Gustav From, Lone Mark Pedersen, Jette Hansen, Morten Christy, Thomas Gjørup, Niels Thorsgaard, Hans Perrild, Olaf Bonnevie and Anne Frølich
Evaluates care plans documented in two different ways, using controlled and randomised studies of consecutive acutely admitted medical patients. Within 24 hours after admission, a…
Abstract
Evaluates care plans documented in two different ways, using controlled and randomised studies of consecutive acutely admitted medical patients. Within 24 hours after admission, a care plan was made for the hospital stay, specifying active problems, a plan of action and a time‐schedule. In study 1, patients had care plans written directly into their medical records during the intervention period, while the normal admittance procedure was followed in the control period. In study 2, all patients had a care plan made on a planning form and in the medical record. Patients were randomised either to have the form stay in the medical record or to have it removed. Study 1 results showed that care plans were associated with earlier recognition of patients’ active problems, whereas the tendency to initiate solutions to active problems earlier was insignificant. Length of stay (LOS) and risk of readmission remained unchanged. In study 2, planning forms were associated with a 1.5‐day lower LOS and higher accuracy of planned LOS. Risk of readmission and accomplishment of plans of action were unaltered.
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Lotte Holck and Sara Louise Muhr
The purpose of this paper is to investigate how the construction and everyday maintenance of racialized psychological borders in the Greenlandic Police Force reproduce a…
Abstract
Purpose
The purpose of this paper is to investigate how the construction and everyday maintenance of racialized psychological borders in the Greenlandic Police Force reproduce a postcolonial hierarchy of knowledge, where Danish knowledge and perceptions of professionalism are constructed as superior to Greenlandic knowledge and perceptions of professionalism.
Design/methodology/approach
The paper is based on an ethnographic study comprising 5 days of observation of a training course for Danish police officers going to Greenland on summer assistance, 13 days of observation of police work in Greenland, 2 days of participatory observation of a leadership development seminar in Greenland, 26 interviews conducted in Denmark and Greenland with both Danish and Greenlandic officers and interventions in Denmark and Greenland.
Findings
The racialized borders create strong perceptions of “us” and “them”, which are maintained and reinforced through everyday work practices. The borders have damaging effects on the way police officers collaborate in Greenland and as the borders are maintained through (often implicit) everyday micro-processes, management has difficulty dealing with it. However, the way the racialized borders became visible through this research project created an awareness of – and sparked conversation about – the colonial stereotypes that have constructed and reinforce the borders. This awareness opens up possibilities of collaborative disruption of those borders.
Research limitations/implications
The paper shows how racialized borders limit the way professionalism is understood in the Greenlandic Police Force. But it also shows that, because these borders are socially constructed, they can be contested. Making the implicit everyday discrimination explicit through vignettes, for example, offers the chance to contest and disrupt the colonial hierarchy otherwise deeply embedded in the work practices of the police force.
Originality/value
Thanks to unique access to Greenland’s police force, this paper offers exclusive in-depth insights into current processes of racialization and colonialization in a contemporary colonial relationship.
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Jette Ernst, Anette Lykke Hindhede and Vibeke Andersen
The purpose of this paper is to examine, first, how social capital was crafted and transformed from a theoretical concept to an organizational tool for public sector improvement…
Abstract
Purpose
The purpose of this paper is to examine, first, how social capital was crafted and transformed from a theoretical concept to an organizational tool for public sector improvement that was adopted by a Danish region and implemented in all regional hospitals. Second, the paper examines the application of social capital in one of these hospitals and, further, in a department of the hospital with the purpose of showing how it was applied by the managerial levels and responded to by the nurses of the department.
Design/methodology/approach
A Bourdieusian ethnographic approach was used for understanding the local and subjective understandings of social capital as well as the wider context in which the new tool was crafted.
Findings
Social capital as a tool for organizational improvement was constructed in a gray zone between science and consultancy. The paper demonstrates that the application of social capital in practice is connected with paradoxes because the concept is inherently ambiguous and Janus-faced in that its official representation is “soft” and voluntary with a working environment focus yet, it envelopes concealed steering intentions. These contrary working features of the concept produce a pressure on the department management and the nurses.
Originality/value
The explanatory critical framework combined with the ethnographic approach is a useful approach for theorizing and understanding social capital as an example of the emergence and consequences of new managerial tools in public organizations.
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Jette Ernst and Astrid Jensen Schleiter
The purpose of this paper is to look at the ways in which standardization for patient safety is approached from different positions in the field, namely nurses and managers in a…
Abstract
Purpose
The purpose of this paper is to look at the ways in which standardization for patient safety is approached from different positions in the field, namely nurses and managers in a hospital department, the hospital management and standard inventers. We understand safety standardization and the responses to it as a strategizing process, where standards are legitimized, taken up, handled or countered.
Design/methodology/approach
Ethnographic fieldwork was conducted in a Danish hospital department. The study included observations, interviews and documents studies. The authors apply a Bourdieusian perspective, where the authors focus on the narratives told by standard inventers, managers and nurses to examine and understand their strategizing activities in relation to safety standardization. We understand strategizing as interested action emerging in the dialectics between a habitus and a position in a field.
Findings
The authors show how the standardization of work rests on the master narrative of patient safety management and how this narrative clashes with the nurses’ practical perception of good care, which rests on the counter-narrative of the clinical judgment.
Originality/value
Safety standardization in healthcare is often studied within the broader framework of performance management using functionalist outside-in and prescriptive approaches. This study contributes to this literature by approaching standardization and the responses to it as taking place in a dialectic movement between subjective shop floor experiences and wider field-level forces. Furthermore, the study contributes to the organization and management literature concerned with change and strategic action by endorsing the Bourdieusian conception of strategizing.
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Michael Armstrong, Duncan Brown and Peter Reilly
This paper seeks to explore the reasons why many organisations do not evaluate the effectiveness of their reward policies and practices, examines the approaches used by those…
Abstract
Purpose
This paper seeks to explore the reasons why many organisations do not evaluate the effectiveness of their reward policies and practices, examines the approaches used by those organizations which do evaluate, and develops a model of evidence‐based reward management which describes how evaluation can take place.
Design/methodology/approach
The paper draws on a study of why organisations do or do not evaluate reward and an examination of what organizations taking evaluation seriously were doing about it. The study was based on a survey of 173 reward and HR practitioners and 13 case studies.
Findings
The survey found that only 46 per cent of respondents carried out a full evaluation. Other surveys have established that an even lower proportion evaluated. Those organisations which evaluate reward do so because they recognise that it is necessary to obtain value for money from their considerable expenditure on pay. Those who do not evaluate offer a number of reasons, but the most important was lack of resources or time. It was established that while an evidence‐based approach was desirable there was no set pattern of conducting an evaluation.
Practical implications
Information about the evaluation practices of the case study organisations and the concept of evidence‐based reward management as an approach to evaluation provide guidance to practitioners on how they can measure the effectiveness of their reward policies and practices.
Originality/value
The paper extends the pioneering research of Corby et al. to develop new insights into the process of reward evaluation.
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Margaret Moussa, Mathew Bright and Maria Estela Varua
The purpose of this paper is to examine the suitability of job and work design theory for investigating knowledge workers’ productivity. The review is a response to recommendation…
Abstract
Purpose
The purpose of this paper is to examine the suitability of job and work design theory for investigating knowledge workers’ productivity. The review is a response to recommendation and adoption of the motivational human resource management approach by a number of knowledge management researchers. The authors show that the existing literature on this topic overlooks key criticisms of HRM job and work design theory itself. The authors suggest modifications.
Design/methodology/approach
The paper proceeds by outlining knowledge management researchers’ arguments rejecting the application of traditional measurement approaches to investigating knowledge workers’ productivity. The review develops to examine the various arguments for adopting work design theory and considers the key contributions and critiques in this field. Drawing on the insights of key HRM work design critics, the paper concludes by offering suggestions for a model suitable for examining the drivers of knowledge work productivity in process.
Findings
The principle finding is that Morgeson and Humphrey’s (2006) Work Design Questionnaire (WDQ) stand as the most conceptually consistent and methodologically considered human resource management work design theory. However, this model must itself be modified to include a category of organizational contextual work characteristics. For application to the filed of knowledge management, WDQ must also be expanded to include knowledge sharing, role breadth self-efficacy and employee well-being as key work design mediators and outcomes.
Research limitations/implications
Greater consideration needs to be given to the distinction between knowledge sharing as a work design mediator and as a work design outcome. Morgeson and Humphrey themselves note that the “common method variance” problems arising in psychometric research have been reduced but not completely eliminated from their model.
Practical implications
Survey instruments based on the recommended model potentially provide a valuable means for understanding and enhancing productivity in a variety of knowledge intensive service industries. The pronounced benefit of this model is that it is applicable in cross-industry and cross-occupational contexts, unlike many existing knowledge worker productivity models. This is an advantage, given the centrality of the inter-connectivity of different types of activities and industries in knowledge work.
Social implications
Work design prioritizes employee motivation and support and links this to the quality of work and the well-being of clients. The benefits of well-designed knowledge work extend well beyond the generation of specific innovations and macroeconomic productivity improvements.
Originality/value
Job design and work design theory have been applied in the field of knowledge management. However, the applications have largely overlooked key critiques of the established models in the human resource management literature. The paper fills this gap. Its original suggestions for modifying Moregeson and Humphry’s (2006) WDQ reflect the authors’ in-depth analysis of the literature.
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J. James Cotter, Wally R. Smith and Peter A. Boling
This review and discussion outline domains and a research agenda leading to improvements in the quality of transitions of care between health‐care settings. Over the past two…
Abstract
This review and discussion outline domains and a research agenda leading to improvements in the quality of transitions of care between health‐care settings. Over the past two decades changes in health care financing have restructured the organization and delivery of health care. Health‐care plans and insurers have shifted to provision of health care in less expensive settings and growing concerns about the quality of health care have arisen – continuity may be lost, errors may occur, and patients may end up deeply dissatisfied. To improve the quality across the continuum of care, providers will need to reconceptualize from an intra‐organizational to an inter‐organizational viewpoint and will have to focus on transitions of care across settings. Services, such as case management, must effectively bridge gaps in the continuity of care. Improved measurement of outcomes, such as satisfaction with the transition, will be necessary.
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Anne Benedicte Juul, Christian Gluud, Jørn Wetterslev, Torben Callesen, Gorm Jensen and Allan Kofoed‐Enevoldsen
To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and…
Abstract
Purpose
To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and international accreditation.
Design/methodology/approach
Interventional “before‐after” study in 51 units (38 surgical and 13 anaesthetic) in nine hospitals participating in a RCT in the greater Copenhagen area; 27 of the units also underwent international accreditation.
Findings
The proportion of units with guidelines increased from 24/51 (47 percent) units before to 38/51 (75 percent) units after the trial. Among the 27 units without guidelines before the trial, significantly more accredited units compared to non‐accredited units had a guideline after the trial (9/10 (90 percent) compared to 5/17 (29 percent). The quality of the systematic development scale and the clinical scales improved significantly after the trial in both accredited units (both p<0.001) and in non‐accredited units (both p<0.02). The improvement of the systematic development scale was significantly higher in accredited than in non‐accredited units (p<0.01).
Originality/value
The combination of conducting both the DIPOM Trial and international accreditation led to a significant improvement of both dissemination and quality of guidelines on perioperative diabetic care.
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Stephanie A. Kolakowsky-Hayner, Kandis Jones, Amanda Kleckner, Kimberly Kuchinski, Alyssa Metzger and Jennifer Schueck-Plominski
Cerebral palsy is one of the leading causes of chronic disability in children. The current pilot study investigated (1) whether an exoskeleton system enables physiological gait…
Abstract
Purpose
Cerebral palsy is one of the leading causes of chronic disability in children. The current pilot study investigated (1) whether an exoskeleton system enables physiological gait patterns and (2) whether the system is user-friendly enough to envision its use in a clinical setting.
Design/methodology/approach
Participants included a convenience sample of six children with cerebral palsy. Following informed consent, study volunteers underwent baseline assessments, participated in eight sessions during which they used the exoskeleton system with the objective of achieving proficiency in use of the system, and underwent an end-of-study assessment of walking. Satisfaction and usability questionnaires were given to the family/caregiver.
Findings
All participants achieved a more regular gait pattern and improved their 6-Minute Walk Test scores. Overall satisfaction and usability were rated as good.
Practical implications
The exoskeleton system enabled physiological gait patterns, and the system was user-friendly enough to envision its use in a clinical setting.
Originality/value
There is potential for guiding treatment plans for individuals with cerebral palsy.