Michael Clark, Sally Denham-Vaughan and Marie-Anne Chidiac
The purpose of this paper is to discuss critical perspectives on what has become a dominant approach to public sector management and leadership in England and sets out a new…
Abstract
Purpose
The purpose of this paper is to discuss critical perspectives on what has become a dominant approach to public sector management and leadership in England and sets out a new conceptual perspective on leadership to improve this situation, namely a relational one.
Design/methodology/approach
A review of key literature on the topics discussed.
Findings
A new relational perspective on leadership and management is proposed, along with epistemological, ethical and practical considerations.
Research limitations/implications
The paper proposes this new approach to leadership and management in the public sector, but no empirical findings are discussed.
Practical implications
The perspective proposes that an explicit consideration of relationships and contextual factors should lie at the heart of leadership and management and all its practice.
Originality/value
This is the first time that a relational perspective on public sector management and leadership has been explicated.
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Sally Denham‐Vaughan and Michael Clark
The article aims to discuss the process of assessment within the developing model of care clusters for mental health being implemented in England as a potential basis for a…
Abstract
Purpose
The article aims to discuss the process of assessment within the developing model of care clusters for mental health being implemented in England as a potential basis for a payment by results (PbR) system. Assessment, leading to allocation to care cluster, determines the care package individuals receive from services. Hence, assessment needs to be thorough and holistic and, it is argued, grounded in the philosophy upon which all care processes should be based.
Design/methodology/approach
The process of assessment is critically reviewed in the context of allocation to care clusters. An innovative approach of recovery focused conversations (RFCs) is outlined, along with its theoretical grounding in Buber's philosophy of “dialogue”, to help ensure assessment processes in PbR are fit for purpose.
Findings
Care clusters present opportunities to deliver high quality care, actively engaging people in their care and supporting their recovery. These are not a given, though. Further means are required to operationalise all the desirable ingredients of what care is delivered and how it is done. RFCs are outlined as an addition to the care cluster to ensure that care planning starts from a co‐produced understanding between professionals and service users.
Practical implications
RFCs are a technology for delivering assessment and cluster allocation with mutually respectful dialogue between professionals and people with mental health problems, and that promotes a recovery oriented approach throughout the subsequent care pathway.
Originality/value
This is the first critical review of assessment processes in care cluster allocation and first description of RFCs as an inclusive, integrative approach.
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Sally Denham‐Vaughan and Marie‐Anne Chidiac
Relational approaches have become fashionable in a variety of areas from organisational to clinical interventions, however the practical implications of such approaches are still…
Abstract
Purpose
Relational approaches have become fashionable in a variety of areas from organisational to clinical interventions, however the practical implications of such approaches are still misunderstood. This paper aims to define what we mean by “relational” and explores how understanding and practising a specific type of relational approach is necessary to truly promote social inclusion and recovery. Design/methodology/approach – A hypothetical case study is described giving a practical illustration of how a relational approach would be used in the context of the provision of socially inclusive mental health services.
Findings
The paper makes the case for a relational and socially inclusive approach to change. A three‐pronged “SOS” model calling attention to the exploration of Self, Other and Situation is outlined. Most importantly, the model attempts to balance the complex and varying needs of clients, others and the wider situation/community/organisation, as opposed to primarily focussing on individual “fault/lack”.
Research limitations/implications
The paper relies on self‐report methods from a relatively small number of individuals.
Originality/value
The paper challenges a still predominant individualistic paradigm to change. Instead it suggests the need to redirect attention to clients’ existing relational supports to effect quicker and more sustainable change.
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Sally Denham‐Vaughan and Michael Clark
This paper aims to critically examine the care clusters descriptors now being introduced in mental health care in England and to discuss them in the context of trying to further…
Abstract
Purpose
This paper aims to critically examine the care clusters descriptors now being introduced in mental health care in England and to discuss them in the context of trying to further approaches to co‐production (and related concepts), and social inclusion and recovery. The paper seeks to introduce a revised set of cluster descriptors that are more lay friendly and that, hence, would be likely to encourage more service user engagement in care.
Design/methodology/approach
The care cluster descriptors are critically examined within the context of desires to engage service users in care and encourage staff to explicitly consider individual strengths as well as needs, i.e. co‐production of care between active service users and providers.
Findings
The implementation of care clusters and the development of new organisations of care based on these present opportunities to further develop in progressive ways how care is planned and developed. The cluster descriptors, however, are not an ideal basis for this. Being designed for one purpose the descriptors do not encourage thinking about individual strengths nor are they very lay friendly. They are not seen as an ideal basis for more actively engaging individuals in the planning and organisation of their care packages. Hence, revised descriptors felt to be more suited to this are presented.
Practical implications
Furthering more recovery oriented and socially inclusive practice in mental health care requires that each part of the system encourages all individuals involved to think in these ways. As the starting point for thinking about care, it is essential that cluster descriptors also work in this way. Services need to consider how the existing cluster descriptors impact on how individual care is thought of and delivered and consider using revised ones for some purposes, especially for engaging individuals in their care.
Originality/value
The care clusters being introduced in mental health care in England need to support progressive developments in care. This is the first time the cluster descriptors have been critiqued from the perspectives of recovery orientation and co‐production.
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Rabia Chahbounia and Abdellah Gantare
In emergency departments, effective communication is of utmost importance to ensure the safety of patients. However, communicating can be quite challenging when dealing with…
Abstract
Purpose
In emergency departments, effective communication is of utmost importance to ensure the safety of patients. However, communicating can be quite challenging when dealing with high-stress situations. This study aims to assess the efficacy of coaching workshops, informed by a transtheoretical coaching model, in managing communication challenges perceived by emergency nurses and enhancing their communication skills.
Design/methodology/approach
The study involved seven emergency room nurses working at a public hospital in Morocco. The data were gathered through various instruments, including observation grids, interviews and pre- and post-test questionnaires.
Findings
The study identified prevalent challenges in communication among nurses, notably difficulties in accurately interpreting messages when faced with confrontational attitudes from colleagues or superiors. Additionally, some nurses exhibited asymmetrical communication patterns, prioritizing their own perspectives over others' during interactions. The findings revealed a statistically significant disparity between pre- and post-test scores (P = 0.017). The nurses’ mean score has improved by 5.14 after attending the four workshop coaching experience, passing from 5.71 in the pre-test to 10.85 in the post-test.
Originality/value
This is the first study in Morocco to evaluate the effectiveness of coaching workshops guided by a transtheoretical coaching model in improving communication skills and overcoming communication barriers among working emergency nurses.