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Why did a powerful department of hospital doctors support a merger with a rival hospital that they knew would ruin their beloved workplace?

This ethnographic study draws on 12 months of fieldwork consisting of 24 one-on-one interviews as well as 26 h of observations, informal conversations and archival records research to answer its research question. Grounded theory and the discourse analysis were employed to analyze all data.

Data reveal how participants' belief in a “merge or go bankrupt” narrative contributed to widespread support for a merger that seemed unthinkable on the surface. Although each doctor believes the merger will jeopardize or ruin their workplace culture, none resisted the merger nor did any ask hospital executives to provide evidence in support of their claims regarding the benefits of the merger (namely, that it would save their organization from inevitable bankruptcy).

The author relied on a family relative to introduce the author to and gain entry into this workplace. One potential consequence is biased interpretations of data. To address this, the author constantly revisited the data and compared the author’s interpretations with interviewees' words (i.e. “grounded” theory).

This study provides empirical and theoretical contributions to organizational storytelling scholarship.

Existing descriptions of trust in health care largely assume a straightforward association between a patient’s relationship with a regular provider and his or her trust in health care. I extend status characteristics theory (SCT) and social identity theory (SIT) to suggest greater variability in this association by investigating the role of social differences between patients and their regular providers. Whereas the SIT extension predicts lower trust in dissimilar than similar dyads, the predictions from the SCT extension depend on status in dissimilar dyads. Further, research examining how social differences in patient–provider dyads shape trust largely emphasizes racial differences, but the theories implicate gender differences too.

I analyze a longitudinal dataset of patient–provider dyads offering a conservative test of the extensions.

Results generally support predictions from the SCT extension. Specifically, patients’ status based on differences in either race or gender: (1) is inversely related to their trust in health care and (2) influences the resiliency of their trust, whereby the degree health care met prior expectations matters less (more) for the trust of low (high) status patients than equal status patients.

When patients and providers differ on both race and gender, findings sometimes depart from predictions. This indicates differences in two social categories is a unique situation where the contributions of each category are distinct from that of the other.

This research extends SCT to explain greater variability in the connection between patient–provider dyads and trust in health care, while also showing how gender compares to race.

The purpose of this paper is to assess perceptions of organizational readiness to integrate clinic-based community health workers (cCHWs) between traditional CHWs and potential cCHW employers and their staff in order to inform training and implementation models.

A cross-sectional mixed-methods approach evaluated readiness to change perceptions of traditional CHWs and potential employers and their staff. Quantitative methods included a printed survey for CHWs and online surveys in Qualtrics for employers/staff. Data were analyzed using SPSS software. Qualitative data were collected via focus groups and key informant interviews. Data were analyzed with NVIVO 11 Plus software.

CHWs and employers and staff were statistically different in their perceptions on appropriateness, management support and change efficacy (p<0.0001, 0.0134 and 0.0020, respectively). Yet, their differences lay within the general range of agreement for cCHW integration (4=somewhat agree to 6=strongly agree). Three themes emerged from the interviews which provided greater insight into their differences and commonalities: perspectives on patient-centered care, organizational systems and scope of practice, and training, experiences and expectations.

Community health workers serve to fill the gaps in the social and health care systems. They are an innovation as an emerging workforce in health care settings. Health care organizations need to learn how to integrate paraprofessionals such as cCHWs. Understanding readiness to adopt the integration of cCHWs into clinical settings will help prepare systems through trainings and adapting organizational processes that help build capacity for successful and sustainable integration.

In 1978, Philip Klein wrote about institutional economists of the Veblen-Commons-Mitchell-Ayres variety: Whatever we call ourselves, we are not given much credit generally among our fellow economists, but I think there is evidence that an ever-wider group of economists has begun to hear what we are saying and to accept a number of our premises…institutionalism must be viewed as either never having died or as being in the process of a resurrection which I suggest will endure (Klein, 1978, p. 252).Klein’s optimism seems justified by the following quote from Joseph Stiglitz’s new book, Globalization and its Discontents: Old-fashioned economics textbooks often talk about market economics as if it had three essential ingredients: prices, private property, and profits. Together with competition, these provide incentives, coordinate economic decision making, ensuring that firms produce what individuals want at the lowest possible cost. But there has also long been a recognition of the importance of institutions (Stiglitz, 2002, p. 139; emphasis in original).Klein and other original institutionalists should be buoyed when they hear such a statement from a recent Nobel Prize winner. One problem, however, is that the “old-fashioned textbooks” are still being published in 2003. The quote also raises a question: just who recognized the importance of institutions and when did they recognize it? Statements such as the above by Stiglitz irk original institutionalists, but why? Is it because he underestimates the prominence of perfect competition in current texts, because he is understating original institutionalists’ positions as “keepers of the faith,” or both? In any case, we may not be able to hoist the V(eblen)-C(ommons) banner and claim total victory but, increasingly, more of economics today is institutional economics. A recent article by Allan Schmid demonstrates that indeed though everyone is not an institutionalist in the Veblen-Commons mold, “good economists find it useful to embrace some of its various elements” (Schmid, 2001, p. 281).

The purpose of this paper is to present a conceptual framework that categorises the features and characteristics of the built environment that impact on health outcomes.

An extensive literature review was carried out. A total of 1,163 abstracts were assessed, leading to 92 papers being reviewed.

There is a considerable amount of evidence linking healthcare environments to patients' health outcomes, despite the lack of clarity in relation to cause‐effect relationships.

The paper proposes a theoretical framework linking different built environment characteristics to health outcomes. This framework provides a structure to group causal effects according to their relation with design features, materials and ambient properties, art and aesthetic aspects and use of the built environment.

Through a survey of 200 employees working in five of the thirty establishments analysed in previous research about the microeconomic effects of reducing the working time (Cahier 25), the consequences on employees of such a reduction can be assessed; and relevant attitudes and aspirations better known.

While research on intergenerational service learning has focused on the benefits for the students, very few studies have focused on the older adults who are the recipients of the service learning. For the current study, we were interested in the benefits of service learning for both the college students and the older adults who participated in a service-learning course. Qualitative data were collected from both the students in a sociology of aging service-learning class and the older adults who participated as recipients of the service learning. Data from the students were collected via student journals and open-ended questionnaire responses written by the students. Data from the older adults were collected via interviews by the students as well as open-ended questionnaire responses written by the older adults. The following themes emerged as benefits to students: (1) a better understanding and less fear of aging; (2) a desire to learn more about older adults; (3) a desire to engage more with older adults. The themes for the benefits to the older adults included (1) improved social connections and companionship and (2) becoming family. We found that engaging in intergenerational service-learning courses is beneficial to all those who are involved.

UK policy seeks to shift commissioning of services ‘closer to the people’ with a view to establishing shared visions of local care services grounded in the opinions and priorities of the public. The participation of older people with mental health problems and their carers in the strategic planning process has been patchy, however. This article compares practitioner and public perspectives of the services that should be provided for older people with mental health problems in an area of North West England. Significant differences were found in the services the various stakeholder groups prioritised for development, and in their views on how they should be organised. The implications for commissioning are discussed.