Wider Organizational Issues Research Articles

The Risk Reference Panel: a thematic analysis of a multidisciplinary forum for complex cases.

Aims and methodTo describe the functions of the Aneurin Bevan University Health Board Risk Reference Panel and characterise the typical referrals presented and outcomes from the panel. A structured thematic analysis was performed on verbatim transcripts of 48 panel sessions. RESULTS: The 79 codes identified were grouped into 16 subthemes. Four principal themes were identified: two characterising cases brought to the panel (childhood risk factors and current presenting difficulties) and two describing advice given (risk management and wider organisational issues). Quotations are given to illustrate cases presented and advice given by the panel.Clinical implicationsThe panel provides a valuable source of special expertise in the management of complex and exceptional cases where risk of harm is significant and clinical teams have ongoing concerns. This paper describes a model of peer-working to support staff and may further reduce the risk of harm associated with mental illness.Declaration of interestNone.

Implementation of a Community-Based Approach to Dementia Care in England: Understanding the Experiences of Staff

ABSTRACTGiven the increasing numbers of people living with dementia, it is imperative that new, practical solutions are found to the issues faced by this group of people and their families. This article draws on findings from a qualitative study that explored the implementation of a community-based project to support people living with dementia in one local area in England. This approach has different names; in the United Kingdom it is Shared Lives or adult placement, which would be most comparable to family care in Europe and adult foster care in the United States. Interviews were conducted with 14 staff connected to the Shared Lives project. Interview data were coded using the normalization process theory constructs of coherence, cognitive participation, and collective action. Supportive program factors identified were a dedicated staff member and resources, and the availability of specialist knowledge and skills. Detriments to program success included lack of understanding about the service, perceptions it was a poor fit with existing practice, and wider organizational issues that negatively affected normalization of the intervention. Suggestions for future research go beyond staff opinions, stressing the importance of using a wider range of stakeholders and incorporating measurement of outcomes for people using the service.

Interprofessional collaboration in palliative nursing: what is the patient-family role?

Interprofessional collaboration occurs when health professionals from different disciplines work together to identify needs, solve problems, make joint decisions on how best to proceed, and evaluate outcomes collectively. Interprofessional collaboration supports patient-centred care and takes place through teamwork. Team interactions, wider organizational issues, and environmental structures, such as safety, quality, efficiency and effectiveness issues influence this model of care. These broader contextual influences affect practice where there are tensions between the ideals of interprofessional collaboration and the realities of practice. This is evident when the patient and family position in interprofessional collaboration is considered. This article will discuss factors that affect interprofessional collaboration in relation to patients and families in palliative care. First, a definition of interprofessional collaboration is given, followed by an outline of the need for interprofessional collaboration. A brief discussion of key issues that influence collaboration follows, and a review of the implications for practice is presented.

Knowledge management within information security: the case of Barings Bank

Managing the growing problem of computer fraud within organisations has led researchers and practitioners to emphasise the need to take into account the 'social' aspects of information security. In addition, wider organisational issues such as lack of communication have been associated with computer fraud. In trying to minimise 'opportunities' for computer fraud, this paper argues that managers' awareness and knowledge of how an organisation functions can significantly affect the effectiveness of management information security. This is because managers can send 'cues' to other employees, which influence how the latter perceive and abide by information security and other policies and procedures in their daily activities. Such perception and application are examples of tacit knowledge development and use. In developing the argument, this paper uses the case of Barings Bank together with Mintzberg's five functions of an organisation. Thus it contributes in effective management of information security from a knowledge management perspective.

Product sustainability: organisational considerations

Most eco-design research has focused on design strategies, methodologies and tools. However, to ensure that eco-design is successfully implemented, companies require strategic, tactical and operational organisational structures and systems to be considered. This article discusses a range of organisational issues in the development and implementation of eco-design and a broader approach to sustainable product development (product sustainability). The article draws together a range of desk research, observation and unstructured conversations with eco-design practitioners and experts, as well as my own concurrent experience as global chair of a group of international experts that wrote and produced the Eco-design Standard ISO14006: 2011 (published globally in July 2011). The article demonstrates to the wider product development community that eco-design is not just an operational design issue at the level of product design and engineering, and highlights this by illustrating through practical examples the wider organisational issues in developing, managing and implementing eco-design and broader product sustainability. On the basis of this research I led the planning, structuring and writing of the article. My co-author contributed specific research elements, expert comments and made editorial suggestions.

Are UK healthy?

Research by Gillian Wright suggests that effective knowledge sharing in public services is shaped by wider organisational issues beyond the sharer-receiver unit.

Are UK healthy?: knowledge sharing

Research by Gillian Wright suggests that effective knowledge sharing in public services is shaped by wider organisational issues beyond the sharer-receiver unit. This paper was presented at the 8th International Research Conference on Quality, Innovation and Knowledge Management, New Delhi, 1114 February 2007. Copyright 2007 Gillian Wright. No part of this article may be reproduced by any means without the written consent of the publisher.

Implementing a new health management information system in Uganda.

This paper reports on research investigating the health management information system (HMIS) implementation process in Uganda, utilizing the diffusion of innovation and dynamic equilibrium organizational change models. Neither perspective guided the HMIS development process. Instead, technological issues, rather than wider organizational issues, dominated the planned change. The need to consider the organizational context when changing information systems arises because the process is more complex than some practitioners have realized, when attempting to understand the causes of information management problems and developing HMIS in low-income countries. In particular, information system developers had not acknowledged that they were promoting an informational approach to management when they promoted a change from a centralized reporting system to a HMIS supporting use of information at the level of collection. Strategies to facilitate this approach were not advocated. Organizational theory can contribute to the diffusion of innovation framework. It has yielded an integration of Rogers's diffusion of innovation framework and Leavitt's concept of organizational forces in equilibrium. The diffusion framework describes the process, but the organizational model has given the context and reason for aspects of the process. The diffusion model does not predict what needs to change within the organization when a particular innovation is introduced, or how much. The addition of the organizational model has helped. These frameworks can facilitate the introduction of future information management innovations and allow practitioners to perceive their introduction as a staged process needing to be managed. Implications for practice are identified.

Creating healthy workplaces in Northern Ireland: evaluation of a lifestyle and physical activity assessment programme.

An observational study was carried out on 2595 Northern Ireland civil servants who attended a workplace lifestyle and physical activity assessment programme involving self-reported lifestyle history, measurement of physiological parameters and a 6 month follow-up postal questionnaire survey. Almost two-thirds of participants did not engage in regular moderate physical activity, with females twice as likely not to than men. Approximately one in six participants were smokers and three-quarters were found to have body fat estimations above the acceptable level, with females much more likely to be obese than men. Aerobic capacity was below average in 17% of participants and was associated with increasing age, smoking in the under 35s and poor physical activity levels. Excessive alcohol intake was found in 8% of all participants, and was more likely in men and smokers. In the follow-up survey, 83% needed to make one or more changes to their lifestyle. Smoking was the most difficult to change, with only 14% remaining abstinent after 6 months. Almost two-thirds were maintaining improved dietary habits and exercise activity, with around one-half moderating alcohol intake and achieving weight reduction. Overall, the average level of non-attempted behaviour change was one in five (19.6%), tried but failed accounted for almost one in three (31.2%) and successful maintenance of positive lifestyle change occurred in one-half (49.2%). Brief lifestyle and physical activity assessment programmes are effective interventions in getting employees to modify their lifestyles. The impact this has on wider organizational issues such as absenteeism and productivity needs further evaluation.

Holistic total quality management must take account of political processes

This paper outlines a holistic version of total quality management (TQM). It discusses TQM's progress to date in terms of some wider organizational issues, which in practice make holistic forms of TQM difficult to achieve. A need to recognize organizational political realities is stressed as fundamental to TQM's success.

Better by Design: Auditing the Computer Workstation – Part Two

In many organisations information systems are difficult to use and so underutilised that managers lose substantial productivity gains. Major problems stem from design processes based on an engineering paradigm; these are critically assessed. How to build the software interface through user profiling, clearing a user migration path and designing suitable methods of dialogue are then discussed. Four fundamental design principles are advanced; the design considerations for workstations and their immediate environments are detailed. Implementation of the important but neglected proposals elucidated here would help towards achieving systems usability – productive, safe preferred use in practice. However, wider organisational issues, for example, personnel policies, work hours, politics, also impact on usability. These also must be considered by management in the process of achieving effective workstation design.