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This paper aims to extend the consideration of distributed leadership in health-care settings. Leadership is typically studied from the classical notion of the place of single leaders and continues to examine distributed leadership within small teams or horizontally. The purpose is to develop a practical understanding of how distributed leadership may occur vertically, between different layers of the health-care leadership hierarchy, examining its influence on health-care outcomes across two hospitals.

Using semi-structured interviews, data were collected from 107 hospital employees (including executive leadership, clinical management and clinicians) from two hospitals in Australia and the USA. Using thematic content analysis, an iterative process was adopted characterized by alternating between social identity and distributed leadership literature and empirical themes to answer the question of how the practice of distributed leadership influences performance outcomes in hospitals?

The perceived social identities of leadership groups shaped communication and performance both positively and negatively. In one hospital a moderating structure emerged as a leadership dyad, where leadership was distributed vertically between hospital hierarchal layers, observed to overcome communication limitations. Findings suggest dyad creation is an effective mechanism to overcome hospital hierarchy-based communication issues and ameliorate health-care outcomes.

The study demonstrates how current leadership development practices that focus on leadership relational and social competencies can benefit from a structural approach to include leadership dyads that can foster these same competencies. This approach could help develop future hospital leaders and in doing so, improve hospital outcomes.

The vast majority of interventions during organizational change tend to focus on individually-held attitudes toward change. However, groups often form collective attitudes that are distinct from those held by its individual members, and organizational change often necessitates collective attitude change within teams, work units, or even the entire organization. We challenge the dominant view that collective attitudes to organizational change merely reflect an aggregation of individual attitudes by considering how and why collectively-held change attitudes are formed and activated. Drawing on social network theory, we propose an alternative approach toward an understanding of change. Acknowledging and detailing attitude formation as a social response to change – a social system of interaction among change recipients – we explain how collective attitudes to organizational change emerge. With this stance, individuals may hold broad and differing attitudes, but as a group can come together to share a collective attitude toward change. Using this approach, we explain how collective attitudes and individual attitudes are linked through top-down or bottom-up processes, or a combination of both. Developing this alternative perspective improves our understanding of how collective attitudes to change develop and evolve and enables both scholars and practitioners to better manage and influence the formation of change-supportive collective attitudes.

Prison social environments play an important role in the health of prisoners. How they respond to imprisonment is partially dependent upon how effectively they integrate into an institution’s social structure, learn to fit in with others and adapt to and cope with becoming detached from society, community and family ‐ hence, how they personally manage the transition from free society to a closed carceral community. This paper reports on findings of an ethnography conducted in an adult male training prison in England, which used participant observation, group interviewing, and one‐to‐one semi‐structured interviews with prisoners and prison officers. The research explored participants’ perceptions of imprisonment, particularly with regard to how they learned to adapt to and ‘survive’ in prison and their perceptions of how prison affected their mental, social and physical well‐being. It revealed that the social world of prison and a prisoner’s dislocation from society constitute two key areas of ‘deprivation’ that can have important health impacts.

This paper seeks to establish design quality indicators (DQIs) that can be utilized for assessing the design of community centers, with an emphasis on the technical, functional, and behavioral performance domains.

A comprehensive literature review resulted in identifying 79 DQIs for community centers. A three round Delphi evaluation approach was utilized to rate the importance of the DQIs through their relative importance index (RII) values. The assessment of the DQIs involved a diverse group of stakeholders including facilities managers, architects/engineers (A/Es), community centers’ staff, and regular visitors of community centers.

The majority of the established DQIs were considered to be either “Very Important” or “Important”.

The established DQIs can be utilized to identify best practices in the design of community centers and benchmark the performance of different community centers.

The design quality of community centers could significantly impact the community's quality of life and user experience. The development of DQIs provides for enhanced accountability and improved service delivery for the communities they serve. This enables community centers to be more effective, efficient, and responsive to the needs of the users they support.

This study aims to develop a better understanding of the key determinants of repetitive visits to coffee shops. The paper intends to answer a simple, yet crucial question, “Why do people go to coffee shops repeatedly, and frequently?”.

Two coffee shops in North Cyprus are used as case studies in order to provide in-depth information about the perceptions and experiences of coffee shop clients, managers and staff. An inductive methodological structure together with qualitative data collection methods provided a rich, exploratory setting.

A social network of customers and employees, communication with familiar people and sharing a homely feel are found to be the key determinants of clients' attachment. Comfort, security, sense of belonging and the convenience of the place also play a pivotal role. The traditional habit of coffee drinking is a prime motivation for people of this area to meet up and socialize.

Managers can optimize operational results as it is evident that social and cultural elements are the key drivers for repeat customer visits, while regional planners can set society-driven policies.

This study contributes to the literature by using a holistic approach to understand the factors which influence revisit intentions of coffee shop clients in relation to the third place, the place attachment and the service space concepts. The research approach employed is also significant as it enabled the presentation of the real-life dynamics and its relation to the literature.

Applying traditional grounded theory techniques, the present research reanalyzed secondary data from four previously conducted studies to explore how generativity is manifested in young adults.

A new conceptual model of generativity was developed to depict how generativity manifests among this age group.

This study's findings provide leadership educators with a refined approach to interacting with this construct while simultaneously increasing young adults’ potential ability to experience the benefits available to them through generativity at an earlier stage in their lives.

This study advances the field of leadership education by establishing foundational insight into the uniqueness of generativity’s development in young adulthood.

Interventions to hasten patient discharge continue to proliferate despite evidence that they may be achieving diminishing returns. To better understand what such interventions can be expected to accomplish, the authors aim to critically examine their underlying program theory.

Within a broader study on patient flow, spanning 10 jurisdictions across Western Canada, the authors conducted in-depth interviews with 300 senior, middle and frontline managers; 174 discussed discharge initiatives. Using thematic analysis informed by a Realistic Evaluation lens, the authors identified the mechanisms by which discharge activities were believed to produce their impacts and the strategies and context factors necessary to trigger the intended mechanisms.

Managers' accounts suggested a common program theory that applied to a wide variety of discharge initiatives. The chief mechanism was inculcation of a sharp focus on discharge; reinforcing mechanisms included development of shared understanding and a sense of accountability. Participants reported that these mechanisms were difficult to produce and sustain, requiring continual active management and repeated (re)introduction of interventions. This reflected a context in which providers, already overwhelmed with competing demands, were unlikely to be able (or perhaps even willing) to sustain a focus on this particular aspect of care.

The finding that “discharge focus” emerged as the core mechanism of discharge interventions helps to explain why such initiatives may be achieving limited benefit. There is a need for interventions that promote timely discharge without relying on this highly problematic mechanism.