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Article
Publication date: 1 December 1998

Ann L. Casebeer and Kathryn J. Hannah

Efforts of governments to adjust the responsiveness and efficiency of their health care systems are evident across the globe. In the seemingly constant search for solutions…

2043

Abstract

Efforts of governments to adjust the responsiveness and efficiency of their health care systems are evident across the globe. In the seemingly constant search for solutions providing both better health outcomes and manageable costs, the directions and designs for change are neither consistent nor well studied. Opportunities for shared learning concerning what strategies for transforming health care systems lead to effective and sustainable change are being missed. There is an urgent need to study and understand the processes of change initiated by health policy shifts aimed at controlling health care costs, altering health service delivery and influencing outcomes of health care. In partial response to this need, research was initiated to study health policy transition within the Western Canadian province of Alberta. The primary objective of this research was: to identify, describe, compare and contrast the processes of change adopted and implemented in a variety of health authorities as a result of health policy shift. Change processes initiated by a specific health policy shift (the restructuring of Alberta’s health care system) were explored from the perspective of the change agents (individuals managing the health system reforms) in order to discover indicators of effective change and to identify questions for further consideration and testing in relation to change process related to health policy shift. This qualitative exploratory study coincided with real time alteration to the health system via legislated health policy shift. Findings relate changes in the structure, process and outcome of the health policy transition. Additionally, a number of questions linked to the reported findings are highlighted to encourage additional and continuing efforts to improve understanding of change process related to health policy shift.

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International Journal of Public Sector Management, vol. 11 no. 7
Type: Research Article
ISSN: 0951-3558

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Article
Publication date: 23 June 2022

Kathryn Nowotny, Hannah Metheny, Katherine LeMasters and Lauren Brinkley-Rubinstein

The USA has a rapidly aging prison population that, combined with their poorer health and living conditions, is at extreme risk for COVID-19. The purpose of this paper is to…

199

Abstract

Purpose

The USA has a rapidly aging prison population that, combined with their poorer health and living conditions, is at extreme risk for COVID-19. The purpose of this paper is to compare COVID-19 mortality trends in the US prison population and the general population to see how mortality risk changed over the course of the pandemic. The authors first provide a national overview of trends in COVID-19 mortality; then, the authors assess COVID-19 deaths among older populations using more detailed data from one US state.

Design/methodology/approach

The authors used multiple publicly available data sets (e.g. Centers for Disease Control and prevention, COVID Prison Project) and indirect and direct standardization to estimate standardized mortality rates covering the period from April 2020 to June 2021 for the US and for the State of Texas.

Findings

While 921 COVID-19-related deaths among people in US prisons were expected as of June 5, 2021, 2,664 were observed, corresponding to a standardized mortality ratio of 2.89 (95%CI 2.78, 3.00). The observed number of COVID-19-related deaths exceeded the expected number of COVID-19-related deaths among people in prison for most of the pandemic, with a substantially widening gap leading to a plateau about four weeks after the COVID-19 vaccine was introduced in the USA. In the state population, the older population in prison is dying at younger ages compared with the general population, with the highest percentage of deaths among people aged 50–64 years.

Research limitations/implications

People who are incarcerated are dying of COVID-19 at a rate that far outpaces the general population and are dying at younger ages.

Originality/value

This descriptive analysis serves as a first step in understanding the dynamic trends in COVID-19 mortality and the association between age and COVID-19 death in US prisons.

Details

International Journal of Prisoner Health, vol. 19 no. 1
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 18 June 2019

Ethlyn Williams, Juanita M. Woods, Attila Hertelendy and Kathryn Kloepfer

The purpose of this paper is to examine the development of leader potential in an extreme context – it develops and tests a model that describes how subordinate perceptions of…

1039

Abstract

Purpose

The purpose of this paper is to examine the development of leader potential in an extreme context – it develops and tests a model that describes how subordinate perceptions of individual-focused transformational leadership, subordinate trust in the leader and subordinate identification with the team influence supervisory evaluations of subordinate crisis leader potential.

Design/methodology/approach

Surveys were administered to emergency services personnel and their supervisors working in a large fire rescue organization in the Southeastern USA. Survey responses were analyzed using hierarchical regression.

Findings

Results support the theoretical model – subordinates reporting high levels of trust in their transformational leader were evaluated by their supervisors as having stronger potential to become crisis leaders. Lower levels of subordinate identification with the team strengthened the transformational leadership to trust association and the indirect effect of perceived transformational leadership on supervisory evaluations of subordinate crisis leader potential (through subordinate trust in the leader).

Practical implications

Supervisors who are viewed as transformational and fostering trusting relationships by subordinates are more likely to evaluate subordinates as having the potential to lead in crisis situations. In an extreme context within an organization facing change, subordinates who identify less with their team might build a more trusting relationship with a leader who is perceived as demonstrating transformational behaviors.

Social implications

Subordinate focus on the leader appears to enhance supervisory evaluations of subordinate potential (for leader development) in the study. Individual-level rewards for employees that involve competition might counter efforts toward shared mental models and remain the greatest challenge in the public emergency services setting.

Originality/value

Evaluating leader development, in terms of crisis leader potential, in an extreme context using a process model – to understand the interplay of individual-focused transformational leadership and trust given the moderating effect of team identification – is a key strength of the current study.

Details

Journal of Organizational Change Management, vol. 32 no. 3
Type: Research Article
ISSN: 0953-4814

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Publication date: 3 March 2016

Susanne Braun, Birgit Schyns and Claudia Peus

In this final chapter, we summarize the core challenges to leadership in complex organizational systems as well as the lessons that we believe leaders can learn from the…

Abstract

In this final chapter, we summarize the core challenges to leadership in complex organizational systems as well as the lessons that we believe leaders can learn from the contributions presented in this book. Building on Complexity Leadership Theory (Uhl-Bien & Marion, 2009), we argue that high levels of complexity characterize the contexts described, and that they are unusual because they deviate from the setting of standard business organizations. Since these contexts are not often discussed in the general leadership literature, there seems to be a largely unused potential in terms of leadership learning. Specifically, in order to better contextualize leadership, scholars and practitioners need to take organizational complexity into account. With reference to the underlying structure of the book, core challenges to leadership are proposed, clustering around four main foci: sports and competition, high risk, creativity and innovation, care and community. Subsequently, we derive six lessons for leadership: adaptability, perseverance, handling paradox, leading with values, inventing the future, and sharing responsibility. We thereby hope to stimulate fruitful discussions that put leadership into context and capitalize on complexity theory as an innovative approach to leadership research and practice.

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Leadership Lessons from Compelling Contexts
Type: Book
ISBN: 978-1-78560-942-8

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Publication date: 29 November 2014

Patrick Blessinger and John M. Carfora

This chapter provides an introduction to how the inquiry-based learning (IBL) approach is being used by colleges and universities around the world to improve faculty and…

Abstract

This chapter provides an introduction to how the inquiry-based learning (IBL) approach is being used by colleges and universities around the world to improve faculty and institutional development and to strengthen the interconnections between teaching, learning, and research. This chapter provides a synthesis and analysis of all the chapters in the volume, which present a range of perspectives, case studies, and empirical research on how IBL is being used across a range of courses across a range of institutions to enhance faculty and institutional development. This chapter argues that the IBL approach has great potential to enhance and transform teaching and learning. Given the growing demands placed on education to meet a diverse range of complex political, economic, and social problems and personal needs, this chapter argues that education should be a place where lifelong and lifewide learning is cultivated and where self-directed learning is nurtured. To that end, this chapter argues that IBL helps cultivate a learning environment that is more meaningful, responsive, integrated, and purposeful.

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Inquiry-based Learning for Faculty and Institutional Development: A Conceptual and Practical Resource for Educators
Type: Book
ISBN: 978-1-78441-235-7

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Book part
Publication date: 19 July 2021

Marco Brydolf-Horwitz and Katherine Beckett

A growing body of work suggests that welfare and punishment should be understood as alternative, yet interconnected ways of governing poor and marginalized populations. While…

Abstract

A growing body of work suggests that welfare and punishment should be understood as alternative, yet interconnected ways of governing poor and marginalized populations. While there is considerable evidence of a punitive turn in welfare and penal institutions over the past half century, recent studies show that welfare and carceral institutions increasingly comanage millions of people caught at the intersection of the welfare and penal sectors. The growth of “mass supervision” and the expansion of the social services sector help explain the blurring of welfare and punishment in the United States in daily practice. We suggest that these developments complicate the idea of an institutional trade-off and contend that welfare and punishment are best understood along a continuum of state management in which poor and socially marginalized populations are subjected to varying degrees of support, surveillance, and sanction. In presenting the punishment–welfare continuum, we pay particular attention to the “murky middle” between the two spheres: an interinstitutional space that has emerged in the context of mass supervision and a social services–centric safety net. We show that people caught in the “murky middle” receive some social supports and services, but also face pervasive surveillance and control and must adapt to the tangle of obligations and requirements in ways that both extend punishment and limit their ability to successfully participate in mainstream institutions.

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The Politics of Inequality
Type: Book
ISBN: 978-1-83909-363-0

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Book part
Publication date: 19 October 2020

Sheila Dolores Arnold

This chapter offers professional advice for educators, particularly those unfamiliar with history-based performance, on how to move their historic character research to the place…

Abstract

This chapter offers professional advice for educators, particularly those unfamiliar with history-based performance, on how to move their historic character research to the place of actual portrayal. Using a questioning method, the author takes the reader step-by-step through essential elements of historical character portrayal such as character perspective, props, and costuming, placing them within the context of educational objectives and performance logistics. The author discusses in detail differences between portraying a well-known historical figure versus someone connected to that person. She explains the importance of choosing a date for a first-person portrayal, as it defines what the character “knows,” and provides techniques for handling questions beyond the character's date range. For newcomers to researching and portraying historical figures, it is important to consider the following points: What is each character teaching? Where will the presentation be held? Is the presentation solely for students, or does it include peers, parents, or administrators? This chapter addresses these critical questions along with research techniques, performance methods, and practical suggestions for obtaining costumes and props. In addition, the author discusses presentation skills required for an effective presentation, such as voice, mood, and movement. She provides examples from her own professional repertoire showing how techniques such as pace level and articulation work effectively in front of an audience and breaks down the structure of a 20- to 45-minute presentation. The author gives examples of how to be prepared for audience questions and unexpected interruptions during a performance. Finally, she explains the importance of the “story” in historic character presentations to enhance its teaching and presentation effectiveness.

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Living History in the Classroom
Type: Book
ISBN: 978-1-78973-596-3

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Article
Publication date: 1 March 1997

Kathryn Covier Hannah

Libraries should not be put off by the initial investment required to build an annual fund. Although direct mail is expensive, it is the only way to acquire a large number of new…

416

Abstract

Libraries should not be put off by the initial investment required to build an annual fund. Although direct mail is expensive, it is the only way to acquire a large number of new donors to launch an annual fund program. Such programs can raise significant revenue for library operations. They work on the premise that a large base of so‐called “small” donors, giving year after year, can provide a level of stable support beyond money raised for special projects. Includes a proven 13‐step plan for building an annual fund using direct mail techniques.

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The Bottom Line, vol. 10 no. 1
Type: Research Article
ISSN: 0888-045X

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Article
Publication date: 13 May 2014

Stephen Timmons, Frank Coffey and Paraskevas Vezyridis

– The purpose of this paper is to examine the implementation of lean methods in an Emergency Department (ED) and the role of the professions in this process.

1969

Abstract

Purpose

The purpose of this paper is to examine the implementation of lean methods in an Emergency Department (ED) and the role of the professions in this process.

Design/methodology/approach

Qualitative, semi-structured interviews with ED staff in a UK NHS hospital.

Findings

Lean was met with more engagement and enthusiasm by the professionals than is usually reported in the literature. The main reasons for this were a combination of a national policy, the unique clinical environment and the status of the professional project for doctors in emergency medicine.

Research limitations/implications

Single site, one-off study.

Practical implications

The status and development of professionals involved may play a big part in the acceptability of initiatives like lean methods in health care. The longer term sustainability of the organisational changes introduced remains open to question.

Originality/value

This paper analyses the success of lean methods in health care with reference to the professional status and stage of development of the professions involved, using the sociology of professions. This approach has not been used elsewhere.

Details

Journal of Health Organization and Management, vol. 28 no. 2
Type: Research Article
ISSN: 1477-7266

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Book part
Publication date: 28 August 2023

Maria Gabaldon-Parish and Kate Cartwright

Across the United States (US), COVID-19 vaccination coverage was lower in rural counties compared to urban counties, exacerbating rural health inequities. While rural communities…

Abstract

Purpose

Across the United States (US), COVID-19 vaccination coverage was lower in rural counties compared to urban counties, exacerbating rural health inequities. While rural communities fall short of the public health goal to vaccinate all who are eligible, most rural residents have chosen to vaccinate for COVID-19. The aim of this study was to better understand rural New Mexicans' attitudes and beliefs about COVID-19 vaccines.

Methodology

We conducted and analyzed 51 in-depth, semi-structured interviews with adults living in rural New Mexican counties, covering a range of topics related to the pandemic, including vaccines. These interviews were conducted in the Summer of 2021 after the vaccines were widely available to all adults over the age of 18 and youth between the ages of 12–17, but not yet available for children under 12 years.

Findings

Two major perspectives were identified: (1) the idea that COVID-19 vaccinations are a tool that individuals can use to achieve freedom and protection and (2) the view which regarded vaccines as an infringement of personal rights and one's autonomy of health. For people who viewed the vaccine as a tool for freedom, several themes emerged, including (1) a preference for vaccine manufacturers, specifically a preference for Pfizer, and (2) frustrations related to vaccine access, specifically, older adults expressed frustrations with the difficulty of scheduling vaccination appointments. However, most participants felt as though they had enough vaccination resources. For people who viewed vaccines (and vaccine mandates) as limiting their freedom, additional themes emerged: (1) overarching distrust of government and the perception that vaccines were an extension of government and (2) distrust in the vaccines themselves, including a perceived lack of research on the vaccines and a perception that the vaccine was developed in too short of a period. Some of the people who hold these beliefs are also vaccinated. We draw from social psychology theories to better understand how people who hold a rural identity come to establish different beliefs and practices compared to larger metropolitan regions. While political identity is a contributor, of our participants, the group who were most likely to report not being vaccinated were the “independent” or “unaffiliated voters.” Our findings can help craft culturally responsive vaccine initiatives for rural communities.

Details

Social Factors, Health Care Inequities and Vaccination
Type: Book
ISBN: 978-1-83753-795-2

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