Search results

Academic healthcare systems face great challenges in coordinating services across a continuum of care that spans hospital, community providers, home and chronic care facilities. The Johns Hopkins Community Health Partnership (J-CHiP) was created to improve coordination of acute, sub-acute and ambulatory care for patients, and improve the health of high-risk patients in surrounding neighborhoods. The paper aims to discuss this issue.

J-CHiP targeted adults admitted to the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, patients discharged to participating skilled nursing facilities (SNFs), and high-risk Medicare and Medicaid patients receiving primary care in eight nearby outpatient sites. The primary drivers of the program were redesigned acute care delivery, seamless transitions of care and deployment of community care teams.

Acute care interventions included risk screening, multidisciplinary care planning, pharmacist-driven medication management, patient/family education, communication with next provider and care coordination protocols for common conditions. Transition interventions included post-discharge health plans, hand-offs and follow-up with primary care providers, Transition Guides, a patient access line and collaboration with SNFs. Community interventions involved forming multidisciplinary care coordination teams, integrated behavioral care and new partnerships with community-based organizations.

This paper offers a detailed description of the design and implementation of a complex program to improve care coordination for high-risk patients in an urban setting. The case studies feature findings from each intervention that promoted patient engagement, strengthened collaboration with community-based organizations and improved coordination of care.

LIBRARIANSHIP is an established profession, international in scope, and currently passing through a period of acute shortage of trained personnel. The City of Liverpool, situated at the gate‐way of the New World, has given its School of Librarian‐ship some of the elements of its international character, while the current dearth of librarians has given it the opportunity to expand.

Manpower is the most valuable asset in the construction industry. Based on an examination of literature, selected key data sources, and views from 29 key informants, this paper addresses the important labour resource context related to the construction industry in the case of Hong Kong. These include the trends of the critical indicators of the labour market in construction and the implications of the changing markets and technology on the future pattern of skill requirements, and the government policies on construction personnel. The findings are of immense importance to anyone involved in the construction industry, particularly training organizations and policy makers in their mission to maintain a skilled, competitive and adequate workforce able to meet the future demands of the industry. The changing labour market trends and skill requirements pose challenges for construction personnel in terms of upgrading their skills. Further research is recommended to construct robust models predicting the occupational trends in labour resources for effective manpower planning and to establish a labour market information system which could lead to capturing periodic labour market signals with a view to assisting the process of policy making on various human resource development aspects of construction workforce in Hong Kong.

Field theory is one of the most visible approaches in the new political sociology of science, and Fligstein & McAdam’s (F&M) Theory of Fields is the most visible recent attempt to further it. This paper evaluates F&M’s theory of field transformation by comparing it with Berman’s (2012a) field-based explanation of the changes in the field of US academic science. While F&M’s general framework is quite useful, their explanation, which focuses on struggles between incumbents and challengers over whose conception of the field should dominate, does not map neatly onto the changes in academic science, which saw no such field-level struggles. This suggests that tools are also needed for explaining new settlements that do not result from intentional efforts to establish them. In particular, the case of US academic science shows that local innovations with practices based on alternative conceptions of the field can lead to field-level change. Attention to the interaction between local practice innovations and larger environments provides insights into how change ripples across fields, as well as the ongoing contention and dynamism within even relatively stable fields.

It was stated by a philosopher of very early days that the Gods sell their choicest goods in the cheapest market; and, it may be added, if it is necessary to impress such an obvious truism, that the greatest poverty may often be found in the midst of riches. The herring well illustrates the truths of the above paragraph.

Since I got married and more or less settled down I seem to have more time for reading. Well that's natural isn't it ? I mean Nellie is reasonably broadminded when it comes to me popping out for a pint but it wouldn't be quite the thing for me to spend every evening of the week in the old “Tacklers Arms” would it ? Besides I don't live in Hindle Way now I'm married so it would be too far to go anyway.

The burden social theorists must be willing to accept, respond to, and act upon pertains to the difficulties that predictably accompany all efforts to convey to nontheorists the unwelcome fact of heteronomy – that as actors, we are not as autonomous as we were told and prefer to assume – and to spell out what heteronomy in the form in which it has been shaping the developmental trajectory of modern societies means for professional theorists. I introduce the concept of “vitacide,” designed to capture that termination of life is a potential vanishing point of the heteronomous processes that have been shaping modern societies continuing to accelerate and intensify in ways that prefigure our future, but not on our human or social terms. Heteronomy pointing toward vitacide should compel us as social theorists to consider critically both the constructive and destructive trajectory that social change appears to have been following for more than two centuries, irrespective of whether the resulting prospect is to our liking or not. In this context, the classical critical theorists of the early Frankfurt School, especially Max Horkheimer and Theodor W. Adorno, pursued what turned out to be an evolving interest in rackets, the authoritarian personality, and the administered society – concepts that served as foils for delineating the kind of theoretical stance that is becoming more and more important as we are moving into an increasingly uncertain future.

Guaranteed maximum price (GMP) and target cost contracting (TCC) with a pain‐share/gain‐share arrangement have been adopted to integrate the construction delivery process and motivate service providers to seek continuous improvements in project outcomes. However, there is still a lack of research evidence to evaluate the levels of success and lessons learned from these innovative procurement strategies. Based on the analysis of a series of in‐depth interviews on the perceptions of various relevant experienced industrial practitioners, this paper aims to explore the key attributes of GMP/TCC including the underlying motives, perceived benefits, potential difficulties, critical success factors, key risk factors involved and optimal project conditions for adopting GMP/TCC. The research findings are useful in assisting key project stakeholders in minimising the detriments brought about by potential difficulties in and maximising the benefits derived from implementing GMP/TCC concepts. The study is also significant in contributing to new knowledge and practical information of GMP/TCC applications and implementation, in both a national and international context.

The purpose of this paper is to review and analyze Albert Hirschman’s landmark book Development Projects Observed, share its insights for managing big projects, discuss its theoretical implications and how it may contribute to the current understanding of project behavior, project management (PM), and in what way it may encourage the rethinking of PM.

The paper is based on an in-depth analysis of Hirschman’s book. The paper draws on the writings of Jeremy Adelman who authored Hirschman’s biography, Cass Sunstein and Michele Alacevich who, respectively, wrote the foreword and afterword of the Brookings Institution classic published in 2014. It also profits from the work of Robert Picciotto who first met Hirschman in 1964, and Bent Flyvbjerg who recently offered a test of validity for Hirschman’s “Hiding Hand” principle.

Albert Hirschman was an original thinker and, the authors argue in many ways, a father of PM scholarship. His ideas had profound implications for social sciences and lasting influence in academy, policy, and practice. Although, to a great extent based on studies of projects, his ideas have had surprisingly little impact on modern writings of PM. This paper contributes to amending this weakness in current literature on PM. The authors identify in Hirschman’s book a set of core ideas that possess analytical power for explaining problems in contemporary PM. They include the principle of the Hiding Hand, the power of context, the role of complexity and uncertainty, the unexpected project effects, project traits, and latitudes/disciplines. For all his work and way of research, the authors conclude that Hirschman is not only an early behavioral theorist in PM but equally an early rethinker of PM.

This is the first paper that offers a discussion of Hirschman’s ideas on contemporary projects, how to understand them, their behavior, including the principle of the Hiding Hand and other important nuggets of wisdom in his research such as the significance of project traits, latitudes, and disciplines. The authors discuss in what respects these ideas may enlighten PM practice and theory. This paper also conveys the novel idea that Hirschman is an early rethinker of PM.

RETROSPECT is natural at the beginning of a new library year. All over the world of libraries of all kinds the shadow of the general depression has fallen; more heavily perhaps in the United States than here. It is a testing time which has made the enemies of libraries vocal and has also fortunately roused their advocates. On balance, optimism may prevail; and in that faith we wish our readers a happy new year.