Changes In Work Practices Research Articles

The role of universities in modern society

ABSTRACT This is a conceptual paper that examines the origin and development of universities and their current role in global society. There has been an unprecedented and exponential growth of technology and artificial intelligence capabilities over the past ten years which is challenging current working practices and affecting all areas of society. The paper examines how this role may change to match the new demands placed on them by a digitally enabled society that has greater leisure time. The design of the paper is first to detail some of the changes in work practices that are taking place and how these will impact on society. It then offers several ways in which universities could modify their role to respond to these emerging challenges. This could include new courses, new organisational structures and new pedagogical practices. The paper provides a platform for discussion and debate around the strategic vision and direction of travel for higher education.

Professional Master's Degree Students' Perceptions on the Changes Digitalisation Imposes on Counselling in the Social and Health Care Sector.

The study portrays the social and health care master’s students’ (N = 19) perceptions on the changes in work practices due to digitalisation, with a special focus on online counselling. Furthermore, the data include thoughts on the impact digitalised interaction, i.e., online counselling, has on their work and professional identities. The students studied how the motivational interviewing method combined with a solution-focused counselling approach is applicable in online settings by using simulation pedagogy. The data consisted of students’ learning diaries. Furthermore, the data were analysed using inductive content analysis. The results show that the digitalisation of work practices demands blended professionalism, which allows the professional to work both face-to-face and online with clients. In addition, the education of social and health care professionals needs to address the lack of competences and skills in digitalised work practices and provide a conceptual and practical understanding of blended professionalism in the sector.

Organization-Based vs. Network-Based Project Work

This article examines how projects shape work biographies. It suggests two distinct concepts of project work in order to explain the variety of challenges to traditional work arrangements. In organization-based projectwork (OPW), a permanent structure acts as a reference point in the work relationship beyond the duration of the project. In network-based projectwork (NPW) the worker will continuously move between permanent structures. This distinction is explored as crucial in order to unfold the potential of ‘project work’ in theorizing changing work practices and challenged work institutions.

What Do Occupational Hygienists Really Know About Skin Exposure?

This article describes responses to a questionnaire on current work practices and understanding of the management of dermal exposure issues in the workplace from members of the British Occupational Hygiene Society (BOHS) and the Australian Institute of Occupational Hygienists (AIOH). The survey comprised questions in four key areas: employment demographics, experience managing dermal exposure, knowledge of dermal exposure management, and opinions on professional knowledge gaps and preferred training methods. The survey was disseminated in 2016 in the UK and 2018 in Australia, with 116 and 114 responses from each jurisdiction, respectively. The majority of respondents had personally evaluated the risks of dermal exposure to chemicals (BOHS 92%; AIOH 86%), albeit infrequently (less than a few times per year). Occupational Hygienists reportedly adopted a range of strategies to control dermal exposure problems, including chemical elimination/substitution (BOHS 68%; AIOH 68%), changing work practices (BOHS 79%; AIOH 75%), and education (BOHS 77%; AIOH 83%). The use of gloves or other personal protective equipment remained the most commonly cited exposure control measure (BOHS 99%; AIOH 97%). While there appeared to be a good understanding of common dermal exposure workplace scenarios (e.g. isocyanate exposure in motor vehicle repair, solvent exposure during spray painting), the overwhelming majority of respondents wished to find out more about assessing the risks from dermal exposure to chemicals (BOHS 89%; AIOH 88%). The outcomes suggest ways to increase the competence of professionals in dealing with dermal exposure matters in the workplace, through mechanisms such as web-based guidance, interactive educational materials and webinars, as well as workshops and seminars.

From Paper Flight Strips to Digital Strip Systems: Changes and Similarities in Air Traffic Control Work Practices

To increase capacity and safety in air traffic control, digital strip systems have superseded paper strips in lower airspace control centers in Europe. Previous ethnographic studies on paper strip systems anticipated a radical change in work practices with digital strip systems, but we are not aware of any studies that evaluated these predictions. We carried out contextual inquiries with controllers and focused on face-to-face and radio communication, interactions with the digital strip system and the workspace in general. In turn, we contribute (1) detailed descriptions of controllers' work practices, such as using tacit information from radio communication and 'standard advocates vs. tinkerers' operation modes, (2) respective implications for design and (3) discuss how the observed work practices are similar or different from the reported practices in the literature of the two preceding decades. Our key insights are, that documentation speed is faster with digital strips, although a high load in the case of radio frequency persists. Controllers retrieve tacit information from the radio communication and combine it with scattered cues from several displays to form empathic decisions that sometimes exceed the standard protocol. We conclude that the role of tacit information holds opportunities for future flight systems and should be considered in a holistic approach to individualized workspaces for controllers.

\u201cNavigation to prioritizing the patient\u201d \u2013 first-line nurse managers\u2019 experiences of participating in a quality improvement collaborative

BackgroundFirst-line nurse managers are central to quality improvement work when changing work practices into better patient outcomes. Quality improvement collaboratives have been adopted widely to support quality management in healthcare services and shared learning. We have little knowledge of the first-line nurse managers’ own perspectives concerning their need for support and knowledge in quality improvement work. Therefore, the aim of this study was to gain understanding of first line nurse managers’ experiences in leading quality improvement work in their own organization when participating in a quality improvement collaborative.MethodsAn interpretive approach was chosen following Graneheim and Lundman’s qualitative content analysis. Data was collected through three focus group interviews with first-line nurse managers representing different workplaces: the local hospital, a nursing home, and a homecare service in a rural area of Norway.Results“Navigation to prioritizing the patient” emerged as an overarching metaphor to describe the first-line nurse managers experiences of leading quality improvement work, based on three themes: 1) fellowship for critical thinking and prioritizing the patient; 2) mastering the processes in quality improvement work; and 3) the everyday reality of leadership as a complex context.ConclusionsA quality improvement collaborative encompassing knowledge transfer and reflection may create an important fellowship for health care leaders, encouraging and enabling quality improvement work in their own organization. It is crucial to invite all leaders from an organization to be able to share the experience and continue their collaboration with their staff in the organization. Continuity over time, following up elements of the quality improvement work at joint meetings, involvement by users, and self-development of and voluntary involvement in the quality improvement collaborative seem to be important for knowledge development in quality improvement. The supportive elements of the quality improvement collaborative fellowship were crucial to critical thinking and to the first-line nurse managers’ own development and security in mastering the quality improvement work processes. They preferred prioritizing the patients in quality improvement work, despite haste and obstructive situations in an everyday context.

How to leverage data security in a post-Covid world

Cyber security is often pushed down the list of priorities, and this was abundantly clear as businesses had to rush to get employees up and running for business continuity in recent months. Many already had some level of protection in place, but with a lasting switch to remote working and changing work habits and practices, there must be a refreshed emphasis on data security to protect employees, customers and businesses.Cyber security is often pushed down the list of priorities and this became abundantly clear as businesses had to rush to get employees up and running when working from home in recent months.With a lasting switch to remote working and changing work habits and practices, there must be a refreshed emphasis on data security. The new normal of hybrid workforces must have the correct layers of security that protect all types of employees. It's about increasing awareness and improving email culture, argues Andrea Babbs of Vipre Security.

Use of interim execs as a nontraditional model

Purpose The purpose of this article is to define the use of interim executives in the workplace. Design/methodology/approach A thought leadership approach is adopted for this article. Findings The article describes the common misconceptions, potential pitfalls and the benefits of hiring an interim executive. Originality/value At a time of changing work practices, economic and political uncertainty, organisations require help, without delay. This article offers an interim management solution as a way of assisting organisations to transform.

Factors Related to Health Informatics Competencies for Nurses-Results of a National Electronic Health Record Survey.

In 2015, the Finnish Ministry of Social Affairs and Health published an eHealth and eSocial strategy with key objectives that by 2020 health information systems will be smart and providers will be able to maximize their use. Measures include improving system usability and decision support, involving professionals in system and service development, and increasing professionals' training in information management, electronic documentation, data protection, and data security. The aim of this study was to explore the level of nurses' informatics competencies and sufficiency of in-house training regarding technology-induced changes in work practices. An electronic questionnaire produced by the National Institute of Health and Welfare was sent in February to April 2017 to 29 283 Finnish working-age nurses, community nurses, and midwives; 3607 replies were received. Respondents rated their overall informatics competency relatively high, with the lowest competency scores on terminology-based documentation (Finnish Care Classification) and patient-related digital work. Education, electronic health record system used, experience using electronic health record systems, sufficiency of training, higher levels of technical functionality, ease of use, and usefulness were all associated with competency and remained significant after all adjustments. One-third of the respondents felt that they had not received sufficient training. Age and participation in system development were associated with experiences of sufficiency of training.

Implementing eHealth Technologies: The Need for Changed Work Practices to Reduce Medication Errors.

Medication errors are a significant health problem and a serious threat to patient safety. In Norway, an estimated one-third of the elderly population has been exposed to potentially inappropriate medications. The Norwegian government has assumed a pivotal role in reducing medication errors and providing safer medication management for its citizens, particularly through the national eHealth system's e-prescription and Summary Care Record. In the present study, we depart from the governmental eHealth initiatives and examine why access to pharmaceutical information is not sufficient to solve the problem with medication errors. Empirical data were collected from 2015 to 2019 through the conduction of 56 qualitative interviews that were transcribed, thematically coded and analysed. The results illustrate how eHealth systems are helpful, at the same time, we emphasise changed work practices and professional knowledge-sharing as a basis for solving the issue of medication errors.

Adoption and use of energy-monitoring technology in ship officers\u2019 communities of practice

The paper offers an analysis of how an energy-monitoring system was implemented and eventually adopted by the crew members in a shipping company. It illustrates how the social process of enacting the system as a collaborative technology-in-practice, enabling a significant reduction in energy consumption, was contingent on the negotiation of meaning and mutual learning among crew members in their community of practice. The case study contributes to the literature on the relation between information technology, organization and energy efficiency by investigating the socially situated nature of technology implementation and work practice change. The findings’ implications for the role of information technology in improving energy efficiency in shipping are discussed.

Contracting development: managerialism and consultants in intergovernmental organizations

Intergovernmental organizations (IGOs) are now managed with an eye to managerial trends associated with transnational professionals, a view that has ramifications for how IGOs govern their policies and processes. Drawing on interviews and focus groups with staff in IGOs, we trace how managerialism in IGOs is changing how staff perceive work practices. We find that IGOs increasingly rely on consultants to enact policy scripts and to evaluate program success. This signals a subtle yet significant shift from expertise and bureaucratic impartiality, grounded in particular types of knowledge, to skills and flexibility to meet client demands and advance best practice norms according to prevailing world cultural frames. This managerial trend in IGOs is partly driven by stakeholder dynamics but is primarily a normative change in who is seen as having the authority to make claims over professional best practices. Such managerialism is contracting the development policy space. This contraction is partly driven by consultants, who defer to their peers and to donors rather than IGO staff and concerned member states. This work also depletes institutional memory for IGO operations. We trace how IGO staff perceive managerial trends and changes in work practices.

A cross-country time and motion study to measure the impact of electronic medication management systems on the work of hospital pharmacists in Australia and England

BackgroundQualitative studies have provided important insights into how hospital pharmacists’ work changes when electronic medication management (EMM) systems are introduced. Quantitative studies of work practice change are rare. Despite the use of EMM systems internationally, there are no cross-country comparative studies of their impact on health professionals’ work. We aimed to quantify and compare the type and magnitude of changes in hospital pharmacists’ work pre- and post-EMM implementation in two countries. MethodsParallel, direct observational, time and motion studies of pharmacists in Australia and England pre- and post-EMM implementation. 20 pharmacists were observed: 9 in an Australian 440-bed hospital (155 h); and 11 pharmacists in a 500-bed English hospital (258 h). The Work Observation Method By Activity Timing (WOMBAT) software was used to collect observational data. Proportions of observed time in 11 tasks by study period (pre- versus post-EMM) and site, time spent with others or alone, and using different tools (e.g computers, paper) were calculated. Magnitude of changes between pre- and post-EMM by task and country were determined using z-tests for proportions adjusting for multiple testing. ResultsAt baseline, Australian and English pharmacists spent the greatest proportion of time in medication review. Post-EMM, time in medication review (Australia 21.6%–27.5%; England 27.1%–33.8%) and history-taking (Australia 7.6%–13.3%; England 19.5%–28.9%) significantly increased. Despite country differences in these tasks at baseline, the magnitude of changes did not significantly differ. English pharmacists increased time engaged in medication discussions with patients post-EMM (from 5.9% to 10.8%; p = 0.01). The Australian rate did not change (18.0%–27.2%; p = 0.09), but was higher at baseline. Post-EMM, Australian pharmacists spent 63.4% of time working alone, compared to 92.0% for English pharmacists. ConclusionsEMM systems impacted the same core areas of work and had a similar magnitude of effect on pharmacists’ work in both countries. Anticipated reductions in medication review and history taking were not observed.

Effect of Strategic Leadership Styles on Organizational Performance: A Survey of Chartered Universities in Kenya

Universities play an important role in the economic development of countries. It is widely agreed to a larger extent that university management and leadership style form an important pillar in the performance of the institutions of higher learning. Leadership is a concept that has undergone much adaptation to suit the unique needs of each organization due to the changes in demographics, globalization, and technology and work practices. As a result of this evolution, strategic leadership approach has been adopted by institutions of higher learning globally. In Kenya, universities practice strategic leadership as they have adopted different strategies at various levels of management. However, there are varying levels of performance in Uuniversities as indicated in their rankings despite all of them adopting strategic leadership. This is a gap that prompted a study on establishing the link between strategic leadership and organizational performance in Kenyan chartered universities. The study used a descriptive cross-sectional research design. The study sample consisted of Vice Chancellors and Deputy Vice Chancellors from 27 public universities and 16 private universities. Data analysis was done using Independent samples t-test, ANOVA, multiple regression and Pearson correlation analysis. The research found that VCs were more likely to use transformational leadership style than DVCs. Organisational performance was also found to be higher among newly appointed VCs and DVCs but it declined as one stayed longer in their management position. The age of the office bearer was found not to influence their choice of leadership style. The results of correlation and multiple regression analysis showed that transformational leadership style had a significant positive effect on performance while transactional leadership had a negative effect on performance. Further regression analysis showed that transformational leadership (intellectual stimulation) was the only significant positive predictor of organisational performance (β=0.532, p=0.000). This implies that transformational leadership is more effective in the university management than transactional leadership. Thus, university management should aim at improving on their ability to deploy this kind of style to achieve better results.

A Realist Evaluation of Local Networks Designed to Achieve More Integrated Care.

Introduction:Not surprisingly given their multi-component nature, initiatives to improve integrated care often evolve to find the best way to bring about change. This paper provides an example of how an evaluation evolved alongside such an initiative designed to better integrate care across primary, community and hospital services in South Auckland, New Zealand.Theory and methods:Using the explanatory power of a realist evaluative approach, theories of new ways of working that might be prompted by the initiative were explored in: (i) interviews with stakeholders in 2012 and 2015, (ii) online surveys of general practices and local care organisations, and (iii) a purposive sample of ten general practices.Results:The results highlighted the institutional contexts that led to difficulties in implementing population health initiatives. They also revealed that changes in work practices focussed mostly on activities that improved the coordination of care for individuals at risk of hospital admissions.Discussion:Multi-component complex interventions can vary in their delivery and be vulnerable to one or more components not being implemented as originally intended. In the case of this intervention, the move towards strengthening local relationships arose when contractual arrangements stalled. Realist evaluative approaches offer a logic that helps unpick the complexity of the relationships and politics in play, and uncover the assumptions made by those developing, implementing and assessing health service changes.Conclusion:Given the multi-component and evolving nature of initiatives seeking to better integrate care, the realist evaluative emphasis on surfacing early the theories to explain how change is expected to occur helps overcome the challenge of evaluating “a moving target”.

Impacts of using the electronic-health education program ‘The Vicious Worm’ for prevention of Taenia solium

BackgroundTaenia solium is a zoonotic tapeworm widely distributed across sub-Saharan Africa. Specific health education is regarded as a central element in controlling T. solium. In 2014, an electronic health education tool called ‘The Vicious Worm’, which was concerned with prevention of T. solium was introduced to health and agricultural professionals in Mbeya, Tanzania, an endemic setting.Introduction to ´The Vicious Worm’ of 1.5 hours significantly improved the participants’ knowledge. This study revisited the same study subjects one year later to assess persistence of knowledge regarding T. solium taeniosis/cysticercosis and to assess if the health education had changed work practices for the participants and the public. MethodsThe study was conducted in Tanzania between June and August 2015, with a fixed population of health and agricultural professionals recruited from a previous study testing ‘The Vicious Worm’. The study used a test, a questionnaire survey, as well as semi-structured group and individual interviews. ResultsThe 79 study subjects, all health or agricultural professionals, had within one year relocated from Mbeya to 16 of 21 administrative regions of Tanzania. Sixty-four agreed to participate in the test and 48 to an interview. The test showed significant improvement in knowledge regarding T. solium taeniosis/cysticercosis, compared with the baseline knowledge level of the participants. Interview data found that the participants had used ‘The Vicious Worm’ as an educational tool and applied the knowledge from the program to implement new practices consisting of by-laws and practical workshops on building latrines, pig pens and hand washing stations in their communities. ConclusionIntroduction to ‘The Vicious Worm’ led to changed practices and persistence in knowledge regarding T. solium. Incorporating health education as a specific health intervention tool should be encouraged and implemented at national or programmatic level.

Understanding BIM’s impact on professional work practices using activity theory

Recent critiques of the BIM literature describe it as largely devoid of critical theoretical perspectives and theorization capable of explaining the nature of change in work practices in a holistic manner. In response, the authors argue that, from a theoretical standpoint, implementing BIM within professional work practices (as activity systems) induces their evolution through dysfunctions created within the systems and their resolution. Cases of professional organizations in South Africa that have implemented BIM within their organization and in multi-organizational projects helped to develop new theoretical insights into how professional work practices evolve using activity theory-based re-description of the data. Changes in professional work practices were analyzed sequentially within the framework, confirming theoretical propositions and revealing the dynamics between and within the interconnected system of actors, their object, tools, rules guiding work, roles they assume and the stakeholders. Essentially, the findings imply that the implementation of BIM significantly changes work practices within organizations, but gradually and over time. This supports an evolutionary, rather than a radical or revolutionary, view of BIM-induced change. This theoretical perspective could explain future dimensions of change in professional work practices involving BIM, and indeed similar work mediating tools.

Developing a learning health system: Insights from a qualitative process evaluation of a pharmacist-led electronic audit and feedback intervention to improve medication safety in primary care.

IntroductionDevelopments in information technology offer opportunities to enhance medication safety in primary care. We evaluated the implementation and adoption of a complex pharmacist-led intervention involving the use of an electronic audit and feedback surveillance dashboard to identify patients potentially at risk of hazardous prescribing or monitoring of medicines in general practices. The intervention aimed to create a rapid learning health system for medication safety in primary care. This study aimed to explore how the intervention was implemented, adopted and embedded into practice using a qualitative process evaluation.MethodsTwenty two participants were purposively recruited from eighteen out of forty-three general practices receiving the intervention as well as clinical commissioning group staff across Salford UK, which reflected the range of contexts in which the intervention was implemented. Interviews explored how pharmacists and GP staff implemented the intervention and how this affected care practice. Data analysis was thematic with emerging themes developed into coding frameworks based on Normalisation Process Theory (NPT).ResultsEngagement with the dashboard involved a process of sense-making in which pharmacists considered it added value to their work. The intervention helped to build respect, improve trust and develop relationships between pharmacists and GPs. Collaboration and communication between pharmacists and clinicians was primarily initiated by pharmacists and was important for establishing the intervention. The intervention operated as a rapid learning health system as it allowed for the evidence in the dashboard to be translated into changes in work practices and into transformations in care.ConclusionsOur study highlighted the importance of the combined use of information technology and the role of pharmacists working in general practice settings. Medicine optimisation activities in primary care may be enhanced by the implementation of a pharmacist-led electronic audit and feedback system. This intervention established a rapid learning health system that swiftly translated data from electronic health records into changes in practice to improve patient care. Using NPT provided valuable insights into the ways in which developing relationships, collaborations and communication between health professionals could lead to the implementation, adoption and sustainability of the intervention.

The policy discourses of patient autonomy in home care and the re-shaping of nurses’ professional work and identities

Introduction: Over the last decade, new health care policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. The aim was to explore how nurses in home care deal with the transformation to fostering patient autonomy. The research questions included: How do community nurses perceive the required changes in professional knowledge, skills and attitudes in promoting self-management of patients and their families? What challenges or dilemmas do they encounter and how do they cope with these? Answering these questions provides insight into the changes in professional work practices and professional identities and the ways practitioners cope with these changes, learn from and develop their own practices. Methods: A qualitative case study was conducted in community care Yin, 2013. The ‘case’ was a professional development project for community nurses, funded by ZonMW, aiming to increase nurses’ professional knowledge, skills and attitude to support autonomy of clients and their social system. Data were collected by the researcher as participant observer of the four meetings of one professional development group. Reflective notes of the observations were taken before, during and after learning circle meetings. A narrative analysis Riessman, 2008 was conducted on these data and three main themes constructed. Theory: The theoretical notion of ‘relational agency’ Edwards, 2010 and the moral concept of ‘practices of responsibility’ Walker, 2007 were used to conduct a narrative analysis on the nurses’ stories about patient autonomy. Findings: Three main themes expressed the moral demands experienced and negotiated by the nurses: adapting to the person; activating patients’ strengths; and collaboration with patients and informal caregivers. The overarching challenge the nurses face, is creating an equal partnership with clients and family members. Discussion: On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on health care budget savings. This is mirrored in the nurses’ ‘stories of ambiguity’: the turn towards autonomy in healthcare raises moral questions about responsibilities for care. Conclusion: Each of these tasks has troublesome elements and presents challenges and ethical dilemmas for the nurses, resulting in shifts in professional identity and practice. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together. Lessons learned: The ‘relational turn in expertise’ Edwards, 2010 requires long-term coaching of individual practitioners as well as teams, and a culture change in healthcare practice. Co-education of nurses, patients and informal caregivers is needed to achieve this goal of promoting patient autonomy. Limitations and suggestions for future research: additional in-depth interviews could have added to the insight into dilemmas and tensions in practice and in nurses’ coping strategies. More research is needed into the conversations and co-actions within patient-family-practitioner partnerships: the relational dynamics of making decisions, establishing connections and breaking them, negotiating responsibility and creating trust or mistrust.

Changes in Work Practices for Safe Use of Formaldehyde in a University-Based Anatomy Teaching and Research Facility.

Anatomy teaching and research relies on the use of formaldehyde (FA) as a preservation agent for human and animal tissues. Due to the recent classification of FA as a carcinogen, university hospitals are facing a challenge to (further) reduce exposure to FA. The aim of this study was to reduce exposure to FA in the anatomy teaching and research facility. Workers participated in the development of improved work practices, both technical and organizational solutions. Over a period of 6 years mitigating measures were introduced, including improvement of a down-flow ventilation system, introduction of local exhaust ventilation, collection of drain liquid from displayed specimens in closed containers and leak prevention. Furthermore, some organizational changes were made to reduce the number of FA peak exposures. Stationary and personal air sampling was performed in three different campaigns to assess the effect of these new work practices on inhalation exposure to FA. Samples were collected over 8 h (full shift) and 15 min (task-based) to support mitigation of exposure and improvement of work practices. Air was collected on an adsorbent coated with 2,4-dinitrophenylhydrazine (DNPH) and analyzed by HPLC-UV. Geometric mean (GM) concentrations of FA in the breathing zone over a work-shift were 123 µg/m3 in 2012 and 114 µg/m3 in 2014, exceeding the workplace standard of 150 µg/m3 (8 h time-weighted average, TWA) on 46% of the workdays in 2012 and 38% of the workdays in 2014. This exposure was reduced to an average of 28.8 µg/m3 in 2017 with an estimated probability of exceeding the OEL of 0.6%. Task-based measurements resulted in a mean peak exposures of 291 µg/m3 in 2012 (n = 19) and a mean of 272 µg/m3 in 2014 (n = 21), occasionally exceeding the standard of 500 µg/m3 (15 min TWA), and were reduced to a mean of 88.7 µg/m3 in 2017 (n = 12) with an estimated probability of exceeding the OEL of 1.6%.