bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relating configuration and learning in Brazil and Australia
Authors: Terra da Silva Marcia , Davison Graydon 
Published: January 2007

PurposeThis paper aims to investigate whether an organisation's configuration, with regard to its operating environment, could have a bearing on the learning that occurs within the organisation because the configuration can be considered an artefact capable of enabling learning and capable of facilitating the storage and utilisation of the results of learning. This raises an interesting question about the ability of organisations to shape the configuration that enables and facilitates them, which in turn would shape the learning itself.Design/methodology/approachReported in this paper is research in healthcare organisations in Brazil and Australia that use a multidisciplinary model of care delivery which test these relationships.FindingsThe paper's findings indicate that in the Brazilian case learning has to do with the formal acquisition of knowledge for use within professions, by professionals who are in practice and teaching. In the Australian case learning has to do with the flexible acquisition of knowledge across professions, within and between teams.Originality/approachThis paper is useful to those wishing to facilitate learning in an organisation.
A hermeneutic science: health economics and Habermas
Authors: Small Neil , Mannion Russell 
Published: January 2007

PurposeMainstream health economics labours under a misleading understanding of the nature of the topic area and suffers from a concomitant poverty of thinking about theory and method. The purpose here is to explore this critical position and argue that health economics should aspire to being more than a technical discipline. It can, and should, engage with transformative discourse.Design/methodology/approachIt is argued that the hermeneutic sciences, emphasising interpretation not instrumentality or domination, offer a route into the change to which one seeks to contribute. The article specifically focuses on the way Habermas provides insights in his approach to knowledge, reason and political economy. How he emphasises complexity and interaction within cultural milieu is explored and primacy is given to preserving the life‐world against the encroachments of a narrow rationalization.FindingsThe argument for a critical re‐imagining of health economics is presented in three stages. First, the antecedents, current assumptions and critical voices from contemporary economics and health economics are reviewed. Second, the way in which health is best understood via engaging with the complexity of both the subject itself and the society and culture within which it is embedded is explored. Third, the contribution that hermeneutics, and Habermas's critical theory, could make to a new health economics is examined.Originality/valueThe paper offers a radical alternative to health economics. It explores the shortcomings of current thinking and argues an optimistic position. Progress via reason is possible if one reframes both in the direction of communication and in the appreciation of reflexivity and communality. This is a position that resonates with many who challenge prevailing paradigms, in economics and elsewhere.
The inception of the National Health Service
Authors: Harding Nancy 
Published: January 2007

PurposeIt is commonplace to talk of the UK's National Health Service (NHS) as having its inception in 1948 in an Act of Parliament which brought together many hundreds of widely dispersed organisations into one, new organisation, “the” NHS. This paper aims to challenge the concept of “a” National Health Service and to argue that the (seeming) accomplishment of this “organisation” is the daily task of health managers.Design/methodology/approachThe paper develops a theoretically‐based analysis of how an “organisation” is accomplished through ongoing processes of construction. First, critiques of the ontological status of this thing called “organisation” are considered. Then Laclau and Mouffe's discourse theory of political action, inspired by Derrida and Gramsci is used, to try to understand this apparent “thing” and the work of those charged with its management.FindingsThere has been little application of this theoretical perspective to understanding management in general and health management in particular but, given the highly politicised nature of health management, their theoretical perspective seems more than apposite. Application of Laclau and Mouffe's theory to the NHS leads to the conclusion that there is no such “thing” as the NHS. There is, rather, a presumption of the thingness of the NHS and one of the major tasks of managers working “within” this organisation is to achieve this sense of thingness.Research limitations/implicationsThis is “work in progress” – these ideas continue to evolve, but feedback from readers is necessary.Originality/valueThis is the first time that Laclau and Mouffe's work has been used to analyse health organizations. The value of the paper is mostly for people working to develop critically‐informed understandings of how organizations work.
The meaning of emotion
Authors: Rowe Dorothy 
Published: January 2007

PurposeTo describe the meaning of emotion.Design/methodology/approachDescribes how emotion has recently become a popular concept for discussion, but it is not often recognised that human beings are, in essence, meaning‐creating creatures and that emotion is one of the forms of meaning they create.FindingsWhat one experiences as “I”, “me”, “myself”, that is, one's sense of being a person, is a meaning‐structure, which has developed through one's interaction with one's environment. One's physiological make‐up is such that all the meanings are guesses about what is going on. Consequently the sense of being a person is always in danger of being invalidated by events. Emotions are meanings, which relate to the validation or invalidation of one's sense of being a person. It is necessary to survive both physically and as a person, but, if there is to be a choice between these two ways of surviving, one almost always chooses to survive as a person and let one's body go. This is seen in acts of heroism and in suicide.Originality/valueEmphasises how the need to survive as a person is so important that children as young as 16 months are able to understand and respond to the emotional meanings of their parents and siblings even though they do not develop an intellectual understanding of the theory of mind until they are about four years old. All interactions between people in health‐care management involve validation and invalidation.
A health‐care model of emotional labour
Authors: Mann Sandi 
Published: January 2007

PurposeThis paper aims to evaluate the literature on emotional labour in the health‐care sector and the benefits and costs of such performance for both the carer and the patient. The aim is to develop a new health care model of emotional labour that has implications for health‐care management in terms of policy and education as well as for future research in this field.Design/methodology/approachA new model to explain the antecedents and consequences of emotional labour within a health‐care setting is developed that builds on existing research.FindingsThe model distinguishes between types of emotional conflict to which emotional labour‐inducing events in health‐care settings might lead. The negative and positive consequences, specific to health‐care settings, of emotional labour performance are also outlined.Practical implicationsEmotional labour should be formally recognised as a key skill in facilitating the patient journey, with emotional skills being taught in innovative ways outside the formal classroom setting. Health‐care professionals should be offered training on coping with the effects of emotional labour performance. Finally, more research should be carried out to further develop the model, particularly in identifying causes of emotional labour within health‐care settings and in differentiating the effects that different kinds of emotional labour performance might have.Originality/valueThe paper draws together previous research on emotional labour within health‐care settings to develop a coherent model that can be used to guide future research and practice.
Different timetables for change: understanding processes in reorganizations
Authors: Bergin Elsmari , Helge Rønnestad Michael 
Published: January 2007

PurposeIt is well‐known that a decrease in economic resources in health care results in increased workload, stress and pressure on personnel. The main aim of this study was to explore and understand how personnel in health care were influenced by multiple obligations in the context of a changing surrounding.Design/methodology/approachPersonnel within psychiatry were interviewed in an open‐ended, interactive mode. The transcribed interviews were analysed using grounded theory as the method of study.FindingsThese professionals working within a turbulent work situation experienced a struggle between external demands and internal obligations of an ethical or ideological character. For many of them earlier psychological contracts were broken, earlier organizational culture was overthrown and their professional authority was threatened. They were required to change or abandon well‐established professional identities. Fundamental changes such as the transition of theoretical framework or revision of internal obligations have quite a different timetable from a technical change of method or organizational structure.Practical implicationsThe findings of two timetables for change should be addressed when considering reorganizations. If these findings are applied to personnel in health care, seeing them also as patients in the system may be avoided.Originality/valueThe different timetables for external change and internal reorganization, with support from findings in in‐depth interviews, have not been described until now.
Gossip and emotion in nursing and health‐care organizations
Authors: Waddington Kathryn , Fletcher Clive 
Published: January 2007

PurposeThe purpose of this paper is to examine the relationship between gossip and emotion in health‐care organizations. It draws on findings from empirical research exploring the characteristics and function of gossip which, to date, has been a relatively under‐researched organizational phenomenon.Design/methodology/approachA multidisciplinary approach was adopted, drawing on an eclectic range of discipline‐based theories, skills, ideas and data. Methods included repertory grid technique, in‐depth interviews and structured diary records of work‐related gossip. The sample comprised 96 qualified nurses working in a range of practice areas and organizational settings in the UK.FindingsTemplate analysis was used to integrate findings across three phases of data collection. The findings revealed that gossip is used to express a range of emotions including care and concern about others, anger, annoyance and anxiety, with emotional outcomes that include feeling reassured and supported. It is the individual who gossips, while the organization provides the content, emotional context, triggers and opportunities.Research limitations/implicationsNurses were chosen as an information‐rich source of data, but the findings may simply reflect the professional culture and practice of nursing. Future research should take into account a wider range of health‐care organizational roles and perspectives in order to capture the dynamics and detail of the emotions and relationships that initiate and sustain gossip.Practical implicationsBecause gossip makes people feel better it may serve to reinforce the “stress mask of professionalism”, hiding issues of conflict, vulnerability and intense emotion. Managers need to consider what the emotions expressed through gossip might represent in terms of underlying issues relating to organizational health, communication and change.Originality/valueThis paper makes a valuable contribution to the under‐researched phenomenon of gossip in organizations and adds to the growing field of research into the role of emotion in health‐care organizations and emotion work in nursing.
Emotional labour at work and at home among Greek health‐care professionals
Authors: Montgomery Anthony J. , Panagopolou Efharis , Benos Alexos 
Published: January 2007

PurposeThe emotionally taxing nature of health‐care work has been increasingly recognized. In parallel, the field of work and family has been searching for more specific antecedents of both work interference with family (WFI) and family interference with work (FWI). The current study aims to examine the relationship between surface acting and hiding negative emotions with WFI and FWI among Greek health‐care professionals.Design/methodology/approachThe research is a cross‐sectional study of 180 Greek doctors and 84 nurses using self‐report measures.FindingsResults indicated that, for doctors, surface acting at work was positively related to WFI and, for nurses, surface acting at home was positively related to FWI.Research limitations/implicationsThe respondents were sampled on a convenience basis and the non‐random procedure may have introduced unmeasured selection effects. The present study is cross‐sectional and thus the postulated relationships cannot be interpreted causally.Practical implicationsEmotional management training and opportunities for emotional decompression for Greek health‐care professionals should be explored. In terms of medical education, the need to train students to understand and cope with emotional demands is an important first step. This research highlights the need for communication‐skills training courses facilitating emotional awareness and emotional management.Originality/valueThese findings position emotional labour as an important antecedent of both WFI and FWI.
Instilling and distilling a reputation for institutional excellence
Authors: Beil‐Hildebrand Margitta B. 
Published: January 2007

PurposeThis ethnographic investigation of a general hospital aims to critically analyse a much lauded corporate culture. Rather than accepting the managerial and academic claims concerning the mobilisation of corporate culture at face value, this study builds upon a labour process analysis and takes a close look at how it actually seems to work.Design/methodology/approachThe paper explores and describes how executive managers seek to design and impose corporate culture change and how it affects the nursing employees of this organisation. This was achieved by means of a six month field study of day‐to‐day life in the hospital's nursing division.FindingsThe results lend little support to the official claims that, if managerial objectives are realised, they are achieved through some combination of shared values and employee participation. The evidence lends more support to the critical view in labour process writing that modern cultural strategies lead to increased corporate control, greater employee subjection and extensive effort intensification. The contradiction this brings into the working lives of the employees leads to the conclusion that the rhetoric of corporate culture change does not affect the pre‐existing attitudes and value orientations of nursing employees. However, there were considerable variations in how employees received the managerial message and thus, by their degree of misbehaviour and adaptation, affected the organisation itself as well as using the cultural rhetoric against the management for their own ends.Originality/valueThe paper concludes that an extended labour process analysis is necessary to challenge the way in which corporate culture change is explored and described by management academics and practitioners.
Leading improvement
Authors: Øvretveit John 
Published: January 2007

PurposeTo provide research‐informed guidance to leaders of quality and safety improvement and evidence‐based materials for education programmes for leadersDesign/methodology/approachSearch of databases and hard copy literature since 1985 into managers' and leaders' role in quality and safety improvement. Classification into “eA”: Empirical research strong evidence, “eB”: Empirical research, weak evidence and, “eC”: Conceptual discussion, not based on systematic empirical research. Summary, and synthesis of the best available evidence for a guidance checklist for leaders.FindingsAlthough most literature emphasises the importance of committed leadership for successful quality and safety improvement, research evidence supporting this is scarce and often scientifically limited. The research shows evidence of the limitations and scope of leader actions for improving health care provision, the need to engage clinicians in this work and ways to do so, as well as the leadership role played by others apart from senior leaders. The ability of managers and other leaders skilfully to tailor Q&SI to the situation may be important but descriptions of how leaders do this and evidence supporting this proposition are lacking.Research limitations/implicationsMore research is needed about whether or how the leader role is different according to the stage of quality and safety development of the organisation, the type of organisation, the type of context, the level and type of leader and the type of improvement and improvement method.Practical implicationsImplications for leaders' actions are provided in a “best evidence guidance” checklist. This provides more tangible and research‐informed guidance than the inspirational literature or studies from single organisations.Originality/valueThis paper provides the first overview and synthesis of a wide range of studies which can be used as a basis for future research and materials for educational programmes. It provides the first detailed guidance for leaders about specific actions which research suggests they need to take to improve quality and safety.
Using operational information and information systems to improve in‐patient flow in hospitals
Authors: Proudlove N.C. , Boaden R. 
Published: January 2007

PurposeTo consider how information and information systems can be used to support improving patient flow in acute hospitals (a key target for the National Health Service in England), and the potential role of the National Programme for Information Technology currently being developed.Design/methodology/approachThe literature plus past and present research, teaching and consulting experience with all levels of the National Health Service is drawn on to consider information provision and requirements.FindingsThe National Programme for Information Technology specifies many features designed to support improving patient flows, though timescales for implementation are longer than those for the pledged flow improvements, and operational use of this type of information system has been problematic in the National Health Service.Research limitations/implicationsThe work is limited to the National Health Service and information systems in use and planned for it. The National Health Service access targets, flow improvement initiatives and the National Programme for Information Technology apply primarily to England.Practical implicationsSome bed/flow management information systems currently in use incorporate tools and capabilities in advance of what is outlined in the National Programme for Information Technology, and some rare cases of culture changes in information system use have been achieved. One should learn from these to inform development and implementation of National Programme systems. These existing information systems and approaches may also be useful to hospitals considering systems prior to implementation of the National Programme for Information Technology.Originality/valueThere has been very little consideration of the use of operational information and information systems for bed/flow management in the literature. Development and implementation of National Programme for Information Technology systems should build from an understanding of the practice and context of bed/flow management.
Project management and action research: two sides of the same coin?
Authors: Whitehead Dean 
Published: January 2007

PurposeTo put forward the, to date, unidentified viewpoint that organisational action research and project management have many shared properties – making it a useful exercise to compare and contrast them in relation to organisational management structures and strategies.Design/methodology/approachA conceptual exploration, drawing on a wide range of supporting literature, is used here.FindingsProject management represents a mainstay strategy for much of the organisational research seen in health care management – and has done for many years. More recently, the exploratory literature on project management has identified many limitations – especially when matched against “traditional” examples. Many health services have witnessed a more recent organisational management drive to seek out alternative strategies that incorporate less hierarchical and more participatory research methods. Action research certainly fits this bill and, on further examination, can be incorporated into a project management ethos and vice versa.Research limitations/implicationsThe views expressed here are of a theoretical construct and have not been implemented, as they are presented in this paper, in practice. The intention, however, is to do so in some of the author's future studies.Practical implicationsIf the management of health service organisations are to evolve to incorporate desirable structures that promote consumer‐oriented empowerment and participation (where the consumers also include the workforce), then having a wider array of research tools at one's disposal is one way of facilitating this. Incorporating action research principles into project management approaches, or the other way round, or marrying them both to form a “hybrid” research strategy – it is argued here – represents an appropriate and representative way forward for future organisational management studies.Originality/valueIn terms of originality, this represents a conceptual piece of work that puts forward constructs that have, to date, not featured in the health care literature. Its value lies in suggesting further options for organisational‐oriented health care research.
Talking towards excellence: a theoretical underpinning of the dialogue between doctors and managers
Authors: Plochg Thomas , Klazinga Niek S. 
Published: January 2007

PurposeTo explore theoretically the reasons for the modest uptake of clinical governance practices by taking the literature on the origin of tensions between doctors and managers as the starting‐point.Design/methodology/approachThe approaches of doctors and managers to the division and coordination of medical work are analysed theoretically from a twofold perspective that combines insights from sociologists' theories on “professionalism” and administrative scientists' theories on “management science”.FindingsThe combined perspective theoretically explains the problems between doctors and managers that frustrate the uptake of clinical governance practices. By inference from this theoretical analysis, a twofold agenda for a constructive dialogue is proposed. Doctors and managers must develop a shared vision of the division and coordination of medical work as well as discussing the values, norms and goals underlying patient care. It is questionable, however, whether this agenda is currently adequately addressed.Originality/valueThis paper provides a theoretical underpinning for the dialogue between doctors and managers. It may be enlightening for all doctors and managers working in the field.