The purpose of this article is to compare the American and British approaches to public diplomacy and the impact that has on the role of business.
Abstract
Purpose
The purpose of this article is to compare the American and British approaches to public diplomacy and the impact that has on the role of business.
Design/methodology/approach
Since the terrorist attacks in the US on September 11, 2001, both the UK and US governments have been examining their public diplomacy activities with a view to a more effective use of their resources as well as the involvement of other parties. Given the strength of the economic relationship between these two countries, it is instructive to compare their resulting definitions of public diplomacy to attitudes found in the transatlantic business community. To that end, their current definitions of public diplomacy will be examined in light of data gathered from business survey of transatlantic companies conducted by UK Trade and Investment and BritishAmerican Business Inc. as well as views from those working in public diplomacy.
Findings
The US has increasingly taken a view of public diplomacy that conflates its political diplomatic agenda concerned with national interest and security with its general outreach in terms of information and dialogue. This makes it more difficult for business to effectively support broader public diplomacy objectives.
Originality/value
This paper provides a different view of US public diplomacy activities that may be a useful guide in revising their approach so as to make it more similar to the UK version which values more of a separation between political and public diplomacy.
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Fiona J. Cooke, Bryony Dean Franklin, Wendy Lawson, Ann Jacklin and Alison Holmes
Antibiotic resistance presents a major public health challenge at local, national and international levels. At a local level, the challenge is to tackle the antibiotic stewardship…
Abstract
Antibiotic resistance presents a major public health challenge at local, national and international levels. At a local level, the challenge is to tackle the antibiotic stewardship agenda, within the clinical governance framework, across all professional groups and specialities. This paper presents the response to this challenge in a large multi‐site NHS trust. The approach focuses around a multi‐disciplinary antibiotic steering group, in which a dedicated infectious diseases pharmacist plays a key role. Proposes seven key elements for a successful antibiotic stewardship programme and discuss examples of local action. These elements are: strong leadership; dedicated individuals with responsibility for leading on antibiotic use; integration into pre‐existing trust structures; harnessing existing resources to deliver change; obtaining local data on prescribing patterns and resistance; communication; and education and training. All pillars of clinical governance are supported by the multi‐disciplinary approach described.
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Samantha Hogg, Nicola Baird, Judith Richards, Sean Hughes, John Nolan, Adrian Jones and Alison Holmes
To describe orthopaedic surgical site infection (SSI) surveillance models at two English pilot sites, and to review their effectiveness and integration into clinical governance.
Abstract
Purpose
To 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/approach
The different organisational models for orthopaedic SSI at two Trusts were examined and assessed.
Findings
Both 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 implications
Infection 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/value
SSI 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.
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Rachel Gibson, Aleksandra Novakovic, Katie Francis, Kathryn McGilloway, Antony Adkin and Saka Odekunle
This service evaluation study aimed to demonstrate the impact of implementing ward‐based multidisciplinary therapy input on an acute psychiatric ward in a London hospital for a…
Abstract
This service evaluation study aimed to demonstrate the impact of implementing ward‐based multidisciplinary therapy input on an acute psychiatric ward in a London hospital for a six‐month period. The results indicated a high level of patient engagement with the project and referrals facilitated for patients following discharge. A reduction of incidents on the ward was reported over the project period compared to the previous year and there was less use of containment measures by staff by the end of the project. Recommendations are made for service improvement.
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Alison C.T. Calnan and Marilyn J. Davidson
The use of tag questions in speech has been hypothesised to make speech sound uncertain and tentative although Holmes (1984) suggests that there are three different types of tag…
Abstract
The use of tag questions in speech has been hypothesised to make speech sound uncertain and tentative although Holmes (1984) suggests that there are three different types of tag questions and only one type is linked to uncertainty. Research on the issue of gender differences in tag question usage has produced confusing findings with some research indicating women use more tag questions, other research revealing men use more and some research finding no difference. The research on tag question use has identified role and power as important factors not just gender. The effects of the presence of the opposite sex on speech is a controversial area of study. Past research suggests that the use of tag questions is affected by whether the conversation is between members of the same sex or members of both sexes. The current study aimed to clarify the controversy of whether men or women use more tag questions, any possible effects of group composition and sought to extend research on the relationship of tag question use to role (chairperson or not) and power (highest status or not). The study was conducted at a power station in England. Ten business meetings which were all male, all female or mixed were tape recorded. From these tape recordings the tag questions were identified, transcribed and classified as modal, affective facilitative or affective softener according to the classification provided by Holmes (1984).
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This paper aims to explore the gendered narratives of change management at Marks and Spencer (M&S) and uses them as a lens to consider the gendered nature of the change process…
Abstract
Purpose
This paper aims to explore the gendered narratives of change management at Marks and Spencer (M&S) and uses them as a lens to consider the gendered nature of the change process itself.
Design/methodology/approach
Two extant stories: Sleeping Beauty and the Trojan War are taken, along with the cultural archetype of the American West gunslinger to explore the gender aspects of change. The Marks and Spencer case is analysed using the corollary patriarchal narrative of Sleeping Beauty, a story whose organising logic is revealed as one of concern for patriarchal lineage, and legitimate succession. The paper, draws on the Marks and Spencer principals' memoirs and biographies.
Findings
Sleeping Beauty is shown as a narrative saturated in misogyny, aggression and violence. This violence, which is shown to characterise the Marks and Spencer case, is amplified in the second narrative, the Trojan War, in the highly personalised battles of the über‐warriors of The Iliad. The paper concludes that violent, hyper‐masculine behaviour creates and maintains a destructive cycle of leadership lionisation and failure at the company which precludes a more feminine and possibly more effective construction of change management.
Originality/value
Demonstrates how M&S, gendered from its birth, its development through the golden years, the crisis, its changes in leadership and its recent change management has attempted to respond to its changing environment.
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This chapter assessed internal and external environmental factors that affect variations in rural hospital profitability with a focus on the impact of the Patient Protection and…
Abstract
This chapter assessed internal and external environmental factors that affect variations in rural hospital profitability with a focus on the impact of the Patient Protection and Affordable Care Act regulations that resulted in the expansion of Medicaid eligibility, as well as four Medicare programs that target rural hospitals. A cross section of 2,114 rural US hospitals operating during 2015 was used. The primary source of data was Medicare Hospital Cost Reports. Ordinary least squares regression with correction for serial correlation, using total margin and operating margin as dependent variables, was employed to ascertain the association between profitability and its correlates.
The mean values for operating margin and total margin were −0.0652 and 0.0259, respectively. Hospital profitability was positively associated with location in a Medicaid expansion state, classification by Medicare as a Critical Access Hospital or Rural Referral Center (total margin only), hospital size, system membership, and occupancy rate. Profitability was negatively associated with average length of stay, government ownership, Medicare and Medicaid share of admissions, teaching status, and unemployment rate.
This chapter found that the Medicaid expansions provided modest help for the financial condition of rural hospitals. However, the estimates for the four targeted Medicare Programs (i.e., Critical Access Hospital, Medicare Dependent, Sole Community Critical Access Hospital, and Rural Referral Center) were either small or not significant (p > 0.10). Therefore, these specially targeted federal programs may have failed to achieve their goals of preserving the financial viability of rural hospitals. This chapter concludes with implications for practice.