bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reforms and clinical managers' responses: a study in Norwegian hospitals
Authors: Johanne Pettersen Inger , Nyland Kari 
Published: May 2014

PurposeThis paper seeks to explore the legitimacy of budgets as management control processes in hospitals after comprehensive reforms were implemented in the Norwegian hospital sector in 2002.Design/methodology/approachThe paper employs qualitative interviews with top level clinical managers in three large hospitals.FindingsThe study shows a variety of practices among the clinical managers as to management control adjustments. The managers use different strategies in order to cope with the budget frames.Research limitations/implicationsThis paper contributes to the current debate and research relating to the budgeting and performance management practices in hospital settings.Practical implicationsThese findings contribute to contextual knowledge that is relevant in understanding the diverse practices of clinical managers in hospitals as complex service producing organizations.Social implicationsThe findings give information to decision makers as to the diversity in management practices within knowledge intensive organizations.Originality/valueThe paper challenges the idea that the strategies used by managers can be understood by the concepts of the means‐end rationality prescribed in most of the reforms introduced into the hospital sector.
Primary care in the United States: practice‐based innovations and factors that influence adoption
Authors: Goetz Goldberg Debora 
Published: May 2014

PurposeThis study aims to explore the use of specific innovations in primary care practices. The research seeks to examine whether a relationship exists between environmental factors and organizational characteristics and the level of innovation in primary care practices in Virginia.Design/methodology/approachThe study utilized multiple secondary data sets and an organizational survey of primary care practices to define the external environment and the level of innovation. Institutional theory was used to explain the connection between innovations in primary care practices and institutional forces within the environment. Resource dependency theory was used to explain motivators for change based on a dependence on scarce financial, human, and information resources.FindingsResults show a positive association between organizational size, organizational relationships, and stakeholder expectations on the level of innovation. A negative association was found between competition and the level of innovation. No relationship was found between degree of Medicare and managed care penetration and innovation, nor between knowledge of, and difficulty complying with, payer organization requirements and innovation.Originality/valuePrimary care physician practices exist in a market‐driven environment characterized by high pressure from regulatory sources, decreasing reimbursement levels, increasing rate of change in technologies, and increasing patient and community expectations. This study contributes new information on the relationship between organizational characteristics, the external environment and specific innovations in primary care practices. Information on the contributing factors to innovation in primary care is important for improving delivery of health care services and the ability of these practices to survive.
Discursive construction of polyphony in healthcare management
Authors: Hujala Anneli , Rissanen Sari 
Published: May 2014

PurposeThe aim of the paper is to understand and define how the polyphony of management is constructed in interaction and to describe this through concrete management meeting cases. Polyphony refers to the diverse voices of various organization members, and how these voices are present, disclosed and utilized in management.Design/methodology/approachThe study is based on the social constructionist and discursive perspectives of management, which question the traditional, individualistic approaches of management. The issue was examined through a qualitative case study by analysing the micro‐level management discourse in three healthcare organizations.FindingsDiscursive practices that enhance or inhibit polyphony are often unnoticed and unconscious. Key moments of management discourse are an example of unconscious mundane practices through which members of organizations construct the reality of management.Research limitations/implicationsThe empirical results are locally contextual. In the future, research will be able to apply the approach to diverse contexts as well as link micro‐level discourses to the construction of broader health and social management discourses.Practical implicationsThe paper increases the understanding of how to enhance participation and staff contribution, and how to utilize the knowledge of all members of the organization.Social implicationsBoth managers and other staff members are fully involved in the social construction of management. Micro‐level discourse should be paid attention to in management work as well as in the education of managers and staff.Originality/valueThe study increases the understanding of micro‐level issues of management and challenges the conventional, taken‐for‐granted assumptions behind organization and management theories.
Quality improvement through clinical communities: eight lessons for practice
Authors: Aveling Emma‐Louise , Martin Graham , Armstrong Natalie , Banerjee Jay , Dixon‐Woods Mary 
Published: May 2014

PurposeApproaches to quality improvement in healthcare based on clinical communities are founded in practitioner networks, peer influence and professional values. However, evidence for the value of this approach, and how to make it effective, is spread across multiple disciplines. The purpose of this paper is to review and synthesise relevant literature to provide practical lessons on how to use community‐based approaches to improve quality.Design/methodology/approachDiverse literatures were identified, analysed and synthesised in a manner that accounted for the heterogeneity of methods, models and contexts they covered.FindingsA number of overlapping but distinct community‐based approaches can be identified in the literature, each suitable for different problems. The evidence for the effectiveness of these is mixed, but there is some agreement on the challenges that those adopting such approaches need to address, and how these can be surmounted.Practical implicationsKey lessons include: the need for co‐ordination and leadership alongside the lateral influence of peers; advantages of starting with a clear programme theory of change; the need for training and resources; dealing with conflict and marginalisation; fostering a sense of community; appropriate use of data in prompting behavioural change; the need for balance between “hard” and “soft” strategies; and the role of context.Originality/valueThe paper brings together diverse literatures with important implications for community‐based approaches to quality improvement, drawing on these to offer practical lessons for those engaged in improving healthcare quality in practice.
Organisational culture and change: implementing person‐centred care
Authors: Carlström Eric D. , Ekman Inger 
Published: May 2014

PurposeThe 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.Design/methodology/approachSurveys were sent out to 170 nurses. The survey included two instruments – the Organisational Values Questionnaire (OVQ) and the Resistance to Change Scale (RTC).FindingsThe 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.Practical implicationsAn 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.Originality/valueEarlier 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.
Determinants of managerial competencies for primary care managers in Southern Thailand
Authors: Mohd‐Shamsudin Faridahwati , Chuttipattana Nirachon 
Published: May 2014

PurposeThe purpose of this paper is first, to identify the critical managerial competencies of primary care managers; and second, to determine the relationship between personality and motivation, and managerial competency.Design/methodology/approachA survey was conducted involving distribution of questionnaires to 358 rural primary care managers in Southern Thailand.FindingsThe survey found six critical managerial competencies: visionary leadership; assessment, planning, and evaluation; promotion of health and prevention of disease; information management; partnership and collaboration; and communication. Both personality and motivation are found to significantly influence primary care managers' managerial competency. In particular, conscientiousness (i.e. perseveres until the task is finished, does a thorough job, full of energy, does things efficiently, and a lot of enthusiasm) is related to all managerial competencies. It is clear that extrinsic and intrinsic factors (i.e. quality of supervision and leadership, organizational policy and administration, interpersonal relationship, working conditions, work itself, amount of responsibility, and job recognition) are influential in primary care manager motivation that can significantly improve morale.Research limitations/implicationsThe short version of the personality instrument may limit the generalization of some of the findings. Future research is needed to assess the relationship between managerial competency and performance. Further research could be done in other countries to see if this conclusion is in fact correct. It would also be useful to research if the findings apply to other health and social areas.Practical implicationsPersonality and motivation are able to co‐predict managerial competency whereby motivation tends to have a stronger influence than personality. These findings will be useful to policy makers and to those responsible for the human development in the preparation of management training and development programs. Moreover, top management should not overlook the motivational system as a way to encourage managers to be competent in their job.Originality/valueThe paper contributes to our understanding of managerial competency within the context of rural primary care sectors. The success of any organized health program depends upon effective management, but health systems worldwide face a lack of competent management at all levels. Management development for health systems, particularly at the first line of supervision, must be given much higher priority for investment.
Social enterprise in health organisation and management: hybridity or homogeneity?
Authors: Millar Ross 
Published: May 2014

PurposeThe purpose of this paper is to reflect on social enterprise as an organisational form in health organisation and management.Design/methodology/approachThe paper presents a critique of the underlying assumptions associated with social enterprise in the context of English health and social care.FindingsThe rise of social enterprise models of service provision reflects increasingly hybrid organisational forms and functions entering the health and social care market. Whilst at one level this hybridity increases the diversity of service providers promoting innovative and responsive services, the paper argues that further inspection of the assumptions associated with social enterprise reveal an organisational form that is symbolic of isomorphic processes pushing healthcare organisations toward greater levels of homogeneity, based on market‐based standardisation and practices. Social enterprise forms part of isomorphic processes moving healthcare organisation and management towards market “norms”.Originality/valueIn line with the aim of the “New Perspectives section”, the paper aims to present a provocative perspective about developments in health and social care, as a spur to further debate and research in this area.
Social values in health priority setting: a conceptual framework
Authors: Clark Sarah , Weale Albert 
Published: May 2014

PurposeIt is commonly recognized that the setting of health priorities requires value judgements and that these judgements are social. Justifying social value judgements is an important element in any public justification of how priorities are set. The purpose of this paper is to review a number of social values relating both to the process and content of priority‐setting decisions.Design/methodology/approachA set of key process and content values basic to health priority setting is outlined, and normative analysis applied to those values to identify their key features, possible interpretations in different cultural and institutional contexts, and interactions with other values.FindingsProcess values are found to be closely linked, such that success in increasing, for example, transparency may depend on increasing participation or accountability, and “content” values are found often to be hidden in technical criteria. There is a complex interplay between value and technical components of priority setting, and between process and content values. Levels of economic development, culture and need will all play a part in determining how different systems balance the values in their decisions.Originality/valueTechnical analyses of health priority setting are commonplace, but approaching the issues from the perspective of social values is a more recent approach and one which this paper seeks to refine and develop.
Social values and healthcare priority setting in Korea
Authors: Ahn Jeonghoon , Kim Gaeun , Sun Suh Hae , Moo Lee Sang 
Published: May 2014

PurposeThe purpose of this paper is to present the role of social values in setting healthcare priorities in Korea.Design/methodology/approachUsing Clark and Weale's draft framework, Korean healthcare priority setting was analysed. The process values used were transparency, accountability, and participation, and the content values used were clinical effectiveness, cost effectiveness, justice/equity, solidarity and autonomy.FindingsIn the Korean health priority setting, it was found that multiple factors influence the decision‐making process. Effectiveness and safety are the two most important values mentioned in the process. Cost‐effectiveness is also considered in reimbursement decisions for new drugs since 2007. Recently, health technology assessment (HTA) has begun to change the social value system traditionally used in the Korean healthcare priority setting.Originality/valueThe paper extends understanding of health priority setting in Korea, and how the interpretation and use of social values has changed over recent years.
Universal health coverage and litigation in Latin America
Authors: Cubillos Leonardo , Escobar Maria‐Luisa , Pavlovic Sebastian , Iunes Roberto 
Published: May 2014

PurposeOver the last five years many middle‐income Latin American countries have seen a steep increase in the number of cases litigating access to curative services. The purpose of this paper is to explore this complex phenomenon and outline some of its roots and impacts.Design/methodology/approachThe authors use an interdisciplinary approach based on a literature review and workshops convened to discuss the issue.FindingsA range of reasons can explain this increased legal activity. These include: a renewed judicial approach to the enforcement of the right to health; a more demanding public interest; an increased prevalence of non communicable diseases; and limited capacity for fair benefit package.Originality/valueThe findings in this paper argue for the need to incorporate a rights‐based approach to health policy as a foundation of societal efforts to achieve universal health coverage in Latin America.
CGIJ review
Authors: MacVane Fiona 
Published: May 2014

PurposeThe purpose of this paper is to enable busy clinicians to review the contents of the journal quickly. They can then choose which articles have the most relevance for them and focus on these.Design/methodology/approachThe paper provides a brief synopsis of the main content of the journal prepared by the review editor.FindingsChanges to healthcare commissioning and delivery will have long‐term consequences for the way in which the NHS functions.Practical implicationsIt is important that all NHS staff have a clear understanding of recent and proposed changes so that they can participate in dialogue about the implications for their roles.Originality/valueThe review editor has no affiliation with any of the authors and no financial or other interest in commissioning and therefore is able to provide an independent overview of the journal contents.
Leveraging the competitive advantage of Iberoamerican scholars
Authors: Lazzarini Sérgio G. 
Published: May 2014

PurposeThe purpose of this paper is to help foster the global reach of Iberoamerican scholars, based on the author's own experiences and observations in the field.Design/methodology/approachThis is an inductive study trying to generate a framework of “academic positioning” using the author's own experience as an example.FindingsThis paper presents an analytical framework of “academic positioning” and derives some practical suggestions for young Iberoamerican scholars.Originality/valueThe paper offers an analytical framework that informs likely career paths for young Iberoamerican scholars.
Analysis of nano‐reinforced layered plates via classical and refined two‐dimensional theories
Authors: Brischetto Salvatore , Carrera Erasmo 
Published: May 2014

PurposeThe purpose of this paper is to consider the static analysis of nanocomposite plates. Nanocomposites consist of a small amount of nanoscale reinforcements which can have an observable effect on the macroscale properties of the composites.Design/methodology/approachIn the present study the reinforcements considered are non‐spherical, high aspect ratio fillers, in particular nanometer‐thin platelets (clays) and nanometer‐diameter cylinders (carbon nanotubes, CNTs). These plates are considered simply supported with a bi‐sinusoidal pressure applied at the top. These conditions allow the solving of the governing equations in a closed form. Four cases are investigated: a single layered plate with CNT reinforcements in elastomeric or thermoplastic polymers, a single layered plate with CNT reinforcements in a polymeric matrix embedding carbon fibers, a sandwich plate with external skins in aluminium alloy and an internal core in silicon foam filled with CNTs and a single layered plate with clay reinforcements in a polymeric matrix. A short review of the most important results in the literature is given to determine the elastic properties of the suggested nanocomposites which will be used in the proposed static analysis. The static response of the plates is obtained by using classical two‐dimensional models such as classical lamination theory (CLT) and first order shear deformation theory (FSDT), and an advanced mixed model based on the Carrera Unified Formulation (CUF) which makes use of a layer‐wise description for both displacement and transverse stress components.FindingsThe paper has two aims: to demonstrate that the use of classical theories, originally developed for traditional plates, is inappropriate to investigate the static response of nanocomposite plates and to quantify the beneficial effect of the nanoreinforcements in terms of static response (displacements and stresses).Originality/valueIn the literature these effects are usually given only in terms of elastic properties such as Young moduli, shear moduli and Poisson ratios, and not in terms of displacements and stresses.
Sensitivity of TM nonlinear magnetooptical integrated optical sensor
Authors: El‐Khozondar Hala J. , El‐Khozondar Rifa J. , Müller Mathias S. , Koch A.W. 
Published: May 2014

PurposeThe purpose of this paper is to consider a detailed investigation of transversal magnetic (TM) nonlinear magnetooptical integrated optical sensor. The sensitivities of two sensors are presented. The first sensor composed of a dielectric thin film surrounded by a lossless, nonmagnetic, isotropic cladding exhibiting a local Kerr‐like dielectric nonlinearity, and a magnetic substrate chosen to be an iron garnet. The second sensor is formed by exchanging the cladding and the substrate media of the first sensor. The homogenous sensitivities of both sensors are calculated as a function of the waveguide thickness and the effective refractive index. The effect of nonlinearity on the sensitivities for both sensors is investigated.Design/methodology/approachThe homogenous sensitivities of both sensors are calculated as a function of the waveguide thickness and the effective refractive index. The effect of nonlinearity on the sensitivities for both sensors is investigated. Numerical calculations are performed using the Maple program.FindingsIt was found that the sensitivity for the first sensor sensitivity increases with nonlinearity. While the sensitivity for the second sensor is hardly affected by the change of nonlinearity. It was also found that the thickness of the guiding layer is a critical parameter for the sensitivity of the optical sensor with the optimum thickness being just above cut‐off in case of the first structure and at the cut‐off in the case of the second structure.Originality/valueA detailed investigation of TM nonlinear magnetooptical integrated optical sensor is considered. The two proposed structures are used to investigate the parameters to get the optimal sensitivity, which is an important issue is the sensor design.
Propagation of waves at an imperfect boundary between heat conducting micropolar thermoelastic solid and fluid media
Authors: Kumar Rajneesh , Kaur Mandeep , Rajvanshi S.C. 
Published: May 2014

PurposeThe purpose of this paper is to establish a mathematical model to investigate the propagation of waves at an imperfect boundary between heat conducting micropolar elastic solid and fluid media.Design/methodology/approachWave propagation and reflection methods have been applied to solve the problem. The expressions for reflection and transmission coefficients are obtained. The corresponding derivation for the normal force stiffness, transverse force stiffness, transverse couple stiffness and perfect bonding has also been included.FindingsA computer program is developed and numerical results are computed to obtain the reflection and transmission coefficients of various reflected waves with incident waves. Some special and particular cases are also discussed.Originality/valueIn this paper, stiffness effect on these amplitude ratios with the angle of incidence has been observed and depicted graphically.