bluuebunny/crossref_metadata_2025_split huggingface dataset:
The changing “soul” of Dutch policing
Authors: Das Dilip , Huberts Leo , van Steden Ronald 
Published: August 2007

PurposeThe purpose of this paper is to address the changing organization and culture of the Dutch police over the last decade.Design/methodology/approachDrawing on personal observation, desk research and a survey among the police and administrative elite in The Netherlands, the paper describes, analyzes and reflects upon developments which are out of tune with the Dutch tradition.FindingsFrom the 1960s onwards, The Netherlands was famous for her pragmatic, decentralized and friendly style of community policing. The slogan “the police are your best friend” summarizes the “essence” or the “soul” of Dutch policing. Increasingly, however, the typically tolerant, friendly and social policing style has come under pressure. The system of relatively independent regional police departments has been fiercely criticized because of the lack of effectiveness and efficiency in solving crime, safety and security challenges. National government now wants a much bigger say in setting its police programs and priorities. Moreover, as elite government officials stipulate, the police must be more “tough” on crime and terrorism. This attitude has led to centralization, penalization and, at the local level, responsibilization, which signifies that a variety of private, (often profit‐seeking) policing agencies and companies are made responsible for public order maintenance. Such changes are leading toward a “state‐centered” police model at some distance from citizens, a development that is seen as contrary to the social soul of Dutch policing.Originality/valueThe paper offers an analysis into the changing “soul” of Dutch policings.
Trust, communication, theory of mind and the social brain hypothesis
Authors: Braithwaite Jeffrey , Iedema Rick A. , Jorm Christine 
Published: August 2007

PurposeThe purpose of the paper is to examine the deep conceptual underpinnings of trust and communication breakdowns via selected health inquiries into things that go wrong using evolutionary psychology.Design/methodology/approachThis paper explains how this is carried out, and explores some of the adverse consequences for patient care. Evolutionary psychology provides a means of explaining important mental capacities and constructs including theory of mind and the social brain hypothesis. To have a theory of mind is to be able to read others' behaviours, linguistic and non‐verbal cues, and analyse their intentions. To have a social (or Machiavellian) brain means being able to assess, compete with and, where necessary, outwit others. In the tough and complex environment of the contemporary health setting, not too different from the Pleistocene, humans display a well‐developed theory of mind and social brains and, using mental attributes and behavioural repertoires evolved for the deep past in hunter‐gatherer bands, survive and thrive in difficult circumstances.FindingsThe paper finds that, while such behaviours cannot be justified, armed with an evolutionary approach one can predict survival mechanisms such as turf protection, competitive strategies, sending transgressors and whistleblowers to Coventry, self‐interest, and politics and tribal behaviours.Originality/valueThe paper shows that few studies examine contemporary health sector behaviours through an evolutionary psychology lens or via such deep accounts of human nature.
Accountingization, trust and medical dilemmas
Authors: Lapsley Irvine 
Published: August 2007

PurposeThe purpose of this paper is to investigate the impact of accounting on clinical practices.Design/methodology/approachThis paper reviews existing studies of clinical budgeting; analyses publicly available data on cost‐effectiveness recommendations for the NHS; analyses publicly available data on the influence of accounting in medical dilemmas.FindingsThe paper finds that there is limited evidence of clinical budgeting dominating clinical decisions, but there is some evidence of central agency directions on appropriateness of treatments, but this is on a cost‐effectiveness basis. Numerous examples of adverse medical outcomes are cited in this paper – but with limited influence of accounting in these decisions.Originality/valueThe paper shows that the combination of accounting and medical data in a topical matter makes this an original and distinctive study.
New workforce roles in health care
Authors: Bridges Jackie , Fitzgerald Louise , Meyer Julienne 
Published: August 2007

PurposeThis paper seeks to present findings from a longitudinal action research study aimed at exploring one such innovation. Little is known about the micro‐level impact of health service innovations over time.Design/methodology/approachThe paper shows that action research is a participatory approach ideally suited to monitoring the process and outcomes of change. Over 20 months, an action researcher studied the work of four interprofessional care co‐ordinators (IPCCs), whose role was intended to speed patient through‐put within a London teaching hospital general medical directorate. The action researcher kept regular participant observation field notes and supplemented these data with a profile of IPCC patients (n=407), in‐depth interviews (n=37) and focus groups (n=16) with staff. Throughout the study, findings were regularly fed back to participants to inform practice developments.FindingsThe findings in this paper show that, in spite of the original intention for this role to provide clerical support to the multidisciplinary team, over time the role shifted beyond its implementation into practice to take on more complex work from registered nurses. This raised actual and potential governance issues that were not attended to by service managers. A complex and turbulent context disrupted managers' and practitioners' abilities to reflect on and respond to these longer‐term role shifts.Originality/valueThis paper argues that the complex nature of the innovation and the setting in which it operated account for the role shift and the lack of attention to issues of governance. Current innovation literature suggests that implementation into routine practice represents the end‐point of an innovation's journey. These findings suggest that certain innovations may in fact continue to shift in nature even after this “end‐point”. The conclusions drawn are likely to be of global interest to those interested in complex health service innovations.
Understanding power relationships in health care networks
Authors: Addicott Rachael , Ferlie Ewan 
Published: August 2007

PurposeThe purpose of this paper is to show that networks are emerging as a new, innovative organisational form in the UK public sector. The emergence of more network‐based modes of organisation is apparent across many public services in the UK but has been particularly evident in the health sector or NHS. Cancer services represent an important and early example, where managed clinical networks (MCNs) for cancer have been established by the UK National Health Service (NHS) as a means of streamlining patient pathways and fostering the flow of knowledge and good practice between the many different professions and organisations involved in care. There is very little understanding of the role of power in public sector networks, and in particular MCNs. This paper aims to explore and theorise the nature of power relations within a network model of governance.Design/methodology/approachThe paper discusses evidence from five case studies of MCNs for cancer in London.FindingsThe findings in this paper demonstrate that a model of bounded pluralism can be used to understand power relations within London MCNs. However, power over the development of policy and strategic direction is instead exerted in a top‐down manner by the government (e.g. Department of Health) and its associated national bodies.Practical implicationsThe paper supports the argument that the introduction of rhetoric of a more collaborative approach to the management of public services has not been enough to destabilise the embedded managerialist framework.Originality/valueThis paper uses empirical data from five case studies of managed clinical networks to theorise the nature of power relations in the development and implementation of network reform in cancer services. Also, there is limited understanding of the nature of power relations in network relationships, particularly in relation to the public sector.
Spanning boundaries in pursuit of effective knowledge sharing within networks in the NHS
Authors: Currie Graeme , Finn Rachael , Martin Graham 
Published: August 2007

PurposeThe purpose of this paper is to examine power asymmetries in the delivery of genetics healthcare that inhibit knowledge sharing across sector, organisational and professional boundaries.Design/methodology/approachThe paper is a longitudinal comparative case study approach, which encompasses semi‐structured interviews and observation.FindingsThe paper finds politics to be significant in its influence on knowledge sharing across sector, organisational and professional boundaries, but this can be mediated by attending to human and social aspects of the context in which knowledge sharing was expected to take place.Research limitations/implicationsThe paper encourages research that evaluates the effect of increased emphasis on human and social aspects of organisational change in pursuit of the “dream” of spanning boundaries and improving knowledge sharing within the NHS.Practical implicationsThe paper shows that structural change appears to be of limited effect in promoting knowledge sharing. Organisational and individual development, career management and performance systems are worthy of attention for the purpose of managing knowledge.Originality/valueThe paper exposes this assumption as managerialist. Policy‐makers assume that professionals are willing and able to share knowledge when delivering healthcare through networks.
Exploring HRD in two Welsh NHS Trusts
Authors: Sambrook Sally 
Published: August 2007

PurposeThe purpose of this paper is to examine human resource development (HRD) in the UK National Health Service (NHS), and particularly in two Welsh NHS Trusts, to help illuminate the various ways in which learning, training and development are talked about. The NHS is a complex organisation, not least with its recent devolution and separation into the four distinct countries of the UK. Within this, there are multiple and often conflicting approaches to human resource development associated with the various forms of employee, professional (nursing, medical etc.), managerial and organisational development. How people are developed is crucial to developing a modern health service, and yet, with the diverse range of health workers, HRD is a complex process, and one which receives little attention. Managers have a key role and their perceptions of HRD can be analysed through the discursive resources they employ.Design/methodology/approachFrom an interpretivist stance, the paper employs semi‐structured interviews with seven Directorate‐General Managers, and adopts discourse analysis to explore how HRD is talked about in two Welsh NHS Trusts.FindingsThe paper finds some of the different discourses used by different managers, including those with a nursing background and those without. It examines how they talk about HRD, and also explores their own (management) development and the impact this has had on their sense of identity.Originality/valueThe paper highlights some of the tensions associated with HRD in the NHS, including ambiguities between professional and managerial development, the functional and physical fragmentation of HRD, conflict between a focus on performance/service delivery and the need to learn, discursive dissonance between the use of the terms training and learning, a delicate balance between “going on courses” and informal, work‐related learning, inequities regarding “protected time” and discourses shifting between competition and cooperation. These tensions are exposed to help develop a shared understanding of the complexities of HRD within the NHS. The paper concludes with a summary of the different discursive resources employed by senior managers to articulate and accomplish HRD. These are “surfaced” to enable managers and HRD practitioners, amongst others, to construct common repertoires and shared meaning.
Policy and organizational implications of gender imbalance in the NHS
Authors: Miller Karen 
Published: August 2007

PurposeThe purpose of the paper is to examine the policy and organizational implications of gender imbalance in management, which research suggests exists in the NHS.Design/methodology/approachThe research in this paper involved a qualitative approach with an analysis of élite interviews conducted with a non‐random sample of officials involved in health policy and interviews with a random sample of senior managers in NHS Scotland. The research formed part of a larger study, which explored the enablers and inhibitors to female career progression in various Scottish sectors.FindingsThe paper finds that gender imbalance in management exists in the NHS. This is manifested in a masculine organizational context, leadership and policy decision‐making process, which have implications for female career advancement opportunities and subsequently access to macro policy decisions.Research limitations/implicationsThe paper involved a sample (30 percent) of senior managers and examined policy processes in NHS Scotland. To improve the external validity of the findings further research should be conducted in NHS organizations in England and Wales.Practical implicationsThe findings in the paper suggest that gender imbalance in management and a masculine organizational context and leadership style within the NHS create a less than conducive environment for female employees. This has practical implications in terms of levels of part‐time employment, career progression and attrition rates.Originality/valueThe paper adds to the debate of gender and organizational studies by examining the health sector, which has high levels of female employment but low levels of female representation at senior management levels. The paper therefore adds to an often‐neglected area of study, women in leadership and senior managerial positions. The paper is original in its approach by examining the micro and meso organizational dimensions which impact on women's ability to influence macro health policy.
Human resource management and performance in healthcare organisations
Authors: Harris Claire , Cortvriend Penny , Hyde Paula 
Published: August 2007

PurposeThe purpose of this paper is to compare the evidence from a range of reviews concerned with the links between human resource management (HRM) and performance. The aim of the paper is to review this diverse literature, and to derive human resource (HR) implications for healthcare researchers, policy makers and managers.Design/methodology/approachRecent reviews of the human resource management and performance literature are examined, in addition to the inclusion of a previously unpublished review. Their methods, HRM focus, findings and recommendations are contrasted in order to produce this review.FindingsThe paper finds that relationships have been found between a range of HRM practices, policies systems and performance. Despite being an important concern for HR professionals, there is little research exploring the link between HRM and performance in the health sector.Research limitations/implicationsThe paper sees that recent studies have found HRM practices to be associated with patient outcomes such as mortality, yet they yield little information regarding the processes through which HRM affects individual performance and its consequent impact on patient care. The use of approaches that seek to gain an understanding of workers' interpretations of their experience, i.e. the psychological process through which HRM can affect individual performance, may shed some light on how these processes work in practice.Practical implicationsThe paper shows that increasing autonomy for healthcare organisations in the UK, i.e. Foundation Trusts, may offer increased opportunity for locally tailored HR systems and practices.Originality/valueThe paper presents findings drawn from a review of previous research on a subject of increasing relevance to HR researchers and practitioners in healthcare organisations. The paper indicates alternative approaches to research and practice in light of extant research.
Patient involvement in a professional body: reflections and commentary
Authors: Baker Alison 
Published: August 2007

PurposeThe purpose of this paper is to consider the issues which emerge when an autonomous, professional, member‐led organisation attempts to demonstrate its accountability to patients through lay involvement in its standard‐setting processes.Design/methodology/approachThe paper reports a project, which is still in progress and could be described as action research. Data were collected through participant observation in a series of discussions and working groups. A limited literature search was carried out at the start of the initiative but found little which relates to lay involvement in professional bodies.FindingsThe paper finds that patient involvement in a professional body is unlikely by itself to be a useful mechanism for delivering greater professional accountability.Research limitations/implicationsThe paper is a single case study and can only suggest hypotheses for further research.Practical implicationsThe paper shows that professional bodies of various types are increasingly being asked to demonstrate public involvement in their decision making. It is important to identify the most effective mechanisms for this and the limitations inherent in the structures of organisations, which are accountable primarily to their members.Originality/valueThe paper shows that individual doctors are held to account through a number of mechanisms, but little attention has been given to how medical professional bodies can be made more accountable for the collective power they hold. Patient involvement is interpreted within a consumerist model, which focuses on the doctor‐patient relationship and ignores the considerable strategic influence which medical royal colleges exercise within the health service.
Involving the public in NHS service planning
Authors: Anton Silvia , McKee Lorna , Harrison Stephen , Farrar Shelley 
Published: August 2007

PurposeThe purpose of this paper is to report the findings of a study that examined the development of an assessment framework for public involvement.Design/methodology/approachThe paper has adopted a multi‐method approach that includes: a focused review of literature relating to tools that might be used to provide valid and reliable assessments of public involvement; key informant interviews with people with experience from various perspectives of efforts to involve the public in the planning and development of health services; and a detailed study of a specific public involvement initiative involving a range of “stakeholder” interviews.FindingsThe paper finds that there are uncertainty and a lack of consensus about how assessment of public involvement should be undertaken. The findings emphasise the need to recognise the diverse nature of public involvement, which may require assessment to be employed flexibly at each individual NHS Board level.Research limitations/implicationsThe paper is a small‐scale study, in which it was only possible to probe a limited number of stakeholders' views due to practical and time restrictions.Originality/valueThe paper adds value to the discussions taking place at Scottish Government level as to the best approach in assessing public involvement in health service decision making.
An analysis of trends related to hospital solid wastes management in Kuwait
Authors: Alhumoud Jasem M. , Alhumoud Hani M. 
Published: August 2007

PurposeThe purpose of this paper is to determine the amount of different kinds of solid wastes produced, segregated, collected, stored, transported and disposed off in the governmental hospitals of Kuwait.Design/methodology/approachThe research in this paper shows that all governmental hospitals were assessed in a period of six months (September, 2005 through December, 2005 and June, 2006 through July, 2006). The weight fraction of each component in the sorting sample was calculated by the weights of the components. The amount of non‐infectious and infectious waste generated in kg/day in each ward and various hospital blocks were determined and recorded.FindingsThe findings in this paper indicated that the waste generation rate is between 3.87 kg/bed/day and 7.44 kg/bed/day. Subsequently, this waste consists of 10,534.5 kg (71.44 percent) of domestic waste, 4,099.4 kg (27.8 percent) of hazardous/infectious waste, and 112.1 kg (0.76 percent) of sharps. Hospital waste makes up approximately 30 percent of all the hazardous waste generated in Kuwait. Segregation of the different types of wastes is practiced in nearly all of the hospitals. All infectious/medical wastes are finally disposed of through incineration.Practical implicationsThe paper shows that the hospitals under study do not organize training courses on hospital waste management and the hazards associated with them. There is a need to establish a detailed database regarding the quantity and quality of the waste generated by the various hospitals.Originality/valueThis paper systematically assesses the obstacles in the existing hospital solid waste management system in all governmental hospitals in Kuwait. Subsequently, recommendations and improvements are suggested.