Search results

The purpose of this paper is to present findings from two studies exploring the Health of the Nation Outcome Scale’s (HoNOS) utility within a new payment by results (PbR) system for mental health services in England.

In the first study principal axis factoring extraction was used to explore a sample of 23,641 HoNOS ratings. In a second study confirmatory factor analysis was used to evaluate four subscale structures on a new sample of 34,716 HoNOS ratings.

No HoNOS factor structure evaluated in this study demonstrated adequate fit statistics across several clinical presentations. A new four-factor model was the only structure to achieve fit statistics across all clinical populations, but can only be championed on a “best fit” basis as opposed to “good fit” at the present time.

Data used in the current studies relate to six NHS mental health service providers. Replication using a national sample is recommended. Exploration of different HoNOS factor structures for different mental health clusters within the PbR system in England is also recommended. However, it is also possible that removing redundant or adding new items may result in a more stable HoNOS generic factor structure.

This is the first HoNOS evaluation as a generic outcome measure for use within a PbR system and provides important insights into its mental health utility and limitations. The findings have significant implications for those developing the national PbR quality and outcomes framework for England’s mental health services. However, there are also implications for all nations in which HoNOS is used to report mental health outcomes.

December 14, 1966 Negligence — Contractor — Faulty equipment supplied by sub‐contractor — Standards for guard rails ordered from reputable sub‐contractors — Sub‐contractors supplied by well known manufacturers — Defective standards supplied — Use of guard rail by building owners' employees for purpose for which not intended — Collapse of guard rail because of defective standard — Injury causing death to independent contractor — Defect in standards not apparent on visual inspection — Whether duty to inspect — Liability of building owners — Liability of contractors and sub‐contractors — Applicability of Building (Safety, Health & Welfare) Regulations, 1948 (S.I. 1948 No. 1145).

Justice research has established that voice enhances procedural justice—a phenomenon known as the ‘voice effect’—through both instrumental and non‐instrumental mechanisms. However, limited research attention has been devoted to the underlying motivational bases for the operation of one or the other explanatory mechanism in a given situation. We report the findings of two laboratory studies examining situational, motivational, and attributional underpinnings for the voice effect. We found that motivation to voice varied with characteristics of the authority to whom a grievance is directed. In both studies, an interaction revealed that non‐instrumental motivation for voice is more important when instrumental motivation is lacking or unavailable. In Study 2, we introduce the role of social attributions into research on the voice effect, finding that grievants' judgments about their objectives in using voice vary with the attributions they make about the motives behind the authority's actions. We discuss implications of our findings for both theory and practice.

In recent years, in research and policy circles, there is growing interest in the subject of speaking up (and silence) within the health sector, and there is a consensus that it is a major issue that needs to be addressed. However, there remain gaps in our knowledge and while scholars talk of a voice system – that is the existence of complementary voice channels designed to allow employees to speak up – empirical evidence is limited. We seek to explore the notion of a voice system in a healthcare organisation as comprising structures and cultures as seen from different stakeholder perspectives. What do they see and how do they behave and why? To what extent do the users see a voice system they can access and easily navigate?

Interviews and focus groups were conducted with a voice stakeholder group (e.g. designers of the system from senior management and HR, which comprised 23 staff members) as well as those who have to use the system, with 13 managers and 26 employees from three units within a metropolitan hospital: an oncology department, an intensive care unit and a community health service. Overall, a total of 62 staff members participated and the data were analysed using grounded theory to identify key themes.

This study revealed that although a plethora of formal voice structures existed, these were not always visible or accessible to staff, leading to confusion as to who to speak up to about which issues. Equally other avenues which were not designated voice platforms were used by employees to get their voices heard.

This papers looks at the voice system across the organisation rather than examining a specific scheme. In doing so it enables us to see the lived perceptions and experiences of potential users of these schemes and their awareness of the system as a whole.

The author argues that we must stop and take a look at what our insistence on human labour as the basis of our society is doing to us, and begin to search for possible alternatives. We need the vision and the courage to aim for the highest level of technology attainable for the widest possible use in both industry and services. We need financial arrangements that will encourage people to invent themselves out of work. Our goal, the article argues, must be the reduction of human labour to the greatest extent possible, to free people for more enjoyable, creative, human activities.

We aim to advance our understanding by examining voices related to employees’ own interests and associated outcomes for employees and healthcare organizations. Patient safety reviews do not explore contextual factors such as organizational or professional cultures and regulatory environments in depth, and arguments for overcoming barriers to voice in health are underdeveloped. The research has largely developed in separate literature (various subdisciplines of management and the health field), and we outline the divergent emphases and opportunities for integration with the aim of investigating all relevant contextual factors and providing guidance on best practice informed by multiple disciplines.

A systematic approach was taken to gathering and reviewing articles, and coding and reporting are in line with the most recent Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (Rethlefsen et al., 2021).

We identified a range of facilitators, barriers and outcomes of employee interest voice at different levels (organizational, leadership, team or individual) in a healthcare context. We identify various theoretical, methodological and knowledge gaps, and we suggest several ways in which these can be addressed in future research efforts.

We make multiple contributions to both theory and practice, including highlighting the importance and implications of integrating disciplinary approaches, broadening context, improving research design and exploring under-researched samples and topics. This information is essential in providing a more comprehensive model of healthcare voice and to shifting management focus to include all forms of employee voice in healthcare for the benefit of staff and patients.

We make multiple contributions to both theory and practice including highlighting the importance of integrating disciplinary approaches, broadening context to include employee interest issues, improving research design and exploring under-researched samples and topics. This information is essential in providing a more comprehensive model of health care voice and to shifting management focus to take a more inclusive view of employee voice in healthcare for the benefit of staff as well as patients.

What does it mean to be a “smart” negotiator? Few scholars have paid much attention to this question, a puzzling omission given copious research suggesting that cognitive ability (the type of intelligence commonly measured by psychometric tests) predicts individual performance in many related contexts. In addition to cognitive ability, other definitions of intelligence (e.g., emotional intelligence) have been proposed that theoretically could influence negotiation outcomes. Aiming to stimulate renewed attention to the role of intelligence in negotiation, we develop theoretical propositions linking multiple forms of intelligence to information acquisition, decision making, and tactical choices in bargaining contexts. We outline measurement issues relevant to empirical work on this topic, and discuss implications for negotiation teaching and practice.

Leadership development goal statements of 92 undergraduate students enrolled in a multi-year self-directed leadership development program were analyzed using content and thematic analyses to investigate patterns of similarities and differences across gender and race. This qualitative analysis utilized a theoretical framework that approached leadership typed traits, skills, or behaviors (Northouse, 2009). Significant differences emerged by gender; women were more interested in developing leadership-oriented traits while men displayed more interest in developing specific skills. No differences emerged across racial groups.