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One of the major issues faced by academic health science centers (AHSCs) is the need for mechanisms to foster the integration of research, clinical, and educational activities to achieve the vision of evidence-informed decision making (EIDM) and optimal client care. The paper aims to discuss this issue.

This paper synthesizes literature on organizational learning and collaboration, evidence-informed organizational decision making, and learning-based organizations to derive insights concerning the nature of effective workplace learning in AHSCs.

An evidence-informed model of collaborative workplace learning is proposed to aid the alignment of research, clinical, and educational functions in AHSCs. The model articulates relationships among AHSC academic functions and sub-functions, cross-functional activities, and collaborative learning processes, emphasizing the importance of cross-functional activities in enhancing collaborative learning processes and optimizing EIDM and client care. Cross-functional activities involving clinicians, researchers, and educators are hypothesized to be a primary vehicle for integration, supported by a learning-oriented workplace culture. These activities are distinct from interprofessional teams, which are clinical in nature. Four collaborative learning processes are specified that are enhanced in cross-functional activities or teamwork: co-constructing meaning, co-learning, co-producing knowledge, and co-using knowledge.

The model provides an aspirational vision and insight into the importance of cross-functional activities in enhancing workplace learning. The paper discusses the conceptual and empirical basis to the model, its contributions and limitations, and implications for AHSCs.

The model’s potential utility for health care is discussed, with implications for organizational culture and the promotion of cross-functional activities.

The purpose of this paper is to describe how an Academic Health Science Centre, providing pediatric rehabilitation services, research, and education, developed a Centres for Leadership (CfL) initiative to integrate its academic functions and embrace the goal of being a learning organization.

Historical documents, tracked output information, and staff members’ insights were used to describe the ten-year evolution of the initiative, its benefits, and transformational learnings for the organization.

The evolutions concerned development of a series of CfLs, and changes over time in leadership and management structure, as well as in operations and targeted activities. Benefits included enhanced clinician engagement in research, practice-based research, and impacts on clinical practice. Transformational learnings concerned the importance of supporting stakeholder engagement, fostering a spirit of inquiry, and fostering leaderful practice. These learnings contributed to three related emergent outcomes reflecting “way stations” on the journey to enhanced evidence-informed decision making and clinical excellence: enhancements in authentic partnerships, greater innovation capacity, and greater understanding and actualization of leadership values.

Practical information is provided for other organizations interested in understanding how this initiative evolved, its tangible value, and its wider benefits for organizational collaboration, innovation, and leadership values. Challenges encountered and main messages for other organizations are also considered.

A strategy map is used to present the structures, processes, and outcomes arising from the initiative, with the goal of informing the operations of other organizations desiring to be learning organizations.

This paper aims to combine and compare the experiences of appreciative inquiry (AI) using AI methods for data creation, collection and analysis to describe a set of “rules of thumb” for the occasions when AI can add value in managing operational and cultural changes in healthcare organisations.

The team that began to introduce AI to King's College Hospital met twice, each time using AI methods to collect and process narrative of their experiences of AI in their work. The eight members recalled as many of the AI‐related experiences and applications in their professional lives as possible, big and small. The data were collected as key points and quotable quotes, and shared for reflection, and a second time to identify and record common features of success and those aspects which seemed to be responsible for that success.

The paper identified ten groups of applications where AI offered solutions superior to others used, or where the currently applied methodology reached an impasse that was resolved by AI. It proposes that these applications are added to the growing list of uses of AI in change management and managing organisational behaviour.

While there are many published descriptions of successful use of AI in organisational development projects, the paper is unable to identify a compendium of practical descriptions of the use of AI. The paper is therefore valuable for anyone in a management or change‐management role with interest and some experience in AI in deciding how to use this methodology from day to day.

The purpose of this paper is to examine the barriers and facilitators to health and social service access and utilization for immigrant parents raising a child with a physical disability, in order to understand their specific needs and experiences of care.

The research involves qualitative interviews with five immigrant parents of four children with a physical disability in two cities in Ontario, Canada.

The findings indicate that divergent perceptions of health care and disability, language, knowledge of service systems, and finances may create obstacles to family-centered and culturally sensitive care. Formal supports, including a third person to navigate the system and services provided in families’ homes, are facilitators that enhance the service care experiences of parents.

Service providers need to accommodate and work with immigrant parents who have a child with a disability to overcome the barriers to their care. To enhance service experiences formal support and home services should be provided when possible.

There is little research on immigrant families’ experiences with pediatric rehabilitation services and this study contributes to this area. This paper shows that immigrant families of children with disabilities have barriers to service access, utilization, and service care experiences that are similar to those of non-immigrant families. There are few studies on facilitators to service access and utilization and positive experiences; therefore, this study makes a contribution to this area.

The purpose of this paper is to explore factors affecting implementing the National Institute for Health and Care Excellence (NICE) quality standard on alcohol misuse (QS11) and barriers and facilitators to its implementation.

Qualitative interview study analysed using directed and conventional content analyses. Participants were 38 individuals with experience of commissioning, delivering or using alcohol healthcare services in Southwark, Lambeth and Lewisham.

QS11 implementation ranged from no implementation to full implementation across the 13 statements. Implementation quality was also reported to vary widely across different settings. The analyses also uncovered numerous barriers and facilitators to implementing each statement. Overarching barriers to implementation included: inherent differences between specialist vs generalist settings; poor communication between healthcare settings; generic barriers to implementation; and poor governance structures and leadership.

QS11 was created to summarise alcohol-related NICE guidance. The aim was to simplify guidance and enhance local implementation. However, in practice the standard requires complex actions by professionals. There was considerable variation in local alcohol commissioning models, which was associated with variation in implementation. These models warrant further evaluation to identify best practice.

Little evidence exists on the implementing quality standards, as distinct from clinical practice guidelines. The authors present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.

I suggest that the search for Adam Smith’s theodicy is likely to be in vain. The paper begins with a brief history of approaches to evil, emphasizing the context in which they arose, and the questions authors were addressing. Approaches most relevant to Adam Smith include those of Augustine and Calvin, and the early modern theodicies of Leibniz, Samuel Clarke and William King, as well as the attacks on them by Bayle and Voltaire. Scottish Enlightenment writers were not terribly interested in theodicy, though Hutcheson and Kames did devote space to their versions of problems of evil. David Hume’s Dialogues on Natural Religion are often taken to be classic statement of the problem of theodicy and argument against religious belief, but his concern was to demolish rationalistic theodicies rather than religious belief or practice. The paper then turns to Smith’s writings, considering similarities and differences to these approaches to evil. Smith emphasizes the wisdom and beneficence of God, and that evils we observe are part of a larger providential plan. He makes no attempt to justify the God in the face of evil, and in this respect Smith shares more with Augustine and Calvin than he does with the early modern theodicists. Smith’s approach to evil is simple and ameliorative. Smith’s approach contrasts with early nineteenth century English political economists, from Malthus onwards, for whom theodicy was important. Whatever view we take of the theodicists project of justifying an all-powerful and good God in the face of evil may, we still struggle to make sense of economic suffering and evil.

The research aims to highlight the differences between State and non‐State employees, and to establish an analytic framework of discussion, looking at the different types of legal and non‐legal regulation in public employment.

To understand the partnership between clinicians and academics who come together to provide high-quality care alongside research and innovation, identifying challenges and productive conditions for innovation and collaboration across multi-disciplinary teams.

An explorative action research methodology was adopted. Semi-structured interviews were conducted with 15 clinical, academic and executive leads at a large metropolitan tertiary care hospital with an academic health services portfolio in the UK.

Clinical leaders recognise the division of limited resource, restrictive employment contracts and the divergent priorities of each organisation as challenges hindering the collaborative process and derailing innovation. Developing a culture of respect, valuing and investing in individuals and allowing time and space for interaction help facilitate successful innovation and collaboration. Successfully leading collaborative innovation requires a combination of kindness, conviction and empowerment, alongside the articulation of a vision and accountability.

Action research continues at this site, and further enquiry into the experiences, challenges and solutions of non-leaders when collaborating and innovating will be captured to present views across the organisation.

Clinical and academic collaboration and innovation are essential to the continued success of healthcare. To ensure hospitals can continue to facilitate this in increasingly challenging circumstances, they must ensure longevity and stability of teams, devote time and resource to research and innovation, nurture interpersonal skills and develop kind and empowering leaders.

This work uniquely focuses on a real-time collaborative and innovative development. By employing action research while this development was happening, we were able to access the real time views of those at the centre of that collaboration. We offer insight into the challenges and effective solutions that consultant-level clinical leaders encounter when attempting to innovate and collaborate in practice.

The potential value of sensory analysis has often been undermined in the food industry, where results tend to be viewed with scepticism. In reality, however, various forms of sensory‐related work can provide an important investigative and informative function in a number of areas. This may include consumer preference and buying behaviour, product development, production and quality control. The objective must be to achieve a realistic balance between sensory and instrumental methods and to manage the sensory process effectively, if results are to be meaningful. The main problem, however, is in dealing with people and their variability. A preliminary study assessed the potential value of using computerized systems to help improve the credibility of sensory analysis and, in particular, to maintain and improve panel motivation and consistency of response. Generally, accuracy improved significantly as tests progressed and panellists preferred using the computerized system.