Search results

The purpose of this paper is to explore the underlying differences in the initial and ongoing development of business leaders on both sides of the Atlantic to see if causal links might be identified that could explain the leadership elements that lie beneath the US' productivity advantage.

Research was undertaken on a Fulbright Scholarship to study management and leadership development. The information was gathered through semi‐structured interviews with 45 internationally experienced human resource managers and management and leadership development practitioners in the public, private and not‐for‐profit sectors across eight states in the USA.

The determinates of business success are highly structural in nature. However, analysis indicates that dramatic improvements in productivity are readily, and universally, available to all business enterprises simply through the adoption of globally existing best practices.

The results obtained from this work are the observations of well‐informed, managers and development practitioners. A high proportion of those interviewed had direct personal experience of working with managers in the UK and Ireland. Their views and opinions are, of course, anecdotal in nature but, where possible, they are either validated or rejected with reference to the current academic literature available.

For private enterprise and public sector policy makers alike, there are clear lessons on the value of investment in leadership and management development as one of the most cost‐effective ways to encourage higher levels of business and economic performance.

The paper provides an analysis of some of the factors that contribute to the persistent productivity gap between the USA and the UK and offers a range of action areas that would help to improve business and economic performance.

Healthcare regulation is one means to address quality challenges in healthcare systems and is carried out using compliance, deterrence and/or improvement approaches. The four countries of the UK provide an opportunity to explore and compare different regulatory architecture and models. The purpose of this paper is to understand emerging regulatory models and associated tensions.

This paper uses qualitative methods to compare the regulatory architecture and models. Data were collected from documents, including board papers, inspection guidelines and from 48 interviewees representing a cross-section of roles from six organisational regulatory agencies. The data were analysed thematically using an a priori coding framework developed from the literature.

The findings show that regulatory agencies in the four countries of the UK have different approaches and methods of delivering their missions. This study finds that new hybrid regulatory models are developing which use improvement support interventions in parallel with deterrence and compliance approaches. The analysis highlights that effective regulatory oversight of quality is contingent on the ability of regulatory agencies to balance their requirements to assure and improve care. Nevertheless, they face common tensions in sustaining the balance in their requirements connected to their roles, relationships and resources.

The paper shows through its comparison of UK regulatory agencies that the development and implementation of hybrid models is complex. The paper contributes to research by identifying three tensions related to hybrid regulatory models; roles, resources and relationships which need to be managed to sustain hybrid regulatory models.

Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools.

This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development.

This paper makes “frugal innovation” recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages.

The study centred primarily on one Canadian community health care services’ organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community.

The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles.

This paper demonstrates how health care leadership can be developed and sustained.

Public sectors have responded to grand societal challenges by establishing collaboratives – new inter-organizational partnerships to secure better quality health services. In the UK, a proliferation of collaboration-based healthcare networks exists that could help to enhance the value of investments in quality improvement programs. The nature and organizational form of such improvements is still a subject of debate within the public-sector literature. Place-based collaboration has been proposed as a possible solution. In response, the purpose of this study is to present the results and findings of a place-based collaborative network, highlighting challenges and insights.

This study adopted a social constructionist epistemological approach, using a qualitative methodology. A single case study was used and data collected in three different stages over a two-year period.

The study finds that leadership, data-enabled learning through system-wide training and development, and the provision of an enabling environment that is facilitated by an academic partner, can go a long way in the managing of healthcare networks for improving quality.

Regardless of the tensions and challenges with place-based networks, they could still be a solution in maximizing the public value required by government investments in the healthcare sector, as they offer a more innovative structure that can help to address complex issues beyond the remit of hierarchical structures. This study is limited by the use of a single case study.

Across countries health systems are moving away from markets to collaborative models for healthcare delivery and from individual services to population-based approaches. This study provides insights to inform leaders of collaborative health models in the design and delivery of these new collaborations.

As demand rises (as a result of increasing complexity and demographics) in the western world, health systems are seeking to redefine the boundaries between health service provision and community self-reliance and resilience. This study provides insights into the new partnership between health institutions and communities, providing opportunities for more social- and solidarity-based healthcare models which place patients and the public at the heart of change.

The city place-based network is the first of such organizational form in healthcare collaboration in the UK.

Many developed countries have seen significant reforms of their health systems for the last few decades. Despite extensive investment in these changes, health systems still face a range of challenges which reform efforts do not seem to have overcome. The purpose of this paper is to argue that there are two particular reasons, which go beyond the standard explanations of changing demographics and disease profiles.

The paper is a commentary based on the literature.

The first explanation relates to the relationship between substantive health care reform and governance reform. These are intertwined processes and the pattern of interaction has distorted both types of reform. Second, reform has multiple meanings and may sometimes be more of an intra-organizational ritual and routine than a coherent plan aiming to bring about particular changes. As such, part of the reason why reform so frequently fails to bring about change is that it was not actually intended to bring about specific changes in the first place. The limited success of reform in recent years, the authors argue, has been a result of the fact that reform has focused too much on the substantive aspects of healthcare, while ignoring the governance aspect of the sector.

As a result, governance has often been obstructed by interest groups inside the system, resulting in paralysis. The authors conclude by arguing that substantive reform of public organizations without an accompanying reassessment of the governance of these organizations are more likely to fail, compared to more comprehensive reform efforts.