Rick Iedema, Raj Verma, Sonia Wutzke, Nigel Lyons and Brian McCaughan
To further our insight into the role of networks in health system reform, the purpose of this paper is to investigate how one agency, the NSW Agency for Clinical Innovation (ACI)…
Abstract
Purpose
To further our insight into the role of networks in health system reform, the purpose of this paper is to investigate how one agency, the NSW Agency for Clinical Innovation (ACI), and the multiple networks and enabling resources that it encompasses, govern, manage and extend the potential of networks for healthcare practice improvement.
Design/methodology/approach
This is a case study investigation which took place over ten months through the first author’s participation in network activities and discussions with the agency’s staff about their main objectives, challenges and achievements, and with selected services around the state of New South Wales to understand the agency’s implementation and large system transformation activities.
Findings
The paper demonstrates that ACI accommodates multiple networks whose oversight structures, self-organisation and systems change approaches combined in dynamic ways, effectively yield a diversity of network governances. Further, ACI bears out a paradox of “centralised decentralisation”, co-locating agents of innovation with networks of implementation and evaluation expertise. This arrangement strengthens and legitimates the role of the strategic hybrid – the healthcare professional in pursuit of change and improvement, and enhances their influence and impact on the wider system.
Research limitations/implications
While focussing the case study on one agency only, this study is unique as it highlights inter-network connections. Contributing to the literature on network governance, this paper identifies ACI as a “network of networks” through which resources, expectations and stakeholder dynamics are dynamically and flexibly mediated and enhanced.
Practical implications
The co-location of and dynamic interaction among clinical networks may create synergies among networks, nurture “strategic hybrids”, and enhance the impact of network activities on health system reform.
Social implications
Network governance requires more from network members than participation in a single network, as it involves health service professionals and consumers in a multi-network dynamic. This dynamic requires deliberations and collaborations to be flexible, and it increasingly positions members as “strategic hybrids” – people who have moved on from singular taken-as-given stances and identities, towards hybrid positionings and flexible perspectives.
Originality/value
This paper is novel in that it identifies a critical feature of health service reform and large system transformation: network governance is empowered through the dynamic co-location of and collaboration among healthcare networks, particularly when complemented with “enabler” teams of people specialising in programme implementation and evaluation.
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Rick Forster, Andrew Lyons, Nigel Caldwell, Jennifer Davies and Hossein Sharifi
The study sets out to demonstrate how a lifecycle perspective on complex, public-sector procurement projects can be used for making qualitative assessments of procurement policy…
Abstract
Purpose
The study sets out to demonstrate how a lifecycle perspective on complex, public-sector procurement projects can be used for making qualitative assessments of procurement policy and practice and reveal those procurement capabilities that are most impactful for operating effectively.
Design/methodology/approach
Agency theory, institutional theory and the lifecycle analysis technique are combined to abductively develop a framework to identify, analyse and compare complex procurement policies and practices in public sector organisations. Defence is the focal case and is compared with cases in the Nuclear, Local Government and Health sectors.
Findings
The study provides a framework for undertaking a lifecycle analysis to understand the challenges and capabilities of complex, public-sector buyers. Eighteen hierarchically-arranged themes are identified and used in conjunction with agency theory and institutional theory to explain complex procurement policy and practice variation in some of the UK’s highest-profile public buyers. The study findings provide a classification of complex buyers and offer valuable guidance for practitioners and researchers navigating complex procurement contexts.
Originality/value
The lifecycle approach proposed is a new research tool providing a bespoke application of theory by considering each lifecycle phase as an individual but related element that is governed by unique institutional pressures and principal-agent relationships.
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Karen Newbigging, Debbie Nixon, John Playle, Christina Lyons and Nigel Harrison
Bridget Rice, Nigel Martin, Peter Fieger and Taiba Hussain
Demographic changes involving a worldwide ageing population and later retirements produce a gradual ageing of the workforce and major concerns about how ageing may influence the…
Abstract
Purpose
Demographic changes involving a worldwide ageing population and later retirements produce a gradual ageing of the workforce and major concerns about how ageing may influence the workplace. This paper aims to provide evidence relating to older workers in healthcare settings in Australia.
Design/methodology/approach
Using a secondary quantitative dataset, the authors sub-sampled a group of workers in the healthcare sector. We used linear regression arrangement with hypotheses focused on the assessment of the significance of interaction or moderation effects relating to job characteristics and age on employee satisfaction.
Findings
The authors note that older workers' job satisfaction is negatively influenced by poor perceptions of job security and autonomy in how their work is carried out. Ensuring that older workers stay in the healthcare workforce is imperative as the work force ages. This paper shows that managing their job security and offering them work autonomy enhance their job satisfaction.
Research limitations/implications
The use of a secondary and cross-sectional dataset has some limitations relating to endogeneity, although these have been managed and assessed. The paper is based on a representative sample of Australian workers, and is thus generalisable within the Australian context, and will be informative elsewhere.
Practical implications
The focus on elements of flexibility for older workers (enhanced autonomy) and clearer job security elements is of practical relevance in the management of older workers.
Social implications
As the overall population ages, supporting older workers in their careers will be of increasing importance. In sectors with a disproportionate share of older workers, like health care, this imperative will come sooner, and the benefits of getting arrangements right be will higher.
Originality/value
No other paper has explored these specific relationships empirically that the authors are aware of. This work is original in terms of its assessment of questions of what second-order effects exist in predicting employee satisfaction among older workers.
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Abstract
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Nigel Driffield, Kai Sun and Yama Temouri
This paper aims to examine the relationship between foreign ownership and firm performance, using an approach which the authors show is more advanced than existing methods, and…
Abstract
Purpose
This paper aims to examine the relationship between foreign ownership and firm performance, using an approach which the authors show is more advanced than existing methods, and more aligned with accepted theory and conceptual frameworks developed in international business. The authors demonstrate that simply relying on a binary distinction between foreign and domestic firms ignores much of the information regarding the importance of ownership structure and is disconnected from the wider literature on ownership structure, motivations for Foreign Direct Investment (FDI) and performance.
Design/methodology/approach
The authors illustrate this by using a threshold estimation method to endogenously uncover the level of foreign ownership up to which the transfer of foreign firm advantage from the parent company to the affiliate is the strongest.
Findings
The results show that for Germany, Poland, Italy and the UK, there are significantly different thresholds of foreign ownership over the period, 2001-2010. Due to non-linearities and different thresholds, the authors argue that before one can entertain secondary considerations concerning foreign firm impact on host countries, one needs to apply the appropriate approach.
Originality/value
This is the first paper that uses an endogenous threshold approach on a large firm level data set to show that there are significant differences and non-linearities in the relationship between foreign ownership and productivity.
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Yogarajah Nanthagopan, Nigel Williams and Karen Thompson
The purpose of this paper is to understand and identify the nature of evaluation criteria, levels and associations among levels of project success in development projects by NGOs…
Abstract
Purpose
The purpose of this paper is to understand and identify the nature of evaluation criteria, levels and associations among levels of project success in development projects by NGOs in Sri Lanka.
Design/methodology/approach
The setting for this study is Sri Lanka, a country currently recovering from civil war and natural disasters and host to a large number of national and international NGOs involved in development projects. Data collection was conducted using a quantitative survey which obtained 447 responses. Multivariate analysis of data was conducted using confirmatory factor analysis and structural equation modelling.
Findings
The study confirmed that overall project success in NGOs could be assessed in three levels: project management (PM) success, project success and NGO success. The results conclude that there are strong associations among the three levels of project success; moreover, PM success and project success are indispensable for achieving NGO success.
Originality/value
This study extends existing research to confirm the presence of the three levels of project success and the interconnections among them. These findings can support subsequent research on development projects and also support the design of holistic evaluation tools to support project practices in NGOs.
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Credit may help farmers survive and grow by helping farm households cope with farm or off-farm income variation and by allowing farmers to adopt more efficient production…
Abstract
Purpose
Credit may help farmers survive and grow by helping farm households cope with farm or off-farm income variation and by allowing farmers to adopt more efficient production technologies and take advantage of scale economies. This study estimates how credit constraints affect the survival and growth of beginning farms and explores how this effect varies depending on the age of the farm operator.
Design/methodology/approach
Farms businesses are classified as credit constrained using a measure of repayment capacity: the interest expense ratio (interest expenses relative to gross income). Linked data from consecutive Agricultural Censuses are used to track individual farms over time.
Findings
Results show that beginning farms with a high interest expense ratio take on less new debt over the subsequent five years. These credit-constrained farms were found to have lower five-year survival and growth rates than similar unconstrained farms. The negative effect of being constrained on growth is greater for farms with operators younger than 40 years old.
Practical implications
The finding that credit constraints impede the growth and survival of beginning farms supports a rationale for targeted loan programs designed to help beginning farmers. Results suggest that some of the benefits from these programs will be greater for farms with younger operators.
Originality/value
This study is the first to estimate the effect of credit constraints on the survival and growth of farm businesses. The expansive farm-level panel dataset, which includes almost all beginning farmers in the US, allows for precise coefficient estimates while controlling for numerous farm and operator characteristics.
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Gregg Harry Rawlings, Christopher Gaskell, Keeley Rolling and Nigel Beail
The novel coronavirus and associated restrictions have resulted in mental health services across the UK having to adapt how they deliver psychological assessments and…
Abstract
Purpose
The novel coronavirus and associated restrictions have resulted in mental health services across the UK having to adapt how they deliver psychological assessments and interventions. The purpose of this paper is to explore the accessibility and prospective acceptability of providing telephone and videoconference-mediated psychological interventions in individuals with intellectual disabilities.
Design/methodology/approach
As part of a service evaluation, a mixed-methods questionnaire was developed and completed by clients who had been referred for psychological therapy at an adult intellectual disabilities’ community health service in the north of England. All clients were assessed using the Red/Amber/Green (RAG) system by a consultant clinical psychologist for risk and potential suitability for indirect service delivery given their ability and needs.
Findings
Overall, 22 clients were invited to take part, of which, only seven (32%) were accepting of telephone or videoconference-mediated psychological therapy. Most of the clients were unable to engage in video-conference therapy and therefore, only suitable for phone therapy. This paper presents the remaining findings and discusses the clinical implications and unique considerations for intellectual disability services drawing on the existing literature.
Originality/value
This is the first paper that the authors are aware of, examining videoconference-mediated psychological therapy in this population. It is hoped the data will be used to help inform practice or policy when using such therapeutic approaches in adults with an intellectual disability.