explorative, descriptive and contextual design was used to conduct the research in which fourth year basic comprehensive students and nurse educators volunteered to take part in the study by signing an informed consent. The participants were purposively selected. Focus group interviews were used to collect data from both groups. Tesch's descriptive method of open coding described in (Creswell, J. 1994. Qualitative and quantitative approach. Sage, London.) was used to analyse data. (Democratic Nursing Organisation of South Africa, 1998. Ethical standards for nurse researchers. Denosa, Pretoria) ethical standards for research were observed to maintain the standard and quality of the research. (Lincoln, Y.S., Guba, E.G. 1985. Naturalistic inquiry. Sage, London.) framework was used to ensure trustworthiness of the study. The following obstacles were identified and recontextualised within the existing literature to be able to describe the strategies to overcome the identified obstacles to the facilitation of critical thinking of students: the educators' lack of knowledge; use of teaching and assessment methods that do not facilitate critical thinking of learners; the negative attitudes of educators and their resistance to change; inappropriate selection process and poor educational background that did not facilitate critical thinking of students; inadequate socialisation, cultural and instructional language incompetence. Findings indicated that there is a need for nurse educators to model critical thinking in all aspects of nursing education. It is recommended that there be a whole paradigm shift in nursing education from the traditional teacher-centred methods to a more learner-centred approach that will facilitate critical thinking of student nurses.

  16. Medical undergraduates’ use of behaviour change talk: the example of facilitating weight management

    PubMed Central

    2013-01-01

    Background Obesity, an increasing problem worldwide, is a leading cause of morbidity and mortality. Management principally requires lifestyle (i.e. behavioural) changes. An evidence-base exists of behaviour change techniques for weight loss; however, in routine practice doctors are often unsure about effective treatments and commonly use theoretically-unfounded communication strategies (e.g. information-giving). It is not known if communication skills teaching during undergraduate training adequately prepares future doctors to engage in effective behaviour change talk with patients. The aim of the study was to examine which behaviour change techniques medical undergraduates use to facilitate lifestyle adjustments in obese patients. Methods Forty-eight medical trainees in their clinical years of a UK medical school conducted two simulated consultations each. Both consultations involved an obese patient scenario where weight loss was indicated. Use of simulated patients (SPs) ensured standardisation of key variables (e.g. barriers to behaviour change). Presentation of scenario order was counterbalanced. Following each consultation, students assessed the techniques they perceived themselves to have used. SPs rated the extent to which they intended to make behavioural changes and why. Anonymised transcripts of the audiotaped consultations were coded by independent assessors, blind to student and SP ratings, using a validated behaviour change taxonomy. Results Students reported using a wide range of evidence-based techniques. In contrast, codings of observed communication behaviours were limited. SPs behavioural intention varied and a range of helpful elements of student’s communication were revealed. Conclusions Current skills-based communication programmes do not adequately prepare future doctors for the growing task of facilitating weight management. Students are able to generalise some communication skills to these encounters, but are over confident and have

  17. Improving Your Organisation's Workplace Learning. Consortium Research Program

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2008

    2008-01-01

    Many organisations, including VET providers, are looking to find ways to achieve competitive advantage through the people they employ. Creating this advantage has a number of facets and most of these depend on training and developing people, and their ability to learn. The VET sector also faces significant changes in the ways it does business.…

  18. The effect of perceived organisational support on burnout among community health nurses in China: the mediating role of professional self-concept.

    PubMed

    Cao, Xiaoyi; Chen, Lin; Tian, Lang; Diao, Yongshu

    2016-01-01

    To examine the mediating effect of professional self-concept on the association between perceived organisational support and burnout among community health nurses in Chengdu, China. Burnout is a common phenomenon among nurses and previous studies have focused on work environmental factors contributing to burnout. Limited studies have examined the effects of perceived organisational support and professional self-concept on burnout among community health nurses. This was a cross-sectional study with 551 community health nurses in Chengdu, China, which included a two-stage sampling method. Structural equation modelling was used to examine the relationships among perceived organisational support, professional self-concept and burnout. The final sample included 456 nurses (82.7%). Perceived organisational support was a significant positive direct predictor for professional self-concept and a significant negative direct predictor for burnout. Professional self-concept was a significant negative direct contributor to burnout. Professional self-concept had a mediating effect on the relationship between perceived organisational support and burnout. Perceived organisational support may result in reduced burnout by facilitating the development of positive professional self-concept. Strategies such as establishing a supportive work environment and professional competence training may be effective methods for burnout prevention and management among community health nurses. © 2015 John Wiley & Sons Ltd.

  19. The Essential Elements of Facilitation.

    ERIC Educational Resources Information Center

    Priest, Simon; Gass, Michael; Gillis, Lee

    Most organizations find it difficult to implement change, and only about 10 percent of learning from training and development experiences is actually applied in the workplace. This book advocates facilitation as a means of enhancing change and increasing productivity. Facilitation engages employees by enhancing the processes associated with their…

  20. Leadership style and organisational commitment among nursing staff in Saudi Arabia.

    PubMed

    Al-Yami, Mansour; Galdas, Paul; Watson, Roger

    2018-03-23

    To examine how nurse managers' leadership styles, and nurses' organisational commitment in Saudi Arabia relate. Effective leadership is influential in staff retention; however, recruiting and maintaining nurses is an increasing problem in Saudi Arabia. Using a survey design, the Multifactor Leadership Questionnaire and the Organisational Commitment Questionnaire were distributed to a sample of 219 nurses and nurse managers from two hospitals in Saudi Arabia. Transformational leadership was the most dominant leadership style. After controlling for the influence of manager/staff status, nationality and hospitals, transformational leadership was the strongest contributor to organisational commitment. Perceptions of both transformational and transactional leadership styles, increased with age for nurse managers and nursing staff. Introducing the Full Range of Leadership model to the Saudi nursing workforce could help to prepare Saudi nurses for positions as nurse managers and leaders. The study provides insight into the type of leadership that is best suited to the dynamic and changing health care system in Saudi Arabia. It is possible that transformational leaders could influence and induce positive changes in nursing. © 2018 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

  1. Facilitating the implementation of clinical technology in healthcare: what role does a national agency play?

    PubMed

    Harvey, Gill; Llewellyn, Sue; Maniatopoulos, Greg; Boyd, Alan; Procter, Rob

    2018-05-10

    Accelerating the implementation of new technology in healthcare is typically complex and multi-faceted. One strategy is to charge a national agency with the responsibility for facilitating implementation. This study examines the role of such an agency in the English National Health Service. In particular, it compares two different facilitation strategies employed by the agency to support the implementation of insulin pump therapy. The research involved an empirical case study of four healthcare organisations receiving different levels of facilitation from the national agency: two received active hands-on facilitation; one was the intended recipient of a more passive, web-based facilitation strategy; the other implemented the technology without any external facilitation. The primary method of data collection was semi-structured qualitative interviews with key individuals involved in implementation. The integrated-PARIHS framework was applied as a conceptual lens to analyse the data. The two sites that received active facilitation from an Implementation Manager in the national agency made positive progress in implementing the technology. In both sites there was a high level of initial receptiveness to implementation. This was similar to a site that had successfully introduced insulin pump therapy without facilitation support from the national agency. By contrast, a site that did not have direct contact with the national agency made little progress with implementation, despite the availability of a web-based implementation resource. Clinicians expressed differences of opinion around the value and effectiveness of the technology and contextual barriers related to funding for implementation persisted. The national agency's intended roll out strategy using passive web-based facilitation appeared to have little impact. When favourable conditions exist, in terms of agreement around the value of the technology, clinician receptiveness and motivation to change, active

  2. Introduction of the transtheoretical model and organisational development theory in weight management: A narrative review.

    PubMed

    Wu, Ya-Ke; Chu, Nain-Feng

    2015-01-01

    Overweight and obesity are serious public health and medical problems among children and adults worldwide. Behavioural change has been demonstrably contributory to weight management programs. Behavioural change-based weight loss programs require a theoretical framework. We will review the transtheoretical model and the organisational development theory in weight management. The transtheoretical model is a behaviour theory of individual level frequently used for weight management programs. The organisational development theory is a more complicated behaviour theory that applies to behavioural change on the system level. Both of these two theories have their respective strengths and weaknesses. In this manuscript, we try to introduce the transtheoretical model and the organisational development theory in the context of weight loss programs among population that are overweight or obese. Ultimately, we wish to present a new framework/strategy of weight management by integrating these two theories together. Copyright © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  3. Mediating the Use of Global University Rankings: Perspectives from Education Facilitators in an International Context

    ERIC Educational Resources Information Center

    O'Connell, Catherine; Saunders, Murray

    2013-01-01

    This study explores responses to rankings from a group of staff working as education partnership facilitators for a professional intermediary organisation, the British Council. The study adopts an activity systems perspective from which to view the contexts in which rankings are encountered and the range of practices used to reduce tensions…

  4. Facilitating transitions. Nursing support for parents during the transfer of preterm infants between neonatal nurseries.

    PubMed

    Rowe, Jennifer; Jones, Liz

    2008-03-01

    Transfers between neonatal units are significant transitional experiences for parents of preterm infants. The study aimed to investigate practices that nurses identify as supportive to parents during preterm infants' transfers. It explored the influence of organisational context on practice and what strategies nurses perceive would help them to provide supportive care. Parents' experiences of neonatal nurseries, their stressors and needs have been well documented. The powerful position of nurses in influencing parenting experience is also recognised. However, nurses' understanding of the transfer process, their roles in supporting parents through this and the organisational context influencing practice have not been explored. A focus group design was used composed of registered nurses from two neonatal units who met for a series of group interviews. Eleven registered nurses participated. They explored and critiqued their current practices and then established aims and strategies for practice development. A qualitative content analysis was conducted. Participants identified validation, empowerment and communication as critical to effective practice. They identified a range of organisational dynamics, from logistical issues to nursing authority and scope of practice, as these influenced practice. They presented strategies for practice development, including staff education and the development of nurse practitioner roles. This study explores nurses' understanding and insights into transitions for parents of preterm infants. It shows a congruence between nurses' perceptions of parents' experiences and needs and those reported by parents in previous studies. It articulates the way nurses practice in response to these perceptions, and the manner in which organisational dynamics influence their ability to facilitate transitions. The need to invest in transitions and invest in nurses to facilitate transitions is proposed, ultimately by increasing their clinical authority

  5. Consequences of a warming climate for social organisation in sweat bees.

    PubMed

    Schürch, Roger; Accleton, Christopher; Field, Jeremy

    The progression from solitary living to caste-based sociality is commonly regarded as a major evolutionary transition. However, it has recently been shown that in some taxa, sociality may be plastic and dependent on local conditions. If sociality can be environmentally driven, the question arises as to how projected climate change will influence features of social organisation that were previously thought to be of macroevolutionary proportions. Depending on the time available in spring during which a foundress can produce worker offspring, the sweat bee Halictus rubicundus is either social or solitary. We analysed detailed foraging data in relation to climate change predictions for Great Britain to assess when and where switches from a solitary to social lifestyle may be expected. We demonstrate that worker numbers should increase throughout Great Britain under predicted climate change scenarios, and importantly, that sociality should appear in northern areas where it has never before been observed. This dramatic shift in social organisation due to climate change should lead to a bigger workforce being available for summer pollination and may contribute towards mitigating the current pollinator crisis. The sweat bee Halictus rubicundus is socially polymorphic, expressing both solitary and social forms, and is socially plastic, capable of transitioning from solitary to social forms, depending on local environmental conditions. Here, we analyse detailed foraging data in relation to climate change predictions for Great Britain to show that worker numbers and sociality both increase under predicted climate change scenarios. Especially dramatic will be the appearance of social H. rubicundus nests in the north of Britain, where previously only solitary forms are found. Particularly, if more taxa are found to be socially plastic, environmentally driven shifts in social organisation may help to mitigate future pollinator crises by providing more individuals for pollination.

  6. Improving Teaching Quality and the Learning Organisation

    ERIC Educational Resources Information Center

    Collie, Sarah L.; Taylor, Alton L.

    2004-01-01

    This study applied a learning organisation framework to understand academic departments' efforts to improve teaching quality. The theoretical framework was generated from literature on learning organisations, organisations devoted to continuous improvement through continuous learning. Research questions addressed relationships among departments'…

  7. Exploring strategies to overcome extra-organisational challenges faced by community pharmacies in Sarawak, Malaysia.

    PubMed

    Kho, Boon Phiaw; Hassali, Mohamed Azmi; Lim, Ching Jou; Saleem, Fahad

    2018-03-15

    The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges. Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations. Items were constructed based on the findings of a prior qualitative research supplemented with relevant literature about these issues. High levels of homogeneity in responses were recorded on various extra-organisational challenges faced, particularly those economy-oriented. Strategic changes to counter these challenges were focused on pricing and product stocked, rather than services provision. Highly rated strategies included increasing discounts for customers (n = 54; 68%) and finding cheaper suppliers (n = 70; 88%). Legislative changes proposed that might increase their share of the pharmaceutical market were strongly supported by respondents, particularly about making it compulsory for general practitioners to provide patients the option to have their medicines dispensed in community pharmacies (n = 72; 90%). Current legislative conditions and Malaysian consumer mindset may have constrained the strategic choices of community pharmacies to deal with the strong extra-organisational challenges. A long-term multipronged approach to address these issues and increased involvement of community pharmacists themselves in this agenda are required to influence practice change. © 2018 Royal Pharmaceutical Society.

  8. Organisational justice and mental health: a systematic review of prospective studies.

    PubMed

    Ndjaboué, Ruth; Brisson, Chantal; Vézina, Michel

    2012-10-01

    The models most commonly used, to study the effects of psychosocial work factors on workers' health, are the demand-control-support (DCS) model and Effort-Reward Imbalance (ERI) model. An emerging body of research has identified Organisational Justice as another model that can help to explain deleterious health effects. This review aimed: (1) to identify prospective studies of the associations between organisational justice and mental health in industrialised countries from 1990 to 2010; (2) to evaluate the extent to which organisational justice has an effect on mental health independently of the DCS and ERI models; and (3) to discuss theoretical and empirical overlap and differences with previous models. The studies had to present associations between organisational justice and a mental health outcome, be prospective, and be entirely available in English or in French. Duplicated papers were excluded. Eleven prospective studies were selected for this review. They provide evidence that procedural justice and relational justice are associated with mental health. These associations remained significant even after controlling for the DCS and ERI models. There is a lack of prospective studies on distributive and informational justice. In conclusion, procedural and relational justice can be considered a different and complementary model to the DCS and ERI models. Future studies should evaluate the effect of change in exposure to organisational justice on employees' mental health over time.

  9. Building a strategic security organisation.

    PubMed

    Howard, Mike

    2016-01-01

    In everyone's day-to-day jobs there is constant need to deal with current and newly detected matters. This is now a world of immediacy, driven by the cadence of the business and its needs. These concerns should not be ignored, as failing to deal with these issues would not bode well for the future. It is essential that the gears are kept spinning. The challenge for any security organisation is to identify its short-term tactical requirements, while developing longer-term strategic needs. Once done, the differences can be accounted for and strides can be made toward a desired future state. This paper highlights several steps that the author and his team have taken in their own journey. There is no magic answer, each organisation will have its own unique challenges. Nevertheless, some of the approaches to building a strategic security organisation described in this paper are applicable to all organisations, irrespective of their size.

  10. 'Ethos' Enabling Organisational Knowledge Creation

    NASA Astrophysics Data System (ADS)

    Matsudaira, Yoshito

    This paper examines knowledge creation in relation to improvements on the production line in the manufacturing department of Nissan Motor Company and aims to clarify embodied knowledge observed in the actions of organisational members who enable knowledge creation will be clarified. For that purpose, this study adopts an approach that adds a first, second, and third-person's viewpoint to the theory of knowledge creation. Embodied knowledge, observed in the actions of organisational members who enable knowledge creation, is the continued practice of 'ethos' (in Greek) founded in Nissan Production Way as an ethical basis. Ethos is knowledge (intangible) assets for knowledge creating companies. Substantiated analysis classifies ethos into three categories: the individual, team and organisation. This indicates the precise actions of the organisational members in each category during the knowledge creation process. This research will be successful in its role of showing the indispensability of ethos - the new concept of knowledge assets, which enables knowledge creation -for future knowledge-based management in the knowledge society.

  11. Facilitators and barriers to initiating change in medical intensive care unit survivors with alcohol use disorders: a qualitative study.

    PubMed

    Clark, Brendan J; Jones, Jacqueline; Cook, Paul; Tian, Karen; Moss, Marc

    2013-10-01

    Alcohol abuse and dependence are collectively referred to as alcohol use disorders (AUD). An AUD is present in up to one third of patients admitted to an intensive care unit (ICU). We sought to understand the barriers and facilitators to change in ICU survivors with an AUD to provide a foundation upon which to tailor alcohol-related interventions. We used a qualitative approach with a broad constructivist framework, conducting semistructured interviews in medical ICU survivors with an AUD. Patients were included if they were admitted to 1 of 2 medical ICUs and were excluded if they refused participation, were unable to participate, or did not speak English. Digitally recorded and professionally transcribed interviews were analyzed using a general inductive approach and grouped into themes. Nineteen patients were included, with an average age of 51 (interquartile range, 36-51) years and an average Acute Physiology and Chronic Health Evaluation II score of 9 (interquartile range, 5-13); 68% were white, 74% were male, and the most common reason for admission was alcohol withdrawal (n=8). We identified 5 facilitators of change: empathy of the inpatient health care environment, recognition of accumulating problems, religion, pressure from others to stop drinking, and trigger events. We identified 3 barriers to change: missed opportunities, psychiatric comorbidity, and cognitive dysfunction. Social networks were identified as either a barrier or facilitator to change depending on the specific context. Alcohol-related interventions to motivate and sustain behavior change could be tailored to ICU survivors by accounting for unique barriers and facilitators. © 2013.

  12. Effectiveness of organisational infrastructures to promote evidence-based nursing practice

    PubMed Central

    Flodgren, Gerd; Rojas-Reyes, Maria Ximena; Cole, Nick; Foxcroft, David R

    2014-01-01

    Background Nurses and midwives form the bulk of the clinical health workforce and play a central role in all health service delivery. There is potential to improve health care quality if nurses routinely use the best available evidence in their clinical practice. Since many of the factors perceived by nurses as barriers to the implementation of evidence-based practice (EBP) lie at the organisational level, it is of interest to devise and assess the effectiveness of organisational infrastructures designed to promote EBP among nurses. Objectives To assess the effectiveness of organisational infrastructures in promoting evidence-based nursing. Search methods We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, LILACS, BIREME, IBECS, NHS Economic Evaluations Database, Social Science Citation Index, Science Citation Index and Conference Proceedings Citation Indexes up to 9 March 2011. We developed a new search strategy for this update as the strategy published in 2003 omitted key terms. Additional search methods included: screening reference lists of relevant studies, contacting authors of relevant papers regarding any further published or unpublished work, and searching websites of selected research groups and organisations. Selection criteria We considered randomised controlled trials, controlled clinical trials, interrupted times series (ITSs) and controlled before and after studies of an entire or identified component of an organisational infrastructure intervention aimed at promoting EBP in nursing. The participants were all healthcare organisations comprising nurses, midwives and health visitors. Data collection and analysis Two authors independently extracted data and assessed risk of bias. For the ITS analysis, we reported the change in the slopes of the regression lines, and the change in the level effect of the outcome at 3

  13. Effectiveness of organisational infrastructures to promote evidence-based nursing practice.

    PubMed

    Flodgren, Gerd; Rojas-Reyes, Maria Ximena; Cole, Nick; Foxcroft, David R

    2012-02-15

    Nurses and midwives form the bulk of the clinical health workforce and play a central role in all health service delivery. There is potential to improve health care quality if nurses routinely use the best available evidence in their clinical practice. Since many of the factors perceived by nurses as barriers to the implementation of evidence-based practice (EBP) lie at the organisational level, it is of interest to devise and assess the effectiveness of organisational infrastructures designed to promote EBP among nurses. To assess the effectiveness of organisational infrastructures in promoting evidence-based nursing. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, LILACS, BIREME, IBECS, NHS Economic Evaluations Database, Social Science Citation Index, Science Citation Index and Conference Proceedings Citation Indexes up to 9 March 2011.We developed a new search strategy for this update as the strategy published in 2003 omitted key terms. Additional search methods included: screening reference lists of relevant studies, contacting authors of relevant papers regarding any further published or unpublished work, and searching websites of selected research groups and organisations.  We considered randomised controlled trials, controlled clinical trials, interrupted times series (ITSs) and controlled before and after studies of an entire or identified component of an organisational infrastructure intervention aimed at promoting EBP in nursing. The participants were all healthcare organisations comprising nurses, midwives and health visitors. Two authors independently extracted data and assessed risk of bias. For the ITS analysis, we reported the change in the slopes of the regression lines, and the change in the level effect of the outcome at 3, 6, 12 and 24 months follow-up. We included one study from the USA (re-analysed as

  14. Developing Organisational Knowledge Management Initiatives: A Collaborative Research Approach

    NASA Astrophysics Data System (ADS)

    Linger, Henry

    The articulation of the knowledge management (KM) concept has occurred in the context of a radical shift away from goods and services to an information- based economy (Porter and Millar, 1985; Drucker, 1993 Boisot 1995; Boisot 1998) The organisational response to this shift has been a move towards global enterprises with very flat structures that, in principle, enable enterprises to react rapidly to changes in their operating environments (Drucker, 1988; Scott Morton, 1991; Galliers and Baets, 1998). Organisations that operate in the information economy require an ability to generate, access and utilise the volumes of information that are now readily available without the constraint of media, geography or time (Boisot, 1995). A critical factor is the speed at which they are able to productively process such information.

  15. Moving forward on facilitation research: response to changing environments and effects on the diversity, functioning and evolution of plant communities

    PubMed Central

    Soliveres, Santiago; Smit, Christian; Maestre, Fernando T.

    2015-01-01

    Once seen as anomalous, facilitative interactions among plants and their importance for community structure and functioning are now widely recognized. The growing body of modelling, descriptive and experimental studies on facilitation covers a wide variety of terrestrial and aquatic systems throughout the globe. However, the lack of a general body of theory linking facilitation among different types of organisms and biomes and their responses to environmental changes prevents further advances in our knowledge regarding the evolutionary and ecological implications of facilitation in plant communities. Moreover, insights gathered from alternative lines of inquiry may substantially improve our understanding of facilitation, but these have been largely neglected thus far. Despite over 15 years of research and debate on this topic, there is no consensus on the degree to which plant–plant interactions change predictably along environmental gradients (i.e. the stress-gradient hypothesis), and this hinders our ability to predict how plant–plant interactions may affect the response of plant communities to ongoing global environmental change. The existing controversies regarding the response of plant–plant interactions across environmental gradients can be reconciled when clearly considering and determining the species-specificity of the response, the functional or individual stress type, and the scale of interest (pairwise interactions or community-level response). Here, we introduce a theoretical framework to do this, supported by multiple lines of empirical evidence. We also discuss current gaps in our knowledge regarding how plant–plant interactions change along environmental gradients. These include the existence of thresholds in the amount of species-specific stress that a benefactor can alleviate, the linearity or non-linearity of the response of pairwise interactions across distance from the ecological optimum of the beneficiary, and the need to explore

  16. Moving forward on facilitation research: response to changing environments and effects on the diversity, functioning and evolution of plant communities.

    PubMed

    Soliveres, Santiago; Smit, Christian; Maestre, Fernando T

    2015-02-01

    Once seen as anomalous, facilitative interactions among plants and their importance for community structure and functioning are now widely recognized. The growing body of modelling, descriptive and experimental studies on facilitation covers a wide variety of terrestrial and aquatic systems throughout the globe. However, the lack of a general body of theory linking facilitation among different types of organisms and biomes and their responses to environmental changes prevents further advances in our knowledge regarding the evolutionary and ecological implications of facilitation in plant communities. Moreover, insights gathered from alternative lines of inquiry may substantially improve our understanding of facilitation, but these have been largely neglected thus far. Despite over 15 years of research and debate on this topic, there is no consensus on the degree to which plant-plant interactions change predictably along environmental gradients (i.e. the stress-gradient hypothesis), and this hinders our ability to predict how plant-plant interactions may affect the response of plant communities to ongoing global environmental change. The existing controversies regarding the response of plant-plant interactions across environmental gradients can be reconciled when clearly considering and determining the species-specificity of the response, the functional or individual stress type, and the scale of interest (pairwise interactions or community-level response). Here, we introduce a theoretical framework to do this, supported by multiple lines of empirical evidence. We also discuss current gaps in our knowledge regarding how plant-plant interactions change along environmental gradients. These include the existence of thresholds in the amount of species-specific stress that a benefactor can alleviate, the linearity or non-linearity of the response of pairwise interactions across distance from the ecological optimum of the beneficiary, and the need to explore further how

  17. E-Learning in Small Organisations

    ERIC Educational Resources Information Center

    Sambrook, Sally

    2003-01-01

    This paper focuses on the existing and potential role of electronic learning in small and medium-sized organisations (SMEs). Innovations in information and communication technologies (ICTs) could create new forms of learning, particularly appealing to small organisations, to overcome traditional barriers such as lack of financial resources, time,…

  18. Development and testing of the 'Culture of Care Barometer' (CoCB) in healthcare organisations: a mixed methods study.

    PubMed

    Rafferty, Anne Marie; Philippou, Julia; Fitzpatrick, Joanne M; Pike, Geoff; Ball, Jane

    2017-08-18

    Concerns about care quality have prompted calls to create workplace cultures conducive to high-quality, safe and compassionate care and to provide a supportive environment in which staff can operate effectively. How healthcare organisations assess their culture of care is an important first step in creating such cultures. This article reports on the development and validation of a tool, the Culture of Care Barometer, designed to assess perceptions of a caring culture among healthcare workers preliminary to culture change. An exploratory mixed methods study designed to develop and test the validity of a tool to measure 'culture of care' through focus groups and questionnaires. Questionnaire development was facilitated through: a literature review, experts generating items of interest and focus group discussions with healthcare staff across specialities, roles and seniority within three types of public healthcare organisations in the UK. The tool was designed to be multiprofessional and pilot tested with a sample of 467 nurses and healthcare support workers in acute care and then validated with a sample of 1698 staff working across acute, mental health and community services in England. Exploratory factor analysis was used to identify dimensions underlying the Barometer. Psychometric testing resulted in the development of a 30-item questionnaire linked to four domains with retained items loading to four factors: organisational values (α=0.93, valid n=1568, M=3.7), team support (α=0.93, valid n=1557, M=3.2), relationships with colleagues (α=0.84, valid n=1617, M=4.0) and job constraints (α=0.70, valid n=1616, M=3.3). The study developed a valid and reliable instrument with which to gauge the different attributes of care culture perceived by healthcare staff with potential for organisational benchmarking. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless

  19. Key elements of high-quality practice organisation in primary health care: a systematic review.

    PubMed

    Crossland, Lisa; Janamian, Tina; Jackson, Claire L

    2014-08-04

    To identify elements that are integral to high-quality practice and determine considerations relating to high-quality practice organisation in primary care. A narrative systematic review of published and grey literature. Electronic databases (PubMed, CINAHL, the Cochrane Library, Embase, Emerald Insight, PsycInfo, the Primary Health Care Research and Information Service website, Google Scholar) were searched in November 2013 and used to identify articles published in English from 2002 to 2013. Reference lists of included articles were searched for relevant unpublished articles and reports. Data were configured at the study level to allow for the inclusion of findings from a broad range of study types. Ten elements were most often included in the existing organisational assessment tools. A further three elements were identified from an inductive thematic analysis of descriptive articles, and were noted as important considerations in effective quality improvement in primary care settings. Although there are some validated tools available to primary care that identify and build quality, most are single-strategy approaches developed outside health care settings. There are currently no validated organisational improvement tools, designed specifically for primary health care, which combine all elements of practice improvement and whose use does not require extensive external facilitation.

  20. Complexity, self-organisation and variation in behaviour in meandering rivers

    NASA Astrophysics Data System (ADS)

    Hooke, J. M.

    2007-11-01

    River meanders are natural features on the surface of Earth that present some degree of regularity of form. They range from being highly dynamic to being stable under present conditions. Conventional theory is that meanders develop to an equilibrium form which is related to discharge and sediment load. Other research has demonstrated that many highly active meanders exhibit a continuous evolution over time and a non-linearity in rate of development. Ideas of autogenesis and of self-organised criticality as being an explanation of some meander changes have been proposed. In this paper data from rivers around the world are examined for further evidence of autogenic, self-organised or non-linear behaviour through analysis of change in sinuosity over time for reaches and change in individual bend form, particularly bend curvature and bend elongation. Some examples do exhibit trends of increasing sinuosity over time and a few show limits from which large decreases occur. Several case studies show non-linearity of behaviour and increasing complexity of form. Other case studies, however, do not exhibit such trends. Phase space plots are used to help uncover emergent behaviour but show a variety of patterns. The example of a reach in which multiple cut-offs occurred is analysed for mechanisms of self-organisation of the planform and in the pool-riffle pattern. Riffles are more closely spaced and also more transient in the more rapidly changing and higher sinuosity parts of the channel. Hypothetical trajectories of different meander behaviour, including for bedrock meanders, are plotted but the challenge remains to uncover the conditions for occurrence and for divergence of tendencies to stability and instability. Identification of attractors and phase space of behaviour of different meandering systems offer the potential for application to sustainable channel management.

  1. Self-concept organisation and mental toughness in sport.

    PubMed

    Meggs, Jennifer; Ditzfeld, Christopher; Golby, Jim

    2014-01-01

    The present study examines the relationship between individual differences in evaluative self-organisation and mental toughness in sport, proposing that motivation and emotional resiliency (facets of mental toughness) stem from differences in core self. A cross-sectional assessment of 105 athletes competing at a range of performance levels took part in an online study including measures of self-reported mental toughness (Sport Mental Toughness Questionnaire; Sheard, M., Golby, J., & van Wersch, A. (2009). Progress towards construct validation of the Sports Mental Toughness Questionnaire (SMTQ). European Journal of Psychological Assessment, 25(3), 186-193. doi:10.1027/1015-5759.25.3.186) and self-organisation (self-descriptive attribute task; Showers, C. J. (2002). Integration and compartmentalisation: A model of self-structure and self-change. In D. Cervone & W. Mischel (Eds.), Advances in personality science (pp. 271-291). New York, NY: Guilford Press). As predicted, global mental toughness was associated with self-concept positivity, which was particularly high in individuals with positive-integrative self-organisation (individuals who distribute positive and negative self-attributes evenly across multiple selves). Specifically, positive integration was associated with constancy (commitment to goal achievement despite obstacles and the potential for failure), which extends presumably from positive integratives' emotional stability and drive to resolve negative self-beliefs.

  2. Exploring organisational competences in Human Factors and UX project work: managing careers, project tactics and organisational strategy.

    PubMed

    Furniss, Dominic; Curzon, Paul; Blandford, Ann

    2018-06-01

    Organisational competence in Human Factors and UX (user experience) has not been looked at before despite its relevance to project success. We define organisational competence as the collective competence of the individuals, bringing together their complementary abilities to deliver an outcome that is typically more than the sum of its parts. Twenty-two UX and Human Factors practitioners were interviewed about their project work in two contrasting domains: web design and safety-critical systems to explore organisational competences. Through doing a FRAM analysis, 29 functions and 6 main areas of competences were identified: the central project process; the process of learning about the problem; maintaining and developing client relations; staff development; evolving practices; and the management of documentation for audit and quality control. These dynamic and situated competences form a web of interactions. Managing competences is essential for project success. Implications for managing careers, project tactics and organisational strategy are discussed. Practitioner Summary: Organisational competences impact how routine and non-routine project work is performed, but these have received little attention in the literature. Six key areas of competences in Human Factors and UX project work were identified from practitioner interviews. Managing combinations of adaptive competences is important for developing careers, project tactics and organisational strategies.

  3. The impact of the Quality and Outcomes Framework on practice organisation and service delivery: summary of evidence from two qualitative studies.

    PubMed

    Checkland, Kath; Harrison, Stephen

    2010-01-01

    In 2003, the new General Medical Services Contract introduced a pay-for-performance programme know as the Quality and Outcomes Framework (QOF) into UK general practice, with payment for meeting a number of both clinical and organisational quality standards. To investigate in detail the impact of the QOF on practice organisation and service delivery. Two linked qualitative case studies in England and Scotland, using interviews and observation to investigate in depth the impact of the QOF in four general medical practices. A number of significant changes to practice organisation and service delivery were observed, including: changes to practice organisational structures; an increased role for information technology; a move towards a more biomedical form of medical care; and changes to roles and relationships, including the introduction of internal peer-review and surveillance. In spite of this, the practices maintained a narrative of 'no change', arguing that they had 'fitted QOF in' to their routines with little trouble.

  4. Social Capacity Assessment for communities and organisations in the CapHaz-Net context

    NASA Astrophysics Data System (ADS)

    Begg, C.; Kuhlicke, C.; Steinführer, A.; Luther, J.

    2012-04-01

    Instead of focusing on physical conditions of a hazard, CapHaz-Net regards the occurrence of a disaster as a result of people, communities and organisations lacking capacities to anticipate, cope with and recover from the impact of a natural hazard. Therefore, the CapHaz-Net project has pooled together knowledge surrounding six topics relating to the social side of natural hazards. These theoretical topics, which include social capacity building, risk governance, social vulnerability, risk perception, risk communication and risk education have been reviewed in terms of how they relate to and how we can improve actions relating to natural hazards. One of the results of this work has been the development of capacities typology that relates to the abilities and resources available to organisations and communities in regards to a future hazard event. It is from this typology we have developed two social capacity audits; one for communities and one for organisations. These assessments aim to identify appropriate measures and strategies regarding how to enhance, develop and build different kinds of capacities. The final outcome of the project is to develop recommendations. By using these assessments participants will be able to identify strong capacities and can refer to the recommendations for tips on how to improve capacities identified as weak. Most importantly, the assessment process is designed to be a self-assessment, completed by members of the community/organisation with the help of a facilitator. That way deficits and outcomes are defined by those who are most likely to be affected by a future hazard event and most likely to be implementing improvements towards resilience.

  5. A case of the birth and death of a high reliability healthcare organisation.

    PubMed

    Roberts, K H; Madsen, P; Desai, V; Van Stralen, D

    2005-06-01

    High reliability organisations (HROs) are those in which errors rarely occur. To accomplish this they conduct relatively error free operations over long periods of time and make consistently good decisions resulting in high quality and reliability. Some organisational processes that characterise HROs are process auditing, implementing appropriate reward systems, avoiding quality degradation, appropriately perceiving that risk exists and developing strategies to deal with it, and command and control. Command and control processes include migrating decision making, redundancy in people or hardware, developing situational awareness, formal rules and procedures, and training. These processes must be tailored to the specific organisation implementing them. These processes were applied to a paediatric intensive care unit (PICU) where care was derived from problem solving methodology rather than protocol. After a leadership change, the unit returned to the hierarchical medical model of care. Important outcome variables such as infant mortality, patient return to the PICU after discharge, days on the PICU, air transports, degraded. Implications for clinical practice include providing caregivers with sufficient flexibility to meet changing situations, encouraging teamwork, and avoiding shaming, naming, and blaming.

  6. How to Trigger Emergence and Self-Organisation in Learning Networks

    NASA Astrophysics Data System (ADS)

    Brouns, Francis; Fetter, Sibren; van Rosmalen, Peter

    The previous chapters of this section discussed why the social structure of Learning Networks is important and present guidelines on how to maintain and allow the emergence of communities in Learning Networks. Chapter 2 explains how Learning Networks rely on social interaction and active participations of the participants. Chapter 3 then continues by presenting guidelines and policies that should be incorporated into Learning Network Services in order to maintain existing communities by creating conditions that promote social interaction and knowledge sharing. Chapter 4 discusses the necessary conditions required for knowledge sharing to occur and to trigger communities to self-organise and emerge. As pointed out in Chap. 4, ad-hoc transient communities facilitate the emergence of social interaction in Learning Networks, self-organising them into communities, taking into account personal characteristics, community characteristics and general guidelines. As explained in Chap. 4 community members would benefit from a service that brings suitable people together for a specific purpose, because it will allow the participant to focus on the knowledge sharing process by reducing the effort or costs. In the current chapter, we describe an example of a peer support Learning Network Service based on the mechanism of peer tutoring in ad-hoc transient communities.

  7. Technological changes in the healthcare sector. A method to assess change readiness.

    PubMed

    Kristensen, M; Nøhr, C

    2000-01-01

    This paper describes the theory, method and recent results of a study developing methods for assessment of change readiness. The empirical focus is on development and implementation of clinical IT systems in the Danish healthcare sector. To assess change readiness, a questionnaire has been developed. The questionnaire has been tested in a hospital department as a part of a pre analysis related to development and implementation of an IT quality assurance system. The study shows a general positive attitude to the IT system and the organisational changes, related to the implementation and use of the system. It also supplies the project organisation with specific information, useful to the project organisation to continue the essential dialogue with the healthcare professionals during the change process. Furthermore it provides a useful tool for planning the ongoing developing processes. Several other healthcare organisations are at the moment entering the study.

  8. Information structure and organisation in change of shift reports: An observational study of nursing hand-offs in a Paediatric Intensive Care Unit.

    PubMed

    Foster-Hunt, Tara; Parush, Avi; Ellis, Jacqueline; Thomas, Margot; Rashotte, Judy

    2015-06-01

    Patient hand-offs involve the exchange of critical information. Ineffective hand-offs can result in reduced patient safety by leading to wrong treatment, delayed diagnoses or other outcomes that can negatively affect the healthcare system. The objectives of this study were to uncover the structure of the information conveyed during patient hand-offs and look for principles characterising the organisation of the information. With an observational study approach, data was gathered during the morning and evening nursing change of shift hand-offs in a Paediatric Intensive Care Unit. Content analysis identified a common meta-structure used for information transfer that contained categories with varying degrees of information integration and the repetition of high consequence information. Differences were found in the organisation of the hand-off structures, and these varied as a function of nursing experience. The findings are discussed in terms of the potential benefits of computerised tools which utilise standardised structure for information transfer and the implications for future education and critical care skill acquisition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Facilitating professional liaison in collaborative care for depression in UK primary care; a qualitative study utilising normalisation process theory.

    PubMed

    Coupe, Nia; Anderson, Emma; Gask, Linda; Sykes, Paul; Richards, David A; Chew-Graham, Carolyn

    2014-05-01

    Collaborative care (CC) is an organisational framework which facilitates the delivery of a mental health intervention to patients by case managers in collaboration with more senior health professionals (supervisors and GPs), and is effective for the management of depression in primary care. However, there remains limited evidence on how to successfully implement this collaborative approach in UK primary care. This study aimed to explore to what extent CC impacts on professional working relationships, and if CC for depression could be implemented as routine in the primary care setting. This qualitative study explored perspectives of the 6 case managers (CMs), 5 supervisors (trial research team members) and 15 general practitioners (GPs) from practices participating in a randomised controlled trial of CC for depression. Interviews were transcribed verbatim and data was analysed using a two-step approach using an initial thematic analysis, and a secondary analysis using the Normalisation Process Theory concepts of coherence, cognitive participation, collective action and reflexive monitoring with respect to the implementation of CC in primary care. Supervisors and CMs demonstrated coherence in their understanding of CC, and consequently reported good levels of cognitive participation and collective action regarding delivering and supervising the intervention. GPs interviewed showed limited understanding of the CC framework, and reported limited collaboration with CMs: barriers to collaboration were identified. All participants identified the potential or experienced benefits of a collaborative approach to depression management and were able to discuss ways in which collaboration can be facilitated. Primary care professionals in this study valued the potential for collaboration, but GPs' understanding of CC and organisational barriers hindered opportunities for communication. Further work is needed to address these organisational barriers in order to facilitate

  10. Digital innovation through partnership between nature conservation organisations and academia: a qualitative impact assessment.

    PubMed

    Galán-Díaz, Carlos; Edwards, Peter; Nelson, John D; van der Wal, René

    2015-11-01

    Nature conservation organisations increasingly turn to new digital technologies to help deliver conservation objectives. This has led to collaborative forms of working with academia to spearhead digital innovation. Through in-depth interviews with three UK research-council-funded case studies, we show that by working with academics conservation organisations can receive positive and negative impacts, some of which cut across their operations. Positive impacts include new ways of engaging with audiences, improved data workflows, financial benefits, capacity building and the necessary digital infrastructure to help them influence policy. Negative impacts include the time and resources required to learn new skills and sustain new technologies, managing different organisational objectives and shifts in working practices as a result of the new technologies. Most importantly, collaboration with academics was shown to bring the opportunity of a profound change in perspectives on technologies with benefits to the partner organisations and individuals therein.

  11. Microgravity changes at the Laguna del Maule volcanic field: Magma-induced stress changes facilitate mass addition

    NASA Astrophysics Data System (ADS)

    Miller, C. A.; Le Mével, H.; Currenti, G.; Williams-Jones, G.; Tikoff, B.

    2017-04-01

    Time-dependent, or 4-D, microgravity changes observed at the Laguna del Maule volcanic field, Chile, since 2013, indicate significant (1.5 × 1011 kg) ongoing mass injection. Mass injection is focused along the Troncoso fault, and subparallel structures beneath the lake at 1.5-2 km depth, and is best modeled by a vertical rectangular prism source. The low-density change (156 to 307 kg/m3) and limited depth extent suggest a mechanism of hydrothermal fluid intrusion into existing voids, or voids created by the substantial uplift, rather than deeper-sourced dike intrusion of rhyolite or basalt magma. Although the gravity changes are broadly spatially coincident with ongoing surface deformation, existing models that explain the deformation are deeper sourced and cannot explain the gravity changes. To account for this discrepancy and the correspondence in time of the deformation and gravity changes, we explore a coupled magmatectonic interaction mechanism that allows for shallow mass addition, facilitated by deeper magma injection. Computing the strain, and mean, normal, and Coulomb stress changes on northeast trending faults, caused by the opening of a sill at 5 km depth, shows an increase in strain and mean and normal stresses along these faults, coincident with the areas of mass addition. Seismic swarms in mid-2012 to the west and southwest of the mass intrusion area may be responsible for dynamically increasing permeability on the Troncoso fault, promoting influx of hydrothermal fluids, which in turn causes larger gravity changes in the 2013 to 2014 interval, compared to the subsequent intervals.

  12. Action Research and Organisational Learning: A Norwegian Approach to Doing Action Research in Complex Organisations

    ERIC Educational Resources Information Center

    Eikeland, Olav

    2012-01-01

    The purpose of this article is to present a specific approach to the practice of action research "in complex organisations". Clearly, there are many approaches to the challenge of doing action research in organisations; approaches that are, and also must be, quite context dependent and specific. But my purpose is neither to give an…

  13. Sustaining Change in a Learning Organization

    ERIC Educational Resources Information Center

    Steenekamp, K.; Botha, G.; Moloi, K. C.

    2012-01-01

    This article looks at how the application of the concept of a "learning organisation" can be used at a specific organisation in South Africa to change the work performance of its employees. We do this by exploring different theories, models and definitions of organisational learning, learning organisation, organisational knowledge and…

  14. Evolutionary Connectionism: Algorithmic Principles Underlying the Evolution of Biological Organisation in Evo-Devo, Evo-Eco and Evolutionary Transitions.

    PubMed

    Watson, Richard A; Mills, Rob; Buckley, C L; Kouvaris, Kostas; Jackson, Adam; Powers, Simon T; Cox, Chris; Tudge, Simon; Davies, Adam; Kounios, Loizos; Power, Daniel

    2016-01-01

    The mechanisms of variation, selection and inheritance, on which evolution by natural selection depends, are not fixed over evolutionary time. Current evolutionary biology is increasingly focussed on understanding how the evolution of developmental organisations modifies the distribution of phenotypic variation, the evolution of ecological relationships modifies the selective environment, and the evolution of reproductive relationships modifies the heritability of the evolutionary unit. The major transitions in evolution, in particular, involve radical changes in developmental, ecological and reproductive organisations that instantiate variation, selection and inheritance at a higher level of biological organisation. However, current evolutionary theory is poorly equipped to describe how these organisations change over evolutionary time and especially how that results in adaptive complexes at successive scales of organisation (the key problem is that evolution is self-referential, i.e. the products of evolution change the parameters of the evolutionary process). Here we first reinterpret the central open questions in these domains from a perspective that emphasises the common underlying themes. We then synthesise the findings from a developing body of work that is building a new theoretical approach to these questions by converting well-understood theory and results from models of cognitive learning. Specifically, connectionist models of memory and learning demonstrate how simple incremental mechanisms, adjusting the relationships between individually-simple components, can produce organisations that exhibit complex system-level behaviours and improve the adaptive capabilities of the system. We use the term "evolutionary connectionism" to recognise that, by functionally equivalent processes, natural selection acting on the relationships within and between evolutionary entities can result in organisations that produce complex system-level behaviours in evolutionary

  15. Fishing for leadership: The role diversification plays in facilitating change agents.

    PubMed

    Stoll, Joshua S

    2017-09-01

    Leadership is often viewed as being critical to successful natural resource management. This research focuses on a set of leaders identified through a social network analysis of fishers in a rural coastal region. Leaders' connections to different fisheries are evaluated, and these actors are found to be significantly more diversified than other fishers in the area. Drawing on theory related to institutional entrepreneurship and a series of in-depth interviews with these actors, this paper puts forward several hypotheses to explain how diverse social-ecological connections facilitate leadership. Three mechanisms are identified. Being diversified facilitates: (1) production of alternative visions; (2) framing of tractable strategies to sustain local marine resource; and (3) participation in the management process. While more research is needed to understand the relationship between diversification and leadership, these exploratory results suggest that leadership is, in part, a manifestation of ecological circumstance, supporting recent assertions that scholarship on leadership in natural resource management settings could benefit from being more attentive to the processes that shape leadership rather than fixating on individuals and their personal attributes. Given that fisheries policies increasingly constrain diversification, policymakers and managers should consider how specialization of fishers might change the form and function of leaders in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Facilitating the adoption of digital technologies by the elderly.

    PubMed

    Loiseau, Séverine; Boog, César; Pelayo, Sylvia

    2015-01-01

    This study examined the major criteria needed to facilitate the adoption of a technology that aims to support elderly autonomy. A User Centered Design process was instigated to design a digital tablet-based application. The two first stages consisted of a literature review and two focus groups that aimed respectively: to specify interaction principles, and to define the needs and expectations of the elderly and collect their feedback on the application's usability. The results show that to be accepted the technology has to provide relevant and useful information on nearby services, aids and social activities. It also has to facilitate the controlled sharing of information and the communication with close family/relations, and residential home and external services to both empower the elderly and counter loneliness. A summative evaluation will be organised after taking into account the current guidelines to further validate the usability of the application with elderly people.

  17. Introduction of Tele-ICU in rural hospitals: Changing organisational culture to harness benefits.

    PubMed

    Goedken, Cassie Cunningham; Moeckli, Jane; Cram, Peter M; Reisinger, Heather Schacht

    2017-06-01

    This study evaluates rural hospital staff perceptions of a telemedicine ICU (Tele-ICU) before and after implementation. We conducted a longitudinal qualitative study utilising semistructured group or individual interviews with staff from three rural ICU facilities in the upper Midwest of the United States that received Tele-ICU support. Interviews occurred pre-implementation and at two time points post-implementation. Interviews were conducted with: ICU administrators (n=6), physicians (n=3), nurses (n=9), respiratory therapists (n=5) and other (n=1) from July 2011 to May 2013. Transcripts were analysed for thematic content. Overall, rural ICU staff viewed Tele-ICU as a welcome benefit for their facility. Major themes included: (1) beneficial where recruitment and retention of staff can be challenging; (2) extra support for day shifts and evening, night and weekend shifts; (3) reduction in the number of transfers larger tertiary hospitals in the community; (4) improvement in standardisation of care; and (5) organisational culture of rural ICUs may lead to under-utilisation. ICU staff at rural facilities view Tele-ICU as a positive, useful tool to provide extra support and assistance. However, more research is needed regarding organisational culture to maximise the potential benefits of Tele-ICU in rural hospitals. Published by Elsevier Ltd.

  18. Reducing Change Management Complexity: Aligning Change Recipient Sensemaking to Change Agent Sensegiving

    ERIC Educational Resources Information Center

    Kumar; Payal; Singhal, Manish

    2012-01-01

    Implementation of change in an organisation through culture can elicit a wide array of reactions from organisational members, spanning from acceptance to resistance. Drawing on Hatch's cultural dynamics model and on Wegner's social theory of learning, this paper dwells on an underdeveloped area in the extant literature, namely understanding change…

  19. How do hospital boards govern for quality improvement? A mixed methods study of 15 organisations in England

    PubMed Central

    Pomeroy, Linda; Burnett, Susan; Anderson, Janet E; Fulop, Naomi J

    2017-01-01

    Background Health systems worldwide are increasingly holding boards of healthcare organisations accountable for the quality of care that they provide. Previous empirical research has found associations between certain board practices and higher quality patient care; however, little is known about how boards govern for quality improvement (QI). Methods We conducted fieldwork over a 30-month period in 15 healthcare provider organisations in England as part of a wider evaluation of a board-level organisational development intervention. Our data comprised board member interviews (n=65), board meeting observations (60 hours) and documents (30 sets of board meeting papers, 15 board minutes and 15 Quality Accounts). We analysed the data using a framework developed from existing evidence of links between board practices and quality of care. We mapped the variation in how boards enacted governance of QI and constructed a measure of QI governance maturity. We then compared organisations to identify the characteristics of those with mature QI governance. Results We found that boards with higher levels of maturity in relation to governing for QI had the following characteristics: explicitly prioritising QI; balancing short-term (external) priorities with long-term (internal) investment in QI; using data for QI, not just quality assurance; engaging staff and patients in QI; and encouraging a culture of continuous improvement. These characteristics appeared to be particularly enabled and facilitated by board-level clinical leaders. Conclusions This study contributes to a deeper understanding of how boards govern for QI. The identified characteristics of organisations with mature QI governance seemed to be enabled by active clinical leadership. Future research should explore the biographies, identities and work practices of board-level clinical leaders and their role in organisation-wide QI. PMID:28689191

  20. Development of the school organisational health questionnaire: a measure for assessing teacher morale and school organisational climate.

    PubMed

    Hart, P M; Wearing, A J; Conn, M; Carter, N L; Dingle, R K

    2000-06-01

    A growing body of empirical evidence suggests that organisational factors are more important than classroom specific issues in determining teacher morale. Accordingly, it is necessary to have available measures that accurately assess morale, as well as the organisational factors that are likely to underpin the experience of morale. Three studies were conducted with the aim of developing a psychometrically sound questionnaire that could be used to assess teacher morale and various dimensions of school organisational climate. A total of 1,520 teachers from 18 primary and 26 secondary schools in the Australian state of Victoria agreed to participate in three separate studies (N = 615, 342 and 563 in Studies 1, 2 and 3, respectively) that were used to develop the questionnaire. The demographic profile of the teachers was similar to that found in the Department as a whole. All teaching staff in the participating schools were asked to complete a self-report questionnaire as part of the evaluation of an organisational development programme. A series of exploratory and confirmatory factor analyses were used to establish the questionnaire's factor structure, and correlation analyses were used to examine the questionnaire's convergent and discriminant validity. The three studies resulted in the 54-item School Organisational Health Questionnaire that measures teacher morale and 11 separate dimensions of school organisational climate: appraisal and recognition, curriculum coordination, effective discipline policy, excessive work demands, goal congruence, participative decision-making, professional growth, professional interaction, role clarity, student orientation, and supportive leadership.

  1. The dynamics of commissioning across organisational and clinical boundaries.

    PubMed

    Baxter, Kate; Weiss, Marjorie; Le Grand, Julian

    2008-01-01

    The purpose of the paper is to investigate the inter- and intra-organisational relationships in the commissioning of secondary care by primary care trusts in England, using a principal-agent framework. The methodology is a qualitative study of three case studies. A total of 13 commissioning-related meetings were observed. In total, 21 managers and six consultant surgeons were interviewed. There are a number of different levels at which contractual and managerial control take place. Different strengths of control at one level can affect willingness to comply with agreements at other levels. Agreements at one level do not necessarily result in appropriate or expected action at another. The system for commissioning in the National Health Service (NHS) has changed with the introduction of payment by results and practice-based commissioning. However, the dynamics of the inter- and intra-organisational relationships studied remain. Incentives within organisations are as important as those between organisations. Within a chain of principal-agent relations, it is important that a strong link in the chain does not result in the exploitation of weaknesses in other links. If government targets and frameworks are to be met through commissioning, it may be advantageous to concentrate efforts on developing incentives that align clinician with NHS trust objectives as well as NHS trust with primary care trust (PCT) and government objectives. This paper is based on original empirical work. It uses a principal-agent framework to understand the relationships between PCTs and NHS trusts and highlights the importance of internal NHS trust governance systems in the fulfilment of commissioning agreements.

  2. The medium-term sustainability of organisational innovations in the national health service

    PubMed Central

    2011-01-01

    Background There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS) and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion Through comparison and

  3. The medium-term sustainability of organisational innovations in the national health service.

    PubMed

    Martin, Graham P; Currie, Graeme; Finn, Rachael; McDonald, Ruth

    2011-03-14

    There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS) and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Through comparison and contrast across four sites, each

  4. Critical success factors in implementing an e-rostering system in a healthcare organisation.

    PubMed

    Soomro, Zahoor A; Ahmed, Javed; Muhammad, Raza; Hayes, Dawn; Shah, Mahmood H

    2017-01-01

    Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts.

  5. Impacts of Intensive Logging on the Trophic Organisation of Ant Communities in a Biodiversity Hotspot

    PubMed Central

    Woodcock, Paul; Edwards, David P.; Newton, Rob J.; Vun Khen, Chey; Bottrell, Simon H.; Hamer, Keith C.

    2013-01-01

    Trophic organisation defines the flow of energy through ecosystems and is a key component of community structure. Widespread and intensifying anthropogenic disturbance threatens to disrupt trophic organisation by altering species composition and relative abundances and by driving shifts in the trophic ecology of species that persist in disturbed ecosystems. We examined how intensive disturbance caused by selective logging affects trophic organisation in the biodiversity hotspot of Sabah, Borneo. Using stable nitrogen isotopes, we quantified the positions in the food web of 159 leaf-litter ant species in unlogged and logged rainforest and tested four predictions: (i) there is a negative relationship between the trophic position of a species in unlogged forest and its change in abundance following logging, (ii) the trophic positions of species are altered by logging, (iii) disturbance alters the frequency distribution of trophic positions within the ant assemblage, and (iv) disturbance reduces food chain length. We found that ant abundance was 30% lower in logged forest than in unlogged forest but changes in abundance of individual species were not related to trophic position, providing no support for prediction (i). However, trophic positions of individual species were significantly higher in logged forest, supporting prediction (ii). Consequently, the frequency distribution of trophic positions differed significantly between unlogged and logged forest, supporting prediction (iii), and food chains were 0.2 trophic levels longer in logged forest, the opposite of prediction (iv). Our results demonstrate that disturbance can alter trophic organisation even without trophically-biased changes in community composition. Nonetheless, the absence of any reduction in food chain length in logged forest suggests that species-rich arthropod food webs do not experience trophic downgrading or a related collapse in trophic organisation despite the disturbance caused by logging

  6. Impacts of intensive logging on the trophic organisation of ant communities in a biodiversity hotspot.

    PubMed

    Woodcock, Paul; Edwards, David P; Newton, Rob J; Vun Khen, Chey; Bottrell, Simon H; Hamer, Keith C

    2013-01-01

    Trophic organisation defines the flow of energy through ecosystems and is a key component of community structure. Widespread and intensifying anthropogenic disturbance threatens to disrupt trophic organisation by altering species composition and relative abundances and by driving shifts in the trophic ecology of species that persist in disturbed ecosystems. We examined how intensive disturbance caused by selective logging affects trophic organisation in the biodiversity hotspot of Sabah, Borneo. Using stable nitrogen isotopes, we quantified the positions in the food web of 159 leaf-litter ant species in unlogged and logged rainforest and tested four predictions: (i) there is a negative relationship between the trophic position of a species in unlogged forest and its change in abundance following logging, (ii) the trophic positions of species are altered by logging, (iii) disturbance alters the frequency distribution of trophic positions within the ant assemblage, and (iv) disturbance reduces food chain length. We found that ant abundance was 30% lower in logged forest than in unlogged forest but changes in abundance of individual species were not related to trophic position, providing no support for prediction (i). However, trophic positions of individual species were significantly higher in logged forest, supporting prediction (ii). Consequently, the frequency distribution of trophic positions differed significantly between unlogged and logged forest, supporting prediction (iii), and food chains were 0.2 trophic levels longer in logged forest, the opposite of prediction (iv). Our results demonstrate that disturbance can alter trophic organisation even without trophically-biased changes in community composition. Nonetheless, the absence of any reduction in food chain length in logged forest suggests that species-rich arthropod food webs do not experience trophic downgrading or a related collapse in trophic organisation despite the disturbance caused by logging

  7. When teachers go the extra mile: foci of organisational identification as determinants of different forms of organisational citizenship behaviour among schoolteachers.

    PubMed

    Christ, Oliver; van Dick, Rolf; Wagner, Ulrich; Stellmacher, Jost

    2003-09-01

    Psychological variables should play an important role in determining teachers' involvement in behaviours not directly or formally forced by contracts. Organisational identification as proposed from the Social Identity Approach is examined as a possible determinant of organisational citizenship behaviour (OCB) among schoolteachers. The aim of the present study was to explore the relationships between different foci of organisational identification and different forms of OCB in schools. Data sets of altogether 447 German school teachers who filled in all relevant items in a cross-sectional questionnaire are used for analyses in the present study. Standardised questionnaires measuring organisational identification and OCB were administered. Exploratory and confirmatory factor analyses revealed the proposed foci of identification (i.e., career identification, team identification, and organisational identification), as well as different forms of OCB (i.e., OCB towards the own qualification, towards the team, and towards the organisation). Structural equation modelling supports the main hypothesis that foci of identification relate differentially to forms of OCB. The results emphasise the importance of organisational identification as a determinant of OCB in schools. Practical implications are discussed.

  8. Building a learning organisation in a child and adolescent mental health service.

    PubMed

    Birleson, P

    1998-01-01

    In recent business literature, the model of the learning organisation has been proposed as a solution to the problem of continually changing environments and increasing consumer expectations of maximum quality and value for money. The model seems highly appropriate for health services, which are staffed by educated professional staff who must become more adaptive and concerned with improving consumer outcomes. This case study describes how the principles of learning organisations have been applied to the design of a new structure and the creation of a learning culture within a mental health service for children and adolescents.

  9. Enhancing engagement with community sector organisations working in sustainable waste management: A case study.

    PubMed

    Dururu, John; Anderson, Craig; Bates, Margaret; Montasser, Waleed; Tudor, Terry

    2015-03-01

    Voluntary and community sector organisations are increasingly being viewed as key agents of change in the shifts towards the concepts of resource efficiency and circular economy, at the community level. Using a meta-analysis and questionnaire surveys across three towns in the East Midlands of England, namely Northampton, Milton Keynes and Luton, this study aimed to understand public engagement with these organisations. The findings suggest that these organisations play a significant and wide-spread role, not only with regard to sustainable environmental management, but also a social role in community development and regeneration. The surveys indicated that there were generally high levels of awareness of the organisations and strong engagement with them. Clothes were the items most donated. Key reasons for engagement included the financial value offered and the perception that it helped the environment. However, potential limitations in future public engagement were also determined and recommendations for addressing these suggested. © The Author(s) 2015.

  10. Relationships "de Confianza" and the Organisation of Collective Social Action

    ERIC Educational Resources Information Center

    Teeters, Leah A.; Jurow, A. Susan

    2018-01-01

    This article examines the social and cultural organisation of learning and community change in a largely new immigrant and under-resourced neighbourhood in the US. Situating our investigation within a local social movement for food justice, we use an ethnographic lens to study how learning is made to become consequential across relationships…

  11. The impact of workplace spirituality dimensions on organisational citizenship behaviour among nurses with the mediating effect of affective organisational commitment.

    PubMed

    Kazemipour, Farahnaz; Mohd Amin, Salmiah

    2012-12-01

    To investigate the relationship between workplace spirituality dimensions and organisational citizenship behaviour (OCB) among nurses through the mediating effect of affective organisational commitment. Nurses' OCB has been considered recently to improve the quality of services to patients and subsequently, their performance. As an influential attitude, affective organisational commitment has been recognized to influence OCB, and ultimately, organisational performance. Meanwhile, workplace spirituality is introduced as a new organisational behaviour concept to increase affective commitment influencing employees' OCB. The cross-sectional study and the respective data were collected with a questionnaire-based survey. The questionnaires were distributed to 305 nurses employed in four public and general Iranian hospitals. To analyse the data, descriptive statistics, Pearson coefficient, simple regression, multiple regression and path analyses were also conducted. The results indicated that workplace spirituality dimensions including meaningful work, a sense of community and an alignment with organisational values have a significant positive relationship with OCB. Moreover, affective organisational commitment mediated the impact of workplace spirituality on OCB. The concept of workplace spirituality through its dimensions predicts nurses' OCB, and affective organisational commitment partially mediated the relationship between workplace spirituality and OCB. Nurses' managers should consider the potentially positive influence of workplace spirituality on OCB and affective commitment among their nurses. With any plan to increase workplace spirituality, the respective managers can improve nurses' performance and would be of considerable importance in the healthcare system. © 2012 Blackwell Publishing Ltd.

  12. Determining organisation-specific factors for developing health interventions in companies by a Delphi procedure: Organisational Mapping.

    PubMed

    van Scheppingen, Arjella R; ten Have, Kristin C J M; Zwetsloot, Gerard J I M; Kok, Gerjo; van Mechelen, Willem

    2015-12-01

    Companies, seen as social communities, are major health promotion contexts. However, health promotion in the work setting is often less successful than intended. An optimal adjustment to the organisational context is required. Knowledge of which organisation-specific factors are relevant to health promotion is scarce. A Delphi procedure is used to identify these factors. The aim is to contribute to more effective workplace health promotion. The identified factors are described and embedded into a practical methodology (Intervention Mapping). A systematic use of these factors (called 'Organisational Mapping') is likely to contribute to more effective health promotion in the work setting. © The Author(s) 2014.

  13. Organisational Learning and the Organisational Life Cycle: The Differential Aspects of an Integrated Relationship in SMEs

    ERIC Educational Resources Information Center

    Tam, Steven; Gray, David E.

    2016-01-01

    Purpose: The purpose of this study is to relate the practice of organisational learning in small- and medium-sized enterprises (SMEs) to the organisational life cycle (OLC), contextualising the differential aspects of an integrated relationship between them. Design/methodology/approach: It is a mixed-method study with two consecutive phases. In…

  14. Effective social justice advocacy: a theory-of-change framework for assessing progress.

    PubMed

    Klugman, Barbara

    2011-11-01

    This article offers a theory-of-change framework for social justice advocacy. It describes broad outcome categories against which activists, donors and evaluators can assess progress (or lack thereof) in an ongoing manner: changes in organisational capacity, base of support, alliances, data and analysis from a social justice perspective, problem definition and potential policy options, visibility, public norms, and population level impacts. Using these for evaluation enables activists and donors to learn from and rethink their strategies as the political context and/or actors change over time. The paper presents a case study comparing factors that facilitated reproductive rights policy wins during the transition from apartheid to democracy in South Africa and factors that undermined their implementation in the post-apartheid period. It argues that after legal and policy victories had been won, failure to maintain strong organizations and continually rethink strategies contributed to the loss of government focus on and resources for implementation of new policies. By implication, evaluating effectiveness only by an actual policy change does not allow for ongoing learning to ensure appropriate strategies. It also fails to recognise that a policy win can be overturned and needs vigilant monitoring and advocacy for implementation. This means that funding and organising advocacy should seldom be undertaken as a short-term proposition. It also suggests that the building and maintenance of organisational and leadership capacity is as important as any other of the outcome categories in enabling success. Copyright © 2011 Foundation Review. Published by Elsevier Ltd. All rights reserved.

  15. Factors Influencing Knowledge Creation and Innovation in an Organisation

    ERIC Educational Resources Information Center

    Merx-Chermin, Mireille; Nijhof, Wim, J.

    2005-01-01

    Purpose: The purpose of this study is to gain a better understanding of the factors that influence the innovative power of organisations. The concept of innovation and innovative power was examined by analysing the relationship between the construct of the learning organisation, knowledge organisation and innovative organisation, and has resulted…

  16. Routines for change: how managers can use absorptive capacity to adopt and implement evidence-based practice.

    PubMed

    Innis, Jennifer; Berta, Whitney

    2016-09-01

    This paper uses the construct of absorptive capacity to understand how nurse managers can facilitate the adoption and use of evidence-based practice within health-care organisations. How health-care organisations adopt and implement innovations such as new evidence-based practices will depend on their absorptive, or learning, capacity. Absorptive capacity manifests as routines, which are the practices, procedures and customs that organisational members use to carry out work and to make work-related decisions. Using the construct of absorptive capacity as well as a recent literature review of how health-care organisations take on best practices, we illustrate how the uptake and use of new knowledge, such as evidence-based practices, can be facilitated through the use of routines. This paper highlights routines that nurse managers can use to foster environments where evidence-based practices can be readily identified, and strategies for facilitating their adoption and implementation. The construct of absorptive capacity and the use of routines can be used to examine the ways in which nurse managers can adopt, implement and evaluate the use of evidence-based practices. © 2016 John Wiley & Sons Ltd.

  17. A Longitudinal Study of Individual and Organisational Learning

    ERIC Educational Resources Information Center

    Campbell, Timothy T.; Armstrong, Steven J.

    2013-01-01

    Purpose: The purpose of this paper is to empirically examine organisational learning (OL) and individual managerial learning and provide a comparative evaluation of the ability of each to generate organisational benefits. Design/methodology/approach: A theoretical model of organisational learning is developed which was then longitudinally tested…

  18. Organisational Learning and Employees' Intrinsic Motivation

    ERIC Educational Resources Information Center

    Remedios, Richard; Boreham, Nick

    2004-01-01

    This study examined the effects of organisational learning initiatives on employee motivation. Four initiatives consistent with theories of organisational learning were a priori ranked in terms of concepts that underpin intrinsic-motivation theory. Eighteen employees in a UK petrochemical company were interviewed to ascertain their experiences of…

  19. [Organisation of Perioperative Pain Management].

    PubMed

    Meißner, Winfried; Erlenwein, Joachim; Stamer, Ulrike

    2018-04-01

    Organisational issues of acute pain management are as important as details of pharmacologic treatments or regional analgesia. Lothar Lachgas is a young intern in the department of anaesthesiology of a German hospital. This overview illuminates organisation of perioperative pain management based on his virtual experiences and questions: pain assessment and documentation, patient information and education, tasks of an Acute Pain Service. Georg Thieme Verlag KG Stuttgart · New York.

  20. Learning organisations: the challenge of finding a safe space in a climate of accountability.

    PubMed

    McKee, Anne

    2017-03-01

    The effects of health policy reforms over a twenty-five year period have changed the NHS as a place in which to work and learn. Some of these changes have had unintentional consequences for learning in the workplace. A recent King's Fund contribution to quality improvement debates included an extensive review of NHS policies encouraging change 'from within' the NHS and renewed calls to develop learning organisations there. I draw upon an action research project designed to develop learning organisations in primary care to locate quality improvement debates amid the realities of practice. The project identified key challenges primary care practices encountered to protect time and space for this form of work based learning, even when they recognised the need for it and wanted to engage in it. Implications for policy makers, primary care practices and health professional educationalists are identified.

  1. Big-pharmaceuticalisation: clinical trials and Contract Research Organisations in India.

    PubMed

    Sariola, Salla; Ravindran, Deapica; Kumar, Anand; Jeffery, Roger

    2015-04-01

    The World Trade Organisation's Trade Related Intellectual Property Rights [TRIPS] agreement aimed to harmonise intellectual property rights and patent protection globally. In India, the signing of this agreement resulted in a sharp increase in clinical trials since 2005. The Indian government, along with larger Indian pharmaceutical companies, believed that they could change existing commercial research cultures through the promotion of basic research as well as attracting international clinical trials, and thus create an international level, innovation-based drug industry. The effects of the growth of these outsourced and off-shored clinical trials on local commercial knowledge production in India are still unclear. What has been the impact of the increasing scale and commercialisation of clinical research on corporate science in India? In this paper we describe Big-pharmaceuticalisation in India, whereby the local pharmaceutical industry is moving from generic manufacturing to innovative research. Using conceptual frameworks of pharmaceuticalisation and innovation, this paper analyses data from research conducted in 2010-2012 and describes how Contract Research Organisations (CROs) enable outsourcing of randomised control trials to India. Focussing on twenty-five semi-structured interviews CRO staff, we chart the changes in Indian pharmaceutical industry, and implications for local research cultures. We use Big-pharmaceuticalisation to extend the notion of pharmaceuticalisation to describe the spread of pharmaceutical research globally and illustrate how TRIPS has encouraged a concentration of capital in India, with large companies gaining increasing market share and using their market power to rewrite regulations and introduce new regulatory practices in their own interest. Contract Research Organisations, with relevant, new, epistemic skills and capacities, are both manifestations of the changes in commercial research cultures, as well as the vehicles to

  2. A model of organisational dysfunction in the NHS.

    PubMed

    Pope, Rachael

    2013-01-01

    This paper explores the reasons for the sometimes seemingly irrational and dysfunctional organisational behaviour within the NHS. It seeks to provide possible answers to the persistent historical problem of intimidating and negative behaviour between staff, and the sometimes inadequate organisational responses. The aim is to develop a model to explain and increase understanding of such behaviour in the NHS. This paper is conceptual in nature based upon a systematic literature review. The concepts of organisational silence, normalised organisational corruption, and protection of image, provide some possible answers for these dysfunctional responses, as does the theory of selective moral disengagement. The NHS exhibits too high a level of collective ego defences and protection of its image and self-esteem, which distorts its ability to address problems and to learn. Organisations and the individuals within them can hide and retreat from reality and exhibit denial; there is a resistance to voice and to "knowing". The persistence and tolerance of negative behaviour is a corruption and is not healthy or desirable. Organisations need to embrace the identity of a listening and learning organisation; a "wise" organisation. The "Elephant in the room" of persistent negative behaviour has to be acknowledged; the silence must be broken. There is a need for cultures of "respect", exhibiting "intelligent kindness". A model has been developed to increase understanding of dysfunctional organisational behaviour in the NHS primarily for leaders/managers of health services, health service regulators and health researchers/academics. Research, with ethical approval, is currently being undertaken to test and develop the conceptual model to further reflect the complexities of the NHS culture.

  3. Improved silver staining of nucleolar organiser regions in paraffin wax sections using an inverted incubation technique.

    PubMed Central

    Coghill, G; Grant, A; Orrell, J M; Jankowski, J; Evans, A T

    1990-01-01

    A new simple modification to the silver staining of nucleolar organiser regions (AgNORs) was devised which, by performing the incubation with the slide inverted, results in minimal undesirable background staining, a persistent problem. Inverted incubation is facilitated by the use of a commercially available plastic coverplate. This technique has several additional advantages over other published staining protocols. In particular, the method is straightforward, fast, and maintains a high degree of contrast between the background and the AgNORs. Images PMID:1702451

  4. International Organisations and Transnational Education Policy

    ERIC Educational Resources Information Center

    Moutsios, Stavros

    2009-01-01

    This paper focuses on the World Bank/IMF (International Monetary Fund), the OECD (Organisation for Economic Cooperation and Development) and the WTO (World Trade Organisation) as institutions of transnational policy making. They are all at present making education policies which are decisively shaping current directions and developments in…

  5. Co-production of community mental health services: Organising the interplay between public services and civil society in Denmark.

    PubMed

    Vaeggemose, Ulla; Ankersen, Pia Vedel; Aagaard, Jørgen; Burau, Viola

    2018-01-01

    Co-production involves knowledge and skills based on both lived experiences of citizens and professionally training of staff. In Europe, co-production is viewed as an essential tool for meeting the demographic, political and economic challenges of welfare states. However, co-production is facing challenges because public services and civil society are rooted in two very different logics. These challenges are typically encountered by provider organisations and their staff who must convert policies and strategies into practice. Denmark is a welfare state with a strong public services sector and a relatively low involvement of volunteers. The aim of this study was to investigate how provider organisations and their staff navigate between the two logics. The present analysis is a critical case study of two municipalities selected from seven participating municipalities, for their maximum diversity. The study setting was the Community Families programme, which aim to support the social network of mental health users by offering regular contact with selected private families/individuals. The task of the municipalities was to initiate and support Community Families. The analysis built on qualitative data generated at the organisational level in the seven participating municipalities. Within the two "case study" municipalities, qualitative interviews were conducted with front-line co-ordinators (six) and line managers (two). The interviews were recorded, transcribed verbatim and coded using the software program NVivo. The results confirm the central role played by staff and identify a close interplay between public services and civil society logics as essential for the organisation of co-production. Corresponding objectives, activities and collaborative relations of provider organisations are keys for facilitating the co-productive practice of individual staff. Organised in this way, co-production can succeed even in a mental health setting associated with social stigma

  6. Holding a Sustainability Bearing through Cutty-Grass and Clearings: Implementing Sustainability during Disruptive Organisational Changes

    ERIC Educational Resources Information Center

    North, Chris; Jansen, Chris

    2013-01-01

    This article explores our experiences as faculty implementing a five year sustainability strategic plan within the Outdoor and Environmental Education (OEE) curriculum centre during a time of organisational restructuring. This paper builds on the work of Jansen and Boardman (2011) who describe the process of developing the strategic plan and some…

  7. Corporate information systems in health organisations.

    PubMed

    Smith, J

    1997-01-01

    This paper presents an overview of the nature of corporate information systems and their applications in health organisations. It emphasises the importance of financial and human resource information in the creation of a corporate data model. The paper summarises the main features of finance and human resource systems as they are used in health organisations. It looks at a series of case studies carried out in health organisations, which were selected on the basis of their representation of different aspects of service delivery. It also discusses the theoretical and practical perspectives of the systems themselves, their roles in information management, executive and decision support, and in planning and forecasting.

  8. Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative.

    PubMed

    Dückers, Michel La; Wagner, Cordula; Vos, Leti; Groenewegen, Peter P

    2011-03-09

    Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects.

  9. Tight Junction Protein 1a regulates pigment cell organisation during zebrafish colour patterning.

    PubMed

    Fadeev, Andrey; Krauss, Jana; Frohnhöfer, Hans Georg; Irion, Uwe; Nüsslein-Volhard, Christiane

    2015-04-27

    Zebrafish display a prominent pattern of alternating dark and light stripes generated by the precise positioning of pigment cells in the skin. This arrangement is the result of coordinated cell movements, cell shape changes, and the organisation of pigment cells during metamorphosis. Iridophores play a crucial part in this process by switching between the dense form of the light stripes and the loose form of the dark stripes. Adult schachbrett (sbr) mutants exhibit delayed changes in iridophore shape and organisation caused by truncations in Tight Junction Protein 1a (ZO-1a). In sbr mutants, the dark stripes are interrupted by dense iridophores invading as coherent sheets. Immuno-labelling and chimeric analyses indicate that Tjp1a is expressed in dense iridophores but down-regulated in the loose form. Tjp1a is a novel regulator of cell shape changes during colour pattern formation and the first cytoplasmic protein implicated in this process.

  10. Building capacity to use and undertake research in health organisations: a survey of training needs and priorities among staff

    PubMed Central

    Barratt, Helen; Fulop, Naomi J

    2016-01-01

    Objectives Efforts to improve healthcare and population health depend partly on the ability of health organisations to use research knowledge and participate in its production. We report the findings of a survey conducted to prioritise training needs among healthcare and public health staff, in relation to the production and implementation of research, across an applied health research collaboration. Design A questionnaire survey using a validated tool, the Hennessy-Hicks Training Needs Assessment Questionnaire. Participants rated 25 tasks on a five-point scale with regard to both their confidence in performing the task, and its importance to their role. Setting A questionnaire weblink was distributed to a convenience sample of 35 healthcare and public health organisations in London and South East England, with a request that they cascade the information to relevant staff. Participants 203 individuals responded, from 20 healthcare and public health organisations. Interventions None. Outcome measures Training needs were identified by comparing median importance and performance scores for each task. Individuals were also invited to describe up to three priority areas in which they require training. Results Across the study sample, evaluation; teaching; making do with limited resources; coping with change and managing competing demands were identified as key tasks. Assessing the relevance of research and learning about new developments were the most relevant research-related tasks. Participants’ training priorities included evaluation; finding, appraising and applying research evidence; and data analysis. Key barriers to involvement included time and resources, as well as a lack of institutional support for undertaking research. Conclusions We identify areas in which healthcare and public health professionals may benefit from support to facilitate their involvement in and use of applied health research. We also describe barriers to participation and differing

  11. Early auditory change detection implicitly facilitated by ignored concurrent visual change during a Braille reading task.

    PubMed

    Aoyama, Atsushi; Haruyama, Tomohiro; Kuriki, Shinya

    2013-09-01

    Unconscious monitoring of multimodal stimulus changes enables humans to effectively sense the external environment. Such automatic change detection is thought to be reflected in auditory and visual mismatch negativity (MMN) and mismatch negativity fields (MMFs). These are event-related potentials and magnetic fields, respectively, evoked by deviant stimuli within a sequence of standard stimuli, and both are typically studied during irrelevant visual tasks that cause the stimuli to be ignored. Due to the sensitivity of MMN/MMF to potential effects of explicit attention to vision, however, it is unclear whether multisensory co-occurring changes can purely facilitate early sensory change detection reciprocally across modalities. We adopted a tactile task involving the reading of Braille patterns as a neutral ignore condition, while measuring magnetoencephalographic responses to concurrent audiovisual stimuli that were infrequently deviated either in auditory, visual, or audiovisual dimensions; 1000-Hz standard tones were switched to 1050-Hz deviant tones and/or two-by-two standard check patterns displayed on both sides of visual fields were switched to deviant reversed patterns. The check patterns were set to be faint enough so that the reversals could be easily ignored even during Braille reading. While visual MMFs were virtually undetectable even for visual and audiovisual deviants, significant auditory MMFs were observed for auditory and audiovisual deviants, originating from bilateral supratemporal auditory areas. Notably, auditory MMFs were significantly enhanced for audiovisual deviants from about 100 ms post-stimulus, as compared with the summation responses for auditory and visual deviants or for each of the unisensory deviants recorded in separate sessions. Evidenced by high tactile task performance with unawareness of visual changes, we conclude that Braille reading can successfully suppress explicit attention and that simultaneous multisensory changes can

  12. Barriers and facilitators in the integration of oral health into primary care: a scoping review

    PubMed Central

    Harnagea, Hermina; Couturier, Yves; Shrivastava, Richa; Girard, Felix; Lamothe, Lise; Bedos, Christophe Pierre

    2017-01-01

    Objective This scoping study has been conducted to map the literature and provide a descriptive synthesis on the barriers and facilitators of the integration of oral health into primary care. Methods Grounded in the Rainbow conceptual model and using the Levac et al six-stage framework, we performed a systematic search of electronic databases, organisational websites and grey literature from 1978 to April 2016. All publications with a focus on the integration of oral health into primary care were included except commentaries and editorials. Thematic analyses were performed to synthesise the results. Results From a total of 1619 citations, 58 publications were included in the review. Barrier-related themes included: lack of political leadership and healthcare policies; implementation challenges; discipline-oriented education; lack of continuity of care and services and patients’ oral healthcare needs. The facilitators of integration were supportive policies and resources allocation, interdisciplinary education, collaborative practices between dental and other healthcare professionals, presence of local strategic leaders and geographical proximity. Discussion and public health implications This work has advanced the knowledge on the barriers and facilitators at each integration domain and level, which may be helpful if the healthcare organisations decide to integrate oral health and dental services into primary care. The scoping review findings could be useful for both dental and medical workforce and allied primary healthcare providers. They could also guide the development of healthcare policies that support collaborative practices and patient-centred care in the field of primary care. PMID:28951405

  13. Analysing organisational context: case studies on the contribution of absorptive capacity theory to understanding inter-organisational variation in performance improvement.

    PubMed

    Harvey, Gill; Jas, Pauline; Walshe, Kieran

    2015-01-01

    Organisational context is frequently cited as an important consideration when implementing and evaluating quality improvement interventions in healthcare, but limited guidance is available on which aspects of context are most influential or modifiable. This paper examines how internal and external contextual factors mediate organisational-level performance improvement through applying the knowledge-based theory of absorptive capacity (AC). Three healthcare case studies are presented. Each case is a UK National Health Service organisation that had been identified as having performance problems. Qualitative data were collected through semi-structured interviews with general and clinical managers within the organisation and members of external teams supporting or overseeing performance improvement (n=22). Interview data were analysed using an existing AC framework from the literature. The organisation with the highest AC showed the quickest and most comprehensive performance improvement. Internal characteristics including strategic priorities, processes for managing information, communication and orientation to learning and development impacted on the organisation's ability to engage successfully with external stakeholders and make use of available knowledge. This enabled the organisation to thrive despite the challenging external environment. Lower levels of AC appeared to delay or limit the improvement trajectory. Developing a more detailed and nuanced understanding of how context influences improvement is an important step towards achieving more effective and sustainable quality improvement programmes in healthcare. AC, with its focus on knowledge and organisational learning, provides a useful way to explore the relationship between context and quality improvement and represents a potentially valuable area for future research and development. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

  14. Risk analysis and its link with standards of the World Organisation for Animal Health.

    PubMed

    Sugiura, K; Murray, N

    2011-04-01

    Among the agreements included in the treaty that created the World Trade Organization (WTO) in January 1995 is the Agreement on the Application of Sanitary and Phytosanitary Measures (SPS Agreement) that sets out the basic rules for food safety and animal and plant health standards. The SPS Agreement designates the World Organisation for Animal Health (OIE) as the organisation responsible for developing international standards for animal health and zoonoses. The SPS Agreement requires that the sanitary measures that WTO members apply should be based on science and encourages them to either apply measures based on the OIE standards or, if they choose to adopt a higher level of protection than that provided by these standards, apply measures based on a science-based risk assessment. The OIE also provides a procedural framework for risk analysis for its Member Countries to use. Despite the inevitable challenges that arise in carrying out a risk analysis of the international trade in animals and animal products, the OIE risk analysis framework provides a structured approach that facilitates the identification, assessment, management and communication of these risks.

  15. Competition and facilitation may lead to asymmetric range shift dynamics with climate change.

    PubMed

    Ettinger, Ailene; HilleRisLambers, Janneke

    2017-09-01

    Forecasts of widespread range shifts with climate change stem from assumptions that climate drives species' distributions. However, local adaptation and biotic interactions also influence range limits and thus may impact range shifts. Despite the potential importance of these factors, few studies have directly tested their effects on performance at range limits. We address how population-level variation and biotic interactions may affect range shifts by transplanting seeds and seedlings of western North American conifers of different origin populations into different competitive neighborhoods within and beyond their elevational ranges and monitoring their performance. We find evidence that competition with neighboring trees limits performance within current ranges, but that interactions between adults and juveniles switch from competitive to facilitative at upper range limits. Local adaptation had weaker effects on performance that did not predictably vary with range position or seed origin. Our findings suggest that competitive interactions may slow species turnover within forests at lower range limits, whereas facilitative interactions may accelerate the pace of tree expansions upward near timberline. © 2017 John Wiley & Sons Ltd.

  16. Barriers and Facilitators to Healthy Lifestyle Changes in Minority Ethnic Populations in the UK: a Narrative Review.

    PubMed

    Patel, Naina; Ferrer, Harriet Batista; Tyrer, Freya; Wray, Paula; Farooqi, Azhar; Davies, Melanie J; Khunti, Kamlesh

    2017-12-01

    Minority ethnic populations experience a disproportionate burden of health inequalities compared with the rest of the population, including an increased risk of type 2 diabetes (T2DM). The purpose of this narrative review was to explore knowledge and attitudes around diabetes, physical activity and diet and identify barriers and facilitators to healthy lifestyle changes in minority ethnic populations in the UK. The narrative review focused on three key research topics in relation to barriers and facilitators to healthy lifestyle changes in minority adult ethnic populations: (i) knowledge and attitudes about diabetes risk; (ii) current behaviours and knowledge about physical activity and diet; and (iii) barriers and facilitators to living a healthier lifestyle. Nearly all of the studies that we identified reported on South Asian minority ethnic populations; we found very few studies on other minority ethnic populations. Among South Asian communities, there was generally a good understanding of diabetes and its associated risk factors. However, knowledge about the levels of physical activity required to gain health benefits was relatively poor and eating patterns varied. Barriers to healthy lifestyle changes identified included language barriers, prioritising work over physical activity to provide for the family, cultural barriers with regard to serving and eating traditional food, different perceptions of a healthy body weight and fear of racial harassment or abuse when exercising. Additional barriers for South Asian women included expectations to remain in the home, fear for personal safety, lack of same gender venues and concerns over the acceptability of wearing 'western' exercise clothing. Facilitators included concern that weight gain might compromise family/carer responsibilities, desire to be healthy, T2DM diagnosis and exercise classes held in 'safe' environments such as places of worship. Our findings suggest that South Asian communities are less likely to

  17. On the Determinants of Employment-Related Organised Education and Informal Learning

    ERIC Educational Resources Information Center

    Nilsson, Staffan; Rubenson, Kjell

    2014-01-01

    This paper analyses the distribution of employment-related organised education and informal learning in the Canadian workforce. The paper draws on a large-scale survey, the Changing Nature of Work and Lifelong Learning (WALL), which was based on structured and standardised telephone interviews with a representative sample of 5783 Canadian members…

  18. Connecting organisational culture and quality of care in the hospital: is job burnout the missing link?

    PubMed

    Montgomery, Anthony; Panagopoulou, Efharis; Kehoe, Ian; Valkanos, Efthymios

    2011-01-01

    To date, relatively little evidence has been published as to what represents an effective and efficient way to improve quality of care and safety in hospitals. In addition, the initiatives that do exist are rarely designed or developed with regard to the individual and organisational factors that determine the success or failure of such initiatives. One of the challenges in linking organisational culture to quality of care is to identify the focal point at which a deficient hospital culture and inadequate organisational resources are most evident. The accumulated evidence suggests that such a point is physician burnout. This paper sets out to examine this issue. The paper reviews the existing literature on organisational culture, burnout and quality of care in the healthcare sector. A new conceptual approach as to how organisational culture and quality of care can be more effectively linked through the physician experience of burnout is proposed. Recommendations are provided with regard to how future research can approach quality of care from a bottom-up organisational change perspective. In addition, the need to widen the debate beyond US and North European experiences is discussed. The present paper represents an attempt to link organisational culture, job burnout and quality of care in a more meaningful way. A conceptual model has been provided as a way to frame and evaluate future research.

  19. Organisation of lymphocytic infiltrates in ANCA-associated glomerulonephritis.

    PubMed

    Brix, Silke R; Noriega, Mercedes; Herden, Elisabeth M; Goldmann, Birgit; Langbehn, Ulrike; Busch, Martin; Jabs, Wolfram J; Steinmetz, Oliver M; Panzer, Ulf; Huber, Tobias B; Stahl, Rolf A K; Wiech, Thorsten

    2018-06-01

    Renal involvement in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis contributes to significant morbidity and mortality in patients. In chronic inflammation, B cells are recruited to the inflamed tissue and organised lymphoid structures have been described in several autoimmune diseases. The aim of this study was to correlate the lymphoid organisation in renal biopsies with renal outcome in ANCA-associated glomerulonephritis (GN). We investigated 112 renal biopsies from patients with newly diagnosed ANCA-associated necrotising GN. We identified four different levels of the intrarenal organisation of lymphocytes: T cells without B cells, scattered B and T cells, clustered lymphocytic infiltrates and nodular compartmentally arranged B and T cell aggregates. Almost half the patients showed clusters of B and T lymphocytes in their biopsies. In 15 of these biopsies, a higher degree of organisation with lymphocytic compartments was detected. Inflammatory cell organisation was associated with renal failure, but not with tubular atrophy and interstitial fibrosis. Patients with organised lymphocytic infiltrates in their biopsy had worse renal function during follow-up and were more likely to develop end stage renal disease. In the present study, we show that the renal lymphocytic organisation is associated with renal outcome in ANCA-associated GN. The organisation of the lymphocytic infiltrate may be a morphological correlate of a perpetual and exaggerated inflammation in renal ANCA disease. Classifying the lymphocytic infiltrate could help to predict renal outcome, and might therefore be used for individualised adjustments in the intensity and duration of immunosuppressive therapy. © 2018 John Wiley & Sons Ltd.

  20. Home care services for sick children: Healthcare professionals' conceptions of challenges and facilitators.

    PubMed

    Castor, Charlotte; Hallström, Inger; Hansson, Helena; Landgren, Kajsa

    2017-09-01

    To explore healthcare professionals' conceptions of caring for sick children in home care services. Families often prefer home care to hospital care, and the number of home care services for children is increasing. Caring for children at home has been recognised as challenging for healthcare professionals in home care services used to providing care predominately for adults. An inductive qualitative design. Seven focus group interviews were performed with 36 healthcare professionals from multidisciplinary home care services. Data were analysed stepwise using a phenomenographic analysis. Three description categories emerged: "A challenging opportunity", "A child perspective", and "Re-organise in accordance with new prerequisites." Providing home care services for children was conceived to evoke both professional and personal challenges such as feelings of inadequacy and fear and professional growth such as increased competence and satisfaction. Conceptions of whether the home or the hospital was the best place for care differed. Adapting to the child's care was conceived as important. Cooperation with paediatric departments and a well-functioning team work were important organisational aspects. Providing home care for children was a challenging but rewarding task for healthcare professionals used to care for adults. To provide care with a child perspective was experienced as important even though there were conflicting conceptions of how this should be done. Close cooperation with paediatric departments and teamwork were prerequisites that make up for the low number of paediatric patients and facilitate confidence and competence. A sufficient number of referred children and enabling healthcare professionals to be part of the re-organising and implementation processes might facilitate the home care services for sick children. Enough time and good teamwork must be emphasised. Early referrals, continuous cooperation with paediatric clinics complemented with

  1. Is the Learning Organisation Still Alive?

    ERIC Educational Resources Information Center

    Pedler, Mike; Burgoyne, John G.

    2017-01-01

    Purpose: It has recently been suggested that the learning organisation (LO) is dead (Pedler, 2013). The authors make the case here that it is still alive. This paper provides a brief history of LO and organisational learning, follows this with some survey findings, a discussion and an exploration of some related contemporary issues and concludes…

  2. Promoting research to improve maternal, neonatal, infant and adolescent health in West Africa: the role of the West African Health Organisation.

    PubMed

    Sombie, Issiaka; Bouwayé, Aissa; Mongbo, Yves; Keita, Namoudou; Lokossou, Virgil; Johnson, Ermel; Assogba, Laurent; Crespin, Xavier

    2017-07-12

    West Africa has adopted numerous strategies to counter maternal and infant mortality, provides national maternal and infant health programmes, and hosts many active technical and financial partners and non-governmental organisations. Despite this, maternal and infant morbidity and mortality indicators are still very high. In this commentary, internal actors and officials of the West African Health Organisation (WAHO) examine the regional organisation's role in promoting research as a tool for strengthening maternal and infant health in West Africa.As a specialised institution of the Economic Community of West African States (ECOWAS) responsible for health issues, WAHO's mission is to provide the sub-region's population with the highest possible health standards by harmonising Member States' policies, resource pooling, and cooperation among Member States and third countries to collectively and strategically combat the region's health problems. To achieve this, WAHO's main intervention strategy is that of facilitation, as this encourages the generation and use of evidence to inform decision-making and reinforce practice.WAHO's analysis of interventions since 2000 showed that it had effected some changes in research governance, management and funding, as well as in individual and institutional capacity building, research dissemination, collaboration and exchanges between the various stakeholders. It also revealed several challenges such as process ownership, member countries' commitment, weak individual and institutional capacity, mobilisation, and stakeholder commitment. To better strengthen evidence-based decision-making, in 2016, WAHO created a unique programme aimed at improving the production, dissemination and use of research information and results in health programme planning to ultimately improve population health.While WAHO's experiences to date demonstrate how a regional health institution can integrate research promotion into the fight against maternal and

  3. Training rural practitioners to use buprenorphine; using The Change Book to facilitate technology transfer.

    PubMed

    McCarty, Dennis; Rieckmann, Traci; Green, Carla; Gallon, Steve; Knudsen, Jeff

    2004-04-01

    The Opiate Medication Initiative for Rural Oregon Residents trained physicians and counselors in Central and Southwestern Oregon to use buprenorphine and develop service models that supported patient participation in drug abuse counseling. The Change Book from Addiction Technology Transfer Centers was used to structure the change process. Fifty-one individuals (17 physicians, 4 pharmacists, 2 nurse practitioners, and 28 drug abuse counselors and administrators) from seven counties completed the training and contributed to the development of community treatment protocols. A pre-post measure of attitudes and beliefs toward the use of buprenorphine suggested significant improvements in attitude after training, especially among counselors. Eight months after training, 10 of 17 physicians trained had received waivers to use buprenorphine and 29 patients were in treatment with six of the physicians. The Change Book facilitated development of county change teams and structured the planning efforts. The initiative also demonstrated the potential to concurrently train physicians, pharmacists, and counselors on the use of buprenorphine.

  4. Facilitating behavioral learning and habit change in voice therapy--theoretic premises and practical strategies.

    PubMed

    Iwarsson, Jenny

    2015-12-01

    A typical goal of voice therapy is a behavioral change in the patient's everyday speech. The SLP's plan for voice therapy should therefore optimally include strategies for automatization. The aim of the present study was to identify and describe factors that promote behavioral learning and habit change in voice behavior and have the potential to affect patient compliance and thus therapy outcome. Research literature from the areas of motor and behavioral learning, habit formation, and habit change was consulted. Also, specific elements from personal experience of clinical voice therapy are described and discussed from a learning theory perspective. Nine factors that seem to be relevant to facilitate behavioral learning and habit change in voice therapy are presented, together with related practical strategies and theoretical underpinnings. These are: 1) Cue-altering; 2) Attention exercises; 3) Repetition; 4) Cognitive activation; 5) Negative practice; 6) Inhibition through interruption; 7) Decomposing complex behavior; 8) The 'each time-every time' principle; and 9) Successive implementation of automaticity.

  5. Included or Excluded? The Dual Influences of the Organisational Field and Organisational Practices on New Female Academics

    ERIC Educational Resources Information Center

    Elg, Ulf; Jonnergard, Karin

    2010-01-01

    A number of measures have been taken by the society to ensure gender equality in higher education. Nevertheless, women still face great difficulties when pursuing an academic career. Our aim is to increase the understanding of how the society, conceptualised as the organisational field, interacts with organisational factors and personal actions as…

  6. How empowering is hospital care for older people with advanced disease? Barriers and facilitators from a cross-national ethnography in England, Ireland and the USA

    PubMed Central

    Selman, Lucy Ellen; Daveson, Barbara A.; Smith, Melinda; Johnston, Bridget; Ryan, Karen; Morrison, R. Sean; Pannell, Caty; McQuillan, Regina; de Wolf-Linder, Suzanne; Pantilat, Steven Z.; Klass, Lara; Meier, Diane; Normand, Charles; Higginson, Irene J.

    2017-01-01

    Abstract Background patient empowerment, through which patients become self-determining agents with some control over their health and healthcare, is a common theme across health policies globally. Most care for older people is in the acute setting, but there is little evidence to inform the delivery of empowering hospital care. Objective we aimed to explore challenges to and facilitators of empowerment among older people with advanced disease in hospital, and the impact of palliative care. Methods we conducted an ethnography in six hospitals in England, Ireland and the USA. The ethnography involved: interviews with patients aged ≥65, informal caregivers, specialist palliative care (SPC) staff and other clinicians who cared for older adults with advanced disease, and fieldwork. Data were analysed using directed thematic analysis. Results analysis of 91 interviews and 340 h of observational data revealed substantial challenges to empowerment: poor communication and information provision, combined with routinised and fragmented inpatient care, restricted patients’ self-efficacy, self-management, choice and decision-making. Information and knowledge were often necessary for empowerment, but not sufficient: empowerment depended on patient-centredness being enacted at an organisational and staff level. SPC facilitated empowerment by prioritising patient-centred care, tailored communication and information provision, and the support of other clinicians. Conclusions empowering older people in the acute setting requires changes throughout the health system. Facilitators of empowerment include excellent staff–patient communication, patient-centred, relational care, an organisational focus on patient experience rather than throughput, and appropriate access to SPC. Findings have relevance for many high- and middle-income countries with a growing population of older patients with advanced disease. PMID:27810850

  7. "Sometimes, to Change the People, You've Got to Change the People": When Learning Is Not Enough

    ERIC Educational Resources Information Center

    Blackman, Deborah; Kennedy, Monica

    2011-01-01

    This paper discusses organisational learning and change management in a major change in an Australian University. The qualitative data highlight the issues faced in the management of change, particularly in the institutionalised resistance of organisational members. Analysis suggests that the development and consolidation of shared genres of doubt…

  8. Delivering Integrated Services. Models for Facilitating Change in Small and Mid-Sized Firms. Business Assistance Tools.

    ERIC Educational Resources Information Center

    Mitchell, Stephen M.

    This guide draws on case studies to identify lessons for small and midsized firms who wish to improve the quality of their services and facilitate change. Following an introduction, section 2 describes the context in which the research was undertaken after a needs analysis was conducted of small and midsized businesses and service providers, and…

  9. Organisational characteristics associated with shift work practices and potential opportunities for intervention: findings from a Canadian study.

    PubMed

    Hall, Amy L; Smit, Andrea N; Mistlberger, Ralph E; Landry, Glenn J; Koehoorn, Mieke

    2017-01-01

    Shift work is a common working arrangement with wide-ranging implications for worker health. Organisational determinants of shift work practices are not well characterised; such information could be used to guide evidence-based research and best practices to mitigate shift work's negative effects. This exploratory study aimed to describe and assess organisational-level determinants of shift work practices thought to affect health, across a range of industry sectors. Data on organisational characteristics, shift work scheduling, provision of shift work education materials/training to employees and night-time lighting policies in the workplace were collected during phone interviews with organisations across the Canadian province of British Columbia. Relationships between organisational characteristics and shift work practices were assessed using multivariable logistic regression models. The study sample included 88 participating organisations, representing 30 700 shift workers. Long-duration shifts, provision of shift work education materials/training to employees and night-time lighting policies were reported by approximately one-third of participating organisations. Odds of long-duration shifts increased in larger workplaces and by industry. Odds of providing shift work education materials/training increased in larger workplaces, in organisations reporting concern for shift worker health and in organisations without seasonal changes in shift work. Odds of night-time lighting policies in the workplace increased in organisations reporting previous workplace accidents or incidents that occurred during non-daytime hours, site maintenance needs and client service or care needs. This study points to organisational determinants of shift work practices that could be useful for targeting research and workplace interventions. Results should be interpreted as preliminary in an emerging body of literature on shift work and health. Published by the BMJ Publishing Group

  10. Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people.

    PubMed

    Flodgren, Gerd; Deane, Katherine; Dickinson, Heather O; Kirk, Sara; Alberti, Hugh; Beyer, Fiona R; Brown, James G; Penney, Tarra L; Summerbell, Carolyn D; Eccles, Martin P

    2010-03-17

    The prevalence of obesity is increasing globally and will, if left unchecked, have major implications for both population health and costs to health services. To assess the effectiveness of strategies to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people. We updated the search for primary studies in the following databases, which were all interrogated from the previous (version 2) search date to May 2009: The Cochrane Central Register of Controlled Trials (which at this time incorporated all EPOC Specialised Register material) (The Cochrane Library 2009, Issue 1), MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid). We identified further potentially relevant studies from the reference lists of included studies. Randomised controlled trials (RCTs) that compared routine provision of care with interventions aimed either at changing the behaviour of healthcare professionals or the organisation of care to promote weight reduction in overweight or obese adults. Two reviewers independently extracted data and assessed study quality. We included six RCTs, involving more than 246 health professionals and 1324 overweight or obese patients. Four of the trials targeted professionals and two targeted the organisation of care. Most of the studies had methodological or reporting weaknesses indicating a risk of bias.Meta-analysis of three trials that evaluated educational interventions aimed at GPs suggested that, compared to standard care, such interventions could reduce the average weight of patients after a year (by 1.2 kg, 95% CI -0.4 to 2.8 kg); however, there was moderate unexplained heterogeneity between their results (I(2) = 41%). One trial found that reminders could change doctors' practice, resulting in a significant reduction in weight among men (by 11.2 kg, 95% CI 1.7 to 20.7 kg) but not among women (who reduced weight by 1.3 kg, 95% CI -4.1 to 6.7 kg). One trial found that

  11. Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative

    PubMed Central

    2011-01-01

    Background Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. Methods The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. Results MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. Conclusions It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects. PMID:21385467

  12. Organisational Communication and Its Relationships with Job Satisfaction and Organisational Commitment of Primary School Staff in Western Australia

    ERIC Educational Resources Information Center

    De Nobile, John

    2017-01-01

    The aim of this study was to investigate the relationships between aspects of organisational communication and dimensions of job satisfaction and general organisational commitment. Participants were 358 staff members from 35 government primary schools in the state of Western Australia, who completed a survey comprising the Organisational…

  13. Going beyond the identification of change facilitators to effectively implement a new model of services: lessons learned from a case example in paediatric rehabilitation.

    PubMed

    Camden, Chantal; Swaine, Bonnie; Tétreault, Sylvie; Carrière, Monique

    2011-01-01

    To identify facilitators and barriers to service reorganization, how they evolved and interacted to influence change during the implementation of a new service delivery model of paediatric rehabilitation. Over 3 years, different stakeholders responded to SWOT questionnaires (n = 139) and participated in focus groups (n = 19) and telephone interviews (n = 13). A framework based on socio constructivist theories made sense of the data. Facilitators related to the programme's structure (e.g. funding), the actors (e.g. willingness to test the new service model) and the change management process (e.g. participative approach). Some initial facilitators became barriers (e.g. leadership lacked at the end), while other barriers emerged (e.g. lack of tools). Understanding factor interactions requires examining the multiple actors' intentions, actions and consequences and their relations with structural elements. Analysing facilitators and barriers helped better understand the change processes, but this must be followed by concrete actions to successfully implement new paediatric rehabilitation models.

  14. Counsellors and Organisational Change: Egan's Systems Model as a Tool in Organisational Consulting.

    ERIC Educational Resources Information Center

    Hermansson, Gary L.

    1993-01-01

    Considers the increasing involvement of counselors as consultants to effect organizational change. Presents a case example to demonstrate how Egan's systems model, "Model A," can be applied effectively for both the development of a consultation relationship and for organizational change. (JPS)

  15. Self-recognition in corals facilitates deep-sea habitat engineering

    USGS Publications Warehouse

    Hennige, Sebastian J; Morrison, Cheryl L.; Form, Armin U.; Buscher, Janina; Kamenos, Nicholas A.; Roberts, J. Murray

    2014-01-01

    The ability of coral reefs to engineer complex three-dimensional habitats is central to their success and the rich biodiversity they support. In tropical reefs, encrusting coralline algae bind together substrates and dead coral framework to make continuous reef structures, but beyond the photic zone, the cold-water coral Lophelia pertusa also forms large biogenic reefs, facilitated by skeletal fusion. Skeletal fusion in tropical corals can occur in closely related or juvenile individuals as a result of non-aggressive skeletal overgrowth or allogeneic tissue fusion, but contact reactions in many species result in mortality if there is no ‘self-recognition’ on a broad species level. This study reveals areas of ‘flawless’ skeletal fusion in Lophelia pertusa, potentially facilitated by allogeneic tissue fusion, are identified as having small aragonitic crystals or low levels of crystal organisation, and strong molecular bonding. Regardless of the mechanism, the recognition of ‘self’ between adjacent L. pertusa colonies leads to no observable mortality, facilitates ecosystem engineering and reduces aggression-related energetic expenditure in an environment where energy conservation is crucial. The potential for self-recognition at a species level, and subsequent skeletal fusion in framework-forming cold-water corals is an important first step in understanding their significance as ecological engineers in deep-seas worldwide.

  16. Harnessing ISO/IEC 12207 to Examine the Extent of SPI Activity in an Organisation

    NASA Astrophysics Data System (ADS)

    Clarke, Paul; O'Connor, Rory

    The quality of the software development process directly affects the quality of the software product. To be successful, software development organisations must respond to changes in technology and business circumstances, and therefore software process improvement (SPI) is required. SPI activity relates to any modification that is performed to the software process in order to improve an aspect of the process. Although multiple process assessments could be employed to examine SPI activity, they present an inefficient tool for such an examination. This paper presents an overview of a new survey-based resource that utilises the process reference model in ISO/IEC 12207 in order to expressly and directly determine the level of SPI activity in a software development organisation. This survey instrument can be used by practitioners, auditors and researchers who are interested in determining the extent of SPI activity in an organisation.

  17. Employee direct participation in organisational decisions and workplace safety.

    PubMed

    Widerszal-Bazyl, Maria; Warszewska-Makuch, Magdalena

    2008-01-01

    Managers from 192 companies filled out the Employee Direct Participation in Organisational Change questionnaire measuring employees' direct participation (DP) in organisational decisions. Four main forms of DP were identified: individual and group consultations, and individual and group delegation. Workplace safety was measured with the number of accidents, the number of employees working in hazardous conditions, accident absenteeism and sickness absence. Results showed that the 2 latter indicators were significantly related to some parameters of DP. Thus, companies that used face-to-face individual consultation had lower accident absenteeism than ones that did not. The same effect was true for group consultation with temporary groups, and individual and group delegation. Workplaces with high scores for scope for group consultation had lower accident absenteeism, and those with high scores for scope for group delegation had lower sickness absence. It was concluded that employee DP had a positive influence on workplace safety, even if involvement was not directly related to safety.

  18. How a Small Family Run Business Adopted Critical Reflection Action Learning Using Hand Drawn Images to Initiate Organisational Change

    ERIC Educational Resources Information Center

    Shepherd, Gary

    2016-01-01

    In this account of practice I would like to share my experiences of facilitating a Critical Reflection Action Learning (CRAL) set with a small family run business, struggling to make change and expand their services due to the problems they encountered in separating their business lives from their family lives. The account I present here is based…

  19. Smart health and innovation: facilitating health-related behaviour change.

    PubMed

    Redfern, J

    2017-08-01

    Non-communicable diseases (NCD) are the leading cause of death globally. Smart health technology and innovation is a potential strategy for increasing reach and for facilitating health behaviour change. Despite rapid growth in the availability and affordability of technology there remains a paucity of published and robust research in the area as it relates to health. The objective of the present paper is to review and provide a snapshot of a variety of contemporary examples of smart health strategies with a focus on evidence and research as it relates to prevention with a CVD management lens. In the present analysis, five examples will be discussed and they include a physician-directed strategy, consumer directed strategies, a public health approach and a screening strategy that utilises external hardware that connects to a smartphone. In conclusion, NCD have common risk factors and all have an association with nutrition and health. Smart health and innovation is evolving rapidly and may help with diagnosis, treatment and management. While on-going research, development and knowledge is needed, the growth of technology development and utilisation offers opportunities to reach more people and achieve better health outcomes at local, national and international levels.

  20. How is cyber threat evolving and what do organisations need to consider?

    PubMed

    Borrett, Martin; Carter, Roger; Wespi, Andreas

    Organisations and members of the public are becoming accustomed to the increasing velocity, frequency and variety of cyber-attacks that they have been facing over the last few years. In response to this challenge, it is important to explore what can be done to offer commercial and private users a reliable and functioning environment. This paper discusses how cyber threats might evolve in the future and seeks to explore these threats more fully. Attention is paid to the changing nature of cyber-attackers and their motivations and what this means for organisations. Finally, useful and actionable steps are provided, which practitioners can use to understand how they can start to address the future challenges of cyber security.

  1. Understanding the role of the OneLove campaign in facilitating drivers of social and behavioral change in southern Africa: a qualitative evaluation.

    PubMed

    Jana, Michael; Letsela, Lebohang; Scheepers, Esca; Weiner, Renay

    2015-01-01

    In the wake of the HIV and AIDS pandemic, health communication has played an important role in social and behavior change in HIV prevention and treatment efforts. Despite this significant role, it is not always clear how health communication influences individuals and communities to facilitate social and behavior change. Guided predominantly by Lewin's theory of change in the context of complexity thinking, and supported by qualitative evidence from Soul City Institute's midterm evaluation of the OneLove multimedia campaign in 9 southern African countries, this article illustrates how carefully designed health edutainment communication materials facilitate drivers of social and behavior change. Thus, researched and theory-based health communication aimed at behavior and social change remains an important pillar in HIV prevention and treatment, where personal and social agency remain key.

  2. Lipids in the cell: organisation regulates function.

    PubMed

    Santos, Ana L; Preta, Giulio

    2018-06-01

    Lipids are fundamental building blocks of all cells and play important roles in the pathogenesis of different diseases, including inflammation, autoimmune disease, cancer, and neurodegeneration. The lipid composition of different organelles can vary substantially from cell to cell, but increasing evidence demonstrates that lipids become organised specifically in each compartment, and this organisation is essential for regulating cell function. For example, lipid microdomains in the plasma membrane, known as lipid rafts, are platforms for concentrating protein receptors and can influence intra-cellular signalling. Lipid organisation is tightly regulated and can be observed across different model organisms, including bacteria, yeast, Drosophila, and Caenorhabditis elegans, suggesting that lipid organisation is evolutionarily conserved. In this review, we summarise the importance and function of specific lipid domains in main cellular organelles and discuss recent advances that investigate how these specific and highly regulated structures contribute to diverse biological processes.

  3. An empirically-derived approach for investigating Health Information Technology: the Elementally Entangled Organisational Communication (EEOC) framework.

    PubMed

    Georgiou, Andrew; Westbrook, Johanna I; Braithwaite, Jeffrey

    2012-07-12

    The purpose of this paper is to illustrate the Elementally Entangled Organisational Communication (EEOC) framework by drawing on a set of three case studies which assessed the impact of new Health Information Technology (HIT) on a pathology service. The EEOC framework was empirically developed as a tool to tackle organisational communication challenges in the implementation and evaluation of health information systems. The framework was synthesised from multiple research studies undertaken across a major metropolitan hospital pathology service during the period 2005 to 2008. These studies evaluated the impact of new HIT systems in pathology departments (Laboratory Information System) and an Emergency Department (Computerised Provider Order Entry) located in Sydney, Australia. Key dimensions of EEOC are illustrated by the following case studies: 1) the communication infrastructure between the Blood Bank and the ward for the coordination and distribution of blood products; 2) the organisational environment in the Clinical Chemistry and Haematology departments and their attempts to organise, plan and control the processing of laboratory specimens; and 3) the temporal make up of the organisation as revealed in changes to the way the Central Specimen Reception allocated, sequenced and synchronised work tasks. The case studies not only highlight the pre-existing communication architecture within the organisation but also the constitutive role communication plays in the way organisations go about addressing their requirements. HIT implementation involves a mutual transformation of the organisation and the technology. This is a vital consideration because of the dangers associated with poor organisational planning and implementation of HIT, and the potential for unintended adverse consequences, workarounds and risks to the quality and safety of patient care. The EEOC framework aims to account for the complex range of contextual factors and triggers that play a role in the

  4. An empirically-derived approach for investigating Health Information Technology: the Elementally Entangled Organisational Communication (EEOC) framework

    PubMed Central

    2012-01-01

    Background The purpose of this paper is to illustrate the Elementally Entangled Organisational Communication (EEOC) framework by drawing on a set of three case studies which assessed the impact of new Health Information Technology (HIT) on a pathology service. The EEOC framework was empirically developed as a tool to tackle organisational communication challenges in the implementation and evaluation of health information systems. Methods The framework was synthesised from multiple research studies undertaken across a major metropolitan hospital pathology service during the period 2005 to 2008. These studies evaluated the impact of new HIT systems in pathology departments (Laboratory Information System) and an Emergency Department (Computerised Provider Order Entry) located in Sydney, Australia. Results Key dimensions of EEOC are illustrated by the following case studies: 1) the communication infrastructure between the Blood Bank and the ward for the coordination and distribution of blood products; 2) the organisational environment in the Clinical Chemistry and Haematology departments and their attempts to organise, plan and control the processing of laboratory specimens; and 3) the temporal make up of the organisation as revealed in changes to the way the Central Specimen Reception allocated, sequenced and synchronised work tasks. Conclusions The case studies not only highlight the pre-existing communication architecture within the organisation but also the constitutive role communication plays in the way organisations go about addressing their requirements. HIT implementation involves a mutual transformation of the organisation and the technology. This is a vital consideration because of the dangers associated with poor organisational planning and implementation of HIT, and the potential for unintended adverse consequences, workarounds and risks to the quality and safety of patient care. The EEOC framework aims to account for the complex range of contextual

  5. Organising Learning: Informal Workplace Learning in a Trade Union Child-Care Campaign

    ERIC Educational Resources Information Center

    Brown, Tony

    2008-01-01

    Purpose: Trade unions, like many other membership-based social movement organisations, are confronted by the challenge of growth and revitalisation. Declining membership numbers, an increasingly restrictive legislative framework, and dramatic changes in modes of employment have combined to challenge many unions to rethink the way they work. In…

  6. Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in children and adults with overweight or obesity.

    PubMed

    Flodgren, Gerd; Gonçalves-Bradley, Daniela C; Summerbell, Carolyn D

    2017-11-30

    The prevalence of overweight and obesity is increasing globally, an increase which has major implications for both population health and costs to health services. This is an update of a Cochrane Review. To assess the effects of strategies to change the behaviour of health professionals or the organisation of care compared to standard care, to promote weight reduction in children and adults with overweight or obesity. We searched the following databases for primary studies up to September 2016: CENTRAL, MEDLINE, Embase, CINAHL, DARE and PsycINFO. We searched the reference lists of included studies and two trial registries. We considered randomised trials that compared routine provision of care with interventions aimed either at changing the behaviour of healthcare professionals or the organisation of care to promote weight reduction in children and adults with overweight or obesity. We used standard methodological procedures expected by Cochrane when conducting this review. We report the results for the professional interventions and the organisational interventions in seven 'Summary of findings' tables. We identified 12 studies for inclusion in this review, seven of which evaluated interventions targeting healthcare professional and five targeting the organisation of care. Eight studies recruited adults with overweight or obesity and four recruited children with obesity. Eight studies had an overall high risk of bias, and four had a low risk of bias. In total, 139 practices provided care to 89,754 people, with a median follow-up of 12 months. Professional interventions Educational interventions aimed at general practitioners (GPs), may slightly reduce the weight of participants (mean difference (MD) -1.24 kg, 95% confidence interval (CI) -2.84 to 0.37; 3 studies, N = 1017 adults; low-certainty evidence).Tailoring interventions to improve GPs' compliance with obesity guidelines probably leads to little or no difference in weight loss (MD 0.05 (kg), 95% CI -0.32 to 0

  7. Facilitating large-scale implementation of evidence based health care: insider accounts from a co-operative inquiry.

    PubMed

    Waterman, Heather; Boaden, Ruth; Burey, Lorraine; Howells, Brook; Harvey, Gill; Humphreys, John; Rothwell, Katy; Spence, Michael

    2015-02-13

    Facilitators are known to be influential in the implementation of evidence-based health care (EBHC). However, little evidence exists on what it is that they do to support the implementation process. This research reports on how knowledge transfer associates (KTAs) working as part of the UK National Institute for Health Research 'Collaboration for Leadership in Applied Health Research and Care' for Greater Manchester (GM CLAHRC) facilitated the implementation of EBHC across several commissioning and provider health care agencies. A prospective co-operative inquiry with eight KTAs was carried out comprising of 11 regular group meetings where they reflected critically on their experiences. Twenty interviews were also conducted with other members of the GM CLAHRC Implementation Team to gain their perspectives of the KTAs facilitation role and process. There were four phases to the facilitation of EBHC on a large scale: (1) Assisting with the decision on what EBHC to implement, in this phase, KTAs pulled together people and disparate strands of information to facilitate a decision on which EBHC should be implemented; (2) Planning of the implementation of EBHC, in which KTAs spent time gathering additional information and going between key people to plan the implementation; (3) Coordinating and implementing EBHC when KTAs recruited general practices and people for the implementation of EBHC; and (4) Evaluating the EBHC which required the KTAs to set up (new) systems to gather data for analysis. Over time, the KTAs demonstrated growing confidence and skills in aspects of facilitation: research, interpersonal communication, project management and change management skills. The findings provide prospective empirical data on the large scale implementation of EBHC in primary care and community based organisations focusing on resources and processes involved. Detailed evidence shows facilitation is context dependent and that 'one size does not fits all'. Co-operative inquiry

  8. Outsourcing in private healthcare organisations: a Greek perspective.

    PubMed

    Moschuris, Socrates J; Kondylis, Michael N

    2007-01-01

    The purpose of this paper is to present a study carried out to investigate the extent of outsourcing, the decision-making process, the impact of outsourcing, and the future trend of outsourcing in private healthcare organisations in Greece. A survey instrument was designed and mailed to a random sample of 100 private healthcare organisations in Greece. A total of 25 usable questionnaires were received, representing a response rate of 25 percent. The survey instrument focused on the extent to which private healthcare organisations outsource services, the decision-making process for choosing an external service provider, the impact of outsourcing, and the future trend of outsourcing. Private healthcare organisations in Greece outsource a variety of activities. Cost savings, customisation, and customer satisfaction are the main factors affecting the outsourcing decision. The cooperation with a contract service provider has led to an improvement in customer satisfaction and to a cost reduction. Most users are highly satisfied with the performance of these companies and believe that there will be a future increase in the usage of these services. The paper provides a framework regarding outsourcing in private healthcare organisations. This research fills the gap in the area of outsourcing in private healthcare organisations in Greece.

  9. Cervical cancer screening in Europe: Quality assurance and organisation of programmes.

    PubMed

    Elfström, K Miriam; Arnheim-Dahlström, Lisen; von Karsa, Lawrence; Dillner, Joakim

    2015-05-01

    Cervical screening programmes have reduced cervical cancer incidence and mortality but the level of success is highly variable between countries. Organisation of programmes is essential for equity and cost-effectiveness. However, there are differences in effectiveness, also among organised programmes. In order to identify the key organisational components that determine effectiveness, we performed a Europe-wide survey on the current status of organisation and organised quality assurance (QA) measures in cervical cancer prevention programmes, as well as organisation-associated costs. A comprehensive questionnaire was developed through systematic review of literature and existing guidelines. The survey was sent to programme organisers, Ministries of Health and experts in 34 European Union (EU) and European Free Trade Agreement (EFTA) countries. Detailed aspects of programme organisation, quality assurance, monitoring, evaluation and corresponding line-item costs were recorded. Documentation of programme guidelines, protocols and publications was requested. Twenty-nine of 34 countries responded. The results showed that organised efforts for QA, monitoring and evaluation were carried out to a differing extent and were not standardised, making it difficult to compare the cost-effectiveness of organisation and QA strategies. Most countries found it hard to estimate the costs associated with launching and operating the organised programme. To our knowledge, this is the first questionnaire to request detailed information on the actual organisation and QA of programmes. The results of this survey can be used as a basis for further development of standardised guidelines on organisation and QA of cervical cancer screening programmes in Europe. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Achieving enhanced organisational resilience by improved management of risk: Summary of research into the principles of resilience and the practices of resilient organisations.

    PubMed

    Hopkin, Paul

    There have been many high-profile incidents in recent times that have affected both individual organisations and large parts of society. In response to these disasters and their consequences, there has been increasing focus on the concept of 'resilience'. Airmic worked with Cranfield School of Management to investigate the features of resilient organisations and whether common characteristics could be identified. The research summarised in this paper discovered five principles that increase an organisation's level of resilence. The paper also reports on the actions taken by organisations to embed these resilience principles into four main business enablers. These business enablers in combination represent the business model of the organisation. The overall conclusion of the research was that, in order to achieve a state of enhanced resilience, organisations need to be aware of risks and threats they face and then combine the actions required to be 'risk compliant' with the ability to be 'risk responsive'.

  11. 'Twin2twin' an innovative method of empowering midwives to strengthen their professional midwifery organisations.

    PubMed

    Cadée, Franka; Perdok, Hilde; Sam, Betty; de Geus, Myrte; Kweekel, Liselotte

    2013-10-01

    midwives need professional support from a national midwifery organisation to be able to provide the services that are by regulatory mechanisms and accreditation expected of them. Not all midwives in the world are united in a professional organisation. The aim of this project was to strengthen the midwifery organisations of Sierra Leone and the Netherlands. During the process of the project it was realised that the development of a platform of exchange at organisational level would be enhanced by introducing personal exchange between individual midwives. In response to this new insight the original project plan was adjusted by incorporating the twin2twin method. twin2twin is a feminist methodology of mutual exchange between twenty pairs of midwives from different organisations (in this case Sierra Leone and the Netherlands). The method can be distinguished by 10 specific steps. It was developed, used and (re)evaluated through focus group discussions, storytelling and written evaluations. twinning of organisations was strengthened by adding a human component to the process. With the use of the 'twin2twin' method, midwives were encouraged to invested in a professional and personal bond with their 'twin sister'. This bond was independent and went beyond the relatively short four year project period. Through personal engagement and mutual exchange of knowledge and skills, midwives empowered each other to build and strengthen their midwifery organisations both in Sierra Leone and the Netherlands. (Empowerment refers to the expansion in people's ability to make strategic life choices in a context where this ability was previously denied to them (Narayan, 2005); organisational empowerment includes processes and structures that enhance members' skills and provides them with the mutual support necessary to effect community level change (Zimmerman, 1995).). despite challenges we are convinced that twin2twin can be of additional benefit for the success of other projects

  12. Changes in organisation of instep kicking as a function of wearing compression and textured materials.

    PubMed

    Hasan, Hosni; Davids, Keith; Chow, Jia Yi; Kerr, Graham

    2017-04-01

    This study investigated effects of wearing compression garments and textured insoles on modes of movement organisation emerging during performance of lower limb interceptive actions in association football. Participants were six skilled (age = 15.67 ± 0.74 years) and six less-skilled (age = 15.17 ± 1.1 years) football players. All participants performed 20 instep kicks with maximum velocity in four randomly organised insoles and socks conditions, (a) Smooth Socks with Smooth Insoles (SSSI); (b) Smooth Socks with Textured Insoles (SSTI); (c) Compression Socks with Smooth Insoles (CSSI); and (d), Compression Socks with Textured Insoles (CSTI). Results showed that, when wearing textured and compression materials (CSSI condition), less-skilled participants displayed significantly greater hip extension and flexion towards the ball contact phase, indicating larger ranges of motion in the kicking limb than in other conditions. Less-skilled participants also demonstrated greater variability in knee-ankle intralimb (angle-angle plots) coordination modes in the CSTI condition. Findings suggested that use of textured and compression materials increased attunement to somatosensory information from lower limb movement, to regulate performance of dynamic interceptive actions like kicking, especially in less-skilled individuals.

  13. Organisational Learning and Performance--An Empirical Study

    ERIC Educational Resources Information Center

    Jyothibabu, C.; Pradhan, Bibhuti Bhusan; Farooq, Ayesha

    2011-01-01

    This paper explores the important question "how the learning entities--individual, group or organisation--are affecting organisational performance". The answer is important for promoting learning and improving performance. This empirical study in the leading power utility in India found that there is a positive relation between…

  14. Managing Evaluation: A Community Arts Organisation Perspective.

    PubMed

    Swan, Peter; Atkinson, Sarah

    2012-09-01

    Arts and health organisations must increasingly provide measurable evidence of impact to stakeholders, which can pose both logistical and ideological challenges. This paper examines the relationship between the ethos of an arts and health organisation with external demands for evaluation. Research involved an ethnographic engagement where the first author worked closely with the organisation for a year. In addition to informal discussions, twenty semi-structured interviews were conducted with core staff and participants. Transcribed interviews were coded and emerging themes were identified. Staff considered evaluation to be necessary and useful, yet also to be time consuming and a potential threat to their ethos. Nevertheless, they were able to negotiate the terms of evaluation to enable them to meet their own needs as well as those of funders and other stakeholders. While not completely resisting outside demands for evaluation, the organisation was seen to intentionally rework demands for evidence into processes they felt they could work with, thus enabling their ethos to be maintained.

  15. Understanding and changing human behaviour--antibiotic mainstreaming as an approach to facilitate modification of provider and consumer behaviour.

    PubMed

    Stålsby Lundborg, Cecilia; Tamhankar, Ashok J

    2014-05-01

    This paper addresses: 1) Situations where human behaviour is involved in relation to antibiotics, focusing on providers and consumers; 2) Theories about human behaviour and factors influencing behaviour in relation to antibiotics; 3) How behaviour in relation to antibiotics can change; and, 4) Antibiotic mainstreaming as an approach to facilitate changes in human behaviour as regards antibiotics. Influencing human behaviour in relation to antibiotics is a complex process which includes factors like knowledge, attitudes, social norms, socio-economic conditions, peer pressure, experiences, and bio-physical and socio-behavioural environment. Further, key concepts are often perceived in different ways by different individuals. While designing and implementing projects or programmes for behavioural change with respect to antibiotics for professionals or consumers it is helpful to consider theories or models of behaviour change, e.g. the 'stages of change model', including pre-contemplation, contemplation, preparation, action, and maintenance. People in different stages of change are susceptible to different behaviour modification strategies. Application of marketing principles to 'global good', so-called 'social marketing', to improve 'welfare of the individual and society' is gaining increased attention in public health. In conclusion, just providing correct knowledge is not sufficient although it is a pre-requisite for behaviour modification in the desired direction. We can never change the behaviour of any other human, but we can facilitate for others to change their own behaviour. One possibility is to implement 'antibiotic mainstreaming' as a potentially effective way for behaviour modification, i.e. to address consequences for maintaining effective antibiotics in all activities and decisions in society.

  16. Organisation Learners' Competence to Overcome Organisation's Learning Inertia: A Conceptual Framework

    ERIC Educational Resources Information Center

    Arunprasad, P.

    2015-01-01

    This paper identifies the interrelationship between the organisational learning (OL) characteristics, strategic human resource management (HRM) practices and the corresponding learning outcome for a sustained competitive advantage (SCA). Through a profound literature review, first, the knowledge assets (human capital), OL and strategic HRM are…

  17. Models of practice organisation using dental therapists: English case studies.

    PubMed

    Sun, N; Harris, R V

    2011-08-12

    A new dental remuneration system based on bands of activity has changed the reward system operating in dental practices and influenced practitioner behaviour in relation to the delegation of tasks to English dental therapists (DTs). Since dental practitioners operate as independent contractors they are free to innovate. A variety of models incorporating DTs in general practice teams exist, some of which may overcome the apparent delegation constraints embedded within this system of remuneration. To describe the way different practices are organised to take account of DTs in their teams and identify whether any of these models address delegation disincentives arising from the system of remuneration. A purposive sample of six dental practices was identified, comprising two small, two medium and two large dental practices, including a variety of models of practice organisation. Semi-structured interviews were carried out with principal dentists, associate dentists, DTs, practice managers and dental hygienists (35 participants in total). A thematic analysis was applied to interview transcripts. The six dental practices demonstrated six different models of practice organisation which could be grouped into 'practice payment' and 'dentist payment' models according to whether the salary costs of the DT were met by a central practice fund or from the income of individual dentists in the team. In both of the large practices only some of the dentists in the team referred work to the DT because of reimbursement issues. In two practices the system was perceived to be satisfactory to all parties, one of these being a single-handed practice with two DTs. Although the remuneration system contained some potential disincentives to DT delegation, some practices innovated in their organisations to overcome these issues.

  18. Feelings over Facts--A University Merger Brings Organisational Identity to the Forefront

    ERIC Educational Resources Information Center

    Puusa, Anu; Kekäle, Jouni

    2015-01-01

    This article presents a qualitative case study based on an analysis of the outcomes and meanings attributed by university academics to an institutional merger, from the perspective of organisational identity. The change process may have broadened the "us and them" gap that exists between those responsible for university leadership and…

  19. How Can Organisations Learn: An Information Systems Development Perspective

    ERIC Educational Resources Information Center

    Baxter, Gavin J.; Connolly, Thomas M.; Stansfield, Mark

    2009-01-01

    This article sets out to argue that organisations can learn but that they cannot do so in their own right without infrastructural support. This article further examines the notion that individuals in organisations also require the cognitive participation of the organisation itself as a learning entity to learn. The close reliance and affiliation…

  20. Organisational aspects of dental practices: do dental students think like patients or like general dental practitioners?

    PubMed

    Sonneveld, R E; Brands, W G; Bronkhorst, E M; Welie, J V M; Truin, G J

    2013-02-01

    In view of transparency in health care, the widespread desire for more patient-centred care, and in an attempt to facilitate educational programmes that effectively respond to these changes, two research questions are formulated: (i) How do dental students rate the importance of various organisational aspects of dental practices compared with dental patients and general dental practitioners (GDPs), and what prescripts, defined as specific operational responsibilities of GDPs in these matters, do dental students propose? and (ii) In doing so, do students resemble patients or GDPs? In two survey studies, dental students (n = 198), patients (n = 3127) and GDPs (n = 303) were asked to rate by questionnaire the importance of 41 organisational aspects of a general dental practice and proposed specific operational responsibilities ('prescripts'). Seven of 41 aspects were rated as important by the majority of the students. Although in a different rank order, three aspects were predominantly selected by all three groups: continuing education, accessibility by telephone and Dutch-speaking GDP. For most aspects, significant differences were found between the prescripts proposed by students and those proposed by patients, and few differences were found between students and GDPs. The findings do not permit the general conclusion that the views of dental students resemble those of patients or GPDs. Looking at the overall rank order, the three respondent groups showed a great resemblance although significant differences were found for specific aspects. With regard to the proposed prescripts, students showed realistic views and the majority wants to participate in continuing education and work with protocols and guidelines. In this, they tend to resemble GDPs more than they resemble patients. © 2012 John Wiley & Sons A/S.

  1. Leadership Practices in German and UK Organisations

    ERIC Educational Resources Information Center

    McCarthy, Grace

    2005-01-01

    Purpose: The aim of this research was to determine whether leadership practices vary between German and UK organisations. Design/methodology/approach: The author used self-assessment documents submitted by German and UK organisations to the European Foundation for Quality Management (EFQM), to identify leadership practices in both countries. A…

  2. Too much information? A document analysis of sport safety resources from key organisations

    PubMed Central

    Finch, Caroline F

    2016-01-01

    Objectives The field of sport injury prevention has seen a marked increase in published research in recent years, with concomitant proliferation of lay sport safety resources, such as policies, fact sheets and posters. The aim of this study was to catalogue and categorise the number, type and topic focus of sport safety resources from a representative set of key organisations. Design Cataloguing and qualitative document analysis of resources available from the websites of six stakeholder organisations in Australia. Setting This study was part of a larger investigation, the National Guidance for Australian Football Partnerships and Safety (NoGAPS) project. Participants The NoGAPS study provided the context for a purposive sampling of six organisations involved in the promotion of safety in Australian football. These partners are recognised as being highly representative of organisations at national and state level that reflect similarly in their goals around sport safety promotion in Australia. Results The catalogue comprised 284 resources. More of the practical and less prescriptive types of resources, such as fact sheets, than formal policies were found. Resources for the prevention of physical injuries were the predominant sport safety issue addressed, with risk management, environmental issues and social behaviours comprising other categories. Duplication of resources for specific safety issues, within and across organisations, was found. Conclusions People working within sport settings have access to a proliferation of resources, which creates a potential rivalry for sourcing of injury prevention information. Important issues that are likely to influence the uptake of safety advice by the general sporting public include the sheer number of resources available, and the overlap and duplication of resources addressing the same issues. The existence of a large number of resources from reputable organisations does not mean that they are necessarily evidence based

  3. The European Stroke Organisation Guidelines: a standard operating procedure.

    PubMed

    Ntaios, George; Bornstein, Natan M; Caso, Valeria; Christensen, Hanne; De Keyser, Jacques; Diener, Hans-Christoph; Diez-Tejedor, Exuperio; Ferro, Jose M; Ford, Gary A; Grau, Armin; Keller, Emanuella; Leys, Didier; Russell, David; Toni, Danilo; Turc, Guillaume; Van der Worp, Bart; Wahlgren, Nils; Steiner, Thorsten

    2015-10-01

    In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published guidelines for the management of intracranial aneurysms and subarachnoidal hemorrhage, for the establishment of stroke units and stroke centers, and recently for the management of intracerebral hemorrhage. In recent years, the methodology for the development of guidelines has evolved significantly. To keep pace with this progress and driven by the strong determination of the European Stroke Organisation to further promote stroke management, education, and research, the European Stroke Organisation decided to delineate a detailed standard operating procedure for its guidelines. There are two important cornerstones in this standard operating procedure: The first is the implementation of the Grading of Recommendations Assessment, Development, and Evaluation methodology for the development of its Guideline Documents. The second one is the decision of the European Stroke Organisation to move from the classical model of a single Guideline Document about a major topic (e.g. management of ischemic stroke) to focused modules (i.e. subdivisions of a major topic). This will enable the European Stroke Organisation to react faster when new developments in a specific stroke field occur and update its recommendations on the related module rather swiftly; with the previous approach of a single large Guideline Document, its entire revision had to be completed before an updated publication, delaying the production of up-to-date guidelines. After discussion within the European Stroke Organisation Guidelines Committee and significant input from European Stroke Organisation members as well as methodologists and analysts, this document presents the official standard operating procedure for

  4. The Institutional Organisation of Knowledge Transfer and Its Implications

    ERIC Educational Resources Information Center

    van der Heide, Sjors; van der Sijde, Peter C.; Terlouw, Cees

    2008-01-01

    How do European universities organise the knowledge transfer (KT) task? We consider the institutional organisation of knowledge transfer as encompassing 1) the knowledge transfer office structure, i.e. the way universities have embedded and organise their KT activities, 2) the focus towards the KT task, linked to the KT strategy, and 3) the KT…

  5. Organisational justice and employee perceptions on hospital management.

    PubMed

    Wiili-Peltola, Erja; Kivimäki, Mika; Elovainio, Marko; Virtanen, Marianna

    2007-01-01

    The purpose to clarify what kind of managerial challenges employees experience regarding organisational justice in hospitals. This exploratory study of 8,971 employees working in 14 hospitals and examines the concept of organisational justice in management with qualitative and quantitative methods. An inductive content analysis of the comments revealed five integrative frames describing challenges in hospital management at respondents' workplaces. These frames should be regarded as major managerial challenges in hospitals. These findings illustrate important antecedents of organisational justice and suggest that work units tend to share the same perceptions of justice. They also reveal that individually produced comments reflect collective experiences in organisational justice. Further, the results indicate that problems in management and policies are often experienced in a complex way, and people making justice judgements do not separate procedural and interactional factors. Although the commentators producing qualitative data represented many organisational hierarchy levels, the results should not be generalised to apply to horizontal, informal social relationships. This paper gives useful information regarding challenges in human resources management in hospitals. The paper suggests that people making fairness judgements do not make a distinction between procedural and interpersonal factors. Instead, they use any information available to judge the righteousness of the management events. This paper serves to guide hospital managers towards a better understanding of the importance of organisational justice and its collective nature.

  6. Organisational interventions for improving wellbeing and reducing work-related stress in teachers.

    PubMed

    Naghieh, Ali; Montgomery, Paul; Bonell, Christopher P; Thompson, Marc; Aber, J Lawrence

    2015-04-08

    The teaching profession is an occupation with a high prevalence of work-related stress. This may lead to sustained physical and mental health problems in teachers. It can also negatively affect the health, wellbeing and educational attainment of children, and impose a financial burden on the public budget in terms of teacher turnover and sickness absence. Most evaluated interventions for the wellbeing of teachers are directed at the individual level, and so do not tackle the causes of stress in the workplace. Organisational-level interventions are a potential avenue in this regard. To evaluate the effectiveness of organisational interventions for improving wellbeing and reducing work-related stress in teachers. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, ASSIA, AEI, BEI, BiblioMap, DARE, DER, ERIC, IBSS, SSCI, Sociological Abstracts, a number of specialist occupational health databases, and a number of trial registers and grey literature sources from the inception of each database until January 2015. Randomised controlled trials (RCTs), cluster-RCTs, and controlled before-and-after studies of organisational-level interventions for the wellbeing of teachers. We used standard methodological procedures expected by Cochrane. Four studies met the inclusion criteria. They were three cluster-randomised controlled trials and one with a stepped-wedge design.Changing task characteristicsOne study with 961 teachers in eight schools compared a task-based organisational change intervention along with stress management training to no intervention. It found a small reduction at 12 months in 10 out of 14 of the subscales in the Occupational Stress Inventory, with a mean difference (MD) varying from -3.84 to 0.13, and a small increase in the Work Ability Index (MD 2.27; 95% confidence interval (CI) 1.64 to 2.90; 708 participants, low-quality evidence).Changing organisational characteristicsTwo studies compared teacher

  7. Primary care organisational interventions for secondary prevention of ischaemic heart disease: a systematic review and meta-analysis.

    PubMed

    Murphy, Edel; Vellinga, Akke; Byrne, Molly; Cupples, Margaret E; Murphy, Andrew W; Buckley, Brian; Smith, Susan M

    2015-07-01

    Ischaemic heart disease (IHD) is the most common cause of death worldwide. To determine the long-term impact of organisational interventions for secondary prevention of IHD. Systematic review and meta-analysis of studies from CENTRAL, MEDLINE(®), Embase, and CINAHL published January 2007 to January 2013. Searches were conducted for randomised controlled trials of patients with established IHD, with long-term follow-up, of cardiac secondary prevention programmes targeting organisational change in primary care or community settings. A random-effects model was used and risk ratios were calculated. Five studies were included with 4005 participants. Meta-analysis of four studies with mortality data at 4.7-6 years showed that organisational interventions were associated with approximately 20% reduced mortality, with a risk ratio (RR) for all-cause mortality of 0.79 (95% confidence interval [CI] = 0.66 to 0.93), and a RR for cardiac-related mortality of 0.74 (95% CI = 0.58 to 0.94). Two studies reported mortality data at 10 years. Analysis of these data showed no significant differences between groups. There were insufficient data to conduct a meta-analysis on the effect of interventions on hospital admissions. Additional analyses showed no significant association between organisational interventions and risk factor management or appropriate prescribing at 4.7-6 years. Cardiac secondary prevention programmes targeting organisational change are associated with a reduced risk of death for at least 4-6 years. There is insufficient evidence to conclude whether this beneficial effect is maintained indefinitely. © British Journal of General Practice 2015.

  8. How empowering is hospital care for older people with advanced disease? Barriers and facilitators from a cross-national ethnography in England, Ireland and the USA.

    PubMed

    Selman, Lucy Ellen; Daveson, Barbara A; Smith, Melinda; Johnston, Bridget; Ryan, Karen; Morrison, R Sean; Pannell, Caty; McQuillan, Regina; de Wolf-Linder, Suzanne; Pantilat, Steven Z; Klass, Lara; Meier, Diane; Normand, Charles; Higginson, Irene J

    2017-03-01

    patient empowerment, through which patients become self-determining agents with some control over their health and healthcare, is a common theme across health policies globally. Most care for older people is in the acute setting, but there is little evidence to inform the delivery of empowering hospital care. we aimed to explore challenges to and facilitators of empowerment among older people with advanced disease in hospital, and the impact of palliative care. we conducted an ethnography in six hospitals in England, Ireland and the USA. The ethnography involved: interviews with patients aged ≥65, informal caregivers, specialist palliative care (SPC) staff and other clinicians who cared for older adults with advanced disease, and fieldwork. Data were analysed using directed thematic analysis. analysis of 91 interviews and 340 h of observational data revealed substantial challenges to empowerment: poor communication and information provision, combined with routinised and fragmented inpatient care, restricted patients' self-efficacy, self-management, choice and decision-making. Information and knowledge were often necessary for empowerment, but not sufficient: empowerment depended on patient-centredness being enacted at an organisational and staff level. SPC facilitated empowerment by prioritising patient-centred care, tailored communication and information provision, and the support of other clinicians. empowering older people in the acute setting requires changes throughout the health system. Facilitators of empowerment include excellent staff-patient communication, patient-centred, relational care, an organisational focus on patient experience rather than throughput, and appropriate access to SPC. Findings have relevance for many high- and middle-income countries with a growing population of older patients with advanced disease. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For

  9. Barriers and Facilitators to Exercise Participation in People with Hip and/or Knee Osteoarthritis: Synthesis of the Literature Using Behavior Change Theory.

    PubMed

    Dobson, Fiona; Bennell, Kim L; French, Simon D; Nicolson, Philippa J A; Klaasman, Remco N; Holden, Melanie A; Atkins, Lou; Hinman, Rana S

    2016-05-01

    Exercise is recommended for hip and knee osteoarthritis (OA). Patient initiation of, and adherence to, exercise is key to the success of managing symptoms. This study aimed to (1) identify modifiable barriers and facilitators to participation in intentional exercise in hip and/or knee OA, and (2) synthesize findings using behavior change theory. A scoping review with systematic searches was conducted through March 2015. Two reviewers screened studies for eligibility. Barriers and facilitators were extracted and synthesized according to the Theoretical Domains Framework (TDF) by two independent reviewers. Twenty-three studies (total of 4633 participants) were included. The greatest number of unique barriers and facilitators mapped to the Environmental Context and Resources domain. Many barriers were related to Beliefs about Consequences and Beliefs about Capabilities, whereas many facilitators were related to Reinforcement. Clinicians should take a proactive role in facilitating exercise uptake and adherence, rather than trusting patients to independently overcome barriers to exercise. Strategies that may be useful include a personalized approach to exercise prescription, considering environmental context and available resources, personalized education about beneficial consequences of exercise and reassurance about exercise capability, and use of reinforcement strategies. Future research should investigate the effectiveness of behavior change interventions that specifically target these factors.

  10. Organisational Blogs: Benefits and Challenges of Implementation

    ERIC Educational Resources Information Center

    Baxter, Gavin J.; Connolly, Thomas M.; Stansfield, Mark H.

    2010-01-01

    Purpose: The purpose of this paper is to identify the theoretical link between blogs and organisational learning. It aims to provide a set of practical guidelines on how to overcome the challenges of implementing an organisational blog. Design/methodology/approach: A literature review will be used to examine blogs and their association towards…

  11. Modelling and simulating a crisis management system: an organisational perspective

    NASA Astrophysics Data System (ADS)

    Chaawa, Mohamed; Thabet, Inès; Hanachi, Chihab; Ben Said, Lamjed

    2017-04-01

    Crises are complex situations due to the dynamism of the environment, its unpredictability and the complexity of the interactions among several different and autonomous involved organisations. In such a context, establishing an organisational view as well as structuring organisations' communications and their functioning is a crucial requirement. In this article, we propose a multi-agent organisational model (OM) to abstract, simulate and analyse a crisis management system (CMS). The objective is to evaluate the CMS from an organisational view, to assess its strength as well as its weakness and to provide deciders with some recommendations for a more flexible and reactive CMS. The proposed OM is illustrated through a real case study: a snowstorm in a Tunisian region. More precisely, we made the following contribution: firstly, we provide an environmental model that identifies the concepts involved in the crisis. Then, we define a role model that copes with the involved actors. In addition, we specify the organisational structure and the interaction model that rule communications and structure actors' functioning. Those models, built following the GAIA methodology, abstract the CMS from an organisational perspective. Finally, we implemented a customisable multi-agent simulator based on the Janus platform to analyse, through several performed simulations, the organisational model.

  12. Major factors for facilitating change in behavioral strategies to reduce obesity

    PubMed Central

    Dalle Grave, Riccardo; Centis, Elena; Marzocchi, Rebecca; El Ghoch, Marwan; Marchesini, Giulio

    2013-01-01

    It is very unlikely that our obesity-promoting environment will change in the near future. It is therefore mandatory to improve our knowledge of the main factors associated with successful adoption of obesity-reducing behaviors. This may help design more powerful procedures and strategies to facilitate the adoption of healthy lifestyles in a “toxic” environment favoring the development of a positive energy balance. The aim of this review is to describe the main factors associated with successful adoption of obesity-reducing behaviors and to describe the most recent development, limits, and outcomes of lifestyle modification programs. The evidence regarding predictors of weight loss and weight loss maintenance remains largely incomplete. It is necessary to develop strategies matching treatments to patients’ needs to improve successful weight loss and its maintenance. How to detect and how to address these needs is a continuous, challenging, research problem. PMID:24124398

  13. Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese adults

    PubMed Central

    Flodgren, Gerd; Deane, Katherine; Dickinson, Heather O; Kirk, Sara; Alberti, Hugh; Beyer, Fiona R; Brown, James G; Penney, Tarra L; Summerbell, Carolyn D; Eccles, Martin P

    2014-01-01

    Background The prevalence of obesity is increasing globally and will, if left unchecked, have major implications for both population health and costs to health services. Objectives To assess the effectiveness of strategies to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people. Search methods We updated the search for primary studies in the following databases, which were all interrogated from the previous (version 2) search date to May 2009: The Cochrane Central Register of Controlled Trials (which at this time incorporated all EPOC Specialised Register material) (The Cochrane Library 2009, Issue 1), MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid). We identified further potentially relevant studies from the reference lists of included studies. Selection criteria Randomised controlled trials (RCTs) that compared routine provision of care with interventions aimed either at changing the behaviour of healthcare professionals or the organisation of care to promote weight reduction in overweight or obese adults. Data collection and analysis Two reviewers independently extracted data and assessed study quality. Main results We included six RCTs, involving more than 246 health professionals and 1324 overweight or obese patients. Four of the trials targeted professionals and two targeted the organisation of care. Most of the studies had methodological or reporting weaknesses indicating a risk of bias. Meta-analysis of three trials that evaluated educational interventions aimed at GPs suggested that, compared to standard care, such interventions could reduce the average weight of patients after a year (by 1.2 kg, 95% CI −0.4 to 2.8 kg); however, there was moderate unexplained heterogeneity between their results (I2 = 41%). One trial found that reminders could change doctors’ practice, resulting in a significant reduction in weight among men (by 11.2 kg, 95% CI 1.7 to 20

  14. Using corporate governance to enhance 'long-term situation awareness' and assist in the avoidance of organisation-induced disasters.

    PubMed

    Siemieniuch, C E; Sinclair, M A

    2008-03-01

    This paper considers the issue of how corporate governance can and should deal with the long-term understanding of systems health-what we may call 'long-term situation awareness' (i.e. which evolves and is coherent over time) for organisational systems (and their component sub systems) in the engineering domain. Many characteristics affect long-term situation awareness-the rate of change to processes, pressures for greater efficiency from existing resources, changes in personnel, cultural changes and changes to the operational environment of the organisational systems. Many disasters (e.g. Chernobyl, Flixborough, Piper Alpha) have a causal path that indicates a loss of group situation awareness, over a long period of time. The problem of the gradual, slow drift over many years towards unsafe conduct of company operations is discussed and examples of possible consequences provided. A 'parable' from the world of manufacturing is used to exemplify the problem. The paper goes on to discuss some ways by which this problem could be addressed and longer-term system situational awareness increased; essentially by good corporate governance, knowledge management and ownership of processes. Links are made to the literature on these topics, and a route map to help organisations to gain the benefits is offered.

  15. Swedish medical students' views of the changing professional role of medical doctors and the organisation of health care.

    PubMed

    Holmström, Inger; Sanner, Margareta A; Rosenqvist, Urban

    2004-01-01

    Medical students will influence future health care considerably. Their professional orientation while at medical school will be related to their future professional development. Therefore, it is important to study this group's view of the role of medical doctors, especially because Swedish health care is currently undergoing major changes and financial cut backs. Here, the theoretical framework was contemporary theories of competence development, which has shown that people's understanding of their work influences their actions. The aim of this study was to describe medical students' views of their future professional role in health care. In total, 57 fourth-year medical students at a Swedish university were asked to write a short essay about how they conceptualised their professional role in future health care. Fifty-three students (93%) replied. The essays were analysed qualitatively in three steps and four themes were subsequently identified: the professional role in change, organisation of health care, working conditions and the possibilities of having a balanced life. Some factors mentioned that would strongly influence the professional role were being team leader, increased specialisation, supporting the patient and computer science and technology. The students expressed ambiguous feelings about power and leadership. The results indicate that the students share a rather dark view of both the medical profession and health care, which seems to be related to stress and financial cut backs. Mentoring, time for reflection and changes in the curricula might be needed.

  16. Implementing a psycho-educational intervention for care assistants working with people with dementia in aged-care facilities: facilitators and barriers.

    PubMed

    Barbosa, Ana; Nolan, Mike; Sousa, Liliana; Figueiredo, Daniela

    2017-06-01

    Many intervention studies lack an investigation and description of the factors that are relevant to its success or failure, despite its relevance to inform future interventions. This study aimed to explore the facilitators and barriers to the implementation of a psycho-educational intervention for care assistants caring for people with dementia in aged-care facilities. A process evaluation was carried out alongside a pretest/post-test controlled study conducted in aged-care facilities. Seven focus-group interviews involving 21 care assistants (female; mean age 43.37 ± 10.0) and individual semi-structured interviews with two managers (female; mean age 45.5 ± 10.26) were conducted 2 weeks and 6 months after the intervention, in two aged-care facilities. Interviews were recorded, transcribed and submitted to content analysis by two independent researchers. Results were organised into implementer, participant and organisation level hindered and facilitator factors. Findings enable the interpretation of the experimental results and underscore the importance of collecting the perception of different grades of staff to obtain information relevant to plan effective interventions. © 2016 Nordic College of Caring Science.

  17. The "State of Art" of Organisational Blogging

    ERIC Educational Resources Information Center

    Baxter, Gavin J.; Connolly, Thomas M.

    2013-01-01

    Purpose: The aim of this paper is to provide an overview of the "state of art" of organisational blogging. It also aims to provide a critical review of the literature on organisational blogging and propose recommendations on how to advance the subject area in terms of academic research. Design/methodology/approach: A systematic literature review…

  18. The organisational structure of urban environmental stewardship

    Treesearch

    Dana R. Fisher; Lindsay Campbell; Erika S. Svendsen

    2012-01-01

    How is the organisational structure of urban environmental stewardship groups related to the diverse ways that civic stewardship is taking place in urban settings? The findings of the limited number of studies that have explored the organisational structure of civic environmentalism are combined with the research on civic stewardship to answer this question. By...

  19. Managing Evaluation: A Community Arts Organisation Perspective

    PubMed Central

    Swan, Peter; Atkinson, Sarah

    2014-01-01

    Background Arts and health organisations must increasingly provide measurable evidence of impact to stakeholders, which can pose both logistical and ideological challenges. This paper examines the relationship between the ethos of an arts and health organisation with external demands for evaluation. Methods Research involved an ethnographic engagement where the first author worked closely with the organisation for a year. In addition to informal discussions, twenty semi-structured interviews were conducted with core staff and participants. Transcribed interviews were coded and emerging themes were identified. Results Staff considered evaluation to be necessary and useful, yet also to be time consuming and a potential threat to their ethos. Nevertheless, they were able to negotiate the terms of evaluation to enable them to meet their own needs as well as those of funders and other stakeholders. Conclusions While not completely resisting outside demands for evaluation, the organisation was seen to intentionally rework demands for evidence into processes they felt they could work with, thus enabling their ethos to be maintained. PMID:25429306

  20. Understanding and changing human behaviour—antibiotic mainstreaming as an approach to facilitate modification of provider and consumer behaviour

    PubMed Central

    Tamhankar, Ashok J.

    2014-01-01

    This paper addresses: 1) Situations where human behaviour is involved in relation to antibiotics, focusing on providers and consumers; 2) Theories about human behaviour and factors influencing behaviour in relation to antibiotics; 3) How behaviour in relation to antibiotics can change; and, 4) Antibiotic mainstreaming as an approach to facilitate changes in human behaviour as regards antibiotics. Influencing human behaviour in relation to antibiotics is a complex process which includes factors like knowledge, attitudes, social norms, socio-economic conditions, peer pressure, experiences, and bio-physical and socio-behavioural environment. Further, key concepts are often perceived in different ways by different individuals. While designing and implementing projects or programmes for behavioural change with respect to antibiotics for professionals or consumers it is helpful to consider theories or models of behaviour change, e.g. the ‘stages of change model’, including pre-contemplation, contemplation, preparation, action, and maintenance. People in different stages of change are susceptible to different behaviour modification strategies. Application of marketing principles to ‘global good’, so-called ‘social marketing’, to improve ‘welfare of the individual and society’ is gaining increased attention in public health. In conclusion, just providing correct knowledge is not sufficient although it is a pre-requisite for behaviour modification in the desired direction. We can never change the behaviour of any other human, but we can facilitate for others to change their own behaviour. One possibility is to implement ‘antibiotic mainstreaming’ as a potentially effective way for behaviour modification, i.e. to address consequences for maintaining effective antibiotics in all activities and decisions in society. PMID:24735112

  1. Perceived Barriers and Facilitators of Exercise and Healthy Dietary Choices: A Study of Employees and Managers within a Large Transport Organisation

    ERIC Educational Resources Information Center

    Donaldson-Feilder, Emma; Lewis, Rachel; Pavey, Louisa; Jones, Bethan; Green, Melanie; Webster, Angela

    2017-01-01

    Objective: The objective of this study was to examine employees' perceived barriers and facilitators of physical activity and healthy dietary choices, and managers' perceptions of how best to facilitate physical activity and healthy dietary choices among their team members. Design: Single time-point survey with categorical and open-ended…

  2. Evolution of local facilitation in arid ecosystems.

    PubMed

    Kéfi, Sonia; van Baalen, Minus; Rietkerk, Max; Loreau, Michel

    2008-07-01

    In harsh environments, sessile organisms can make their habitat more hospitable by buffering environmental stress or increasing resource availability. Although the ecological significance of such local facilitation is widely established, the evolutionary aspects have been seldom investigated. Yet addressing the evolutionary aspects of local facilitation is important because theoretical studies show that systems with such positive interactions can exhibit alternative stable states and that such systems may suddenly become extinct when they evolve (evolutionary suicide). Arid ecosystems currently experience strong changes in climate and human pressures, but little is known about the effects of these changes on the selective pressures exerted on the vegetation. Here, we focus on the evolution of local facilitation in arid ecosystems, using a lattice-structured model explicitly considering local interactions among plants. We found that the evolution of local facilitation depends on the seed dispersal strategy. In systems characterized by short-distance seed dispersal, adaptation to a more stressful environment leads to high local facilitation, allowing the population to escape extinction. In contrast, systems characterized by long-distance seed dispersal become extinct under increased stress even when allowed to adapt. In this case, adaptation in response to climate change and human pressures could give the final push to the desertification of arid ecosystems.

  3. The Impact and the Implications of Policy Regarding the Organisation of Support for Pupils with Dyslexia in Irish Primary Mainstream Schools

    ERIC Educational Resources Information Center

    Tiernan, Bairbre; Casserly, Ann Marie

    2018-01-01

    There have been vast changes in relation to the way educational teaching support provision is organised for pupils with dyslexia in Ireland. A qualitative research approach was utilised to examine the impact and implications of the General Allocation Model (GAM) regarding the organisation of support for pupils with dyslexia in Irish Primary…

  4. From service quality in organisations to self-determination at home.

    PubMed

    Martínez-Tur, V; Moliner, C; Peñarroja, V; Gracia, E; Peiró, J M

    2015-10-01

    In our proposed model, family members' perceptions of service quality in organisations improve communication about self-determination. In turn, family perceptions of communication openness have a positive relationship with self-determination attitudes of family members. Finally, these attitudes predict self-determination behaviours of individuals with intellectual disability, as reported by family members. We tested this model with a sample of 625 family members (196 using 'day care services' and 429 using 'occupational services'). Multi-sample structural equation modelling (SEM) supported the model. Communication and attitudes fully mediated the link from service quality to self-determination behaviours. Improving family members' perceptions of service quality and opening channels of communication between professionals and family members are useful strategies to facilitate parents' positive attitudes and increase the frequency of self-determination behaviours at home. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  5. Metaphors, models and organisational ethics in health care

    PubMed Central

    McCrickerd, J.

    2000-01-01

    Crucial to discussions in organisational ethics is an evaluation of the metaphors and models we use to understand the organisations we are discussing. I briefly defend this contention and evaluate three possible models: the current corporate model, an orchestrator model which puts hospitals in the same class as malls and airports, and a community model. I argue that the corporate and orchestrator model push to the background some important organisational ethics issues and bias us inappropriately towards certain solutions. Furthermore, I argue that the community model allows these to be more easily brought up. I also respond to the likely challenge that hospitals really are corporations by arguing that this is not relevant to evaluations of the appropriateness of the corporate model. Key Words: Metaphor • model • organisational ethics • health care ethics PMID:11055036

  6. Behaviour change opportunities at mother and baby checks in primary care: a qualitative investigation of the experiences of GPs.

    PubMed

    Talbot, Hannah; Strong, Emily; Peters, Sarah; Smith, Debbie M

    2018-04-01

    Pregnancy is widely recognised as a 'teachable moment' for healthy behaviour change and the postnatal period has been identified as the opportune time to initiate this change. In the UK, all women are offered a routine health check at 6-8 weeks postpartum with their GP. This provides a potential opportunity to facilitate long-term behaviour change discussions. To explore GPs' views and experiences of using the postnatal check as a health-related behaviour change opportunity. A qualitative, inductive study in general practice. Semi-structured telephone interviews were conducted with 18 GPs. Audiorecorded interviews were transcribed verbatim and analysed using thematic analysis. One theme emerged from the data: the postnatal check is an unrealised opportunity to facilitate health-related behaviour change. This theme was organised into three subthemes: opportunity for health-related behaviour change; role responsibility; and patient-led versus GP-led behaviour change. Although GPs recognise the postnatal check as a potential opportunity for health-related behaviour change, it is underutilised as they do not perceive this to be the purpose of the check and are uncertain as to their role in facilitating lifestyle changes. To enable this long-term lifestyle behaviour change opportunity to be utilised more fully, further research is needed to understand women's expectations of the postnatal checks and the scope for further recommendations, guidance, and communication training around behaviour change. © British Journal of General Practice 2018.

  7. Improving discharge care: the potential of a new organisational intervention to improve discharge after hospitalisation for acute stroke, a controlled before-after pilot study.

    PubMed

    Cadilhac, Dominique A; Andrew, Nadine E; Stroil Salama, Enna; Hill, Kelvin; Middleton, Sandy; Horton, Eleanor; Meade, Ian; Kuhle, Sarah; Nelson, Mark R; Grimley, Rohan

    2017-08-04

    Provision of a discharge care plan and prevention therapies is often suboptimal. Our objective was to design and pilot test an interdisciplinary, organisational intervention to improve discharge care using stroke as the case study using a mixed-methods, controlled before-after observational study design. Acute care public hospitals in Queensland, Australia (n=15). The 15 hospitals were ranked against a benchmark based on a composite outcome of three discharge care processes. Clinicians from a 'top-ranked' hospital participated in a focus group to elicit their success factors. Two pilot hospitals then participated in the organisational intervention that was designed with experts and consumers. Hospital clinicians involved in discharge care for stroke and patients admitted with acute stroke or transient ischaemic attack. A four-stage, multifaceted organisational intervention that included data reviews, education and facilitated action planning. Three discharge processes collected in Queensland hospitals within the Australian Stroke Clinical Registry were used to select study hospitals: (1) discharge care plan; (2) antihypertensive medication prescription and (3) antiplatelet medication prescription (ischaemic events only). Primary measure: composite outcome. Secondary measures: individual adherence changes for each discharge process; sensitivity analyses. The performance outcomes were compared 3 months before the intervention (preintervention), 3 months postintervention and at 12 months (sustainability). Data from 1289 episodes of care from the two pilot hospitals were analysed. Improvements from preintervention adherence were: antiplatelet therapy (88%vs96%, p=0.02); antihypertensive prescription (61%vs79%, p<0.001); discharge planning (72%vs94%, p<0.001); composite outcome (73%vs89%, p<0.001). There was an insignificant decay effect over the 12-month sustainability period (composite outcome: 89% postintervention vs 85% sustainability period, p=0

  8. Organisational Values in Higher Education: Perceptions and Preferences of Staff

    ERIC Educational Resources Information Center

    Kleijnen, Jan; Dolmans, Diana; Muijtjens, Arno; Willems, Jos; Van Hout, Hans

    2009-01-01

    In this paper, staff members' perceptions about the organisational culture are measured. The questions addressed are: what are their opinions about the current and preferred organisational culture? Are there differences between the current and preferred situation? Do the perceptions differ per department? The Organisational Culture Assessment…

  9. Implementation of data management and effect on chronic disease coding in a primary care organisation: A parallel cohort observational study.

    PubMed

    Greiver, Michelle; Wintemute, Kimberly; Aliarzadeh, Babak; Martin, Ken; Khan, Shahriar; Jackson, Dave; Leggett, Jannet; Lambert-Lanning, Anita; Siu, Maggie

    2016-10-12

    Consistent and standardized coding for chronic conditions is associated with better care; however, coding may currently be limited in electronic medical records (EMRs) used in Canadian primary care.Objectives To implement data management activities in a community-based primary care organisation and to evaluate the effects on coding for chronic conditions. Fifty-nine family physicians in Toronto, Ontario, belonging to a single primary care organisation, participated in the study. The organisation implemented a central analytical data repository containing their EMR data extracted, cleaned, standardized and returned by the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), a large validated primary care EMR-based database. They used reporting software provided by CPCSSN to identify selected chronic conditions and standardized codes were then added back to the EMR. We studied four chronic conditions (diabetes, hypertension, chronic obstructive pulmonary disease and dementia). We compared changes in coding over six months for physicians in the organisation with changes for 315 primary care physicians participating in CPCSSN across Canada. Chronic disease coding within the organisation increased significantly more than in other primary care sites. The adjusted difference in the increase of coding was 7.7% (95% confidence interval 7.1%-8.2%, p < 0.01). The use of standard codes, consisting of the most common diagnostic codes for each condition in the CPCSSN database, increased by 8.9% more (95% CI 8.3%-9.5%, p < 0.01). Data management activities were associated with an increase in standardized coding for chronic conditions. Exploring requirements to scale and spread this approach in Canadian primary care organisations may be worthwhile.

  10. Barriers and facilitators in the integration of oral health into primary care: a scoping review.

    PubMed

    Harnagea, Hermina; Couturier, Yves; Shrivastava, Richa; Girard, Felix; Lamothe, Lise; Bedos, Christophe Pierre; Emami, Elham

    2017-09-25

    This scoping study has been conducted to map the literature and provide a descriptive synthesis on the barriers and facilitators of the integration of oral health into primary care. Grounded in the Rainbow conceptual model and using the Levac et al six-stage framework, we performed a systematic search of electronic databases, organisational websites and grey literature from 1978 to April 2016. All publications with a focus on the integration of oral health into primary care were included except commentaries and editorials. Thematic analyses were performed to synthesise the results. From a total of 1619 citations, 58 publications were included in the review. Barrier-related themes included: lack of political leadership and healthcare policies; implementation challenges; discipline-oriented education; lack of continuity of care and services and patients' oral healthcare needs. The facilitators of integration were supportive policies and resources allocation, interdisciplinary education, collaborative practices between dental and other healthcare professionals, presence of local strategic leaders and geographical proximity. This work has advanced the knowledge on the barriers and facilitators at each integration domain and level, which may be helpful if the healthcare organisations decide to integrate oral health and dental services into primary care. The scoping review findings could be useful for both dental and medical workforce and allied primary healthcare providers. They could also guide the development of healthcare policies that support collaborative practices and patient-centred care in the field of primary care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. The use of information technologies for knowledge sharing by secondary healthcare organisations in New Zealand.

    PubMed

    Ali, Nor'ashikin; Whiddett, Dick; Tretiakov, Alexei; Hunter, Inga

    2012-07-01

    To explore the extent of use of information technologies (ITs) for knowledge sharing by secondary healthcare organisations in New Zealand. We used a self-administered questionnaire to survey Chief Information Officers at all 21 of New Zealand's District Health Boards regarding the extent to which their organisations use knowledge sharing activities involving ITs. The list of activities to include in the questionnaire was compiled by reviewing the literature. We analysed the extent of use of the knowledge sharing activities using descriptive statistics, repeated measures ANOVA, and correlation analysis. The response rate was 76%. Although all the responding organisations reported using ITs to share knowledge, they used ITs to share documents significantly more than to support discussions or to connect employees to experts. Discussions via teleconferencing, videoconferencing, and email lists were significantly more common than discussions via social media technologies: electronic discussion forums, blogs, and on-line chatrooms. There were significant positive correlations between publishing and accessing documents, between using teleconferencing and using videoconferencing, and between publishing and finding contact details of experts. New Zealand's District Health Boards are using a range of ITs to share knowledge. Knowledge sharing activities emphasising the sharing of explicit knowledge (via exchanging documents in electronic form) are significantly more common than knowledge sharing activities emphasising the sharing of tacit knowledge (via technology-mediated discussions and via using technology to connect employees to experts). In view of the evidence in the literature that information technology may be highly effective in supporting tacit knowledge exchanges, our results suggest that health organisations should consider greater adoption of ITs for sharing tacit knowledge. The finding that several organisations are currently making extensive use of

  12. [The organisation and future development of Veterinary Services in Latin America].

    PubMed

    Gimeno, E

    2003-08-01

    Latin America undoubtedly has comparative advantages in the fields of animal production, animal health and the production of food of animal origin. However, countries in Latin America must build on these strengths if the continent is to become more competitive and be able to deal with the complexities of world markets. To do this, Veterinary Services must define their objectives and establish quality standards on which to base their work. For this to occur, the State must create well-defined regulations, establish systems of audit and find ways of working which allow for a high degree of coordination and collaboration between the public and private sectors. This should be done within a framework of a quality assurance system, which allows for responsible accreditation and independent audit and evaluation. The author discusses the approaches of the different countries in the region to animal health, zoonosis, food safety, veterinary drugs control, animal welfare and export-import control. All programmes relating to these issues must be based on technical information gained through epidemiological surveillance, the network of diagnostic laboratories, quarantine systems, risk analysis, identification and traceability of animals and animal products, registration and control of veterinary drugs, and food safety research. In some countries these systems are already being developed. Maintaining good international relations and cooperating with neighbouring countries is always a challenge for official Veterinary Services and international organisations such as the OIE (World organisation for animal health) have a key role to play in facilitating these relationships.

  13. Transformational change in action.

    PubMed

    Lucy, Botting

    2011-02-01

    In recent years, there has been an imperative to improve productivity in the NHS. This requires the use of appropriate tools and appropriate leadership at all levels of organisations. This article outlines to concept of transformational change, discusses productivity as a national driver for improving healthcare services, looks at the most appropriate tools to use at various levels of organisations to achieve this, and considers why leadership is a vital component in transformational change.

  14. Building capacity to use and undertake research in health organisations: a survey of training needs and priorities among staff.

    PubMed

    Barratt, Helen; Fulop, Naomi J

    2016-12-07

    Efforts to improve healthcare and population health depend partly on the ability of health organisations to use research knowledge and participate in its production. We report the findings of a survey conducted to prioritise training needs among healthcare and public health staff, in relation to the production and implementation of research, across an applied health research collaboration. A questionnaire survey using a validated tool, the Hennessy-Hicks Training Needs Assessment Questionnaire. Participants rated 25 tasks on a five-point scale with regard to both their confidence in performing the task, and its importance to their role. A questionnaire weblink was distributed to a convenience sample of 35 healthcare and public health organisations in London and South East England, with a request that they cascade the information to relevant staff. 203 individuals responded, from 20 healthcare and public health organisations. None. Training needs were identified by comparing median importance and performance scores for each task. Individuals were also invited to describe up to three priority areas in which they require training. Across the study sample, evaluation; teaching; making do with limited resources; coping with change and managing competing demands were identified as key tasks. Assessing the relevance of research and learning about new developments were the most relevant research-related tasks. Participants' training priorities included evaluation; finding, appraising and applying research evidence; and data analysis. Key barriers to involvement included time and resources, as well as a lack of institutional support for undertaking research. We identify areas in which healthcare and public health professionals may benefit from support to facilitate their involvement in and use of applied health research. We also describe barriers to participation and differing perceptions of research between professional groups. Published by the BMJ Publishing Group Limited

  15. Learning Organisations: A Literature Review and Critique

    DTIC Science & Technology

    2014-01-01

    autocratic, laissez - faire and democratic work-group principles attributed to Lewin, provided evidence that people would learn and self-manage in an...each with their own particular emphasis on learning, leadership behaviours and organisational structure. A Learning Organisation’s salient...the organisational and structural factors that affect learning. These include the importance specific leadership actions or practices, the utility of

  16. Positioning in Groups: A New Development in Systemic Consultation

    ERIC Educational Resources Information Center

    Matthews, Jeff W.; Singh, RajVinder

    2015-01-01

    This article describes a new approach, employing a combination of Positioning Theory and Semantic Polarities, that educational psychologists can use to develop and facilitate change in organisations and groups. Resistance to change can be seen as reflecting a lack of the language that the members of an organisation need to participate effectively…

  17. Personality traits and perceptions of organisational justice.

    PubMed

    Törnroos, Maria; Elovainio, Marko; Hintsa, Taina; Hintsanen, Mirka; Pulkki-Råback, Laura; Jokela, Markus; Lehtimäki, Terho; Raitakari, Olli T; Keltikangas-Järvinen, Liisa

    2018-01-04

    This study examined the association between five-factor model personality traits and perceptions of organisational justice. The sample for the study comprised 903 participants (35-50 years old; 523 women) studied in 2007 and 2012. Measures used were the Neuroticism, Extraversion, Openness, Five-Factor Inventory questionnaire and the short organisational justice measure. The results showed that high neuroticism was associated with low distributive, procedural and interactional justice. Furthermore, high agreeableness was associated with high procedural and interactional justice and high openness with high distributive justice. This study suggests that neuroticism, agreeableness and openness are involved in perceptions of organisational justice and that personality should be considered in research and in practices at the workplace. © 2018 International Union of Psychological Science.

  18. Bridging Theory and Practice: A Conceptual Framework for Consulting Organisations

    ERIC Educational Resources Information Center

    Mohammed, Meca B.; Welch, Jennie; Hazle Bussey, Leslie

    2015-01-01

    A growing number of organisations are emerging as partners to districts pursuing systemic improvement. Given the critical role a consulting organisation could play in supporting system reform efforts, how does a district leader looking to establish a consulting partnership determine what characteristics in a consulting organisation may be more…

  19. Career Orientations and Career Cultures: Individual and Organisational Approaches to Beginning Teachers' Careers

    ERIC Educational Resources Information Center

    Coldwell, Mike

    2016-01-01

    Despite the very large literature on teacher careers from an individual perspective, there is relatively little that links the perspectives of teachers themselves to how schools as organisations approach careers. The aim of this paper is, first, to outline how teachers' orientations towards careers change across three dimensions, and, second, to…

  20. Leadership within Emergent Events in Complex Systems: Micro-Enactments and the Mechanisms of Organisational Learning and Change

    ERIC Educational Resources Information Center

    Hazy, James K.; Silberstang, Joyce

    2009-01-01

    One tradition within the complexity paradigm considers organisations as complex adaptive systems in which autonomous individuals interact, often in complex ways with difficult to predict, non-linear outcomes. Building upon this tradition, and more specifically following the complex systems leadership theory approach, we describe the ways in which…

  1. Technology adoption and implementation in organisations: comparative case studies of 12 English NHS Trusts

    PubMed Central

    Ahmad, Raheelah; Holmes, Alison

    2012-01-01

    Objectives To understand organisational technology adoption (initiation, adoption decision, implementation) by looking at the different types of innovation knowledge used during this process. Design Qualitative, multisite, comparative case study design. Setting One primary care and 11 acute care organisations (trusts) across all health regions in England in the context of infection prevention and control. Participants and data analysis 121 semistructured individual and group interviews with 109 informants, involving clinical and non-clinical staff from all organisational levels and various professional groups. Documentary evidence and field notes were also used. 38 technology adoption processes were analysed using an integrated approach combining inductive and deductive reasoning. Main findings Those involved in the process variably accessed three types of innovation knowledge: ‘awareness’ (information that an innovation exists), ‘principles’ (information about an innovation's functioning principles) and ‘how-to’ (information required to use an innovation properly at individual and organisational levels). Centralised (national, government-led) and local sources were used to obtain this knowledge. Localised professional networks were preferred sources for all three types of knowledge. Professional backgrounds influenced an asymmetric attention to different types of innovation knowledge. When less attention was given to ‘how-to’ compared with ‘principles’ knowledge at the early stages of the process, this contributed to 12 cases of incomplete implementation or discontinuance after initial adoption. Conclusions Potential adopters and change agents often overlooked or undervalued ‘how-to’ knowledge. Balancing ‘principles’ and ‘how-to’ knowledge early in the innovation process enhanced successful technology adoption and implementation by considering efficacy as well as strategic, structural and cultural fit with the organisation's context

  2. Barriers and facilitators to participation in workplace health promotion (WHP) activities: results from a cross-sectional survey of public-sector employees in Tasmania, Australia.

    PubMed

    Kilpatrick, Michelle; Blizzard, Leigh; Sanderson, Kristy; Teale, Brook; Jose, Kim; Venn, Alison

    2017-12-01

    Issue addressed Workplaces are promising settings for health promotion, yet employee participation in workplace health promotion (WHP) activities is often low or variable. This study explored facilitating factors and barriers associated with participation in WHP activities that formed part of a comprehensive WHP initiative run within the Tasmanian State Service (TSS) between 2009 and 2013. Methods TSS employee (n=3228) completed surveys in 2013. Data included sociodemographic characteristics, employee-perceived availability of WHP activities, employee-reported participation in WHP activities, and facilitators and barriers to participation. Ordinal log-link regression was used in cross-sectional analyses. Results Significant associations were found for all facilitating factors and participation. Respondents who felt their organisation placed a high priority on WHP, who believed that management supported participation or that the activities could improve their health were more likely to participate. Time- and health-related barriers were associated with participation in fewer activities. All associations were independent of age, sex, work schedule and employee-perceived availability of programs. Part-time and shift-work patterns, and location of activities were additionally identified barriers. Conclusion Facilitating factors relating to implementation, peer and environmental support, were associated with participation in more types of activities, time- and health-related barriers were associated with less participation. So what? Large and diverse organisations should ensure WHP efforts have manager support and adopt flexible approaches to maximise employee engagement.

  3. Female employees' perceptions of organisational support for breastfeeding at work: findings from an Australian health service workplace.

    PubMed

    Weber, Danielle; Janson, Anneka; Nolan, Michelle; Wen, Li Ming; Rissel, Chris

    2011-11-30

    Women's return to work can be a significant barrier to continued breastfeeding. Workplace policies and practices to promote and support continued, and longer duration of, breastfeeding are important. In the context of the introduction of a new breastfeeding policy for Area Health Services in New South Wales, Australia, a baseline survey was conducted to describe current practices and examine women's reports of perceived organisational support on breastfeeding intention and practice. A cross sectional survey of female employees of the Sydney South West Area Health Service was conducted in late 2009. A mailed questionnaire was sent to 998 eligible participants who had taken maternity leave over the 20-month period from January 2008 to August 2009. The questionnaire collected items assessing breastfeeding intentions, awareness of workplace policies, and the level of organisational and social support available. For those women who had returned to work, further questions were asked to assess the perceptions and practices of breastfeeding in the work environment, as well as barriers and enabling factors to combining breastfeeding and work. Returning to work was one of the main reasons women ceased breastfeeding, with 60 percent of women intending to breastfeed when they returned to work, but only 40 percent doing so. Support to combine breastfeeding and work came mainly from family and partners (74% and 83% respectively), with little perceived support from the organisation (13%) and human resources (6%). Most women (92%) had received no information from their managers about their breastfeeding options upon their return to work, and few had access to a room specially designated for breastfeeding (19%). Flexible work options and lactation breaks, as well as access to a private room, were identified as the main factors that facilitate breastfeeding at work. Enabling women to continue breastfeeding at work has benefits for the infant, employee and organisation. However, this

  4. Female employees' perceptions of organisational support for breastfeeding at work: findings from an Australian health service workplace

    PubMed Central

    2011-01-01

    Background Women's return to work can be a significant barrier to continued breastfeeding. Workplace policies and practices to promote and support continued, and longer duration of, breastfeeding are important. In the context of the introduction of a new breastfeeding policy for Area Health Services in New South Wales, Australia, a baseline survey was conducted to describe current practices and examine women's reports of perceived organisational support on breastfeeding intention and practice. Methods A cross sectional survey of female employees of the Sydney South West Area Health Service was conducted in late 2009. A mailed questionnaire was sent to 998 eligible participants who had taken maternity leave over the 20-month period from January 2008 to August 2009. The questionnaire collected items assessing breastfeeding intentions, awareness of workplace policies, and the level of organisational and social support available. For those women who had returned to work, further questions were asked to assess the perceptions and practices of breastfeeding in the work environment, as well as barriers and enabling factors to combining breastfeeding and work. Results Returning to work was one of the main reasons women ceased breastfeeding, with 60 percent of women intending to breastfeed when they returned to work, but only 40 percent doing so. Support to combine breastfeeding and work came mainly from family and partners (74% and 83% respectively), with little perceived support from the organisation (13%) and human resources (6%). Most women (92%) had received no information from their managers about their breastfeeding options upon their return to work, and few had access to a room specially designated for breastfeeding (19%). Flexible work options and lactation breaks, as well as access to a private room, were identified as the main factors that facilitate breastfeeding at work. Conclusions Enabling women to continue breastfeeding at work has benefits for the infant

  5. Perspectives on Instituting Change Management in Large Organisations

    ERIC Educational Resources Information Center

    Lawler, Alan; Sillitoe, James

    2010-01-01

    Australian universities are currently undergoing significant and deep-seated change to their funding models through their relationship to Federal government social development and research agendas. Consequently, changes are being instituted at all levels of university activity. Such changes are often accompanied by considerable disruption to…

  6. The effects of ownership, staffing level and organisational justice on nurse commitment, involvement, and satisfaction: a questionnaire study.

    PubMed

    Heponiemi, Tarja; Elovainio, Marko; Kouvonen, Anne; Kuusio, Hannamaria; Noro, Anja; Finne-Soveri, Harriet; Sinervo, Timo

    2011-12-01

    Elderly care systems have undergone a lot of changes in many European countries, including Finland. Most notably, the number of private for-profit firms has increased. Previous studies suggest that employee well-being and the quality of care might differ according to the ownership type. The present study examined whether the ownership type and the staffing level were associated with organisational commitment, job involvement, and job satisfaction. In addition, we examined the potential moderating effect of organisational justice on these associations. Cross-sectional questionnaire study. 1047 Finnish female staff members aged 18-69 years working in sheltered housing or nursing homes (units n=179). The relationships were studied with analyses of covariance (ANCOVA), adjusting for the effects of age and case-mix. Organisational commitment and job satisfaction levels were low in for-profit sheltered homes when justice levels were low, but when justice levels were high, for-profit sheltered homes did not differ from other ownership types. Similarly, organisational justice acted as a buffer against low commitment resulting from low staffing levels. Staffing levels were lowest in public sheltered homes and highest in not-for-profit sheltered homes. The results show that organisational justice can act as a buffer against low organisational commitment that results from low staffing levels and working in for-profit sheltered homes. Increasing justice in regard to the management, outcomes, and procedures in the organisation would thus be important. 2011 Elsevier Ltd. All rights reserved.

  7. Organisational characteristics associated with the use of daily interruption of sedation in US hospitals: a national study.

    PubMed

    Miller, Melissa A; Krein, Sarah L; Saint, Sanjay; Kahn, Jeremy M; Iwashyna, Theodore J

    2012-02-01

    Daily interruption of sedation (DIS) has multiple proven benefits, but implementation is erratic. Past research on sedative interruption utilisation focused on individual clinicians, ignoring the role of organisations in shaping practice. The authors test the hypothesis that specific hospital organisational characteristics are associated with routine use of DIS. National, mailed survey to a stratified random sample of US hospitals in 2009. Respondents were the lead infection control professionals at each institution. Survey items enquired about DIS use, institutional structure, and organisational culture. Multivariable analysis was used to evaluate the independent association of these factors with DIS use. A total of 386 hospitals formed our final analytic sample; the response rate was 69.4%. Hospitals ranged in size from 25 to 1359 beds. 26% of hospitals were associated with a medical school. Almost 80% reported regular use of DIS for ventilated patients. While 75.4% of hospitals reported having leadership focus on safety culture, only 42.7% reported that their staff were receptive to changes in practice. In a multivariable logistic regression model, structural characteristics such as size and academic affiliation were not associated with use of DIS. However, leadership emphasis on safety culture (p=0.04), staff receptivity to change (p=0.02) and involvement in an infection prevention collaborative (p=0.04) were significantly associated with regular DIS use. Several elements of hospital organisational culture were associated with regular use of DIS in US hospitals. These findings emphasise the importance of combining specific administrative approaches with strategies to encourage receptivity to change among bedside clinicians in order to successfully implement complex evidence-based practices in the intensive care setting.

  8. Animal welfare: the role of non-governmental organisations.

    PubMed

    Wilkins, D B; Houseman, C; Allan, R; Appleby, M C; Peeling, D; Stevenson, P

    2005-08-01

    The welfare of animals is of interest to many people in most parts of the world. Concern about the way that animals are treated will depend on many factors, including socio-economic conditions, culture, religion and tradition. The World Organisation for Animal Health (OIE) is committed to ensuring that all animal welfare standards are science-based, but recognises that these other factors must also be taken into account. The International Coalition for Farm Animal Welfare (ICFAW) was formed to represent the interests of non-governmental animal welfare organisations from most corners of the globe and opinions, comment and information from these animal welfare organisations will play a part in the OIE decision-making process. In coming together for this purpose it was recognised that the views of the various member organisations of ICFAW vary depending on which part of the world they come from. The authors provide information about the situation in three continents: Africa, North America and Europe. This information includes details of relevant legislation, farming practices, and educational and campaign programmes developed by both animal welfare non-governmental organisations and governments. The authors also look to the future to see what issues may influence the way that farm animals are reared, transported and slaughtered.

  9. Investing in organisational culture: nursing students' experience of organisational learning culture in aged care settings following a program of cultural development.

    PubMed

    Grealish, Laurie; Henderson, Amanda

    2016-10-01

    Concerns around organisational learning culture limit nursing student placements in aged care settings to first year experiences. Determine the impact of an extended staff capacity building program on students' experiences of the organisational learning culture in the aged care setting. Pre and post-test design. A convenience sample of first, second and third year Bachelor of Nursing students attending placements at three residential aged care facilities completed the Clinical Learning Organisational Culture Survey. Responses between the group that attended placement before the program (n = 17/44; RR 38%) and the group that attended following the program (n = 33/72; RR 45%) were compared. Improvements were noted in the areas of recognition, accomplishment, and influence, with decreases in dissatisfaction. Organisational investment in building staff capacity can produce a positive learning culture. The aged care sector offers a rich learning experience for students when staff capacity to support learning is developed.

  10. [Planning by service organisation priorities. The process of preparing strategic service-organisation plans].

    PubMed

    Sampietro-Colom, Laura; Costa, Dolors; Busqué, Anna; Lacasa, Carme

    2008-12-01

    Strategic planning designs the general setting and the strategic principles of a healthcare system, as well as the general guidelines that govern the development of a health system. Strategic service-organisation plans deal with translating healthcare policies into service policies and respond, principally, to the need for services; these give rise to problems that require a solution. They are developed in line with advances in scientific knowledge, the implementation and current characteristics of the healthcare services and the evolution in the competences of professional teams. There are five stages for their development: identification of health/service requirements; prioritisation of needs in health/services; definition of and agreement on service organisation models (care model and service portfolio); the preparation of and agreement on territorial action plans; introduction and evaluation. A conceptual framework is presented along with practical applications carried out in Catalonia.

  11. Regional variation in acute stroke care organisation.

    PubMed

    Muñoz Venturelli, Paula; Robinson, Thompson; Lavados, Pablo M; Olavarría, Verónica V; Arima, Hisatomi; Billot, Laurent; Hackett, Maree L; Lim, Joyce Y; Middleton, Sandy; Pontes-Neto, Octavio; Peng, Bin; Cui, Liying; Song, Lily; Mead, Gillian; Watkins, Caroline; Lin, Ruey-Tay; Lee, Tsong-Hai; Pandian, Jeyaraj; de Silva, H Asita; Anderson, Craig S

    2016-12-15

    Few studies have assessed regional variation in the organisation of stroke services, particularly health care resourcing, presence of protocols and discharge planning. Our aim was to compare stroke care organisation within middle- (MIC) and high-income country (HIC) hospitals participating in the Head Position in Stroke Trial (HeadPoST). HeadPoST is an on-going international multicenter crossover cluster-randomized trial of 'sitting-up' versus 'lying-flat' head positioning in acute stroke. As part of the start-up phase, one stroke care organisation questionnaire was completed at each hospital. The World Bank gross national income per capita criteria were used for classification. 94 hospitals from 9 countries completed the questionnaire, 51 corresponding to MIC and 43 to HIC. Most participating hospitals had a dedicated stroke care unit/ward, with access to diagnostic services and expert stroke physicians, and offering intravenous thrombolysis. There was no difference for the presence of a dedicated multidisciplinary stroke team, although greater access to a broad spectrum of rehabilitation therapists in HIC compared to MIC hospitals was observed. Significantly more patients arrived within a 4-h window of symptoms onset in HIC hospitals (41 vs. 13%; P<0.001), and a significantly higher proportion of acute ischemic stroke patients received intravenous thrombolysis (10 vs. 5%; P=0.002) compared to MIC hospitals. Although all hospitals provided advanced care for people with stroke, differences were found in stroke care organisation and treatment. Future multilevel analyses aims to determine the influence of specific organisational factors on patient outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. PORTRAYALS OF COLOMBIAN AND VENEZUELAN IMMIGRANT ORGANISATIONS IN THE UNITED STATES.

    PubMed

    Sanchez-R, Magaly; Aysa-Lastra, Maria

    2013-10-01

    This article compares the public images of Colombian and Venezuelan immigrant organisations in the United States. Immigrant organisations' webpages and the expression of their main aims and goals serve to identify their major concerns as they create public images not only for the organisation but for the immigrant community itself. To interpret the immigrant organisations' public images and their goals, we offer a multilevel study that considers immigrants' contexts of exit, which are related to the motivation of migrate and the particular sociodemographic makeup of immigrant groups. This paper adds the Venezuelan immigrant experience to the literature on immigrant organisations.

  13. Too much information? A document analysis of sport safety resources from key organisations.

    PubMed

    Bekker, Sheree; Finch, Caroline F

    2016-05-06

    The field of sport injury prevention has seen a marked increase in published research in recent years, with concomitant proliferation of lay sport safety resources, such as policies, fact sheets and posters. The aim of this study was to catalogue and categorise the number, type and topic focus of sport safety resources from a representative set of key organisations. Cataloguing and qualitative document analysis of resources available from the websites of six stakeholder organisations in Australia. This study was part of a larger investigation, the National Guidance for Australian Football Partnerships and Safety (NoGAPS) project. The NoGAPS study provided the context for a purposive sampling of six organisations involved in the promotion of safety in Australian football. These partners are recognised as being highly representative of organisations at national and state level that reflect similarly in their goals around sport safety promotion in Australia. The catalogue comprised 284 resources. More of the practical and less prescriptive types of resources, such as fact sheets, than formal policies were found. Resources for the prevention of physical injuries were the predominant sport safety issue addressed, with risk management, environmental issues and social behaviours comprising other categories. Duplication of resources for specific safety issues, within and across organisations, was found. People working within sport settings have access to a proliferation of resources, which creates a potential rivalry for sourcing of injury prevention information. Important issues that are likely to influence the uptake of safety advice by the general sporting public include the sheer number of resources available, and the overlap and duplication of resources addressing the same issues. The existence of a large number of resources from reputable organisations does not mean that they are necessarily evidence based, fully up to date or even effective in supporting sport

  14. Perceived Barriers and Facilitators to Positive Therapeutic Change for People with Intellectual Disabilities: Client, Carer and Clinical Psychologist Perspectives

    ERIC Educational Resources Information Center

    Ramsden, Sarah; Tickle, Anna; Dawson, David L.; Harris, Samantha

    2016-01-01

    Studies have highlighted successful outcomes of psychological therapies for people with intellectual disabilities. However, processes underlying these outcomes are uncertain. Thematic analysis was used to explore the perceptions of three clinical psychologists, six clients and six carers of barriers and facilitators to therapeutic change for…

  15. Hierarchical radial and polar organisation of chromosomes in human sperm.

    PubMed

    Millan, N M; Lau, P; Hann, M; Ioannou, D; Hoffman, D; Barrionuevo, M; Maxson, W; Ory, S; Tempest, H G

    2012-10-01

    It is well established that chromosomes occupy distinct positions within the interphase nuclei, conferring a potential functional implication to the genome. In addition, alterations in the nuclear organisation patterns have been associated with disease phenotypes (e.g. cancer or laminopathies). The human sperm is the smallest cell in the body with specific DNA packaging and the mission of delivering the paternal genome to the oocyte during fertilisation. Studies of nuclear organisation in the sperm have postulated nonrandom chromosome position and have proposed a chromocentre model with the centromeres facing toward the interior and the telomeres toward the periphery of the nucleus. Most studies have assessed the nuclear address in the sperm longitudinally predominantly using centromeric or telomeric probes and to a lesser extent with whole chromosome paints. To date, studies investigating the radial organisation of human sperm have been limited. The purpose of this study was to utilise whole chromosome paints for six clinically important chromosomes (18, 19, 21, 22, X, and Y) to investigate nuclear address by assessing their radial and longitudinal nuclear organisation. A total of 10,800 sperm were analysed in nine normozoospermic individuals. The results have shown nonrandom chromosome position for all chromosomes using both methods of analysis. We present novel radial and polar analysis of chromosome territory localization within the human sperm nucleus. Specifically, a hierarchical organisation was observed radially with chromosomes organised from the interior to the periphery (chromosomes 22, 21, Y, X, 19, and 18 respectively) and polar organisation from the sperm head to tail (chromosomes X, 19, Y, 22, 21, and 18, respectively). We provide evidence of defined nuclear organisation in the human sperm and discuss the function of organisation and potential possible clinical ramifications of these results in regards to male infertility and early human development.

  16. The effect of organisational resources and eligibility issues on transition from child and adolescent to adult mental health services.

    PubMed

    Belling, Ruth; McLaren, Susan; Paul, Moli; Ford, Tamsin; Kramer, Tami; Weaver, Tim; Hovish, Kimberly; Islam, Zoebia; White, Sarah; Singh, Swaran P

    2014-07-01

    To investigate the organisational factors that impede or facilitate transition of young people from child and adolescent (CAMHS) to adult mental health services (AMHS). Thirty-four semi-structured interviews were conducted with health and social care professionals working in child and adult services in four English NHS Mental Health Trusts and voluntary organisations. Data were analysed thematically using a structured framework. Findings revealed a lack of clarity on service availability and the operation of different eligibility criteria between child and adult mental health services, with variable service provision for young people with attention deficit hyperactivity disorder, autism spectrum disorders and learning disabilities. High workloads and staff shortages were perceived to influence service thresholds and eligibility criteria. A mutual lack of understanding of services and structures together with restrictive eligibility criteria exacerbated by perceived lack of resources can impact negatively on the transition between CAMHS and AMHS, disrupting continuity of care for young people. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Linking research to practice: the organisation and implementation of The Netherlands health and social care improvement programmes.

    PubMed

    Ovretveit, John; Klazinga, Niek

    2013-02-01

    Both public and private health and social care services are facing increased and changing demands to improve quality and reduce costs. To enable local services to respond to these demands, governments and other organisations have established large scale improvement programmes. These usually seek to enable many services to make changes to apply proven improvements and to make use of quality improvement methods. The purpose of this paper is to provide an empirical description of how one organisation coordinated ten national improvement programmes between 2004 and 2010. It provides details which may be useful to others seeking to plan and implement such programmes, and also contributes to the understanding of knowledge translation and of network governance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. Prolonged rote learning produces delayed memory facilitation and metabolic changes in the hippocampus of the ageing human brain.

    PubMed

    Roche, Richard Ap; Mullally, Sinéad L; McNulty, Jonathan P; Hayden, Judy; Brennan, Paul; Doherty, Colin P; Fitzsimons, Mary; McMackin, Deirdre; Prendergast, Julie; Sukumaran, Sunita; Mangaoang, Maeve A; Robertson, Ian H; O'Mara, Shane M

    2009-11-20

    Repeated rehearsal is one method by which verbal material may be transferred from short- to long-term memory. We hypothesised that extended engagement of memory structures through prolonged rehearsal would result in enhanced efficacy of recall and also of brain structures implicated in new learning. Twenty-four normal participants aged 55-70 (mean = 60.1) engaged in six weeks of rote learning, during which they learned 500 words per week every week (prose, poetry etc.). An extensive battery of memory tests was administered on three occasions, each six weeks apart. In addition, proton magnetic resonance spectroscopy (1H-MRS) was used to measure metabolite levels in seven voxels of interest (VOIs) (including hippocampus) before and after learning. Results indicate a facilitation of new learning that was evident six weeks after rote learning ceased. This facilitation occurred for verbal/episodic material only, and was mirrored by a metabolic change in left posterior hippocampus, specifically an increase in NAA/(Cr+Cho) ratio. Results suggest that repeated activation of memory structures facilitates anamnesis and may promote neuronal plasticity in the ageing brain, and that compliance is a key factor in such facilitation as the effect was confined to those who engaged fully with the training.

  19. The paediatric change laboratory: optimising postgraduate learning in the outpatient clinic.

    PubMed

    Skipper, Mads; Musaeus, Peter; Nøhr, Susanne Backman

    2016-02-02

    This study aimed to analyse and redesign the outpatient clinic in a paediatric department. The study was a joint collaboration with the doctors of the department (paediatric residents and specialists) using the Change Laboratory intervention method as a means to model and implement change in the outpatient clinic. This study was motivated by a perceived failure to integrate the activities of the outpatient clinic, patient care and training of residents. The ultimate goal of the intervention was to create improved care for patients through resident learning and development. We combined the Change Laboratory intervention with an already established innovative process for residents, 3-h meetings. The Change Laboratory intervention method consists of a well-defined theory (Cultural-historical activity theory) and concrete actions where participants construct a new theoretical model of the activity, which in this case was paediatric doctors' workplace learning modelled in order to improve medical social practice. The notion of expansive learning was used during the intervention in conjunction with thematic analysis of data in order to fuel the process of analysis and intervention. The activity system of the outpatient clinic can meaningfully be analysed in terms of the objects of patient care and training residents. The Change Laboratory sessions resulted in a joint action plan for the outpatient clinic structured around three themes: (1) Before: Preparation, expectations, and introduction; (2) During: Structural context and resources; (3) After: Follow-up and feedback. The participants found the Change Laboratory method to be a successful way of sharing reflections on how to optimise the organisation of work and training with patient care in mind. The Change Laboratory approach outlined in this study succeeded to change practices and to help medical doctors redesigning their work. Participating doctors must be motivated to uncover inherent contradictions in their

  20. A case study of organisational Cultural Competence in mental healthcare.

    PubMed

    Adamson, Jean; Warfa, Nasir; Bhui, Kamaldeep

    2011-09-15

    Ensuring Cultural Competence (CC) in health care is a mechanism to deliver culturally appropriate care and optimise recovery. In policies that promote cultural competence, the training of mental health practitioners is a key component of a culturally competent organisation. This study examines staff perceptions of CC and the integration of CC principles in a mental healthcare organisation. The purpose is to show interactions between organisational and individual processes that help or hinder recovery orientated services. We carried out a case study of a large mental health provider using a cultural competence needs analysis. We used structured and semi-structured questionnaires to explore the perceptions of healthcare professionals located in one of the most ethnically and culturally diverse areas of England, its capital city London. There was some evidence that clinical staff were engaged in culturally competent activities. We found a growing awareness of cultural competence amongst staff in general, and many had attended training. However, strategic plans and procedures that promote cultural competence tended to not be well communicated to all frontline staff; whilst there was little understanding at corporate level of culturally competent clinical practices. The provider organisation had commenced a targeted recruitment campaign to recruit staff from under-represented ethnic groups and it developed collaborative working patterns with service users. There is evidence to show tentative steps towards building cultural competence in the organisation. However, further work is needed to embed cultural competence principles and practices at all levels of the organisation, for example, by introducing monitoring systems that enable organisations to benchmark their performance as a culturally capable organisation.

  1. Organisational commitment in nurses: is it dependent on age or education?

    PubMed

    Jones, April

    2015-02-01

    In hospitals in the United States, the ratio of nurses to patients is declining, resulting in an increase in workloads for the remaining nurses. Consequently, the level of commitment that these nurses have to their jobs is important. Outside health care, employees from different generations working for a variety of organisations differ in their levels of organisational commitment, but this information has not been available for nurses. This study, carried out in the state of Alabama, looks at whether nurses from different generations differ in their levels of organisational commitment, and also whether there are any differences in organisational commitment between licensed practical nurses (LPNs) and registered nurses (RNs). A questionnaire designed to measure levels of organisational commitment was answered by 145 nurses. The results were analysed for any differences in organisational commitment in nurses from different generations and with different nursing degrees. Nurses from different generations showed the same levels of organisational commitment, but LPNs showed significantly less affective commitment, that is, lower feelings of loyalty to their workplace, than RNs. This information may be useful for hospital administrators and human resource managers in the United States to highlight the value of flexible incentive packages to address the needs of a diverse workforce. For healthcare employers in the UK, the concept that there is an association between nursing qualifications and levels of organisational commitment is critical for building organisational stability and effectiveness, and for nurse recruitment and retention.

  2. Questionnaire for measuring organisational attributes in dental-care practices: psychometric properties and test-retest reliability.

    PubMed

    Goetz, Katja; Hasse, Philipp; Szecsenyi, Joachim; Campbell, Stephen M

    2016-04-01

    The consideration of organisational aspects, such as shared goals and clear communication, within the health care team is important to ensure good quality care. In primary health care, the instrument Survey of Organizational Attributes for Primary Care (SOAPC) is available to measure organisational attributes of care. However, there is no instrument available for dental care. The aim of the present study was to investigate psychometric properties and test-retest reliability of the version of SOAPC adapted for dental care, namely the Survey of Organizational Attributes in Dental Care (SOADC). The SOADC consists of 21 items in the following four subscales: communication; decision making; stress/chaos; and history of change. Convergent construct validity was measured using the job satisfaction scale. A total of 287 dental-care practices were asked to participate in the validation study. Psychometric properties and test-retest reliability were observed. A total of 43 dental-care practices responded to the survey. At baseline, 178 dental-care staff completed the questionnaire, and 4 weeks later 138 did so. Internal consistency, measured by Cronbach's alpha, was 0.718 or higher in the subscales. The test-retest reliability for each subscale and the overall SOADC score demonstrated good correlations over the 4-week test-retest interval, except for 'history of change'. A strong correlation with the aggregated job-satisfaction scale showed high convergent construct validity of SOADC. The consideration of organisational aspects from the perspective of dental-care teams is important for providing good quality of care. The SOADC is a reliable instrument with good psychometric properties and is suitable for the evaluation of organisational attributes in dental-care practices. © 2015 FDI World Dental Federation.

  3. Why TQM does not work in Iranian healthcare organisations.

    PubMed

    Mosadeghrad, Ali Mohammad

    2014-01-01

    Despite the potential benefits of total quality management (TQM), many healthcare organisations encountered difficulties in its implementation. The purpose of this paper is to explore the barriers to successful implementation of TQM in healthcare organisations of Iran. This study involved a mixed research design. In-depth interviews were conducted with TQM practitioners to explore TQM implementation obstacles in Iranian healthcare organisations. In addition, this study involved survey-based research on the obstacles associated with successful TQM transformation. TQM implementation and its impact depend on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in Iranian healthcare organisations can be attributed to the non-holistic approach adopted in its implementation, inadequate knowledge of managers' about TQM implementation, frequent top management turnover, poor planning, vague and short-termed improvement goals, lack of consistent managers' and employees' commitment to and involvement in TQM implementation, lack of a corporate quality culture, lack of team orientation, lack of continuous education and training and lack of customer focus. Human resource problems, cultural and strategic problems were the most important obstacles to TQM successful implementation, respectively. Understanding the factors that are likely to obstruct TQM implementation would enable managers to develop more viable strategies for achieving business excellence. Understanding the factors that are likely to obstruct TQM implementation will help organisations in planning better TQM models.

  4. Instructional Design, Facilitation, and Perceived Learning Outcomes: An Exploratory Case Study of a Human Trafficking MOOC for Attitudinal Change

    ERIC Educational Resources Information Center

    Watson, Sunnie Lee; Loizzo, Jamie; Watson, William R.; Mueller, Chad; Lim, Jieun; Ertmer, Peggy A.

    2016-01-01

    This exploratory case study describes the design and facilitation of a massive open online course (MOOC) for attitudinal change regarding human trafficking. It examines the course from the learners', instructor's, and instructional designer's perspectives. Two interviews with the instructor and instructional designer were conducted, and data from…

  5. Assessing climate change risks to the natural environment to facilitate cross-sectoral adaptation policy.

    PubMed

    Brown, Iain

    2018-06-13

    Climate change policy requires prioritization of adaptation actions across many diverse issues. The policy agenda for the natural environment includes not only biodiversity, soils and water, but also associated human benefits through agriculture, forestry, water resources, hazard alleviation, climate regulation and amenity value. To address this broad agenda, the use of comparative risk assessment is investigated with reference to statutory requirements of the UK Climate Change Risk Assessment. Risk prioritization was defined by current adaptation progress relative to risk magnitude and implementation lead times. Use of an ecosystem approach provided insights into risk interactions, but challenges remain in quantifying ecosystem services. For all risks, indirect effects and potential systemic risks were identified from land-use change, responding to both climate and socio-economic drivers, and causing increased competition for land and water resources. Adaptation strategies enhancing natural ecosystem resilience can buffer risks and sustain ecosystem services but require improved cross-sectoral coordination and recognition of dynamic change. To facilitate this, risk assessments need to be reflexive and explicitly assess decision outcomes contingent on their riskiness and adaptability, including required levels of human intervention, influence of uncertainty and ethical dimensions. More national-scale information is also required on adaptation occurring in practice and its efficacy in moderating risks.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'. © 2018 The Author(s).

  6. Assessing climate change risks to the natural environment to facilitate cross-sectoral adaptation policy

    NASA Astrophysics Data System (ADS)

    Brown, Iain

    2018-06-01

    Climate change policy requires prioritization of adaptation actions across many diverse issues. The policy agenda for the natural environment includes not only biodiversity, soils and water, but also associated human benefits through agriculture, forestry, water resources, hazard alleviation, climate regulation and amenity value. To address this broad agenda, the use of comparative risk assessment is investigated with reference to statutory requirements of the UK Climate Change Risk Assessment. Risk prioritization was defined by current adaptation progress relative to risk magnitude and implementation lead times. Use of an ecosystem approach provided insights into risk interactions, but challenges remain in quantifying ecosystem services. For all risks, indirect effects and potential systemic risks were identified from land-use change, responding to both climate and socio-economic drivers, and causing increased competition for land and water resources. Adaptation strategies enhancing natural ecosystem resilience can buffer risks and sustain ecosystem services but require improved cross-sectoral coordination and recognition of dynamic change. To facilitate this, risk assessments need to be reflexive and explicitly assess decision outcomes contingent on their riskiness and adaptability, including required levels of human intervention, influence of uncertainty and ethical dimensions. More national-scale information is also required on adaptation occurring in practice and its efficacy in moderating risks. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  7. Interorganisational Integration: Healthcare Professionals’ Perspectives on Barriers and Facilitators within the Danish Healthcare System

    PubMed Central

    Godtfredsen, Nina Skavlan; Frølich, Anne

    2016-01-01

    Introduction: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. Methods: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department at a university hospital in the Capital Region of Denmark. Results and discussion: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration. Especially, clinical, functional and normative integration seems fundamental to developing integrated care in practice from the perspective of healthcare professionals. PMID:27616948

  8. Alternative Organisational Learning Therapy: An Empirical Case Study Using Behaviour and U Theory

    ERIC Educational Resources Information Center

    Ho, Li-An; Kuo, Tsung-Hsien

    2009-01-01

    This paper draws on the concept and process of deeper learning, namely the U theory (Senge, Scharmer, Jaworski, & Flowers, 2004a). As a driver to get a deeper exploration of organisational change process, the theory of U goes beyond the interpersonal aspects of learning, instead focusing on a deeper personal generative learning that emphasizes…

  9. Measuring Organisational Capabilities in the Higher Education Sector

    ERIC Educational Resources Information Center

    Bobe, Belete J.; Kober, Ralph

    2015-01-01

    Purpose: Drawing on the resource-based view (RBV), the purpose of this paper is to develop a framework and instrument to measure the organisational capabilities of university schools/departments. In doing so, this study provides evidence of the way competitive resources are bundled to generate organisational capabilities that give university…

  10. Influence of Organisational Defensive Patterns on Learning ICT

    ERIC Educational Resources Information Center

    Yau, Hon Keung; Cheng, Alison Lai Fong

    2011-01-01

    Purpose: The purpose of this paper is to investigate whether the IT professionals in a Hong Kong public transport company have a general perception of influence of the organisational defensive patterns on learning of ICT; and whether skilled incompetence, organisational defensive routines and fancy footwork are positively associated with each…

  11. Decoding Training Effectiveness: The Role of Organisational Factors

    ERIC Educational Resources Information Center

    Kodwani, Amitabh Deo

    2017-01-01

    Purpose: Organisations invest heavily in training and development initiatives (Miller, 2012). However, a small percentage of what is learnt by the trainees from training gets transferred to the job (Mackay, 2007). The purpose of this study is to extend previous findings and examine various organisational factors, which have not been studied…

  12. Transforming Health Professionals into Population Health Change Agents

    PubMed Central

    Naccarella, Lucio; Butterworth, Iain; Moore, Timothy

    2016-01-01

    Background With the recognition that professional education has not kept pace with the challenges facing the health and human service system, there has been a move to transformative education and learning professional development designed to expand the number of enlightened and empowered change agents with the competence to implement changes at an individual, organisation and systems level. Design and Methods Since 2010, the Department of Health and Human Services in Victoria, Australia, in collaboration with The University of Melbourne’s School of Population and Global Health, has delivered seven population health short courses aimed to catalyse participants’ transformation into population health change agents. This paper presents key learnings from a combination of evaluation data from six population health short courses using a transformative learning framework from a 2010 independent international commission for health professionals that was designed to support the goals of transformative and interdependent health professionals. Participatory realist evaluation approaches and qualitative methods were used. Results Evaluation findings reveal that there were mixed outcomes in facilitating participants’ implementation of population health approaches, and their transformation into population health agents upon their return to their workplaces. Core enablers, barriers and requirements, at individual, organisational and system levels influence the capability of participants to implement population health approaches. The iterative and systemic evolution of the population health short courses, from a one off event to a program of inter-dependent modules, demonstrates sustained commitment by the short course developers and organisers to the promotion of transformative population health learning outcomes. Conclusions To leverage this commitment, recognising that professional development is not an event but part of an ongoing transformative process, suggestions to

  13. Applying change management metaphors to a national e-Health strategy.

    PubMed

    Saunders, Chad; Scott, Richard E

    2014-01-01

    Recent attempts at a collective understanding of how to develop an e-Health strategy have addressed the individual organisation, collection of organisations, and national levels. At the national level the World Health Organisation's National eHealth Strategy Toolkit serves as an exemplar that consolidates knowledge in this area, guides practical implementations, and identifies areas for future research. A key implication of this toolkit is the considerable number of organisational changes required to successfully apply their ideas in practice. This study looks critically at the confluence of change management and e-Health strategy using metaphors that underpin established models of change management. Several of Morgan's organisational metaphors are presented (highlighting varied beliefs and assumptions regarding how change is enacted, who is responsible for the change, and guiding principles for that change), and used to provide a framework. Attention is then directed to several prominent models of change management that exemplify one or more of these metaphors, and these theoretical insights are applied to evaluate the World Health Organisation's National eHealth Strategy Toolkit. The paper presents areas for consideration when using the WHO/ITU toolkit, and suggestions on how to improve its use in practice. The goal is to seek insight regarding the optimal sequence of steps needed to ensure successful implementation and integration of e-health into health systems using change management models. No single model, toolkit, or guideline will offer all the needed answers, but clarity around the underlying metaphors informing the change management models being used provides valuable insight so potentially challenging areas can be avoided or mitigated.

  14. Increasing public awareness and facilitating behavior change: Two guiding heuristics

    NASA Astrophysics Data System (ADS)

    Maibach, E.

    2016-12-01

    If there is a single aspiration that unifies the professionals who work on the challenges associated with global change, it is likely their desire to see policy makers, business managers and members of the public make decisions that are better informed by the realities of what we know about how to stabilize the climate and prevent needless harm to people and eco-systems. This calls an obvious question: What can we - as scientists and science organizations - to do more effectively promote evidence-based decision-making and actions by important decision-makers? In this talk I will distinguish between two related challenges: more effectively sharing what we know (i.e., improving our communication); and more effectively helping decision-makers take helpful actions (i.e., improving our efforts to facilitate behavior change). Drawing on both theory and empirical evidence in communication science, behavioral science and other related social sciences, I suggest two guiding heurstics - one for each of the two challenges - that will help scientists and science organizations improve the impact of their outreach efforts. To more effectively share what we know, we need "simple clear messages, repeated often, by a variety of trusted sources." To help people convert their good intentions into effective actions, we need to do more to "make the behaviors we are promoting easy, fun and popular." I refer to each of these as "heuristics" in the sense that they organize a relatively large amount of prescriptive information into a relatively easy to use method or process. In this talk, I will unpack each of these heurtistics with the aim of making them practical for all in attendance.

  15. How do consumer leaders co-create value in mental health organisations?

    PubMed

    Scholz, Brett; Bocking, Julia; Happell, Brenda

    2017-10-01

    Objectives Contemporary mental health policies call for consumers to be involved in decision-making processes within mental health organisations. Some organisations have embraced leadership roles for consumers, but research suggests consumers remain disempowered within mental health services. Drawing on a service-dominant logic, which emphasises the co-creation of value of services, the present study provides an overview of consumer leadership within mental health organisations in the Australian Capital Territory. Methods Mental health organisations subscribing to the local peak body mailing list were invited to complete a survey about consumer leadership. Survey data were summarised using descriptive statistics and interpreted through the lens of service-dominant logic. Results Ways in which organisations may create opportunities for consumers to co-create value within their mental health services included soliciting feedback, involving consumer leaders in service design, having consumer leaders involved in hiring decisions and employing consumer leaders as staff or on boards. Strategies that organisations used to develop consumer leaders included induction, workshops and training in a variety of organisational processes and skills. Conclusions The findings of the present study extend the application of a service-dominant logic framework to consumer leadership within mental health organisations through consideration of the diverse opportunities that organisations can provide for consumer co-creation of service offerings. What is known about the topic? Policy calls for consumer involvement in all levels of mental health service planning, implementation and delivery. The extent to which service organisations have included consumer leaders varies, but research suggests that this inclusion can be tokenistic or that organisations choose to work with consumers who are less likely to challenge the status quo. Service literature has explored the way consumers can co

  16. The specificity and organisation of autobiographical memories.

    PubMed

    Schulkind, Matthew D; Rahhal, Tamara A; Klein, Megan R; Lacher, Samantha R

    2012-01-01

    Previous research suggests that autobiographical memories are over-general and are organised according to life periods. One experiment assessed the specificity and organisation of autobiographical memory by manipulating two variables. The retrieval cues were either a set of three words (a theme, a time period, and an emotional valence) or a short narrative that included a specific theme, time period, and emotional valence. The instructions either encouraged the participants to respond as though they were conversing with a friend (social instructions) or did not specify a target audience (standard instructions). Narrative cues and standard instructions elicited more specific responses than word cues and social instructions, respectively. Whereas word cues elicited memories that were most likely to match the cues in terms of time period, narrative cues elicited memories that were most likely to match the cues in terms of theme. These data suggest that previous research underestimated the specificity of the autobiographical knowledge base and overestimated the importance of temporally defined life periods for organising autobiographical memory. Previous conclusions regarding the specificity and organisation of autobiographical memory may reflect the structure of autobiographical narratives and the methodologies used to collect such narratives rather than the content of autobiographical memory itself.

  17. Organisational Studies in an Era of Educational Reform

    ERIC Educational Resources Information Center

    Hoyle, Eric; Wallace, Mike

    2014-01-01

    One social science base for educational administration proposed in the Baron and Taylor collection was organisation theory. In the event this expectation turned out to be over-optimistic. Organisation theory was much too contested and insufficiently pragmatic for the British taste. Major developments in this field occurred mainly in the USA.…

  18. Differences in psychosocial determinants of physical activity in older adults participating in organised versus non-organised activities.

    PubMed

    Deforche, B; De Bourdeaudhuij, I

    2000-12-01

    With the introduction of the new consensus on 30 minutes of moderate physical activity preferably on all days of the week, exercise implemented into daily activities is promoted whereas structured activity programs lose importance. Activity levels of most older people don't come up with current recommendations. Therefore strategies to enhance attendance of older adults in physical activities should be developed. Group programs may be more effective in changing exercise behaviour of older adults than non-supervised physical activity. The purpose of this study was to investigate the differences in level of activity and psychosocial determinants of physical activity between seniors involved in an exercise class and seniors not engaged in any organised physical activity. Seventy-five elderly who were currently involved in structured exercise classes and 75 elderly who did not participate in any organised physical activity during the previous year were recruited in senior citizens' centres and were asked to fill out a questionnaire. Subjects involved in an exercise program had higher levels of activity and reported more social influences and higher self-efficacy compared to the respondents practising on an individual basis. No differences were found in perceived barriers or benefits. Exercising in a group program gives the opportunity to accumulate some extra physical activity and positively affects the level of activity outside the program. Stimulating older adults to join a structured activity program in the company of family or friends in order to enhance supporting social influences and perceived competence could be an important intervention strategy.

  19. M-Learning--On Path to Integration with Organisation Systems

    ERIC Educational Resources Information Center

    Srivastava, Shilpa; Gulati, Ved Prakash

    2014-01-01

    Learning is essential in organizations for them to survive. However, given the changing environment owing to global inter-connectedness, mobile workforce, global unpredictability and complexities, the learning approach must also change. Today the Learning and Development unit must be able to facilitate collaborative work, develop learning…

  20. A case study of organisational cultural competence in mental healthcare

    PubMed Central

    2011-01-01

    Background Ensuring Cultural Competence (CC) in health care is a mechanism to deliver culturally appropriate care and optimise recovery. In policies that promote cultural competence, the training of mental health practitioners is a key component of a culturally competent organisation. This study examines staff perceptions of CC and the integration of CC principles in a mental healthcare organisation. The purpose is to show interactions between organisational and individual processes that help or hinder recovery orientated services. Methods We carried out a case study of a large mental health provider using a cultural competence needs analysis. We used structured and semi-structured questionnaires to explore the perceptions of healthcare professionals located in one of the most ethnically and culturally diverse areas of England, its capital city London. Results There was some evidence that clinical staff were engaged in culturally competent activities. We found a growing awareness of cultural competence amongst staff in general, and many had attended training. However, strategic plans and procedures that promote cultural competence tended to not be well communicated to all frontline staff; whilst there was little understanding at corporate level of culturally competent clinical practices. The provider organisation had commenced a targeted recruitment campaign to recruit staff from under-represented ethnic groups and it developed collaborative working patterns with service users. Conclusion There is evidence to show tentative steps towards building cultural competence in the organisation. However, further work is needed to embed cultural competence principles and practices at all levels of the organisation, for example, by introducing monitoring systems that enable organisations to benchmark their performance as a culturally capable organisation. PMID:21920044

  1. Perceived organisational support, organisational commitment and self-competence among nurses: a study in two Italian hospitals.

    PubMed

    Battistelli, Adalgisa; Galletta, Maura; Vandenberghe, Christian; Odoardi, Carlo

    2016-01-01

    This study examined the contributions of perceived organisational support (POS) and organisational commitment (i.e. affective, continuance and normative) to self-competence among nurses. In high-POS environments, workers benefit from socio-emotional resources to improve their skills, while positive forms of commitment (e.g. affective commitment) create a fertile context for developing one's competencies. A cross-sectional study was conducted among the nursing staff of two Italian urban hospitals (hospital A, n = 160; hospital B, n = 192). A structured questionnaire was administered individually to the nurses. Data analysis was conducted through multi-group analysis and supplemented by a bootstrapping approach. The results showed that POS was positively related to self-competence through affective commitment. In contrast, continuance and normative commitment did not mediate this relationship. This study shows that supporting employees through caring about their well-being as well as fostering positive forms of organisational commitment increases nurses' self-competence. Nurse managers may increase support perceptions and commitment among their staff by rewarding their contributions and caring about their well-being, as well as concentrating on training strategies that improve work-related skills. © 2015 John Wiley & Sons Ltd.

  2. Organisational justice and markers of inflammation: the Whitehall II study.

    PubMed

    Elovainio, Marko; Ferrie, Jane E; Singh-Manoux, Archana; Gimeno, David; De Vogli, Roberto; Shipley, Martin; Vahtera, Jussi; Brunner, Eric; Marmot, Michael G; Kivimäki, Mika

    2010-02-01

    Low organisational justice has been shown to be associated with increased risk of various health problems, but the underlying mechanisms remain unclear. We tested whether organisational injustice contributes to chronic inflammation in a population of middle-aged men and women. This prospective cohort study uses data from 3205 men and 1204 women aged 35-55 years at entry into the Whitehall II study (phase 1, 1985-1988). Organisational justice perceptions were assessed at phase 1 and phase 2 (1989-1990) and circulating inflammatory markers C-reactive protein (CRP) and interleukin (IL)-6 at phase 3 (1991-1993) and phase 7 (2003-2004). In men, low organisational justice was associated with increased CRP levels at both follow-ups (phase 3 and 7) and increased IL-6 at the second follow-up (phase 7). The long term (phase 7) associations were largely independent of covariates, such as age, employment grade, body mass index and depressive symptoms. In women, no relationship was found between organisational justice and CRP or IL-6. This study suggests that organisational injustice is associated with increased long-term levels of inflammatory markers among men.

  3. Organisational Factors of Occupational Accidents with Movement Disturbance (OAMD) and Prevention

    PubMed Central

    LECLERCQ, Sylvie

    2014-01-01

    Workplace design and upkeep, or human factors, are frequently advanced for explaining so-called Occupational Slip, Trip and Fall Accidents (OSTFAs). Despite scientific progress, these accidents, and more broadly Occupational Accidents with Movement Disturbance (OAMDs), are also commonly considered to be “simple”. This paper aims to stimulate changes in such perceptions by focusing on organisational factors that often combine with other accident factors to cause movement disturbance and injury in work situations. These factors frequently lead to arbitration between production and safety, which involves implementation of controls by workers. These controls can lead to greater worker exposure to OAMD risk. We propose a model that focuses on such controls to account specifically for the need to confront production and safety logics within a company and to enhance the potential for appropriate prevention action. These are then integrated into the set of controls highlighted by work organisation model developed by the NIOSH. PMID:25345425

  4. Developing methods for systematic reviewing in health services delivery and organisation

    PubMed Central

    Alborz, Alison; McNally, Rosalind

    2007-01-01

    Objectives To develop methods to facilitate the ‘systematic’ review of evidence from a range of methodologies on diffuse or ‘soft’ topics, as exemplified by ‘access to healthcare’. Data sources 28 bibliographic databases, research registers, organisational web sites or library catalogues. Reference lists from identified studies. Contact with experts and service users. Current awareness and contents alerting services in the area of learning disabilities. Review methods Inclusion criteria were English language literature from 1980 onwards, relating to people with learning disabilities of any age and all study designs. The main criteria for assessment was relevance to Guillifords’ model of access to health care which was adapted to the circumstances of people with learning disabilities. Selected studies were evaluated for scientific rigour then data was extracted and the results synthesised. Quality assessment was by an initial set of ‘generic’ quality indicators. This enabled further evidence selection before evaluation of findings according to specific criteria for qualitative, quantitative or mixed-method studies. Results 82 studies were fully evaluated. Five studies were rated ‘highly rigorous’, 22 ‘rigorous’, 46 ‘less rigorous’ and 9 ‘poor’ papers were retained as the sole evidence covering aspects of the guiding model. The majority of studies were quantitative but used only descriptive statistics. Most evidence lacked methodological detail, which often lowered final quality ratings. Conclusions The application of a consistent structure to quality evaluation can facilitate data appraisal, extraction and synthesis across a range of methodologies in diffuse or ‘soft’ topics. Synthesis can be facilitated further by using software, such as the Microsoft ‘Access’ database, for managing information. PMID:15606880

  5. The facilitators of communication with people with dementia in a care setting: an interview study with healthcare workers

    PubMed Central

    Stanyon, Miriam Ruth; Griffiths, Amanda; Thomas, Shirley A.; Gordon, Adam Lee

    2016-01-01

    Objectives: to describe the views of healthcare workers on the facilitators of communication with people with dementia in a care setting. Design: thematic analysis of semi-structured interviews. Setting: all participants were interviewed in their place of work. Participants: sixteen healthcare workers whose daily work involves interacting with people with dementia. Results: four overarching categories of themes were identified from the interviews that impact on communication: the attributes of a care worker, communication strategies used, organisational factors and the physical characteristics of the care environment. Conclusion: many strategies used by healthcare workers to facilitate communication have not yet been studied in the research literature. Participants' views on training should be incorporated into future dementia training programmes. PMID:26764403

  6. Informal Workplace Learning among Nurses: Organisational Learning Conditions and Personal Characteristics That Predict Learning Outcomes

    ERIC Educational Resources Information Center

    Kyndt, Eva; Vermeire, Eva; Cabus, Shana

    2016-01-01

    Purpose: This paper aims to examine which organisational learning conditions and individual characteristics predict the learning outcomes nurses achieve through informal learning activities. There is specific relevance for the nursing profession because of the rapidly changing healthcare systems. Design/Methodology/Approach: In total, 203 nurses…

  7. Taxonomic and thematic organisation of proper name conceptual knowledge.

    PubMed

    Crutch, Sebastian J; Warrington, Elizabeth K

    2011-01-01

    We report the investigation of the organisation of proper names in two aphasic patients (NBC and FBI). The performance of both patients on spoken word to written word matching tasks was inconsistent, affected by presentation rate and semantic relatedness of the competing responses, all hallmarks of a refractory semantic access dysphasia. In a series of experiments we explored the semantic relatedness effects within their proper name vocabulary, including brand names and person names. First we demonstrated the interaction between very fine grain organisation and personal experience, with one patient with a special interest in the cinema demonstrating higher error rates when identifying the names of actors working in a similar film genre (e.g., action movies: Arnold Schwarzenegger, Bruce Willis, Sylvester Stallone, Mel Gibson) than those working in different genres (e.g., Arnold Schwarzenegger, Gregory Peck, Robin Williams, Gene Kelly). Second we compared directly two potential principles of semantic organisation - taxonomic and thematic. Furthermore we considered these principles of organisation in the context of the individuals' personal knowledge base. We selected topics matching the interests and experience of each patient, namely cinema and literature (NBC) and naval history (FBI). The stimulus items were arranged in taxonomic arrays (e.g., Jane Austen, Emily Bronte, Agatha Christie), thematic arrays (e.g., Jane Austen, Pride and Prejudice, Mr Darcy), and unrelated arrays (e.g., Jane Austen, Wuthering Heights, Hercule Poirot). We documented that different patterns of taxonomic and thematic organisation were constrained by whether the individual has limited knowledge, moderate knowledge or detailed knowledge of a particular vocabulary. It is suggested that moderate proper name knowledge is primarily organised by taxonomy whereas extensive experience results in a more detailed knowledge base in which theme is a powerful organising principle.

  8. Taxonomic and Thematic Organisation of Proper Name Conceptual Knowledge

    PubMed Central

    Crutch, Sebastian J.; Warrington, Elizabeth K.

    2011-01-01

    We report the investigation of the organisation of proper names in two aphasic patients (NBC and FBI). The performance of both patients on spoken word to written word matching tasks was inconsistent, affected by presentation rate and semantic relatedness of the competing responses, all hallmarks of a refractory semantic access dysphasia. In a series of experiments we explored the semantic relatedness effects within their proper name vocabulary, including brand names and person names. First we demonstrated the interaction between very fine grain organisation and personal experience, with one patient with a special interest in the cinema demonstrating higher error rates when identifying the names of actors working in a similar film genre (e.g. action movies: Arnold Schwarzenegger, Bruce Willis, Sylvester Stallone, Mel Gibson) than those working in different genres (e.g. Arnold Schwarzenegger, Gregory Peck, Robin Williams, Gene Kelly). Second we compared directly two potential principles of semantic organisation – taxonomic and thematic. Furthermore we considered these principles of organisation in the context of the individuals' personal knowledge base. We selected topics matching the interests and experience of each patient, namely cinema and literature (NBC) and naval history (FBI). The stimulus items were arranged in taxonomic arrays (e.g. Jane Austen, Emily Bronte, Agatha Christie), thematic arrays (e.g. Jane Austen, Pride and Prejudice, Mr Darcy), and unrelated arrays (e.g. Jane Austen, Wuthering Heights, Hercule Poirot). We documented that different patterns of taxonomic and thematic organisation were constrained by whether the individual has limited knowledge, moderate knowledge or detailed knowledge of a particular vocabulary. It is suggested that moderate proper name knowledge is primarily organised by taxonomy whereas extensive experience results in a more detailed knowledge base in which theme is a powerful organising principle. PMID:22063815

  9. Organisational stressors, coping, and outcomes in competitive sport.

    PubMed

    Arnold, Rachel; Fletcher, David; Daniels, Kevin

    2017-04-01

    Organisational stressors are associated with positive and negative outcomes in extant literature; however, little is known about which demands predict which outcomes. Extant theory and literature also suggests that coping style may influence an individual's resilience or vulnerability to stressors and, subsequently, their psychological responses and outcomes. The purpose of this study was, therefore, to examine the main effects of organisational stressors and coping styles on various outcomes (e.g., positive and negative affect, performance satisfaction). Sport performers (n = 414) completed measures of organisational stressors, coping styles, positive and negative affect, and performance satisfaction. Multiple regression analyses revealed positive relationships of both goals and development stressors (duration and intensity) and team and culture stressors (frequency and intensity) on negative affect. Furthermore, problem-focused coping was positively related to positive affect, and emotion-focused coping was positively related to negative affect. This study furthers theoretical knowledge regarding the associations that both organisational stressors (and their dimensions) and coping styles can have with various outcomes, and practical understanding regarding the optimal design of stress management interventions.

  10. Financial contribution to global surgery: an analysis of 160 international charitable organisations.

    PubMed

    Gutnik, Lily A; Yamey, Gavin; Dare, Anna J; Ramos, Margarita S; Riviello, Robert; Meara, John G; Shrime, Mark G

    2015-04-27

    The non-profit and volunteer sector provides substantial contributions to global health. Within the field of surgery, this sector has made notable service contributions in low-income and middle-income countries (LMICs) where access to surgical care is poor. Little is known about financing and funding flows to surgical care in LMICs from both domestic and international sources. Because an estimated 55% of surgical care delivered in LMICs is via charitable organisations, understanding the financial contributions of this sector could provide valuable insight into estimating funding flows and understanding financing priorities in global surgery. Between June, and September, 2014, we searched public online databases of registered charitable organisations in five high-income nations (the USA, the UK, Canada, Australia, and New Zealand) to identify organisations committed exclusively to surgical needs. Based on availability, the most current 5 years (2007-13) of financial data per organisation were collected. For each charitable organisation, we identified the type of surgical services provided. We examined revenues and expenditures for each organisation. 160 organisations representing 15 different surgical specialties were included in the analysis. Total aggregated revenue over the years 2008-2013 was US$3·3 billion. Total aggregated expenses for all 160 organisations amounted to US$3·0 billion. 28 ophthalmology organisations accounted for 45% of revenue and 49% of expenses. 15 cleft lip and palate organisations totalled 26% of both revenue and expenses. 19 organisations providing a mix of diverse surgical specialty services amounted to 14% of revenue and 16% of expenses. The remaining 15% of funds represented 12 specialties and 98 organisations. The US accounted for 77·7% of revenue and 80·8% of expenses. The UK accounted for 11·0% of revenue and 11·91% of expenses. Canada accounted for 1·85% of revenue and 2·01% of expenses. Australia and New Zealand accounted

  11. The relationship between organised physical recreation and mental health.

    PubMed

    Street, Gillian; James, Ray; Cutt, Hayley

    2007-12-01

    The mental health benefit of participation in organised physical recreation is investigated as strategies aimed at enhancing mental health and well-being in the community have the potential to decrease social and economic costs. A literature review was undertaken to explore evidence relating to the mental health benefits of participation in organised physical recreation. Regular physical activity is widely recognised as protective against the overall burden of disease. Evaluations by government departments in Australia and the United States (US) found that people who participate in sports clubs and organised recreational activity enjoy better mental health, are more alert, and more resilient against the stresses of modern living. Participation in recreational groups and socially supported physical activity is shown to reduce stress, anxiety and depression, and reduce symptoms of Alzheimer's disease, yet more than one-third of adult Australians report no participation in sports and physical recreation. Evaluations of some programs found that physical activity is increased when the social environment is supportive and that the mental and physical benefits of participating in organised recreational activity can be experienced by people other than those directly involved with the sport or activity. This review supports the development and maintenance of organised sport and recreational activities that are socially and culturally appropriate. An increase in valid and reliable evaluations of sport and physical recreation programs would contribute to the international body of evidence of the mental health benefits of organised physical recreation.

  12. Improving organisational resilience through enterprise security risk management.

    PubMed

    Petruzzi, John; Loyear, Rachelle

    Enterprise Security Risk Management (ESRM) is a new philosophy and method of managing security programmes through the use of traditional risk principles. As a philosophy and life cycle, ESRM is focused on creating a business partnership between security practitioners and business leaders to more effectively provide protection against security risks in line with acceptable risk tolerances as defined by business asset owners and stakeholders. This paper explores the basics of the ESRM philosophy and life cycle and also shows how embracing the ESRM philosophy and implementing a risk-based security management model in the business organisation can lead to higher levels of organisational resilience as desired by organisation leaders, executives and the board of directors.

  13. Caring and Sharing: Becoming a Peer Facilitator.

    ERIC Educational Resources Information Center

    Myrick, Robert D.; Erney, Tom

    This book contains information and skill-building activities designed to train adolescents as peer facilitators. The first chapter describes peer facilitation and provides an overview of the book. The second chapter discusses principles, concepts, and ideas to help better understand how people learn, make decisions, change, and develop their own…

  14. [Organising an investigation site: a national training reference document].

    PubMed

    Cornu, Catherine; David, Frédérique; Duchossoy, Luc; Hansel-Esteller, Sylvie; Bertoye, Pierre-Henri; Giacomino, Alain; Mouly, Stéphane; Diebolt, Vincent; Blazejewski, Sylvie

    2014-01-01

    Several surveys have shown a declining performance of French investigators in conducting clinical trials. This is partly due to insufficient and heterogeneous investigator training and site organisation. A multidisciplinary group was set up to propose solutions. We describe the tools developed to improve study site organisation. This working group was made up of clinical research experts from academia, industry, drug regulatory authorities, general practice, and consulting. Methods and tools were developed to improve site organisation. The proposed tools mainly focus on increasing investigators' awareness of their responsibilities, their research environment, the importance of a thorough feasibility analysis, and the implementation of active patient recruitment strategies. These tools should be able to improve site organisation and performances in conducting clinical trials. © 2014 Société Française de Pharmacologie et de Thérapeutique.

  15. Linking Action Learning and Inter-Organisational Learning: The Learning Journey Approach

    ERIC Educational Resources Information Center

    Schumacher, Thomas

    2015-01-01

    The article presents and illustrates the learning journey (LJ)--a new management development approach to inter-organisational learning based on observation, reflection and problem-solving. The LJ involves managers from different organisations and applies key concepts of action learning and systemic organisational development. Made up of…

  16. Resource allocation and organisational features in Swedish primary diabetes care: Changes from 2006 to 2013.

    PubMed

    Husdal, Rebecka; Rosenblad, Andreas; Leksell, Janeth; Eliasson, Björn; Jansson, Stefan; Jerdén, Lars; Stålhammar, Jan; Steen, Lars; Wallman, Thorne; Adolfsson, Eva Thors

    2017-02-01

    To compare the resource allocation and organisational features in Swedish primary diabetes care for patients with type 2 diabetes mellitus (T2DM) between 2006 and 2013. Using a repeated cross-sectional study design, questionnaires covering personnel resources and organisational features for patients with T2DM in 2006 and 2013 were sent to all Swedish primary health care centres (PHCCs) during the following year. In total, 684 (74.3%) PHCCs responded in 2006 and 880 (76.4%) in 2013. Compared with 2006, the median list size had decreased in 2013 (p<0.001), whereas the median number of listed patients with T2DM had increased (p<0.001). Time devoted to patients with T2DM and diabetes-specific education levels for registered nurses (RNs) had increased, and more PHCCs had in-house psychologists (all p<0.001). The use of follow-up systems and medical check-ups had increased (all p<0.05). Individual counselling was more often based on patients' needs, while arrangement of group-based education remained low. Patient participation in setting treatment targets mainly remained low. Even though the diabetes-specific educational level among RNs increased, the arrangement of group-based education and patient participation in setting treatment targets remained low. These results are of concern and should be prioritised as key features in the care of patients with T2DM. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  17. Serious Game Leverages Productive Negativity to Facilitate Conceptual Change in Undergraduate Molecular Biology: A Mixed-Methods Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Gauthier, Andrea; Jenkinson, Jodie

    2017-01-01

    We designed a serious game, MolWorlds, to facilitate conceptual change about molecular emergence by using game mechanics (resource management, immersed 3rd person character, sequential level progression, and 3-star scoring system) to encourage cycles of productive negativity. We tested the value-added effect of game design by comparing and…

  18. Taking on the gender challenge in organisations: what does it take?

    PubMed

    Henry, Sarah K; Sandler, Joanne; Passerini, Luca; Darmstadt, Gary L

    2017-07-01

    Clear patterns emerged and are summarised on conditions for success in integrating a gender equality perspective across organisational programmes and culture. In short, organisations should consider five key 'ingredients' when designing their approach to integrating a gender equality perspective: (1) have a clear vision of success with measurable indicators; (2) have high-level, consistent, visible support; (3) take an intentional approach deeply rooted in the organisational culture and competencies; (4) ensure accountability at all levels and (5) invest both financial and technical resources. A vibrant community exists in virtually every region of the world of highly experienced gender equality experts that can support organisations on this path. Late adopters of integrating a gender equality perspective can benefit from decades of practice and a robust evidence base which has shifted focus among development organisations from asking 'why' addressing gender inequalities is important to learning 'how' to most effectively do this in programmes, policies, research and organisational culture while building a strong results framework.

  19. The Cumbria Rural Health Forum: initiating change and moving forward with technology.

    PubMed

    Ditchburn, Jae-Llane; Marshall, Alison

    2016-01-01

    The Cumbria Rural Health Forum was formed by a number of public, private and voluntary sector organisations to collaboratively work on rural health and social care in the county of Cumbria, England. The aim of the forum is to improve health and social care delivery for rural communities, and share practical ideas and evidence-based best practice that can be implemented in Cumbria. The forum currently consists of approximately 50 organisations interested in and responsible for delivery of health and social care in Cumbria. An exploration of digital technologies for health and care was recognised as an initial priority. This article describes a hands-on approach undertaken within the forum, including its current progress and development. The forum used a modified Delphi technique to facilitate its work on discussing ideas and reaching consensus to formulate the Cumbria Strategy for Digital Technologies in Health and Social Care. The group communication process took place over meetings and workshops held at various locations in the county. A roadmap for the implementation of digital technologies into health and social care was developed. The roadmap recommends the following: (i) to improve the health outcomes for targeted groups, within a unit, department or care pathway; (ii) to explain, clarify, share good (and bad) practice, assess impact and value through information sharing through conferences and events, influencing and advocacy for Cumbria; and (iii) to develop a digital-health-ready workforce where health and social care professionals can be supported to use digital technologies, and enhance recruitment and retention of staff. The forum experienced issues consistent with those in other Delphi studies, such as the repetition of ideas. Attendance was variable due to the unavailability of key people at times. Although the forum facilitated collective effort to address rural health issues, its power is limited to influencing and supporting implementation of change

  20. The Student Volunteer Army: a 'repeat emergent' emergency response organisation.

    PubMed

    Carlton, Sally; Mills, Colleen E

    2017-10-01

    This paper seeks to contribute to understanding of the factors associated with an effective emergent emergency response organisation and to provide new insights into this understudied area. It examines, through an analysis of a range of textual resources, the emergence and re-emergence of the Student Volunteer Army (SVA) during the devastating earthquakes in Canterbury, New Zealand, in 2010-11. This evaluation is conducted in relation to the four key features of an effective emergency response organisation: adaptability; direction; leadership; and communication. In addition, the paper aims to further understanding of 'emergency entrepreneurship' and thus of the values and strategies that underpin social entrepreneur organisations in times of normalcy. The paper concludes that the unique position of the SVA as a 'repeat emergent' emergency response organisation enabled it to innovate continually and to improve repeatedly its systems, relationships, and image, such that it exhibited features common to emergent and established emergency response organisations. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.