Louise Stoll, Tim Swanwick, Julia Foster‐Turner and Fiona Moss
An innovative programme of “Darzi” Fellowships in Clinical Leadership provides doctors in postgraduate training with a unique opportunity to engage in improving systems of health…
Abstract
Purpose
An innovative programme of “Darzi” Fellowships in Clinical Leadership provides doctors in postgraduate training with a unique opportunity to engage in improving systems of health care and develop their capability as future clinical leaders. The purpose of this paper is to report an impact evaluation of the programme, highlighting transferable design principles.
Design/methodology/approach
Qualitative and quantitative data were used iteratively and included a review of literature, analysis of background documents and internal evaluation results, face‐to‐face and telephone interviews, observation of educational events, online questionnaires and representative case studies.
Findings
Impact was found at the level of the fellows' learning, their organisations and the wider health system. Identified influencing factors included: clarity of purpose and aims, mutuality of workplace and external learning, learning for transformational change, ambitious but “do‐able” projects, a committed and learning‐oriented sponsor, a supportive organisational culture, high‐quality mentoring, a network of supportive peers, diversity of participants, ongoing monitoring and adaptation, planning for sustainability and the tracking of impact over time.
Research limitations/implications
The extent to which results are generalisable needs to be considered within the constraints of this programme evaluation.
Practical implications
The “Darzi” Fellowship programme is effective and impactful, spawning clinical leadership development throughout a wider system. Whole system engagement of trainee doctors in leadership will require more than a Fellowship programme alone, but it is a start.
Originality/value
The evaluation adds to what we know about leadership development generally and provides a rare study in the medical context generating helpful principles for the design of leadership development programmes, particularly in the clinical setting.
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Rachael Elizabeth Sanders, Corina Modderman, Stacey Bracksley-O'Grady, Fiona Harley, Jacquelin Spencer and Jacinta Molloy
There is a growing recognition of the urgency to enhance health outcomes for children and young people residing in out-of-home care (OOHC). Research underscores the need to…
Abstract
Purpose
There is a growing recognition of the urgency to enhance health outcomes for children and young people residing in out-of-home care (OOHC). Research underscores the need to establish effective pathways to quality health care for children and young people who have been exposed to trauma. Child protection (CP) practitioners should play a vital role in proactively improving health outcomes and navigating the intricacies of healthcare systems. Their involvement in initiating and collaborating on healthcare interventions is pivotal for the well-being of these vulnerable children and young people. However, challenges associated with poor health literacy and the complexities of healthcare systems hinder collaborative service delivery in the Australian context. This review explores how CP practitioners support the health care of children and young people in their care.
Design/methodology/approach
A scoping review followed Arksey and O’Malley’s framework, employing a narrative synthesis to assess the selected studies.
Findings
Health outcomes for children and young people in OOHC remain under-researched and potentially under-resourced within the realm of CP practice. There is room for enhanced practices and system integration in CP service delivery to better address health needs and prevent further health and well-being disparities.
Originality/value
Through this scoping review and involving industry experts in the discussion of findings, this study contributes valuable insights to the existing knowledge base regarding the active participation of CP practitioners in addressing the healthcare needs of vulnerable children.
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Corina Modderman, Rachael Elizabeth Sanders, Fiona Harley, Renée Ficarra and Cheree Jukes
There is a growing recognition that the integration of health systems will benefit children in out-of-home care (OOHC), especially those who have experienced trauma. This paper…
Abstract
Purpose
There is a growing recognition that the integration of health systems will benefit children in out-of-home care (OOHC), especially those who have experienced trauma. This paper examines the adaptation of existing health systems and the persistent barriers between rural health and child protection programs. It focuses on health systems integration for children aged 0–6 years in kinship care and their siblings.
Design/methodology/approach
The study applied a multi-methods qualitative approach involving individual interviews and focus groups with project members from operational or strategic reference groups, child protection personnel and the kinship carer program. We also reviewed documentary evidence.
Findings
We found evidence that health clinicians and child protection practitioners adapted and adjusted services as they collaboratively worked together to improve care delivery to children in kinship care. Yet, despite successful adaptations to systems and the appointment of a health navigator, systemic barriers remain. These include service and staff shortages in rural Australia, complications around information sharing, authority and power dynamics and siloed operations. Such barriers prevent better-integrated health systems and ultimately impair health outcomes for children in kinship care.
Originality/value
This paper contributes to knowledge and practice to improve the integration of child protection and healthcare services in Australian OOHC. It provides valuable insights into the challenges and successes of health systems integration, highlighting the need for continued collaborative effort to create effective, place-based models of care that benefit these children and their carers.
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Kelly Page‐Thomas, Gloria Moss, David Chelly and Song Yabin
The purpose of this study is to investigate Western and Central European consumers and web retailers with respect to the importance and accessibility of delivery information…
Abstract
Purpose
The purpose of this study is to investigate Western and Central European consumers and web retailers with respect to the importance and accessibility of delivery information online prior to purchase.
Design/methodology/approach
To investigate the importance and accessibility of delivery information online, a survey was conducted of 715 internet consumers from the UK, Hungary and the Czech Republic to explore how important they rate online delivery information. In addition to this, retailing web sites from leading retailers in the UK, Hungary and the Czech Republic were content analysed in order to establish the extent to which they provided online delivery information.
Findings
The research identifies that consumers rate delivery pricing guides, delivery guarantees and delivery schedules as the most important delivery information they expect online prior to purchase. However, content analysis of retailer web sites reveals that many retailers do not adequately provide information about how they “guarantee product delivery”.
Practical implications
It is recommended here that prior to purchase online retailers should make detailed delivery information more accessible to consumers (e.g. pricing guides, timing schedules, etc.) and should consider using delivery service guarantees to assure consumers of delivery service standards and retailer responsibilities.
Originality/value
This paper makes a decisive contribution to e‐shopping behaviour and online retailing by providing insight into why visits to retailing web sites may not be followed up by purchase. This insight results from an examination of an often neglected area of the online buying process, namely “order delivery and fulfilment”. By examining the expectations of e‐consumers across Europe it investigates the role access to delivery information can have in managing customer delivery service expectations and in building trust in online retailers.
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Alison Bullock, Fiona Fox, Rebecca Barnes, Natasha Doran, Wendy Hardyman, Duncan Moss and Mark Stacey
The purpose of this paper is to describe experiences of transition from medical school to new doctor in the UK and to examine the development and evaluation of initiatives…
Abstract
Purpose
The purpose of this paper is to describe experiences of transition from medical school to new doctor in the UK and to examine the development and evaluation of initiatives designed to lessen anxiety and assist transition.
Design/methodology/approach
The evaluations of two recent interventions for new doctors are reported, one at organisational and one at the individual level: first, a longer induction programme; and second, provision of a library of medical textbooks on smartphones (the “iDoc” project). The paper also reports on mindfulness training designed to help trainees' well‐being.
Findings
These initiatives address different aspects of transition challenges (related to roles and responsibilities, cognitive and environmental factors). Benefit can be gained from multiple approaches to supporting this time of uncertainty.
Practical implications
Given the link between transition, doctor stress and patient safety, there is a need to review existing strategies to ameliorate the stress associated with transition and seek novel ways to support new doctors. The authors argue that diverse approaches, targeted at both the organisational and individual level, can support new trainees, both practically and emotionally.
Originality/value
The paper reports initiatives that support transition, of value to medical schools, deaneries, researchers and trainees themselves.
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Mobilization by diaspora activists against illiberalism in their country of origin and by immigrants for equality in their country of settlement has received widespread attention…
Abstract
Mobilization by diaspora activists against illiberalism in their country of origin and by immigrants for equality in their country of settlement has received widespread attention in political science and sociology, respectively. However, because extant studies treat these mobilizations as distinct types, little is known about the relationship between diaspora and immigrant mobilization. This chapter addresses this theoretical gap using 167 interviews with Syrian and Yemeni activists in the United States and Britain. The findings demonstrate how Syrian and Yemeni diaspora mobilization in support of the 2011 Arab Spring revolutions facilitated their visibility and voice as immigrants. Syrians built an organizational field with the capacity to contest host-country discrimination and local extremism; Yemenis instituted protests and brokerage that shaped the context of reception for home-country elites and challenged intragroup inequality. At the same time, economic disparities between national groups shaped their capacities to diversify tactics and sustain efforts over time. My chief claim is that diaspora mobilization facilitates immigrant voice and visibility but is mitigated in important ways by group-wise resources. The chapter concludes by emphasizing the importance of voice and visibility among marginalized groups subjected to intersecting repressions.
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David Cashman, Wesley O’Brien and Fiona Chambers
This study aims to capture children’s interpretation of holistic well-being within Irish primary schools and add to the development of a comprehensive systems-informed positive…
Abstract
Purpose
This study aims to capture children’s interpretation of holistic well-being within Irish primary schools and add to the development of a comprehensive systems-informed positive education model.
Design/methodology/approach
This study utilized visual participatory research methods, including PhotoVoice and one-on-one interviews, to assess children’s (n = 16) well-being, guided by Von Unger’s comprehensive seven-step framework. Data analysis was anchored within grounded theory, beginning with data collection, initial coding, focused coding and culminating in identifying themes and subthemes. Data were interpreted using the mosaic approach by integrating visual and verbal data.
Findings
This analysis uncovered three primary themes that affect student well-being: relationships, space and physical environment and learning and curriculum, each with detailed subthemes. For instance, student–teacher relationships, peer relationships, safety, learning spaces, the creative curriculum including arts and music and the experiential richness of outdoor learning are crucial to students' educational growth and well-being. These aspects are seen as interconnected, shaping a holistic educational experience beyond academic learning to encompass students’ comprehensive well-being. The students' narratives demonstrated that learning is not merely an academic exercise but a vital component of their well-being.
Originality/value
This study significantly departs from traditional educational research by advocating for a dynamic, action-oriented understanding of “well-being.” It challenges the static, possessive interpretations of well-being and introduces the concept of well-being as a fluid and ever-evolving process. This reconceptualization positions well-being as a complex construct, influenced by an intricate web of relationships, spanning human and non-human interactions, organizational and environmental structures, personal desires, behavioral practices and broader societal and cultural frameworks.
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Building on relational inequality theory, this paper incorporates social capital as a device to trace the flow of resources through relationships originating within and beyond…
Abstract
Building on relational inequality theory, this paper incorporates social capital as a device to trace the flow of resources through relationships originating within and beyond organizations. I draw on a survey of over 1,700 lawyers to evaluate key dynamics of social capital that shape earnings: bridging and bonding, reciprocity exchanges and sponsorship, and boundary maintenance. The findings show social capital lends a lift to law graduates through bridges to professional careers and sponsorship following job entry. Racial minorities, however, suffer a shortfall of personal networks to facilitate job searches, and once having secured jobs, minorities experience social closure practices by clients and colleagues that disadvantage them in their professional work. A sizeable earnings gap remains between racial minority and white lawyers after controlling for human and social capitals, social closure practices, and organizational context. This earnings gap is particularly large among racial minorities with more years of experience and those working in large law firms. The findings demonstrate the importance of identifying the interrelations that connect social network and organizational context to impact social inequality.