bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why did mainstream economics miss the crisis? The role of epistemological and methodological blinkers
Authors: Cameron John , Astrid Siegmann Karin 
Published: November 2014

PurposeIn this paper the aim is to show how the translation of a logical positivist epistemology into neoclassical economics has had profound methodological consequences which over‐determine an inability to predict cusps and their associated crises.Design/methodology/approachBased on a review of epistemological and methodological literature, it is argued that the financial crises of the past 20 years ought to initiate a questioning of the epistemological foundations of the discipline.FindingsAs an alternative, it is suggested that an economics methodology informed by critical realism would increase the probability of a timely prediction of crises.Originality/valueThe paper de‐emphasises falsification as a key criterion for assessing the quality of knowledge, provides more space for non‐quantified reflections on relationships, a thicker model of human agency, a well‐specified model of collective human economic behaviour as well as an endogenous possibility of dramatic change within the economic domain.
Economics as a polymorphic discursive construct: heterodoxy and pluralism
Authors: Pilkington Marc 
Published: November 2014

PurposeWhat do economists talk about? This seemingly innocent interrogation conceals a broader and innovative research programme, with the potential to renew the reflection on heterodox economics in a post‐crisis scenario. The aim of this paper is to show that convergence between language for specific purposes and economics is possible, so as to single out the genesis and the emergence of critical economic discourse.Design/methodology/approachAfter underlining the necessary collaboration between language and subject‐matter specialists, the paper addresses the question of the problematic use of economics textbooks in English‐speaking countries. Then, it deals with the fascinating question of the multiplicity of specialized meanings in economics. After pointing out the shortcomings of orthodoxy characterized by hyper‐formalization and its inevitable corollary, the mathematical nature of the discipline, it investigates the genesis of critical economic discourse, which requires the acknowledgement of pluralism and the components of heterodoxy, in order to converge towards a process of disciplinary acculturation that goes hand in hand with the learning process of language for specific purposes.FindingsA deep‐seated renewal of economics, consisting of a methodological shift towards the components of heterodoxy, has the potential to enhance the effectiveness of teaching English for economics, so that the latter effectively conveys specialized meaning.Research limitations/implicationsTeaching and researching English for specific purposes necessitates enhanced collaboration between subject‐matter specialists and applied linguists. However, this type of collaboration can be hampered by institutional or socio‐professional obstacles.Social implicationsDiscursive analysis has become indispensable in order to surmount the collective failure of mainstream economics in the aftermath of the global financial crisis. With the help of textbooks of a new kind, one must go beyond the vision of students as mere consumers of knowledge.Originality/valueLanguage for specific purposes has long shown interest in economics, but is the reciprocal true? This paper proposes an original association, by putting the two disciplinary fields on an equal footing, and by bringing new synergies forward.
Mostly empty words – what the discourse of “choice” in health care does
Authors: Nordgren Lars 
Published: November 2014

PurposeThis paper has two purposes: one is to analyse how the policy of freedom of choice emerged and was formed in the Swedish health care discourse; the second is related to how free choice influences the discourse in health care and how subjects are formed within the field, i.e. what the language of choice in health care does.Design/methodology/approachThe research strategy is inspired by a combined theoretical framework borrowed from Michel Foucault's concepts of “discursive formation” and “subjectivization” completed with Judith Butler's concept of performativity.FindingsThe language of “freedom of choice” calls to mind the rhetoric of promises, i.e. that the patient should be free and responsible, in his or her relation to health care. Since patients seem to be insufficiently informed and supported about the actual benefits of possibilities and limitations associated with the severely restricted reform of free choice, the statements concerning opportunities to make personal health decisions will lose their significance. The advocacy of discourses of freedom of choice seems therefore mostly like empty words, as they are producing weak patients instead of free and empowered people.Research limitations/implicationsAs the reform was initiated in the beginning of 2000 it is rather fresh.Originality/valueThe paper produces insights into the rhetoric of political promises and the limitations of the reform dealing with freedom of choice in health care.
The role of learning and customer orientation for delivering service quality to patients
Authors: Bellou Victoria 
Published: November 2014

PurposeThis study seeks to investigate the impact that learning orientation, internal and external customer orientation have on quality of care delivered to patients. Additionally, given the differences between managerial and non‐managerial employees regarding organizational value perception and focus on the needs of internal customers and patients, the study aims to examine potential variations in these relationships.Design/methodology/approachThe study took place in ten out of 31 public hospitals operating in the five largest districts in continental Greece. Hospitals were chosen on a random basis. Out of 800 questionnaires that were personally administered, 499 usable responses were gathered.FindingsThe extent to which employees create and use knowledge and focus on satisfying the needs of both internal customers and patients is indicative of the quality of care provided. In addition, only managerial employees believe that learning orientation reinforces quality of care.Research limitations/implicationsThe fact that employees rated quality of care delivered to patients and that most employees had extended tenure should be taken into consideration when interpreting these findings.Practical implicationsTop management needs to create a strong and clear culture that emphasizes learning, as well as internal customer and patient orientation, and infuse them among all organizational members. Moreover, human resource management policies should be aligned to meeting or exceeding patients' requests and expectations.Originality/valueThe paper enhances existing knowledge with regard to the antecedents of offering medical care of high quality.
Taking account of what young women want from school sex education
Authors: Cook Sinead 
Published: November 2014

PurposeThis study seeks to explore what young women want from their school‐based sex education.Design/methodology/approachQualitative methods were used to explore the perspectives of two groups of young women from Uganda and Scotland.FindingsOf particular importance to all the young women were: a diverse sex education curriculum appropriate to the ages of the students, being taught by an outside female facilitator, single‐sex classes and access to a female teacher. Furthermore, they proposed that discussion between small groups of friends is very useful. The Scottish group said that having a young teacher, teaching about emotions and relationships and being guided through their own decision making is also important. The Ugandan group emphasized the importance of being taught by female family members and having written materials provided on sex education.Originality/valueThe study showed that young women from different backgrounds have strong opinions about sex education, and are an important resource for policy makers.
Disclosing clinical performance: the case of cardiac surgery
Authors: Exworthy Mark , Smith Glenn , Gabe Jonathan , Rees Jones Ian 
Published: November 2014

PurposeIn recent years, the clinical performance of named cardiac surgeons in England has been disclosed. This paper aims to explore the nature and impact of disclosure of clinical performance.Design/methodology/approachThe paper draws on literature from across the social sciences to assess the impact of disclosure, as a form of transparency, in improving clinical performance. Specifically, it employs the “programme theory” of disclosure.FindingsThe “programme theory” of disclosure involves identification, naming, public sanction and recipient response. Named individual (consultant) surgeons have been identified through disclosure but this masks the contribution of the clinical team, including junior surgeons. Mortality is the prime performance measure but given low mortality rates, there are problems interpreting this measure. The naming of surgeons has been achieved through disclosure on web sites, developed between the health‐care regulator and the surgical profession itself. However, participation remains voluntary. The intention of disclosure is that interested parties (especially patients) will shun poorly performing surgeons. However, these parties' willingness and ability to exercise this sanction appears limited. Surgeons' responses are emergent but about a quarter of surgeons are not participating currently. Fears that surgeons would avoid high‐risk patients seem to have been unrealised. While disclosure may have a small effect on individual reputations, the surgical profession as a whole has embraced disclosure.Originality/valueWhile the aim of disclosure has been to create a transparent medical system and to improve clinical performance, disclosure may have the opposite effect, concealing some performance issues and possibly strengthening professional autonomy. Disclosure therefore represents greater transparency in health‐care but it is uncertain whether it will improve performance in the ways that the policy intends.
Connecting organisational culture and quality of care in the hospital: is job burnout the missing link?
Authors: Montgomery Anthony , Panagopoulou Efharis , Kehoe Ian , Valkanos Efthymios 
Published: November 2014

PurposeTo 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.Design/methodology/approachThe 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.FindingsRecommendations 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.Originality/valueThe 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.
Introducing innovation in a management development programme for a UK primary care organisation
Authors: Smith Paul , Hampson Libby , Scott Jonathan , Bower Karen 
Published: November 2014

PurposeThe aim of this paper is to examine the introduction of innovation as part of a management development programme at a primary care organisation, a legal form known as a Primary Care Trust (PCT), in the UK.Design/methodology/approachThe paper draws on experience of managing a successful management development programme for a PCT. The report of the case study analyses the key events that took place between 2008 and 2010, from direct observation, surveys, discussion and documentary evidence.FindingsThe Northern PCT has partnerships with a number of educational providers to deliver their leadership and management development programmes. A close working relationship had developed and the programme is bespoke – hence it is current and of practical use to the UK's National Health Service (NHS). In addition, there are regular meetings, with module leaders gaining a firsthand understanding of the organisation's needs and aspirations. This has resulted in a very focused and personalised offering and a genuine involvement in the programme and individuals concerned.Research limitations/implicationsThe research was conducted among a relatively small sample, and there is a lack of previous literature evidence to make significant comparisons.Practical implicationsThe paper identifies key implications for practitioners and educators in this area.Originality/valueThis paper is one of few to investigate innovation and improvement in the NHS, and is unique in that it uses the lenses of a management development programme to explore this important, and under‐researched, topic.
Barriers in implementation of evidence‐based practice
Authors: Hasson Henna , Andersson Mats , Bejerholm Ulrika 
Published: November 2014

PurposeThe aim of this paper is to identify initial barriers influencing implementation of supported employment (SE). SE, according to the individual placement and support (IPS) approach, has been recognised as an evidence‐based method to help people with severe mental illness to find regular employment.Design/methodology/approachA systematic implementation evaluation of the first randomised controlled SE (IPS) trial in Sweden was conducted in August 2008 and August 2009. Data were collected on a regular basis from SE employment specialists, process heads, clients and representatives from mental health care units and vocational services (social insurance and public employment offices) using interviews, non‐participant observations and document analysis.FindingsSE employment specialists reported that existing regulations for social insurance and employment regulations presented major obstacles to implementation. Difficulties were reported in cooperation with handling officers at the vocational services. Scepticism towards persons with mental illness was common and employers expected to receive subsidies if they hired a person with mental illness. SE participants expressed fear of losing their social benefits.Originality/valueThe results illuminate a collision between an innovative evidence‐based practice and the existing systems for social benefits and work rehabilitation.
Power in health care organizations
Authors: Isosaari Ulla 
Published: November 2014

PurposeThe aim of this paper is to examine health care organizations' power structures from the first‐line management perspective. What liable power structures derive from the theoretical bases of bureaucratic, professional and result based organizations, and what power type do health care organizations represent, according to the empirical data? The paper seeks to perform an analysis using Mintzberg's power configurations of instrument, closed system, meritocracy and political arena.Design/methodology/approachThe empirical study was executed at the end of 2005 through a survey in ten Finnish hospital districts in both specialized and primary care. Respondents were all first‐line managers in the area and a sample of staff members from internal disease, surgical and psychiatric units, as well as out‐patient and primary care units. The number of respondents was 1,197 and the response percentage was 38. The data were analyzed statistically.FindingsAs a result, it can be seen that a certain kind of organization structure supports the generation of a certain power type. A bureaucratic organization generates an instrument or closed system organization, a professional organization generates meritocracy and also political arena, and a result‐based organization has a connection to political arena and meritocracy. First line managers regarded health care organizations as instruments when staff regarded them mainly as meritocracies having features of political arena. Managers felt their position to be limited by rules, whereas staff members regarded their position as having lots of space and influence potential.Practical implicationsIf the organizations seek innovative and active managers at the unit level, they should change the organizational structure and redistribute the work so that there could be more space for meaningful management.Originality/valueThis research adds to the literature and gives helpful suggestions that will be of interest to those in the position of first‐line management in health care.
Culture in community pharmacy organisations: what can we glean from the literature?
Authors: Jacobs Sally , Ashcroft Darren , Hassell Karen 
Published: November 2014

PurposeThe 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.Design/methodology/approachThis 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.FindingsThe 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.Research limitations/implicationsThere 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.Originality/valueThis 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.
Regulating time commitments in healthcare organizations
Authors: Tengelin Ellinor , Arman Rebecka , Wikström Ewa , Dellve Lotta 
Published: November 2014

PurposeThe purpose of this paper is to explore managers' boundary setting in order to better understand their handling of time commitment to work activities, stress, and recovery during everyday work and at home.Design/methodology/approachThe paper has qualitatively‐driven, mixed method design including observational data, individual interviews, and focus group discussions. Data were analyzed according to Charmaz' view on constructivist grounded theory.FindingsA first step in boundary setting was to recognize areas with conflicting expectations and inexhaustible needs. Second, strategies were formed through negotiating the handling of managerial time commitment, resulting in boundary‐setting, but also boundary‐dissolving, approaches. The continuous process of individual recognition and negotiation could work as a form of proactive coping, provided that it was acknowledged and questioned.Research limitations/implicationsThese findings suggest that recognition of perceived boundary challenges can affect stress and coping. It would therefore be interesting to more accurately assess stress, coping, and health status among managers by means of other methodologies (e.g. physiological assessments).Practical implicationsIn regulating managers' work assignments, work‐related stress and recovery, it seems important to: acknowledge boundary work as an ever‐present dilemma requiring continuous negotiation; and encourage individuals and organizations to recognize conflicting perspectives inherent in the leadership assignment, in order to decrease harmful negotiations between them. Such awareness would benefit more sustainable management of healthcare practice.Originality/valueThis paper highlights how managers can handle ever‐present boundary dilemmas in the healthcare sector by regulating their time commitments in various ways.
Managing professionals: exploring the role of the hospital HR function
Authors: McDermott Aoife , Keating Mary 
Published: November 2014

PurposeThe purpose of this paper is to consider the role of the HR function in the management of professional and non‐professional staff in the acute hospital sector.Design/methodology/approachA qualitative approach was adopted. Empirical data from three hospital case studies is utilised to explore the role of the hospital HR function. Cases were compiled from 45 interviews, observation and secondary data analysis.FindingsThe paper finds that in two of the three cases the human resource (HR) function predominantly provides services to non‐professional workforce groups. However, the effective and strategic management of professionals is undertaken in the third case, without a professional HR function.Research limitations/implicationsThe findings of this paper require some caution in extrapolation, being based on research in one national context. The authors suggest the delivery of service as a useful lens to explore the enacted practice of HRM in hospitals.Practical implicationsThe paper draws attention to a significant deficit in the role of the HR function in managing core professional staff.Originality/valueThe paper applies an existing conceptual framework to explore the role of the HR function in hospitals. It identifies a significant deficit in the management of core professional staff. On this basis the paper suggests alternative research methodologies to investigate the management of all hospital staff.