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1 – 10 of 10In many countries leadership theories and leadership development programs in healthcare have been dominated by individualistic and heroic approaches that focus on developing the…
Abstract
Purpose
In many countries leadership theories and leadership development programs in healthcare have been dominated by individualistic and heroic approaches that focus on developing the skills and competencies of health professionals. Alternative approaches have been proffered but mainly in the form of post‐heroic and distributed forms of leadership. The notion of “hybridity” has emerged to challenge the assumptions of distributed leadership. The paper seeks to explore how the concept of hybridity can be used to re‐theorize leadership in healthcare as it relates to clinician managers (or hybrid‐professional managers).
Design/methodology/approach
The theoretical developments are explored and empirical material is presented from research in Australian public hospitals to support the case for the existence of hybridized forms of leadership in healthcare. The paper discusses whether hybridity needs re‐theorizing to adequately account for clinician leadership. It contributes to debates surrounding the role of clinician leadership in healthcare reform particularly in relation to those doctors who occupy management positions at the division or unit levels as distinct to CEOs. The study uses qualitative research, i.e. interactive interviews to present accounts of how healthcare professionals describe leadership. It undertakes both deductive and inductive theme analysis of the interview material.
Findings
There is support for hybridized configurations of leadership in interview materials of healthcare professionals but other aspects were also noted that cannot be explained by this approach alone.
Originality/value
The paper is the first to examine the concept of hybridity in the context of clinician leadership. Many approaches to leadership in healthcare fail to address the complexity of leadership within the ranks of clinician managers and thus are unable to deal adequately with the role of leadership in healthcare reform and change.
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Ann Dadich, Liz Fulop, Mary Ditton, Steven Campbell, Joanne Curry, Kathy Eljiz, Anneke Fitzgerald, Kathryn J. Hayes, Carmel Herington, Godfrey Isouard, Leila Karimi and Anne Smyth
Positive organizational scholarship in healthcare (POSH) suggests that, to promote widespread improvement within health services, focusing on the good, the excellent, and the…
Abstract
Purpose
Positive organizational scholarship in healthcare (POSH) suggests that, to promote widespread improvement within health services, focusing on the good, the excellent, and the brilliant is as important as conventional approaches that focus on the negative, the problems, and the failures. POSH offers different opportunities to learn from and build resilient cultures of safety, innovation, and change. It is not separate from tried and tested approaches to health service improvement – but rather, it approaches this improvement differently. The paper aims to discuss these issues.
Design/methodology/approach
POSH, appreciative inquiry (AI) and reflective practice were used to inform an exploratory investigation of what is good, excellent, or brilliant health service management.
Findings
The researchers identified new characteristics of good healthcare and what it might take to have brilliant health service management, elucidated and refined POSH, and identified research opportunities that hold potential value for consumers, practitioners, and policymakers.
Research limitations/implications
The secondary data used in this study offered limited contextual information.
Practical implications
This approach is a platform from which to: identify, investigate, and learn about brilliant health service management; and inform theory and practice.
Social implications
POSH can help to reveal what consumers and practitioners value about health services and how they prefer to engage with these services.
Originality/value
Using POSH, this paper examines what consumers and practitioners value about health services; it also illustrates how brilliance can be theorized into health service management research and practice.
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Andi Sebastian, Liz Fulop, Ann Dadich, Anneke Fitzgerald, Louise Kippist and Anne Smyth
The purpose of this paper is to call for strong medical co-leadership in transforming the Australian health system. The paper discusses how Health LEADS Australia, the Australian…
Abstract
Purpose
The purpose of this paper is to call for strong medical co-leadership in transforming the Australian health system. The paper discusses how Health LEADS Australia, the Australian health leadership framework, offers an opportunity to engage medical clinicians and doctors in the leadership of health services.
Design/methodology/approach
The paper first discusses the nature of medical leadership and its associated challenges. The paper argues that medical leaders have a key role in the design, implementation and evaluation of healthcare reforms, and in translating these reforms for their colleagues. Second, this paper describes the origins and nature of Health LEADS Australia. Third, this paper discusses the importance of the goal of Health LEADS Australia and suggests the evidence-base underpinning the five foci in shaping medical leadership education and professional development. This paper concludes with suggestions on how Health LEADS Australia might be evaluated.
Findings
For the well-being of the Australian health system, doctors need to play an important role in the kind of leadership that makes measurable differences in the retention of clinical professions; improves organisational cultures; enhances the engagement of consumers and their careers; is associated with better patient and public health outcomes; effectively addresses health inequalities; balances cost effectiveness with improved quality and safety; and is sustainable.
Originality/value
This is the first article addressing Health LEADS Australia and medical leadership. Australia is actively engaging in a national approach to health leadership. Discussions about the mechanisms and intentions of this are valuable in both national and global health leadership discourses.
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Will Rifkin and Liz Fulop
Examines popular theories of learning in organizations to highlight their limitations for reform and change. Divides learning approaches into four general strategies …
Abstract
Examines popular theories of learning in organizations to highlight their limitations for reform and change. Divides learning approaches into four general strategies ‐ organizational learning, learning organization, learning environment, and “learning space”. Examines how issues of power, diversity, indeterminacy and hierarchy are treated in each approach and the extent to which multi‐vocal strategies of learning are engendered. These issues have been central to concerns raised in the literature about organizational control. However, much of what is popularly promoted as prescriptions for learning in organizations ‐ on dimensions such as teamwork, leadership, and culture ‐ have significant elements in which there is little evidence of reflection on issues of control. Gives particular attention to Peter Senge’s book, The Fifth Discipline, which has become the blueprint for many organizational learning projects and other learning approaches. Also gives attention to a popular account of learning, an address by the CEO of the Australian telecommunications firm, Telstra. The analysis provides a basis for raising questions about popular learning strategies and underlines the need for managers to reflect on the complex, contextualized, and contentious nature of learning and its macro‐level constraints and its micro‐level impacts.
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Ron Fisher, Maree V. Boyle and Liz Fulop
The purpose of this paper is to investigate the gendered and emotionalized nature of organizational commitment in a university context.
Abstract
Purpose
The purpose of this paper is to investigate the gendered and emotionalized nature of organizational commitment in a university context.
Design/methodology/approach
The paper presents a qualitative study that utilizes a grounded theory approach. The research investigates the gendered and emotionalized nature of commitment which is often not accurately and clearly understood in the context of the modern workplace.
Findings
The research finds that the existing measures of organizational commitment are biased and are not appropriate measures of the commitment of women and some men in contemporary workplaces. Studying organizational commitment using an interpretive approach allows a more realistic picture to emerge.
Practical implications
Current approaches focus on measurement rather than understanding the nature of organizational commitment. As a consequence, the commitment of women, and some men, is not accurately and clearly understood in many workplaces. Lack of understanding leads to the perception that women, and some men, are lacking in commitment to their organizations. Many management decisions, such as promotion and performance management, are based on the perceptions that managers have of subordinates' commitment to the organization.
Originality/value
Few researches have been conducted into how organizational commitment is understood from the perspective of the employees themselves. This paper provides insight into how managers can make more appropriate decisions based on a clearer understanding of commitment.
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Liz Wiggins and Janet Smallwood
The purpose of this paper is to explore the application of ideas and practice from Organisation Development to the creation of a leadership development programme, based in a UK…
Abstract
Purpose
The purpose of this paper is to explore the application of ideas and practice from Organisation Development to the creation of a leadership development programme, based in a UK Business School. When leadership development is constructed as a personal and relational endeavour, rather than using competences to create identikit heroes, faculty need to draw less on the espoused certainties of “expert” power and adapt their teaching style and language.
Design/methodology/approach
This case study of an ongoing Masters programme in health leadership, draws on external evaluation data and action research.
Findings
The paper’s prime contribution is as a conceptual stimulus to rethink leadership development programmes based on OD.
Practical implications
The practical implications could be far reaching if business schools want to offer an alternative to perpetuating heroic, individualist models of leadership.
Social implications
As leaders take charge of their own learning, as much as their leading, faculty become powerful participants and draw on OD skills rather than those of expert knowledge.
Originality/value
The paper thus offers a practical example with evaluation of how leadership development can be redesigned congruent with seeing leadership as a socially constructed, relational, dynamic and context specific.
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Liz Gill, Lesley White and Ian Cameron
This paper synthesises the literature on the issues related to the older patient, health service quality and its measurement. It discusses the need to consider these perspectives…
Abstract
This paper synthesises the literature on the issues related to the older patient, health service quality and its measurement. It discusses the need to consider these perspectives in the definition and assessment of quality of a community‐focused aged healthcare programme, and critically examines the existing evaluation of quality in healthcare, contrasting the patient's role and impact on the quality of the service and its outcome. The paper then reviews the documented problems associated with using satisfaction as an indicator of the patient's view of quality. An alternate validated approach to measuring the patient's perception of the quality of the service is identified in the services literature; this multidimensional hierarchical tool and scale, which specifically measures the patient's view of quality, is presented. The tool covers nine sub‐dimensions, four dimensions and the global perspective of quality as perceived by the patient. An adaptation of this tool is presented to measure the patient's view of quality using the relatively new Transition Aged Care programme as an example, and make the argument for the holistic measurement of transitional aged care quality, using a validated and reliable patient‐specific tool. Importantly, the paper proposes that the identification of the patient view of service quality will offer information that could specifically assist with service improvement.
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In the last four years, since Volume I of this Bibliography first appeared, there has been an explosion of literature in all the main functional areas of business. This wealth of…
Abstract
In the last four years, since Volume I of this Bibliography first appeared, there has been an explosion of literature in all the main functional areas of business. This wealth of material poses problems for the researcher in management studies — and, of course, for the librarian: uncovering what has been written in any one area is not an easy task. This volume aims to help the librarian and the researcher overcome some of the immediate problems of identification of material. It is an annotated bibliography of management, drawing on the wide variety of literature produced by MCB University Press. Over the last four years, MCB University Press has produced an extensive range of books and serial publications covering most of the established and many of the developing areas of management. This volume, in conjunction with Volume I, provides a guide to all the material published so far.
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Marina Papalexi, David Bamford, Alexandros Nikitas, Liz Breen and Nicoleta Tipi
This paper aims to evaluate the implementation of innovative programmes within the downstream domain of the pharmaceutical supply chain (PSC), with the aim of informing improved…
Abstract
Purpose
This paper aims to evaluate the implementation of innovative programmes within the downstream domain of the pharmaceutical supply chain (PSC), with the aim of informing improved service provision.
Design/methodology/approach
A mixed-method approach was used to assess to what extent innovation could be adopted by hospital and community pharmacies to improve the delivery process of pharmaceutical products. Unstructured interviews and 130 questionnaires were collected and analysed to identify factors that facilitate or prevent innovation within PSC processes.
Findings
The analysis led to the creation of the innovative pharmaceutical supply chain framework (IPSCF) that provides guidance to health-care organisations about how supply chain management problems could be addressed by implementing innovative approaches. The results also indicated that the implementation of Lean and Reverse Logistics (RL) practices, supported by integrated information technology systems, can help health-care organisations to enhance their delivery in terms of quality (products and service quality), visibility (knowledge and information sharing), speed (response to customers and suppliers needs) and cost (minimisation of cost and waste).
Practical implications
The study’s recommendations have potential implications for supply chain theory and practice, particularly for pharmacies in terms of innovation adoption. The IPSCF provides guidance to pharmacies and health-care organisations to develop more efficient and effective supply chain strategies.
Originality/value
This research contributes to the academic literature as it adds novel theoretical insights to highly complex delivery process innovation.
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Catherine Durose, Liz Richardson, Helen Dickinson and Iestyn Williams
Involving communities, citizens and service users in the design and delivery of public services has long been a key aim of government policy and arguably has it never been more…
Abstract
Purpose
Involving communities, citizens and service users in the design and delivery of public services has long been a key aim of government policy and arguably has it never been more important than within times of austerity. Yet, whilst acknowledging the importance of engagement, many health and social care organisations struggle with this in practice. This paper sets out some guiding principles for engagement.
Design/methodology/approach
This paper draws on conversations at a series of events in 2013 which brought together researchers, those charged with delivering on government policy at the local level and active citizens, to debate and explore evidence and practice on how to involve and mobilise citizens in local decision making in a time of austerity. Learning is distilled from these events to provide a useful guide for working effectively with communities.
Findings
As with any issue as complex as this, there is no magic bullet, quick fix, simple check-list or solve-all tool. Like doing anything worthwhile, working with communities is difficult, takes time and is at its core about building relationships. However, this does not mean that every attempt to design involvement processes needs to start entirely from scratch. There is a wealth and diversity of experience in designing and developing involvement mechanisms to draw upon.
Originality/value
This paper will provide a helpful guide to those who are about to embark on a programme of engagement or who are presently involved in engagement activities with communities, citizens and service users.
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