bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emotional structure and commitment: implications for health care management
Authors: Humphreys John , Brunsen Bill , Davis Dale 
Published: January 2007

PurposeThis paper aims to determine if the emotional structure of direct healthcare workers was related to their commitment to the organization.Design/methodology/approachA total of 105 direct healthcare workers completed self‐report surveys to determine their emotional intelligence, emotional coping ability, and affective organizational commitment. Pearson Product Moment Correlation and independent samplettests were used to analyze the data.FindingsA significant correlation was found between emotional intelligence, emotional coping ability, and organizational commitment. In addition, emotional intellect served as a moderating variable between coping ability and commitment such that those direct care workers who exhibited higher emotional coping abilities were more committed when emotional intelligence was high rather than low.Research limitations/implicationsThis was an exploratory study. Larger sample sizes across multiple healthcare settings should be examined before definitive inferences should be drawn. Future studies should likely introduce other variables such as satisfaction, effort, and even performance appraisals to delineate causal relationships.Practical implicationsIt appears that personality constructs such as emotional intelligence and coping ability could possibly be used as predictive instruments to determine who might be most successful in operating in the highly emotionally charged environment of healthcare.Originality/valueThis is the first study that examined the constructs of emotional intellect and coping ability and organizational commitment using a direct healthcare worker sample. It provides support for the conjecture that interpersonal emotional dynamics are critical in emotionally charged environments. This knowledge could assist healthcare managers in addressing the shortage and attrition rates associated with many direct healthcare fields.
Appreciating change in cancer services – an evaluation of service development strategies
Authors: Reed Jan , Turner Jill 
Published: January 2007

PurposeThe purpose of this paper is to report on an evaluative study which used appreciative inquiry (AI) to explore the processes of change during the Cancer Services Collaborative Improvement programme instituted by the Department of Health in the UK. This was a three‐stage programme which expanded from nine pilot projects to a national service change, focussing on improving the patient's experience throughout the journey from diagnosis to treatment.Design/methodology/approachThe paper uses AI questions in interviews with a range of CSC staff who had had different roles and length of involvement.FindingsThe study identified a range of strategies and skills that participants had developed in order to support and facilitate service change.Practical implicationsThe paper offers a discussion of skills and strategies that can facilitate change in health care across clinical areas, and a discussion of the use of AI as a method of evaluation.Originality/valueThis study is one of the first to use AI in health care evaluation in the UK, and thus makes a contribution to understanding change from an AI perspective.
Tales of the unexpected?
Authors: Learmonth Mark 
Published: January 2007

PurposeReceived wisdom about management and leadership in health care takes it for granted that better management is, by definition, a good thing. Aims to raise some doubts about this received wisdom and suggest that perhaps better management may be unconditionally “better” for only a few people.Design/methodology/approachThese doubts are raised mainly via accounts of the author's personal experiences of being a manager in the UK National Health Service.FindingsAuthor's attraction to some parts of a body of literature called critical management studies is discussed that was subsequently used to make sense of these experiences.Originality/valueThe accounts are offered in the belief that they will be of interest to other people who are wrestling with their own ways of making sense of personal experiences in and around better management in health care.
Shifting the balance of power?
Authors: McDonald Ruth 
Published: January 2007

PurposeA recurring theme in Government policy documents has been the need to change the culture of the NHS in order to deliver a service “fit for the twenty‐first century”. However, very little is said about what constitutes “culture” or how this culture change is to be brought about. This paper seeks to focus on an initiative aimed ostensibly at “empowering” staff in an English Primary Care Trust as a means of changing organisational culture.Design/methodology/approachIt presents findings from an ethnographic study which suggests that this attempt at “culture change” is aimed at manipulating the behaviour and values of individual employees and may be interpreted as a process of changing employee identity.FindingsEmployees reacted in different ways to the empowerment initiative, with some resisting attempts to shape their identity and others actively engaging in projects to bring their unruly self into line with the ideal self to which they were encouraged to aspire.Originality/valueThe challenges presented by the need to respond to conflicting Government policies created tensions between individuals and conflicts of allegiance and identity within individual members of staff. Alternative forms of selfhood did not merely replace existing identities, but interacted with them, often uncomfortably. The irony is that, whilst Government seeks to promote culture change, the frustrations created by its top‐down target‐driven regime acted to mitigate the transformational and reconstitutive effects of a discourse of empowerment aimed at achieving this change.
Exhausting management work: conflicting identities
Authors: Mischenko Jane 
Published: January 2007

PurposeThe primary purpose of this paper is to critically explore managers' experience of work identity in the National Health Service (NHS).Design/methodology/approachThis paper is unconventional in that it uses an auto‐ethnographic approach and poetry as the empirical data from which the conceptual framework evolves. The concepts of identity, power and self are analysed in relation to the narrative utilising a post‐structuralist, critical management lens, particularly drawing from Foucault.FindingsThe paper reflects and critiques the challenges of undertaking auto‐ethnography, not least the publication and exposure of a “vulnerable aspect” of the author but also identifies this as a powerful method to explore how one uses narrative to create meaning and constitute oneself; the challenges of such textual representation and the various ways one adapts, resists and survives the challenge of the “multiphrenic” world.Originality/valueThe contribution this paper makes is an “outing” of the dynamics of being a manager in the NHS and an opening of a debate on current management discourse and practice. The further value of this paper is the experimentation of critically evaluating an auto‐ethnographic approach to researching management identity work.
MMR – public policy in crisis: whose tragedy?
Authors: Stroud Laura 
Published: January 2007

PurposeTo explore the issues surrounding the falling rates of MMR vaccination following the publication of a controversial study by Wakefieldet al.Design/methodology/approachIn order to take a fresh look at the MMR crisis, the Greek tragedy,Antigone, was used as a “strong plot” to de‐contextualise the underlying social and political issues. In this short paper, two themes are explored that emerge from readingAntigonewith respect to the unfolding crisis of public confidence in the MMR vaccine: first, the challenge to government in the form of a decrease in public trust in government and government policies; and second, how such a challenge assumes significance and, arising from that, the question of how one might respond to the challenge.FindingsThe MMR debate throws issues of importance to society into relief – for example, public trust in government and science; and notions of public good versus rational choice in public policy on vaccination, However, much of the debate has been polarised into good versus evil – good and evil being subjective positions that are interchangeable, depending on the side one favours. It is argued that the issues are more complex than this, and are as much to do with political consent and the bargain between citizen and state.Originality/valueUsing “strong plots” to theorise about current issues is powerful because it allows one to explore them from different angles and challenge one's understanding.Antigoneprovides us with a way of standing back from the MMR crisis and re‐conceptualising the issues to capture the essence of the underlying debate.
Organizing emotions in health care
Authors: Mark Annabelle 
Published: January 2007

PurposeTo introduce the articles in this special issue, discussing emotion in the in health‐care organisations.Design/methodology/approachDiscusses such topics as what makes health care different, editorial perspectives, how health care has explored emotion so far, and the impact of emotion on patients and the consequences for staff.FindingsHealth care provides a setting that juxtaposes emotion and rationality, the individual and the body corporate, the formal and the deeply personal, the public and the private, all of which must be understood better if changes in expectations and delivery are to remain coherent.Originality/valueThe papers indicate a shared international desire to understand meaning in emotion that is now spreading across organizational process and into all professional roles within health care.
Cultural characteristics of “high” and “low” performing hospitals
Authors: Mannion R. , Davies H.T.O. , Marshall M.N. 
Published: January 2007

PurposeTo compare and contrast the cultural characteristics of “high” and “low” performing hospitals in the UK National Health Service (NHS).Design/methodology/approachA multiple case study design incorporating a purposeful sample of “low” and “high” performing acute hospital Trusts, as assessed by the star performance rating system.FindingsThese case studies suggest that “high” and “low” performing acute hospital organisations may be very different environments in which to work. Although each case possessed its own unique character, significant patternings were observed within cases grouped by performance to suggest considerable cultural divergence. The key points of divergence can be grouped under four main headings: leadership and management orientation; accountability and information systems; human resources policies; and relationships within the local health economy.Practical implicationsAs with any study, interpretation of findings should be tempered with a degree of caution because of methodological considerations. First, there are the limitations of case study which proceeds on the basis of theoretical rather than quantitative generalisation. Second, organisational culture was assessed by exploring the views of middle and senior managers. While one should in no way suggest that such an approach can capture all important cultural characteristics of organisations, it is believed that it may be at least partially justified, given the agenda‐setting powers and influence of the senior management team. Finally “star” performance measures are far from a perfect measure of organisational performance. Despite such reservations, the findings indicate that organisational culture is associated in a variety of non‐trivial ways with the measured performance of hospital organisations.Originality/valueHighlights considerable cultural divergence within UK NHS hospitals.
Network structure and attitudes toward collaboration in a community partnership for diabetes control on the US‐Mexican border
Authors: Provan Keith G. , Harvey Jennel , Guernsey de Zapien Jill 
Published: January 2007

PurposeThis study seeks to provide an examination of a health policy network operating in a single, small community along the US‐Mexican border. The purpose of the paper is to discuss why and how this network evolved, and then to present findings on how the network was structured. Analysis will focus especially on agency involvement, or “embeddedness” in the network, and its relationship to attitudes held by network members regarding trust, reputation, and perceived benefit.Design/methodology/approachData were collected from 15 public and nonprofit agencies trying to work collaboratively to influence local policy and services regarding the prevention of obesity‐related chronic disease, especially diabetes. Embeddedness was measured in three different ways and both confirmed and unconfirmed networks were assessed. Network analysis methods were utilized as well as nonparametric correlation statistics.FindingsThe network was found to be densely connected through unconfirmed linkages, but much less so when these links were confirmed. Strongest findings were found for shared information. Measures of agency embeddedness in the network were strong predictors of agency reputation, but findings for trust and perceived benefit were generally weak.Originality/valueFrom a practice perspective, the study points to the problems in building and sustaining community‐based chronic disease health networks, especially in a small community with substantial health needs. The research also contributes to theory on embeddedness and to methodology for collecting and analyzing data on community health networks.
Clinical effectiveness: a structured teaching approach for junior doctors
Authors: Bashir G.M. , Henderson R. , Henderson K. 
Published: January 2007

PurposeTo formulate an effective teaching prog ramme in the principles of clinical effectiveness for junior doctors, with simultaneous participation in a clinical audit project during their six‐month period of employment.Design/methodology/approachAccident and Emergency (A&E) Senior House Officers (SHOs) were educated in the principles of clinical effectiveness through a structured five‐session approach whilst they concurrently performed their clinical audit project. Throughout the process the A&E SHOs were supported by the Clinical Effectiveness Unit and the A&E Consultant overseeing departmental audit.FindingsThe structured teaching programme resulted in a good understanding of the clinical effectiveness process amongst the A&E SHOs, as demonstrated by their ability to perform a clinical audit project which ultimately improved practice.Research limitations/implicationsThis study has involved the construction and assessment of a teaching framework for junior doctors. The conclusions have been drawn on the basis of objective measures such as the completion of a clinical audit project which successfully improved practice. Thus, the publications of the findings may be considered in the category of a research paper. However, the authors accept that the assessment of a teaching programme's success and its portability to other departments or institutions can be highly subjective.Practical implicationsWith appropriate guidance and support, junior doctors are able to perform meaningful clinical effectiveness exercises at an early stage in their careers and within the constraints of short periods of employment. The structured teaching approach could be considered as a template which other institutions may wish to adopt to educate their own juniors.Originality/valueDespite the increasing importance of clinical audit in modern practice, the authors are not aware of any published teaching programmes which provide junior doctors with the necessary understanding of and skills required to take part in the clinical effectiveness process.
Developing surgical site infection surveillance within clinical governance
Authors: Hogg Samantha , Baird Nicola , Richards Judith , Hughes Sean , Nolan John , Jones Adrian , Holmes Alison 
Published: January 2007

PurposeTo describe orthopaedic surgical site infection (SSI) surveillance models at two English pilot sites, and to review their effectiveness and integration into clinical governance.Design/methodology/approachThe different organisational models for orthopaedic SSI at two Trusts were examined and assessed.FindingsBoth sites recognised that regular feedback to clinical staff and clinical ownership are important determinants of success, and this was addressed by both models. Each site appointed a surveillance coordinator within the infection control service to oversee the programme, but tasked data collection to different staff groups directly involved with the care of orthopaedic patients. Feedback programmes to Clinical Governance Committees, clinical staff and managers were developed, reinforcing surveillance of SSI as a core component of surgical risk management and quality assurance, and an integral part of clinical governance. The pilots demonstrated the importance of a dedicated surveillance coordinator.Practical implicationsInfection following joint replacement surgery is associated with high morbidity and financial costs. In 2004 surveillance of orthopaedic SSI became mandatory in England. A description and assessment of these pilot sites will be of practical value to Trusts that must now implement SSI surveillance.Originality/valueSSI surveillance is a corner‐stone of risk management and quality clinical care, yet little has been published on organisational frameworks needed for implementation, particularly in the context of clinical governance. This paper addresses these issues in describing and assessing the models at two English pilot sites.
Audit: efficiency of fast‐tracking hip fractures from accident and emergency
Authors: Syed Mujahid Ali , Mahmood Faisal , Ramesh Palanisamy 
Published: January 2007

PurposeTo analyse the implementation of fast‐tracking pathway of hip fractures from accident and emergency to the orthopaedic wards.Design/methodology/approachA retrospective audit analysing 100 case notes of fast‐tracked hip fractures selected at random for the period of one year was undertaken.FindingsSeveral deficiencies were identified in the implementation of the pathway.Practical implicationsRecommendations have been made for correction of the inadequacies identified.Originality/valueThis paper aims to increase the efficiency and safety of fast‐tracking system for hip fractures, which is being deployed by many hospitals throughout the UK.
Clinical audit and the implementation of the Ottawa Ankle Rules
Authors: Jennings V. , Newton C. , Bonner K. , Hancock R. 
Published: January 2007

PurposeTo implement the research‐based Ottawa Ankle Rules in a district hospital and audit their impact on the number and appropriateness of X‐rays for ankle injuries in A&E.Design/methodology/approachThe method used was retrospective data collection, followed by education and prospective data collection on the management of subsequent ankle injuries. The computer records of the first 150 people presenting to A&E with ankle/foot injuries in one month were reviewed to determine whether the patient underwent an X‐ray, and what the results were. Every doctor working in A&E was then educated using a hand‐out giving the Ottawa Ankle Rules. The management of 150 people presenting with ankle/foot injuries in the month after this intervention was assessed.FindingsThere was a reduction in the number of patients receiving X‐rays (83/150 or 55 per cent versus 128/150 or 85 per cent pre‐intervention; p<<0.001). There was also an increase in the proportion of X‐rays showing fractures (17/83 or 20 per cent versus 16/128 or 12.5 per cent; difference not statistically significant).Research limitations/implicationsPossible to stimulate good practice with audit.Practical implicationsImprovement in practice stimulated by a motivated trainee doctor with appropriate support. Factors contributing to success discussed.Originality/valueEncouraging example of successful audit, of interest to those interested in using clinical audit to improve care.
The Patients Accelerating Change Project: does it make any difference?
Authors: Sweeney Grace , O'Hagan Bridget , Squire Sarah , Powell Caroline 
Published: January 2007

PurposeThe purpose of this survey was to evaluate the impact and experience of the Patients Accelerating Change (PAC) project from the perspective of 28 people who were closely involved in the project.Design/methodology/approachData were collected by telephone interview with 28 individuals from nine acute NHS Trusts which piloted the PAC project.FindingsPAC was seen to make a positive impact in terms of improving communication and information, helping patients feel valued and listened to, providing real direction as a result of listening to feedback from patients, and improving processes and procedures in the participating Trusts. The PAC project raised the profile of the Patient and Public Involvement Agenda within the NHS Trust organisations that participated in the project.Research limitations/implicationsThe PAC project was still in its infancy at the time of data collection for this study, and over half of the sample was likely to have been composed of enthusiasts for the process: this may have contributed to a positive bias.Practical implicationsThe PAC project works on a “staggered approach” in terms of realising short‐ and then long‐term improvements in the patient's experience. By the end of the project it was expected that some “quick wins” could be identified and the PAC organisers acknowledged that more time is needed in order to realise longer‐term improvements.Originality/valueThis survey provides useful information to patients and staff at NHS Trusts who may be considering how best to involve patients in planning and improving the quality of care that they receive.
Cataract surgery: reducing risk through better practice
Authors: Cowan Jane , Kavanagh Sean 
Published: January 2007

PurposeA guideline to the practice of cataract surgery was produced in 2004 by the Royal College of Ophthalmologists. This complemented a guideline to best practice produced in 2000 by the NHS Executive. This paper reviews the guidance given by these documents and examines their clinical governance and risk management advice and usefulness.Design/methodology/approachThe guideline is critiqued in terms of its usefulness to clinicians and health‐care managers. Recent research on the consenting process for cataract surgery is used as a benchmark of best practice and compared with the guideline's recommended methods. The medico‐legal caseload experience of The Medical Protection Society (the authors' institution) is used to discuss areas of concern relating to risk management in cataract surgery of interest to clinicians and managers.FindingsThe guideline is felt to be a useful, well‐produced and recommended resource for clinicians and managers with clinical governance responsibilities for cataract surgery services. There was felt to be scope to improve some of the guidance on reporting adverse events following cataract surgery to patients.Practical implicationsThis paper will help to inform the gaining of consent for cataract surgery in the light of the latest research in this area, and help train staff in this task.Originality/valueThis paper will be of value to clinicians and managers with responsibility for cataract surgical services. It should help to inform how they set up, review and audit their practice in this area and be useful for staff training. It highlights areas of the guideline which may be of relevance to those without time to read the whole guideline.