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1 – 10 of 11Gillian King, Nicole Thomson, Mitchell Rothstein, Shauna Kingsnorth and Kathryn Parker
One of the major issues faced by academic health science centers (AHSCs) is the need for mechanisms to foster the integration of research, clinical, and educational activities to…
Abstract
Purpose
One of the major issues faced by academic health science centers (AHSCs) is the need for mechanisms to foster the integration of research, clinical, and educational activities to achieve the vision of evidence-informed decision making (EIDM) and optimal client care. The paper aims to discuss this issue.
Design/methodology/approach
This paper synthesizes literature on organizational learning and collaboration, evidence-informed organizational decision making, and learning-based organizations to derive insights concerning the nature of effective workplace learning in AHSCs.
Findings
An evidence-informed model of collaborative workplace learning is proposed to aid the alignment of research, clinical, and educational functions in AHSCs. The model articulates relationships among AHSC academic functions and sub-functions, cross-functional activities, and collaborative learning processes, emphasizing the importance of cross-functional activities in enhancing collaborative learning processes and optimizing EIDM and client care. Cross-functional activities involving clinicians, researchers, and educators are hypothesized to be a primary vehicle for integration, supported by a learning-oriented workplace culture. These activities are distinct from interprofessional teams, which are clinical in nature. Four collaborative learning processes are specified that are enhanced in cross-functional activities or teamwork: co-constructing meaning, co-learning, co-producing knowledge, and co-using knowledge.
Practical implications
The model provides an aspirational vision and insight into the importance of cross-functional activities in enhancing workplace learning. The paper discusses the conceptual and empirical basis to the model, its contributions and limitations, and implications for AHSCs.
Originality/value
The model’s potential utility for health care is discussed, with implications for organizational culture and the promotion of cross-functional activities.
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Panita Surachaikulwattana and Nelson Phillips
Drawing on a case study of the adoption of an American organizational form – the “Academic Health Science Centre” (or “AHSC”) – in English healthcare, the authors develop a model…
Abstract
Drawing on a case study of the adoption of an American organizational form – the “Academic Health Science Centre” (or “AHSC”) – in English healthcare, the authors develop a model of the “translation work” required to translate an organizational form from one organizational field to another. The findings contribute to the literature on translation and shed light on the microfoundations of institutions by examining the complex relationship among agency, meaning, institutions, and temporality that underpin the translation of a contested organizational form. The authors also show the important, but limited, role of agency when translation occurs at the broad field level and argue that the translation of organization forms can, in at least some situations, best be understood as a “garbage can” rather than the linear and agentic view usually described in the translation literature.
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Gillian King, Kathryn Parker, Sean Peacocke, C.J. Curran, Amy C. McPherson, Tom Chau, Elaine Widgett, Darcy Fehlings and Golda Milo-Manson
The purpose of this paper is to describe how an Academic Health Science Centre, providing pediatric rehabilitation services, research, and education, developed a Centres for…
Abstract
Purpose
The purpose of this paper is to describe how an Academic Health Science Centre, providing pediatric rehabilitation services, research, and education, developed a Centres for Leadership (CfL) initiative to integrate its academic functions and embrace the goal of being a learning organization.
Design/methodology/approach
Historical documents, tracked output information, and staff members’ insights were used to describe the ten-year evolution of the initiative, its benefits, and transformational learnings for the organization.
Findings
The evolutions concerned development of a series of CfLs, and changes over time in leadership and management structure, as well as in operations and targeted activities. Benefits included enhanced clinician engagement in research, practice-based research, and impacts on clinical practice. Transformational learnings concerned the importance of supporting stakeholder engagement, fostering a spirit of inquiry, and fostering leaderful practice. These learnings contributed to three related emergent outcomes reflecting “way stations” on the journey to enhanced evidence-informed decision making and clinical excellence: enhancements in authentic partnerships, greater innovation capacity, and greater understanding and actualization of leadership values.
Practical implications
Practical information is provided for other organizations interested in understanding how this initiative evolved, its tangible value, and its wider benefits for organizational collaboration, innovation, and leadership values. Challenges encountered and main messages for other organizations are also considered.
Originality/value
A strategy map is used to present the structures, processes, and outcomes arising from the initiative, with the goal of informing the operations of other organizations desiring to be learning organizations.
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Edward John Maile, Mahima Mitra, Pavel Ovseiko and Sue Dopson
Hospital mergers are common in the United Kingdom and internationally. However, mergers rarely achieve their intended benefits and are often damaging. This study builds on…
Abstract
Purpose
Hospital mergers are common in the United Kingdom and internationally. However, mergers rarely achieve their intended benefits and are often damaging. This study builds on existing literature by presenting a case study evaluating a merger of two hospitals in Oxford, United Kingdom with three distinct characteristics: merger between two university hospitals, merger between a generalist and specialist hospital and merger between two hospitals of differing size. In doing so, the study draws practical lessons for other healthcare organisations.
Design/methodology/approach
Mixed-methods single-case evaluation. Qualitative data from 19 individual interviews and three focus groups were analysed thematically, using constant comparison to synthesise and interpret findings. Qualitative data were triangulated with quantitative clinical and financial data. To maximise research value, the study was co-created with practitioners.
Findings
The merger was a relative success with mixed improvement in clinical performance and strong improvement in financial and organisational performance. The merged organisation received an improved inspection rating, became debt-free and achieved Foundation Trust status. The study draws six lessons relating to the contingencies that can make mergers a success: (1) Develop a strong clinical rationale, (2) Communicate the change strategy widely and early, (3) Increase engagement and collaboration at all levels, (4) Be transparent and realistic about the costs and benefits, (5) Be sensitive to the feelings of the other organisation and (6) Integrate different organizational cultures effectively.
Originality/value
This case study provides empirical evidence on the outcome of merger in a university hospital setting. Despite the relatively positive outcome, there is no strong evidence that the benefits could not have been achieved without merger. Given that mergers remain prevalent worldwide, the practical lessons might be useful for other healthcare organisations considering merger.
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Alexandra Edelman, Judy Taylor, Pavel V. Ovseiko and Stephanie M. Topp
Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train…
Abstract
Purpose
Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity.
Design/methodology/approach
Peer-reviewed and grey literature published in English between 2000 and 2016 were searched. Articles that identified AHCs as the primary unit of analysis and that also addressed health equity concepts in relation to the AHC’s activity or role were included.
Findings
In total, 103 publications met the inclusion criteria of which 80 per cent were expert opinion. Eight descriptive themes were identified through which health equity concepts in relation to AHCs were characterised, described and operationalised: population health, addressing health disparities, social determinants of health, community engagement, global health, health system reform, value-based and accountable financing models, and role clarification/recalibration. There was consensus that AHCs can and should address health disparities, but there is a lack of empirical evidence to show that AHCs have a capacity to contribute to health equity goals or are demonstrating this contribution.
Originality/value
This review highlights the relevance of health equity concepts in discussions about the role and missions of AHCs. Future research should improve the quality of the evidence base by empirically examining health equity strategies and interventions of AHCs in multiple countries and contexts.
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Global health challenges and threats could be confronted by collaborative efforts of international community. Governance for global health is a set of formal and informal…
Abstract
Purpose
Global health challenges and threats could be confronted by collaborative efforts of international community. Governance for global health is a set of formal and informal processes, operating beyond state boundaries, and refers to institutions and mechanisms established at the national, regional and international levels. Nordic countries demonstrated a long-standing commitment to development assistance for health (DAH), and more recently to governance for global health. Governance for global health tools could be used effectively to achieve collective solutions for the maintenance and promotion of health as a common good, could ensure accountability and transparency, and reconcile the interests of different actors on the international and national levels. The aim of this paper is to provide an overview of tools and approaches in support of eight sub-functions of governance for global health applied by the Nordic countries. This will help international audience to compare those mechanisms with similar mechanisms that are available or planned in their countries and regions, and may benefit policy scholars and practitioners.
Design/methodology/approach
This study uses qualitative review of research literature, policy documents and information available from institutional websites related to the governance of global health in four Nordic countries. In total, 50 selected publications were analyzed using framework synthesis, mapping all findings to 8 dimensions (sub-functions) of governance for global health and related tools.
Findings
Review reveals which tools are available, how they have been applied by the Nordic countries and influenced all domains (sub-functions) of governance for global health at different levels: national governments, agencies and networks; bilateral and multilateral partnerships; inter-governmental institutions and international health-related organizations. Common trends and approaches in governance for global health have been formulated.
Originality/value
This study is unique in relation to the prior literature as it looks at the role of Nordic countries in the governance for global health system through the lens of tools applied in support to its sub-functions.
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The purpose of this paper is to examine language, academic, social‐cultural and financial adjustments facing mainland Chinese students in Hong Kong.
Abstract
Purpose
The purpose of this paper is to examine language, academic, social‐cultural and financial adjustments facing mainland Chinese students in Hong Kong.
Design/methodology/approach
The current study employed both quantitative and qualitative methods and included over 300 mainland Chinese students from seven major universities in Hong Kong. In addition to a survey questionnaire, in‐depth interviews were also conducted. Purposive and snowball sampling methods were used to recruit participants.
Findings
The findings indicate that though mainland Chinese students were satisfied with the quality of Hong Kong's higher education, many expressed that they were having language, academic, social and cultural, and financial challenges during their stay in Hong Kong. The results are consistent with the current literature to a large extent with some variations. Few differences were found by gender and between undergraduate and graduate students.
Research limitations/implications
Two thirds of the sample was undergraduate students and only one third graduate students. Future research may want to include an equal number of participants from both groups to get a more balanced view. In addition, since the sample of our sub‐degree students was very small, generalization to this group will be inappropriate. Future studies are needed to explore the unique challenges facing these mainland Chinese students who are pursuing their sub‐degree in Hong Kong.
Originality/value
Most of the current research is limited to mainland Chinese students studying in Western countries, such as the USA, the UK and Australia. Few studies to date examine adjustment problems of mainland Chinese students studying in Hong Kong. There is a need, therefore, to deepen our understanding of the major adjustment issues experienced by these mainland Chinese students in Hong Kong.
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