Serena Yu, Kees van Gool, Karen Edwards, Sue Kirby, Karen Gardner, Louise Robinson, Tricia Linehan, Mark Harris and Jane Hall
The Western New South Wales Integrated Care Strategy (ICS) was rolled out from November 2014 across three rural sites. The purpose of this paper is to assess its impact on general…
Abstract
Purpose
The Western New South Wales Integrated Care Strategy (ICS) was rolled out from November 2014 across three rural sites. The purpose of this paper is to assess its impact on general practices, and examine the feasibility of implementing an ICS, within a predominantly fee-for-service delivery model.
Design/methodology/approach
Mixed methods were used to analyse the implementation of the ICS, including practice-level patient data on changes in service provision. This includes unit-record data on 130 enroled patients across three rural sites, as well as qualitative data collection from providers.
Findings
There were significant increases in both revenue-generating and non-revenue-generating activities (primarily care coordination activities) associated with implementing the ICS. Each occasion of service involved greater contact time with practice staff other than GPs, as well as greater administration time. There is evidence that ICS activities such as case conferencing and team care planning substitute for traditional GP consultations. Overall, the study found that a significant investment of resources – namely staff time devoted to a range of activities – was required to support the implementation of the ICS. Such an investment was supported both externally and through revenue-generating practice-level activities.
Research limitations/implications
The data collection and evaluation project is ongoing, with analysis based on the first wave of data from three sites.
Practical implications
At the practice level, a substantial commitment of resources is required to invest in, and sustain, a new model of integrated care (IC). This commitment can currently be supported both through higher revenue generation at the practice level, and externally by health system stakeholders, but changes in financial settings could impact on financial viability.
Originality/value
This paper provides evidence on the role of blended payment mechanisms in facilitating the implementation of IC in a rural setting where there are medical workforce constraints.
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Beverly Sibthorpe, Karen Gardner, Mier Chan, Michelle Dowden, Ginny Sargent and Dan McAullay
Continuous quality improvement (CQI) programmes have been taken up widely by indigenous primary health care services in Australia, but as yet there has not been a systematic…
Abstract
Purpose
Continuous quality improvement (CQI) programmes have been taken up widely by indigenous primary health care services in Australia, but as yet there has not been a systematic assessment of their focus and achievements. A scoping review of the literature from studies of CQI in indigenous primary health care services was undertaken to explore impacts on service systems, care and client outcomes with the aim of providing guidance on future evaluation efforts. The paper aims to discuss these issues,
Design/methodology/approach
Searches were conducted in MEDLINE, CINAHL and the Cochrane Database of Systematic Reviews to December 2016 and handsearching of key websites and publications. Studies of CQI programs or activities in Indigenous primary health care services which demonstrated some combination of CQI characteristics, as described by Rubenstein (2013) were included. A two-stage approach to analysis was undertaken. Stage 1 identified the range and scope of literature, and Stage 2 investigated impacts to service systems, care and client outcomes. The Framework for Performance Assessment in Primary Health Care was used to frame the Stage 2 analysis.
Findings
The majority of Aboriginal community controlled health services have been involved in CQI but there are gaps in knowledge about uptake in general practice and government clinics. There are as many baseline studies as studies on impacts over time. Of the 14 studies included for further analysis, 6 reported on impacts on service systems; all 14 reported on impacts on care and 6 on client outcomes. Changes to services systems are variable and studies of impacts on care and client outcomes show promising though uneven improvements. There are no economic studies or studies addressing community engagement in CQI activities.
Research limitations/implications
To supplement existing limited knowledge about which service system change strategies are effective and sustainable for which problems in which settings, there needs to be investment in research and development. Research needs to be grounded in the realities of service delivery and contribute to the development of CQI capacity at the service level. Knowledge translation needs to be built into implementation to ensure maximum benefit to those endeavouring on a daily basis to constantly reflect on and improve the quality of the care they deliver to clients, and to the stewardship structures supporting services at regional, state/territory and national levels.
Practical implications
Improved approaches, methods, data capture and reporting arrangements are needed to enhance existing activity and to ensure maximum benefit to services endeavouring to reflect on and improve quality of care and to the stewardship structure supporting services at regional, state/territory and national levels.
Originality/value
Although there is a growing body of research evidence about CQI both nationally and internationally, and considerable investment by the federal government in Australia to support CQI as part of routine practice, there has not been a systematic assessment of the achievements of CQI in Indigenous primary health care services. Many unanswered questions remain about the extent of uptake, implementation and impacts. This is a barrier to future investment and regional and local programme design, monitoring and evaluation. The authors conducted a scoping review to address these questions. From this, the authors draw conclusions about the state of knowledge in Australia with a view to informing how future CQI research and evaluation might be intensified.
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Summer Dahyang Jung, Sahej Claire and Sohyeong Kim
Generation Z will be the leading consumer group in the future. Using convenience stores, the study provides an in-depth analysis on Gen Z’s current experience and future…
Abstract
Purpose
Generation Z will be the leading consumer group in the future. Using convenience stores, the study provides an in-depth analysis on Gen Z’s current experience and future expectations from retail stores. The study further highlights the differences between Gen Z’s perception of convenience stores across three different regions – the USA, South Korea and Japan.
Design/methodology/approach
This study conducted a series of in-depth, semi-structured interviews with 36 Gen Z participants from the USA (12), South Korea (11) and Japan (13). All interviews were first coded based on a preselected list of themes and were further coded with new themes that emerged from exploratory coding.
Findings
Each regional cohort varied in terms of how they experienced and what they expected from convenience stores. US participants showed negative or utilitarian attitudes toward convenience stores, whereas South Korean participants had a positive, personal attachment to them. In comparison, Japanese participants had a relatively neutral attitude. However, all three groups showed a common preference for smart technology and health concerns surrounding convenience store foods.
Practical implications
Convenience store chains should consider the cultural nuances when designing future services. The chains should further strive to remove the health concerns about the foods provided at the stores and design smart technologies that enhance user experience.
Originality/value
The present study broadens the knowledge in this budding consumer segment where current research is limited. It further sheds light on the variance among Gen Zers across different cultural contexts.
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Gary Lamph, Alison Elliott, Kathryn Gardner, Karen Wright, Emma Jones, Michael Haslam, Nicola Graham-Kevan, Raeesa Jassat, Fiona Jones and Mick McKeown
Workforce development is crucial to the offender personality disorder (OPD) service to provide contemporary, evidenced care and treatment. This study aims to provide an overview…
Abstract
Purpose
Workforce development is crucial to the offender personality disorder (OPD) service to provide contemporary, evidenced care and treatment. This study aims to provide an overview and the research evaluation results of a regional higher education programme delivered to a range of criminal justice workers used on the OPD pathway.
Design/methodology/approach
Three modules were developed and delivered; these are (1) enhancing understanding (20 students), (2) formulation and therapeutic intervention (20 students) and (3) relationships, teams and environments (17 students). A mixed-methods study evaluated participant confidence and compassion. Pre, post and six-month follow-up questionnaires were completed. Additionally, a series of focus groups were conducted to gain in-depth qualitative feedback with a cross-section of students across the modules (N = 7). Quantitative data was collected and analysed separately due to the three modules all having different content. Qualitative data was analysed, and a synthesis of qualitative findings was reported from data taken across the three modules.
Findings
A total of 52 students participated, drawn from three modules: Module 1 (N = 19); Module 2 (N = 18); Module 3 (N = 15). Confidence in working with people with a personality disorder or associated difficulties improved significantly following completion of any of the modules, whereas compassion did not. Results have been synthesised and have assisted in the future shaping of modules to meet the learning needs of students.
Research limitations/implications
Further evaluation of the effectiveness of educational programmes requires attention, as does the longer-term durability of effect. Further research is required to explore the post-training impact upon practice, and further exploration is required and larger sample sizes to draw definitive conclusions related to compassion.
Practical implications
This unique model of co-production that draws upon the expertise of people with lived experience, occupational frontline and academics is achievable and well received by students and can be reproduced elsewhere.
Social implications
The positive uptake and results of this study indicate a need for expansion of accessible OPD workforce training opportunities across the UK. Further research is required to explore student feedback and comparisons of effectiveness comparing different modes of training delivery, especially in light of the pandemic, which has forced organisations and higher education institutions to develop more digital and distance learning approaches to their portfolios.
Originality/value
This novel research provides an evaluation of the only higher education credit-bearing modules in the UK focussed solely upon the OPD workforce and aligned with the national drive for non-credit bearing awareness level training “knowledge and understanding framework” (KUF).
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Gary Lamph, Alison Elliott, Sue Wheatcroft, Gillian Rayner, Kathryn Gardner, Michael Haslam, Emma Jones, Mick McKeown, Jane Gibbon, Nicola Graham-Kevan and Karen Wright
The aim of this paper is to provide an overview of a novel offender personality disorder (OPD) higher education programme and the research evaluation results collected over a…
Abstract
Purpose
The aim of this paper is to provide an overview of a novel offender personality disorder (OPD) higher education programme and the research evaluation results collected over a three-year period. Data from Phase 1 was collected from a face-to-face mode of delivery, and Phase 2 data collected from the same programme was from an online mode of delivery because of the COVID-19 pandemic.
Design/methodology/approach
In Phase 1, three modules were developed and delivered in a fully face-to-face format before the pandemic in 2019–2020 (n = 52 student participants). In 2020–2021 (n = 66 student participants), training was adapted into a fully online mode of delivery in Phase 2. This mixed-methods study evaluated participant confidence and compassion. Pre-, post- and six-month follow-up questionnaires were completed. Qualitative interviews were conducted across both phases to gain in-depth feedback on this programme (Phase 1: N = 7 students, Phase 2: N = 2 students, N = 5 leaders). Data from Phase 1 (face-to-face) and Phase 2 (online) are synthesised for comparison.
Findings
In Phase 1 (N = 52), confidence in working with people with personality disorder or associated difficulties improved significantly, while compassion did not change. In Phase 2 (N = 66), these results were replicated, with statistically significant improvements in confidence reported. Compassion, however, was reduced in Phase 2 at the six-month follow-up. Results have been integrated and have assisted in shaping the future of modules to meet the learning needs of students.
Research limitations/implications
Further research into the impact of different modes of delivery is important for the future of education in a post-pandemic digitalised society. Comparisons of blended learning approaches were not covered but would be beneficial to explore and evaluate in the future.
Practical implications
This comparison provided informed learning for consideration in the development of non-related educational programmes and, hence, was of use to other educational providers.
Originality/value
This paper provides a comparison of a student-evaluated training programme, thus providing insights into the impact of delivering a relational-focused training programme in both face-to-face and online distance learning delivery modes. From this pedagogic research evaluation, the authors were able to derive unique insights into the outcomes of this programme.
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The purpose of this paper is to explore subjective life histories and leadership journeys of senior leaders, drawing upon elements of an authentic leadership framework (life…
Abstract
Purpose
The purpose of this paper is to explore subjective life histories and leadership journeys of senior leaders, drawing upon elements of an authentic leadership framework (life trigger events, values and emotions). The paper surfaces partial life histories and the often unheard of individual experiences of becoming a leader, offering stories to others as a media for learning and extending authentic leadership theory.
Design/methodology/approach
The paper draws upon a qualitative empirical study engaging 22 UK senior leaders in semi‐structured interviews, involving a life‐history approach to generate subjective narratives of how individuals establish and sustain leadership.
Findings
The empirical data highlights that elements of authentic leadership theory resonate in practice. Senior leaders' life histories and in particular negative trigger events are significant to their approach as leaders. The values of honesty and integrity were important to the leaders, with some able to sustain their values uncompromisingly. The leaders openly expressed emotion and vulnerability when re‐telling their stories, but whether they do so as leaders in relationships with others, requires further research. Authentic leadership theory may be over simplified in terms of emotion and vulnerability in practice.
Practical implications
Elements of authentic leadership offer alternative understandings of experiences of leaders. The life history approach enables important insights into leaders' subjective realities and should be integral to leadership development approaches.
Originality/value
The paper offers empirical data from UK senior leaders, highlighting the unheard of strutting and fretting of leadership and contributing empirical research to authentic leadership theory.
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This paper proposes that organizations have a characteristic level of change describing the amount and tempo of change an organization typically exhibits. The level of change is…
Abstract
This paper proposes that organizations have a characteristic level of change describing the amount and tempo of change an organization typically exhibits. The level of change is held in place by a combination of individual, leadership, and organizational factors. It becomes part of the organizational context and is difficult to modify. The paper explores some key determinants and consequences of a characteristic level of change, including the limitations it creates for taking strategic action.
Tamira King and Charles Dennis
Research reveals alarming results on the prevalence of the dishonest consumer behaviour known as deshopping. Deshopping is the “deliberate return of goods for reasons other than…
Abstract
Research reveals alarming results on the prevalence of the dishonest consumer behaviour known as deshopping. Deshopping is the “deliberate return of goods for reasons other than actual faults in the product, in its pure form premeditated prior to and during the consumption experience”. In effect this means buying something with no intention of keeping it. The authors consider the implications of deshopping and retailers’ prevention of deshopping, exploring the research undertaken to date and the methodology for further research.