bluuebunny/crossref_metadata_2025 huggingface dataset:
Reforming the police in Britain
Authors: Leishman Frank , Cope Stephen , Starie Peter
Published: July 2002

Since the late 1970s the public sector in Britain has been subject
to major reforms, which have been consistent with the prominent
international trend of bringing new public management into government.
The police service has escaped significant reform, particularly when
compared with other policy areas. But in 1993 the Conservative
government put forward a series of police reform measures, corresponding
largely to the tenets of new public management. However, despite
political commitment to reform, the implementation of many of the reform
proposals has been successfully resisted by the police. Provides an
explanation of the attempt to reform the police service by using a
policy networks approach.
Privatizing local authority service in Ireland
Authors: Reeves Eoin
Published: July 2002

Presents the first survey evidence of privatization of local authority services in the Republic of Ireland. The survey focuses on the case of refuse collection. Describes findings in the context of economic theories underpinning such policies which have relevance to countries adopting pragmatic and gradual approaches to public‐service reform. Unlike the pioneers of privatization such as the UK, this form of privatization has evolved in Ireland without any governmental edicts or policy guidelines. The consequence of such a development is the evolution of an array of privatization arrangements which have been generalized into three basic models. While it is too soon to assess the results of the transformation in terms of cost savings and effects on service quality, the survey primarily highlights the deficiencies in procedures adhered to. This is attributed to the absence of a general privatization policy. Despite the inadequacy of procedures already initiated, argues that, because reform is at a preliminary stage, new developments in public‐service management can contribute positively to a much needed public‐service reform policy.
Measuring service quality in local government: the SERVQUAL
approach
Authors: Donnelly Mike , Wisniewski Mik , Dalrymple John F. , Curry Adrienne C.
Published: July 2002

Local government in the UK is not immune from the pressures driving
successful organizations towards top quality services that delight their
customers. Outlines some of the special features of local government
service provision and the way in which these might affect the assessment
of service quality. Highlights some of the limitations of conventional
customer satisfaction surveys which lead the authors to consider the
SERVQUAL approach. This method, which has been the subject of
considerable academic scrutiny and extensive private sector service
application, merits serious consideration by local government managers
as a robust, adaptable, diagnostic instrument to measure service
quality.
The commercialization of the Australian public service and the accountability of government
Authors: Dixon John , Kouzmin Alexander , Korac‐Kakabadse Nada
Published: July 2002

States the Australian Public Service (APS) has been engaged in a comprehensive reform process for more than 20 years. A significant dimension of this reform process has been commercialization. With this growing commercialization, the relationship between civil servants, as APS managers, and their ministers has changed. Explores the accountability implications of the commercialization of the APS in the context of the recasting of the accountability responsibilities of civil servants associated with the demise, in Australia, of Westminster accountability conventions.
The hitch‐hiker’s guide to innovation?
Authors: Osborne Stephen P.
Published: July 2002

Describes and evaluates the management of innovation within an inter‐organizational context in the UK. Focuses specifically on the work and role of a local voluntary agency. Argues that the management of such innovation needs to embrace this context in all its complexity, rather than attempting to control it through traditional, rational management techniques. Uses this case as an example from which to draw out some general lessons about the management of public services in complex inter‐organizational environments.
Introducing system contradiction to effect change in the public sector
Authors: Lawrence Stewart , Doolin Bill
Published: July 2002

The purpose of this paper is twofold. The first part introduces a theoretical argument from Giddens to help explain the way in which accounting systems and systems of accountability have changed abruptly in New Zealand’s health care sector. The changes are proceeding, surrounded by controversy and the second part used Habermas’s theory of communicative action to assess the benefits or otherwise of reform and restructuring of the public health of New Zealanders. What counts as valid evidence is contentious. The reforms have been socially divisive, and surrounded by ideology and rhetoric. There appears to be little evidence to demonstrate that the reforms have improved or will ever improve access to health care by those without personal wealth.
Leadership, learning and local democracy
Authors: Martin Steve
Published: July 2002

Draws upon detailed empirical work undertaken with elected members and senior officers from a sample of 30 UK local authorities. Its focus is on the ways in which authorities have responded to rapid changes in the economic, social and political contexts and the profound challenges which these present to traditional modes of policy making and public management. Suggests that existing theoretical frameworks give insufficient attention to implications of changing local governance for the roles of elected members and that, in practice, most councillors feel ill‐equipped to respond to these changes. Local authorities need therefore to develop training and support for local politicians in fulfilling their rapidly changing and increasingly demanding roles. In particular they should look at ways of supporting elected members in working with external agencies so that they bring the “added value” of locally accountable political leadership to the work of partnerships involving public, private and voluntary sectors agencies. This will require them to embrace new forms of communication and methods of learning which are likely to be one of the key ingredients in attempts to revitalize local democracy.
Contracting‐out in public health and water services in Ghana
Authors: Larbi George A.
Published: July 2002

This article examines contracting‐out in practice in public health and water services in Ghana. Drawing on in‐depth interviews and discussions with knowledgeable officials, complemented by documentary analysis and secondary sources, the article provides insights into some of the institutional constraints and capacity issues that policy‐makers and implementers need to be aware of in seeking to introduce and implement contracting‐out policies in a developing country context. Though contracting‐out in Ghana’s health and water sectors has so far been used in the provision of support services, attempts to broaden its application to include the direct provision of core services raise a number of capacity questions related to regulatory frameworks, enforcement and monitoring mechanisms, development of management information systems and skills for contract management. The capacity and willingness of the private sector to take on direct provision of public services are also crucial.
Welfare benefits and the customer: a longitudinal perspective
Authors: Stafford Bruce
Published: July 2002

In the UK the Benefits Agency is seeking to process its business more efficiently, and commissioned research to investigate the number and nature of the contacts customers have with the Agency. The paper draws on this research and outlines the case for adopting a longitudinal perspective to elucidate and analyse customers’ contacts with a welfare provider. No research design is unproblematic, and the lessons learned in mapping the customers’ contacts will be discussed. In particular, the difficulties encountered and the solutions adopted in drawing a sample representative of pieces of business, in designing a contact grid, and in operationalising the notion of a contact will be elaborated. Some key findings from the research are used to illustrate the advantages of a longitudinal study.
Delivering primary education in Bangladesh
Authors: Saad Andaleeb Syed
Published: July 2002

To transform the population of Bangladesh into a more literate and numerate group so that higher‐order nation building objectives can be attained, primary education has a vital role to play. Its effective delivery depends significantly on the ability of the field personnel to carry out their supervision, reporting, and related managerial tasks. A field survey was conducted; it found that various constraints and obstacles continue to hinder the performance of these tasks. What is vitally important is to enable the field personnel; by doing so, primary education planners can better attain their objectives and the nation can progress more rapidly on the path to development.
Empowerment in an executive agency? A grass‐roots assessment of strategic intent
Authors: Mabey Christopher , Skinner Denise
Published: July 2002

Empowerment has been described as providing local management with a clear framework within which to manage, with the maximum devolution of responsibility and with the skills and confidence to accept it. Despite their wide adoption there is a dearth of research which elevates the voice of those on the receiving‐end of such empowering strategies, especially as applied in public sector organisations. This paper examines the impact of a five‐year empowerment programme, as perceived by the managers and staff within a “Next Steps” agency. Based on individual and group interviews with 75 staff, it is found that the programme is associated with a number of new working practices and a shift in management attitudes but the extent to which these are experienced as empowering varies considerably.
An internal marketing approach to public sector management
Authors: Ewing Michael T. , Caruana Albert
Published: July 2002

Internal marketing (IM) focuses on acquiring and retaining customer‐oriented employees. Critics of internal marketing claim that the term is simply a synonym for good human resources management. The concepts of internal marketing and human resource effectiveness (HRE), at both a strategic and technical level, are considered and suitable measures identified. Data are collected from the Australian public sector and a moderated regression analysis is used to investigate the hypothesized relationships. The study provides empirical support that there is a valid and distinct demarcation between IM and HRE, and that IM is an important antecedent to HRE.
A comparison of contracting arrangements in Australia, Canada and New Zealand
Authors: Ryan Neal
Published: July 2002

Increasingly, governments are using contracts as a means of achieving accountability for public resources directed towards community organisations. This paper compares contractual arrangements between community organisations and governments in British Columbia, Queeensland, and New Zealand. The paper examines the extent to which these contracts are able to measure performance. These contracts are also examined with respect to the power relationships between government and community organisations. The paper concludes that performance measurement may rest on establishing an appropriate “value” framework, and that autonomy of community organisations from government may vary according to broader objectives within policy areas.
Learning to manage within limited resources
Authors: Bovaird Tony , Davis Paul
Published: July 2002

This article sets out the main conclusions of a research project into how UK local authorities are managing within limited resources (MLR). Frameworks are developed to aid authorities to plan their approaches to MLR and to situate what they have already done and what they plan to do within a wider portfolio of tactics and strategies. An evaluation is made of how well local government is learning its way through to getting “more from less” and of what local authority support agencies need to do to help authorities to accelerate their learning. Finally, the authors argue that existing learning systems like benchmarking and quality management, while developing rapidly in local government, need further, significant refinement if the costs and benefits of resource management strategies are to be systematically evaluated.
The changing management agenda for primary heads
Authors: Jones Norah
Published: July 2002

There has been unprecedented change in education in the last decade since the 1988 Education Reform Act (ERA), and there is little doubt that these changes in education are causing profound shifts in the nature of the headteacher’s role. This paper investigates the role of the primary headteacher and is based on empirical evidence from experienced primary headteachers, all working in schools in one of the South Wales Valleys. There are three qualitative methods used to gather data: participant observation, interviews and Repertory Grids. The results from the empirical data reveal many changes in the role of the primary head; the most significant of the changes is an increase in management activities. The changes do not support the view that an increase in management leads to a deprofessionalisation; the core values of the primary head remain rooted in their philosophies of education. The results support the view that there is a changing management agenda, a new professional emerging, a New Public Management where the head manages but retains the core education sector values and visions.
Culture and drama
Authors: Goddard Andrew
Published: July 2002

This paper is an investigation of the interrelationship between organisational culture and financial control systems (FCS). A comparison is made between three local government organisations using an interpretive research methodology. Several researchers have advocated the adoption of an interpretive approach, among others, to accounting research. The first part of the paper discusses the relevant literature and outlines the research framework used to analyse the empirical data. This framework is based on the approach to studying organisational culture developed by Whipp et al. in 1989 which views culture in terms of a set of core beliefs and four modes of expression of these beliefs. Further, the framework acknowledges the dynamic nature of culture and uses the concept of social dramas to study the interrelationship between culture and the FCS. The second part describes the cultures and the financial control systems of the three organisations and discusses the interrelationship between them using the research framework. The final part summarises the findings, discusses a general model of the interrelationships and suggests some directions for more research in this area.
Standard costing and budgetary control in the British iron and steel industry
Authors: Edwards John Richard , Boyns Trevor , Matthews Mark
Published: July 2002

The use of accounting to help apply the principles of scientific management to business affairs is associated with the adoption of standard costing and budgetary control. This first British industry‐based study of the implementation of these calculative techniques makes use of the case study research tool to interrogate archival data relating to leading iron and steel companies. We demonstrate the adoption of standard costing and budgetary control early on (during the inter‐war period) by a single economic unit, United Steel Companies Ltd, where innovation is attributed to the engineering and scientific background and US experiences of key personnel. Elsewhere, significant management accounting change occurred only with the collapse in iron and steel corporate profitability that began to become apparent in the late 1950s. The process of accounting change is addressed and the significance for our study of the notions of evolution and historical discontinuity is examined. The paper is contextualised through an assessment of initiatives from industry‐based regulatory bodies and consideration of the economic circumstances and business conditions within which management accounting practices were the subject of radical revision.
An Analysis of Municipal Budget Variances
Authors: Mayper Alan G. , Granof Michael , Giroux Gary
Published: July 2002

The objective of this research was to determine the extent to which
municipal budget variances are systematically biased, the direction of
any biases, and the relationship between the biases and various
political, economic, demographic and organisational factors. We compared
budgeted and actual revenues and expenditures for 125 of the largest US
cities and developed regression models to explain the magnitude of
differences. Our results indicate that budget variances are decidedly
conservative and are most significantly influenced by the extent of
political competition and the percentage of funding from
inter‐governmental grants. Inasmuch as unreliable budget estimates can
thwart the political process, our findings suggest that there may be a
need for both citizens and legislative bodies to review more thoroughly
the budgets presented to them by city officials.
Differences in Social‐Cost Disclosures: A Market Test of
Investor Reactions
Authors: Freedman Martin , Stagliano A.J.
Published: July 2002

A decision of the US Supreme Court to require enforcement of an
environmental standard in the cotton textile industry provides a unique
opportunity to observe the market impact of social‐cost disclosures.
This research examines the reaction of investors to an exogenous factor
which has an impact on a particular group of firms. A valuation‐effects
paradigm is applied in the context of the standard market model to
evaluate the aggregate assessment of investors to the news that a costly
new Occupational Safety and Health Administration requirement would be
enforced. Risk‐adjusted returns in a sample of cotton textile firms were
observed to decline as a negative investor revaluation occurred. To
determine if ex ante disclosure of the potential financial
impact of this new environmental standard affected announcement‐period
market reaction, subsamples were developed on the basis of the type of
reporting provided. The results tend to support the view that market
pre‐conditioning occurred. Differential impacts were observable, with
less negative investor reaction to quantitative disclosures than to
other types of information provided by sample companies. These results
suggest that emphasis should be placed on quantitative social‐cost
disclosures, and that regulatory authorities might look more closely at
present disclosure guidelines to determine if they allow too much
reporting variability.
“Negative Political Feedback: An Examination of the Problem
of Modelling Political Responses in Public Sector Effectiveness
Auditing” – A Comment
Authors: Orford Robert J.
Published: July 2002

A response to Smith′s (1992) article in this issue of this journal.
Discusses the role of performance auditing from a national audit
perspective. Examines in particular the role of performance auditing in
addressing issues of government policy; considers the role of
statistical performance indicators in performance auditing; and provides
examples of the ways in which performance auditing can lead to improved
performance in government organizations.
Elements of a Theoretical Framework for Public Sector
Accounting
Authors: Pallot June
Published: July 2002

Suggests a notion of community assets based on common property that
recognizes the fundamental importance of accountability and democratic
control over resources in the public sector, the sociopolitical nature
of accounting, and the need to give visibility to public as well as
private interests. The development of such a concept has immediate
effects on the way the accounting entity and the relationship between
government and society are viewed and may even have ramifications for
accounting in the “private” sector.
Management Control and Accounting Systems under a
Competitive Strategy
Authors: Cunningham Gary M.
Published: July 2002

Explores management control and accounting systems of three
successfully competing companies to gain deeper insight and fill
knowledge gaps. Results show that management control and accounting
systems do exist which enhance successful competition. Common features
are heavy influence of marketing strategy and activities, but with
little interaction between the marketing and accounting functions and
with substantial accounting‐type activity, notably activity based cost
accounting, outside the accounting function. Traditional budgetary
accounting controls are used only for operating costs; social and
behavioural controls are used for revenues. Company executives believe
these features contribute to effective competition strategy. Findings
differ from conventional wisdom but provide implications for system
design and continued research.
Losing One’s Reason: On the Integrity of Accounting
Academics
Authors: Willmott Hugh , Puxty Tony , Sikka Prem
Published: July 2002

Amplifies and addresses a number of issues raised by Gray (1992) in
his review of the Fabian paper Accounting for Change: Proposals for
Reform of Audit and Accounting. It explores the terrain of
self‐reflection where the accounting academic struggles with the
question of what it may mean in practice as well as in theory, to aspire
to intellectual honesty and integrity. Argues that attention to the
politics of scholarship is helpful in understanding the comparative
novelty of Accounting for Change as well as the vocabulary that
it adopts. Contends that Gray′s identification of inconsistency and loss
of reason in Accounting for Change reflects a taken‐for‐granted
commitment to a particular, monological concept of reason. Contrasts
this with an alternative, dialogical conception of reason, arguing that
the latter takes fuller account of the socially negotiated and
consequential nature of communication.
Principals, Agents and the Economics of Accountability in the New Public Sector
Authors: Mayston David
Published: July 2002

Examines the recent changes made to the public sector in the UK in
the context of relevant economic models, including the principal‐agent
model, public goods theory and the median voter model. Considers a
number of possible justifications for the changes, including the
emulation of the private sector as a model of accountability and
efficiency, and increasing the accountability of the public sector.
Finds major problems with each of these justifications, highlights other
possible explanations for the changes, and emphasizes the importance of
the concept of “residual loss” when monitoring and bonding
processes are imperfect.
The negative effect of an accounting standard on employee welfare
Authors: Baker C. Richard , Stephan Hayes Rick
Published: July 2002

Investigates the negative effect on employee welfare caused by
economic decisions taken by corporate managements which they attribute
to the adoption of an accounting standard, focusing on the case of
McDonnell Douglas Corporation, which ended health‐care benefits for
non‐union employees as a result of adopting the Financial Accounting
Standards Board′s Statement 106 (FASB 106). It is estimated that the
adoption of FASB 106 caused $148 billion in charges to earnings
to be recorded by companies in the Standard & Poor′s 500 Index.
Despite the large negative effect on earnings, FASB 106 had little or no
impact on the economic condition of the affected firms. Nevertheless,
managements have taken economic actions that have negatively affected
employee welfare, and these actions have been attributed to FASB 106.
Some of the hardest hit are employees at older industrial companies with
mature workforces hired during the 1950s and 1960s. Some companies ended
retirement health plans abruptly, while others required workers and
retirees to pay more towards insurance premiums, or prevented new hires
from receiving retirement health coverage.
Pastoral accounting in pre‐Federation Victoria
Authors: Carnegie Garry D.
Published: July 2002

Investigates the dimensions of accounting information prepared for
use in managing non‐corporate pastoral entities in pre‐Federation
Western Victoria and the local, time‐specific environmental factors
which shaped these dimensions. Based on examinations of 23 sets of
surviving business records prepared during 1836‐1900, provides evidence
of the structure and usage of pastoral accounting information in an
unregulated financial reporting environment. Draws conclusions about the
likely impact of cultural, legal and political, professional,
educational, economic and other factors as key explanatory variables.
Also argues a case for lost relevance based on the evidence of
accounting change in the closing decades of the nineteenth century.
Inside contracting at the Waltham Watch Company
Authors: Fleischman Richard K. , Tyson Thomas
Published: July 2002

Accounting historians continue to debate the development of cost accounting procedures in late nineteenth‐century US mass‐production industries. While conventional historians (economic rationalists) emphasize efficiency and co‐ordination, labour process and other “critical” scholars prioritize social, political, and ideological concerns. One neglected, but significant, aspect of this controversy is inside contracting. Clawson presented an important overview of inside contracting at several prominent US manufacturing establishments, including the Waltham Watch Company (WWC). Clawson’s work is significant because his most salient remarks have been cited by scholars who advocate the “new accounting history”. Discusses inside contracting in general terms within the socio‐political context of nineteenth‐century US mass‐production industries. Subsequently, evaluates specific WWC archival data from both the economic rationalist and labour process perspectives, the reasons for inside contracting’s abandonment, and the impact of inside contracting on cost accounting developments.
Rhetoric and case study research: response to Joni Young and Alistair Preston and to Sue Llewellyn
Authors: Humphrey Christopher , Scapens Robert W.
Published: July 2002

Provides a response to the comments by Joni Young and Alistair Preston and by Sue Llewellyn, and seeks to clarify the authors’ use of the term “rhetoric”. Argues that both sets of commentators rely on rhetoric to express their own arguments. While the authors recognize and agree with most of the concerns raised by Llewellyn, they do not accept many of Young/Preston’s criticisms of their paper. Emphasizes that, although the authors were arguing for more scholarship, they were not seeking to dismiss the work of others.
Art and accountability: the languages of design and managerial control
Authors: Armstrong Peter , Tomes Anne
Published: July 2002

To hard‐pressed managements in competitive product markets, the aesthetic design of products appears to offer an attractive means of creating competitive advantage. In this situation, researchers on design management are beginning to construct forms of accountability for design so as to guarantee its impact on the market in advance. There are parallels between this initiative and the encroachment of audit controls in the public services. Drawing on theoretical resources developed in the body of research on this ‘audit explosion’, this paper argues that these attempts to subject the design process to audit involve a redefinition of the ‘language’ through which it communicates. Insofar as the result is to subordinate design’s languages of form texture and colour to audit’s languages of words and number, the result is likely to be a self‐defeating reduction of design to rehearsals of the banal, the clichéd and the bland.
Interactions between Japanese and international accounting academics
Authors: Kokubu Katsuhiko
Published: July 2002

Explores four themes at the 1998 APIRA conference – critical perspectives of accounting, organizational and institutional perspectives, public sector accounting in Japan and international accounting issues.
Quality management in German health care – the EFQM Excellence Model
Authors: Moeller Johannes , Breinlinger‐O’Reilly Jochen , Elser John
Published: July 2002

A brief insight into the issues affecting German health care is given. Namely, upward pressure on costs leads to increasing expenditure within health care and downward pressure from economic recession and political unwillingness to increase taxes and budget spending. In the case of competing key stakeholder perspectives, a quality management framework is seen as a potential approach for addressing these issues. The framework is the European Foundation for Quality Management (EFQM) Excellence Model. The article briefly explains the pilot phase for utilising the EFQM Excellence Model within German health care organisations and the various implementation approaches recommended by EFQM. Specific details of an approach used by a health care organisation within Germany (providing social medicine, geriatric and elderly services) are described in detail. The benefits achieved from using the Model are a clear picture of where the gaps are in the organisation and a clear vision for concentrating future efforts towards total quality management.
Predicting in‐home time of community care professionals
Authors: Kipp Jean , Killick Linda , Kipp Walter
Published: July 2002

The aim of this study was to test whether the client homebound score (CHS), the case management intensity score (CMIS) and the client priority visit score (CPVS) could be used to predict in‐home time of professional caregivers in the Aspen community care program. A random sample of 34 community care clients from the different geographical areas of the Aspen Regional Health Authority was selected and the home visits for each client were tracked for three months. Information such as client demographics, the client diagnostic category, number and in‐home time of visits was collected. In addition, the CHS, the CMIS and the CPVS were measured for each client. Data were analyzed, using a robust variance estimator regression model. CMIS was found to be the best predictor of in‐home time (coefficient 9.521, p > 0.001), followed by the CHS and the CPVS.
Patient Satisfaction Studies
Authors: Batchelor Claire , Owens David J. , Read Martin , Bloor Michael
Published: July 2002

Discusses how consumer evaluation studies of health‐care services might
be undertaken to provide valid assessments of consumer opinions and
priorities, amenable to subsequent, effective management action. To do
so, provides an account of the history of patient satisfaction surveys,
presents a detailed examination of key examples, and discusses the
well‐documented strengths and weaknesses of this approach. Draws
attention to recent critiques of survey methods and growing interest in
qualitative research focusing on the rationale that the latter provides
more useful data for managers. Argues that the search for a “best”
consumer evaluation method is misplaced since appropriate methods should
be determined by research objectives which themselves may vary. Points
to existing analyses of relevant research which offer sound
methodological guidelines and concludes by offering explicit suggestions
for the future conduct of consumer evaluation research.
Using adverse events in health‐care quality improvement
Authors: Walshe Kieran , Bennett Jennifer , Ingram David
Published: July 2002

Adverse event monitoring is a problem‐oriented approach to clinical
audit and health‐care quality improvement, which was developed and has
been widely used in the USA. Briefly explores the technique itself and
its evolution. Presents experience gained from the widespread use of the
approach in a British acute hospital, and results from one specialty
– ophthalmology. Suggests that the study of adverse events in
patient care can produce significant improvements in patients’ care,
that it is particularly suited to some specialties, and that it should
be used alongside other techniques in hospital clinical audit
programmes. Concludes that, as the demand for quality‐monitoring
information from purchasers and within providers grows, adverse event
monitoring may become one of the key techniques for quality assessment
and improvement.
Planning and management tools to help with provision of effective
health care
Authors: Stockley Alan
Published: July 2002

Introduces the Planman system of techniques and diagrams. Describes
each tool and how it should be used. Suggests that this system could
meet many of the planning and management needs of the health‐care
profession.
Using consumer feedback to improve services
Authors: Spencer Alison
Published: July 2002

Describes how a consumer satisfaction survey was carried out at a community mental health centre and the improvements that occurred as a result. A questionnaire was designed to be delivered as a semi‐structured interview to elicit the views and opinions of the clients. Their responses highlighted a number of positive areas about the centre, especially in terms of the staff and the therapeutic support they provide. The feedback also revealed a number of areas where improvements were needed. Reports on six recommendations which were made in terms of medication, activities, privacy, reviews, social service issues and complaints. The staff worked hard to implement a number of changes to improve the quality of the service they provide. The end result is that users’ views and opinions have been integrated with the service design and delivery, making the centre a more user‐friendly place.
Benchmarking in the UK National Health Service
Authors: Bullivant John R.N.
Published: July 2002

Traces the development of benchmarking in a number of UK National Health Service trusts, highlighting practical processes and the benefits of benchmarking but also identifying common pitfalls and ways of handling them when they arise or, better still, anticipating them. Several examples of successful benchmarking initiatives are given, emphasizing the advantages of using a systematic benchmarking approach, using benchmarking clubs and the need to develop ad hoc performance measures. Concludes by emphasizing the need for a new commitment to continuous improvement by senior managers to avoid the failures of previous drives for improvement.
Clinical audit, the case for ethical scrutiny?
Authors: Rix Gary , Cutting Keith
Published: July 2002

The UK Government’s White paper stated their commitment to the development of medical audit. The subsequent growth of audit activity by all health‐care professions has led to a proliferation of activity, often involving direct contact with the patient. However, there seems to be wide acceptance that there are no ethical dimensions to audit activity, even though it may be wide‐ranging and unco‐ordinated. Argues that, while research has a well‐developed mechanism for ethical scrutiny, audit activity can sometimes be indistinguishable from research and so, in some cases, it should be submitted to external scrutiny in order to protect the patient. Suggests five criteria as activities where ethical scrutiny should be considered.
Quality assessment of discharge letters in a French university hospital
Authors: Bertrand D. , François P. , Bosson J.‐L. , Fauconnier J. , Weil G.
Published: July 2002

The quality of discharge letters has been evaluated in order to initiate a process of improved communications between the hospital and general practitioners. From each of 37 volunteer clinical departments of a French university hospital, a random sample of 30 stays was selected among the hospitalisations for one year. The quality of discharge letters was assessed according to recipients’ needs and to French legislation. In total, 1,024 medical records were relevant and were analysed. This study showed deficiencies in management of discharge letters in the hospital. It constitutes the first step of a quality improvement process based on the awareness of concerned actors through information feedback and the follow‐up of specific indicators.
Improving the quality of institutional care of urinary incontinence among the elderly: a challenge for governmental regulation
Authors: Fleishman Rachel , Heilbrun Gabriella , Mandelson Jenny , Shirazi Vicky
Published: July 2002

This article describes actual UI prevalence and quality of care at Israeli LTC institutions for the elderly. The analysis is based on current regulatory data on 14,406 residents at 196 residential homes, and 8,278 patients at 159 hospitals for the chronically ill. It includes a calculation of summary indices of quality, the percentage of institutions with deficient items and of those showing change, and a description of functional status profiles. Multiple regression explains the deficiency rate variance through independent institutional variables. There is a higher prevalence of severe functional impairment and full incontinence at hospitals for the chronically ill than at residential homes. There were higher rates of deficiencies and lower rates of corrections for structural items than for process items at both. A major improvement occurred for process items (50‐100 per cent). Regarding outcomes, 34 percent of the residents with UI during the first assessment were continent two years later.
Using the Business Excellence Model to develop a strategy for a healthcare organisation
Authors: Naylor Gail
Published: July 2002

This article examines the appropriateness of the Business Excellence Model in developing a strategy for Bolton Hospitals NHS Trust to measure organisational performance. The need for a strategy to measure organisational performance and to improve organisational performance was highlighted with the production of the Government White Paper, The New NHS: Modern and Dependable. At the heart of recommendations there is emphasis on improving quality and driving efficiency. Greater emphasis will be placed on organisations measuring their performance. By utilising the conceptual framework, which consisted of The European Foundation for Quality Management (EFQM) Model, it became evident that, although tools were in existence within Bolton Hospitals to measure organisational performance, several critical areas needed addressing. By addressing these key areas, the organisation could begin to work towards its goal of business excellence. The conclusions drawn from this project demonstrated that there was scope for Bolton Hospitals to improve on organisational performance. It was highlighted that the Trust was functioning well in some areas of the EFQM Model, but not in others. For Bolton Hospitals NHS Trust to improve organisational performance, the EFQM Model should be adopted.
The Patient’s Charter: a tool for quality improvement?
Authors: Farrell Christine
Published: July 2002

Reports on research carried out in 1997/98 which used four different methods in a staged process: literature review, in‐depth interviews, a postal questionnaire and focus groups in acute and primary care. There was a surprising level of agreement between patients, carers and NHS staff about what was wrong with the existing charter and about what a new charter should contain. Patients knew very little about the contents of the Charter. NHS staff were much more knowledgeable and much more critical of its impact on them and NHS services. The overall view was that it had been of limited usefulness. Although there were differences in emphasis, there was almost unanimous agreement about what a new charter should contain: it should be based on the principles of openness, accountability and equity; there should be a much stronger focus on primary and community health care; there should be clearer statements about patients’ rights of access to services; standards which focus on clinical need, effectiveness and health outcomes; and standards for better communication and information in a usable form. A new charter should emphasis the rights and responsibilities of patients and staff. Most important of all, patients and staff should be involved in the development of a new charter so that it will reflect their views.
Developing a competency framework to support training in evidence‐based healthcare
Authors: Cowling Alan , Newman Karin , Leigh Susie
Published: July 2002

This paper focuses on the practice of evidence‐based healthcare by doctors, nurses, midwives and the professions allied to medicine in four NHS Trusts in and around London. This qualitative study, based on interviews and self‐efficiency ratings uncovered the extent of evidence based practice between different groups and between acute and community Trusts, the perceived obstacles to the adoption and implementation of EBHC, and throws light on the knowledge, skills and attitudes required for such practice. Five clusters of competencies were identified – personal attributes, interpersonal, self‐management, information management and technical knowledge skills – and these form the basis of a competency framework of measurable criteria to assess proficiency as well as staff training needs which it is hoped will enable NHS Trusts to devise strategies to meet the requirements and challenges of clinical governance from April 1999.
Q methodology, risk training and quality management
Authors: McKeown Mick , Hinks Martin , Stowell‐Smith Mark , Mercer Dave , Forster Joe
Published: July 2002

The results of a Q methodological study of professional understandings of the notion of risk in mental health services within the UK are discussed in relation to the relevance for staff training and quality assurance. The study attempted to access the diversity of understandings of risk issues amongst a multi‐professional group of staff (n = 60) attending inter‐agency risk training workshops in 1998. Q methodology is presented as both an appropriate means for such inquiry and as a novel experiential technique for training purposes. A tentative argument is advanced that the qualitative accounts generated by Q research could assist in systematic reviews of quality, complementing the singularly quantitative approaches typically represented in the audit process.
Women and Power in Organizations
Authors: Lahtinen Heli K. , Wilson Fiona M.
Published: July 2002

Men have power in organizations that women often lack. Investigates
generally men′s and women′s employment, job segregation, and part‐time
employment. Discusses the barriers to women′s progress. The first
barrier is the role women have been socialized to adopt, for example,
passive. The second is lack of support including limited financial
resources, education and training, lack of child care arrangements,
networks, role models, mentors and domestic constraints. A third barrier
is attitudes such as employer biases, negative perceptions of women,
attribution of female behaviour and use of language. Suggests how women
could gain more power. Positive action is required within schools to
encourage girls to pursue non‐traditional career plans. Further
awareness of the problems arising from sex stereotyping is needed.
Through mentoring women could have access to the power network. However,
peer mentoring can be an egalitarian alternative for women. Discusses
the importance of assertiveness training for women.
From Chaos to Complexity
Authors: Lewis Ralph
Published: July 2002

Complexity theory is a new science that builds on chaos. Its
implications for organizations are many – specifically in understanding
change. Leaders need to keep their organizations in the complexity zone
where learning takes place, rather than stability or chaos. The basic
“rules” that govern all behaviours in an organization need to be
identified. Complexity theory explains how competition happens and also
suggests that top‐down culture change will not work.
Executive Competencies
Authors: Pierce Chris
Published: July 2002

Examines research activity in executive competencies, and the Management
Charter Initiative M3 framework. Briefly outlines executive competency
frame‐works currently being developed and indicates future directions.
Critical theory and the psychodynamics of change
Authors: Carr Adrian
Published: July 2002

The critical theory of the Frankfurt School was imbued with a vision that apprehended social milieu as dialectic. Those who wish to adopt a dialectical orientation to their work as agents of and for change need to appreciate that such an orientation is likely to engender certain psychodynamics within themselves and others. In this particular setting, both individual and collective catharsis is to be expected as the contextually‐discovered revelation of, and reflection on, the “social amnesia” of the present organizational and social patterns. In many senses the organization should be considered as functioning as a therapeutic setting.
Phenomenal complexity theory and change at DisneyResponse to Letiche
Authors: Boje David M.
Published: July 2002

This article develops an example of Letiche’s article on phenomenal complexity by contrasting academic research projects that have contradictory findings concerning Disney. Some academics think Disney is unfairly critiqued while others think that Disney escapes. Phenomenal complexity theory is used to explain the disparate results.
Staying on top: characteristics of long‐term survival
Authors: Bonn Ingrid
Published: July 2002

Reports the results of an empirical study investigating the key factors that affected the survival of large manufacturing organizations between 1982 and 1993 in Australia. Four broad categories of variables were examined: environmental variables, organizational variables, company strategies and ownership characteristics. Using logistic regression analysis, it was found that the following variables were significant for company survival: size, planning system, corporate direction, research and development and ownership characteristics.
Organizational learning, knowledge and wisdom
Authors: Bierly Paul E. , Kessler Eric H. , Christensen Edward W.
Published: July 2002

To improve our understanding of the impact of organizational learning and knowledge on competitive advantage, we propose a framework that includes the constructs of data, information, knowledge, and wisdom. Each of these constructs is then associated with a different type of learning. We further argue that wisdom is an important, albeit missing, construct in the knowledge‐based theory of the firm. A key to organizational wisdom is judgement and decision making, which requires an understanding of the complexity of a situation, but also requires the ability to make sense and simplify so that action can be taken. Three important drivers for the development of organizational wisdom are experience, a passion to learn, and spirituality. Processes for acquiring organizational wisdom such as transformational leadership, organizational culture and knowledge transfer are also discussed.
Development of a measure to assess organizational change
Authors: Szamosi Leslie T. , Duxbury Linda
Published: July 2002

Discusses the use of the act frequency approach methodology to develop and validate a measure of organizational support of revolutionary change. A total of nine unique behaviors, describing three constructs, were viewed by employees as supportive of revolutionary change; and 12 unique behaviors, describing two constructs, were perceived as being non‐supportive of revolutionary change. The measures developed were found to have high internal reliability. The measures were also found to be highly correlated with relevant individual and organizational outcome measures. These results provide empirical support for the idea that how an organization supports revolutionary change can have an impact on both the organization and its employees and that contextual variable may not influence perceptions.