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The needs of complex patients with chronic conditions can be unpredictable and can strain resources. Exploring how tasks vary for different patients, particularly those with complex needs, can yield insights about designing better processes in healthcare. The purpose of this paper is to explore the tasks required to manage complex patients in an anticoagulation therapy context.

The authors analyzed interviews with 55 staff in six anticoagulation clinics using the Systems Engineering Initiative for Patient Safety (SEIPS) work system framework. The authors qualitatively described complex patients and their effects on care delivery.

Data analysis highlighted how identifying complex patients and their effect on tasks and organization, and the interactions between them was important. Managing complex patients required similar tasks as non-complex patients, but with greater frequency or more intensity and several additional tasks. After complex patients and associated patient interaction and care tasks were identified, a work system perspective was applied to explore how such tasks are integrated within clinics and the resulting implications for resource allocation.

The authors present a complex patient management framework to guide workflow design in specialty clinics, to better support high quality, effective, efficient and safe healthcare.

The complex patient framework presented here, based on the SEIPS framework, suggests a more formal and integrated analysis be completed to provide better support for appropriate resource allocation and care coordination.

Many approaches are available and widely used to represent and design business processes. The axiomatic approach developed by Suh has not received much attention because it is taught primarily as a product design tool. In this paper, we share our experience in applying this approach to a product obsolescence procedure in a semiconductor‐manufacturing environment. The approach provides structure for analyzing process outcomes and the means used to achieve them, a framework that is valuable in business process design. The rules that form the foundation of the axiomatic approach allow the user to evaluate the quality of a proposed design in satisfying the problem or perceived need. We found that the axiomatic approach was an excellent tool for generating process designs and evaluating them, although some effort is required initially to understand the approach. In addition, because it is essentially a process mapping technique, turning the proposed design into reality requires organizational understanding and change.

Business schools need to prepare students for effective, ethical decision-making. When faced with stressful life events that negatively affect wellbeing, making decisions can become more challenging. As future managers, students will need to learn how to make decisions when they are at the same time faced with stress and cognitive overload. In such situations, the brain looks for mental shortcuts in making choices to make things faster and easier, which leads to less optimal decision-making. Research shows that mindfulness meditation can effectively decrease stress and anxiety. Mindfulness meditation increases metacognition and, in the process, reduces the effects of biases, ethical blind spots, and psychological traps. Therefore, introducing students to these techniques has significant pedagogical potential for business education as students learn mindfulness meditation and show a need to include such practices in the curriculum. This chapter sheds light on two mindfulness technique cases with business school students in Lebanon and Switzerland. In these cases, the authors explore the impact of mindfulness practices on students by applying the emotional intelligence mood metre and mindfulness meditation. The authors also apply the ‘response time testing’ (RTT) methodology in the Swiss case to measure students’ attitudes. As a result, the authors provide simple confirmations from their classrooms that engaging in mindfulness activities and meditation is a simple and productive exercise that is essential for student wellbeing, learning, and decision-making. Therefore, the authors’ purpose is to encourage and give mindfulness practices a viable place in business education.

Current research about American Indians of all ages is in short supply, yet design and allocation of public services and resources are increasingly guided by ‘evidence’ provided by research. The health and wellness of this population is persistently poorer than that of other marginalized populations. American Indian tribes have been beset progressively since the earliest arrival of European settlers by both malevolent and well-intentioned assaults on their cultures and peoples. This long history of cultural and physical genocide continues into the present and undermines the effectiveness of Eurocentric processes for research that have been shaped by values and beliefs antithetical to those of most tribes (e.g. individualism, proprietary ownership, science as the way of knowing). Individual and collective historical trauma is present in all of the more than 500 federally recognized tribes in the United States of America, and a lack of trust further compromises the validity and positive impact of most research. This chapter describes the roots and foundations of flawed and successful research and identifies practical resources and approaches that are valid and beneficial for conducting research with indigenous people. The processes described in this chapter are grounded in the experiences of tribes in the United States of America; however, parallel experiences of indigenous populations that have a continuing legacy of trauma are found in many other countries (such as in Brazil and New Zealand) and the insights and approaches found in this chapter may be applicable to some degree.

Purpose – Having concluded that the long-term and ongoing murders and disappearances of Indigenous women, girls, and 2SLGBTQQIA (MMIWG2S+) people is genocide, the National Inquiry into Missing and Murdered Indigenous Women and Girls (NIMMIWG) (2019) made 231 Calls for Justice in relation to culture, health, security, and criminal justice to broadly address the ongoing colonial dispossession and systemic, racialized, and gendered violence against MMIWG2S+ people. In response to these Calls for Justice, this article traces Indigenous grassroots initiatives to show the many ways that justice can be broadly conceived and mobilized to address the murders and disappearances.

Methodology/Approach – Drawing on the Unearthing Justices Resource Collection of 500+ Indigenous grassroots initiatives for the MMIWG2S+ people, this work theorizes a spatial approach to justice using mapping methodologies.

Findings – Not only have Indigenous families and communities been calling for justice, but they have also been cultivating justice across the land by building constellations of resource and support. The author traces the land-based activities specific to community patrols, land-based commemorations, search support, and walks and journeys to show the vast resources, skills, and strengths that already exist in Indigenous communities and how justice can be conceptualized within its local and spatial arrangements, and beyond the imaginaries of a criminal justice system.

Originality/Value – Where the ongoing colonial dispossession and systemic, racialized, and gendered violence against MMIWG2S+ people is well documented, there has been less consideration of how Indigenous families and communities have navigated a terrain where justice continues to be absent,elusive, or invasive.

IT SEEMS THAT librarians, in common with many other forms of mankind, do not learn from history. One of the more interesting sessions of the recent La Public Librarians' Conference in Aberdeen dealt with the need for many more librarians in school libraries, and the kind of qualifications which would best fit them for the work. Clearly, professional training in librarianship and knowledge of the educational process are both relevant and valuable.

The purpose of this paper is to investigate a boundary spanning, interprofessional collaboration between advanced practice nurses (APNs) and junior doctors to support junior doctors’ learning and improve patient management during the overtime shift.

A mixed methods evaluation of an intervention in an adult tertiary referral hospital, to enhance interprofessional collaboration on overtime shifts. Phase 1 compared tasks and ward rounds on 86 intervention shifts with 106 “regular” shifts, and examined the effect on junior doctor patient management testing a model using regression techniques. Phase 2 explored the experience of the intervention for stakeholders. 91 junior doctors participated (89 percent response rate) on 192 overtime shifts. Junior doctors, APNs and senior medical professionals/administrators participated in interviews.

The intervention was associated with an increase in self-initiated ward rounds by junior doctors, partially explained by junior doctors completing fewer tasks skilled nurses could also complete. The intervention significantly reduced doctors’ engagement in tasks carried over from day shifts as well as first year (but not more experienced) junior doctors’ total tasks. Interviews suggested the initiative reduced junior doctors’ work pressure and promoted a safe team climate, situation awareness, skills, confidence, and well-being.

Junior doctors overtime shifts (5 p.m. to 11 p.m.) are important, both for hospitals to maintain patient care after hours and for junior doctors to learn and develop independent clinical decision making skills. However, junior doctors frequently report finding overtime shifts challenging and stressful. Redesigning overtime shifts to facilitate interprofessional collaboration can improve patient management and junior doctors’ learning and well-being.

The article asserts that systems thinking and its concurrent organizational processes are central organizing structures in schools, yet “hide in plain sight” and are therefore underexplored and underutilized in leadership theorizing.

By exploring the theoretical literature concerning school organization and leadership, tensions and contradictions within the literature are surfaced. The article examines and critiques distributed leadership theory and provides new directions for thinking about leadership practice based on school organization literature.

Recent work (Kruse and Johnson, 2017; Murphy, 2015, 2016) suggests that schools are far too complex to be led and managed by a single dedicated leader, yet the practice of leadership remains largely reified within the literature (Bryk et al., 2015), Insofar as leadership theory relies on narratives derived from and about work of “the” leader, it ignores the larger system. A contrasting literature is that of distributed leadership (Gronn, 2000; Spillane, 2006). Yet, even within that literature, the focus remains on interpersonal interactions and conjoint actions concerning school operation. While not dismissing the importance of leadership as a theoretical and practical construct, thinking about leadership as less a property of individuals and more a variable within effective organizational practice holds promise for the study of educational leadership.

This article extends the existing literature by suggesting how systems processes and structures serve school leaders in addressing the leadership demands of fostering continuous (rather than episodic) change, processing information and creating contextual local knowledge with the potential to enhance school outcomes.

This is a comparative case study of how three high school history teachers in the U.S.A. use art in their practice. The following research question was investigated: How do secondary history teachers incorporate the arts—paintings, music, poems, novels, and films—in their teaching of history and why? Data were collected from three sources: interviews, observations, and classroom materials. Grounded theory was utilized to analyze the data. Findings suggest these teachers use the arts as historical evidence roughly for three purposes: First, to teach the spirit of an age; second, to teach the history of ordinary people invisible in official historical records; and third, to teach, both with and without art, the process of writing history. Two of the three teachers, however, failed to teach historical thinking skills through art.