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This paper aims to share the findings of a realist evaluation study that set out to identify how to strengthen nursing, midwifery and allied health professions (NMAHP) leadership across all health-care contexts in the UK conducted between 2018 and 2019. The collaborative research team were from the Universities of Bangor, Ulster, the University of the West of Scotland and Canterbury Christ Church University.

Realist evaluation and appreciative inquiry were used across three phases of the study. Phase 1 analysed the literature to generate tentative programme theories about what works, tested out in Phase 2 through a national social media Twitter chat and sense-making workshops to help refine the theories in Phase 3. Cross-cutting themes were synthesised into a leadership framework identifying the strategies that work for practitioners in a range of settings and professions based on the context, mechanism and output configuration of realist evaluation. Stakeholders contributed to the ongoing interrogation, analysis and synthesis of project outcomes.

Five guiding lights of leadership, a metaphor for principles, were generated that enable and strengthen leadership across a range of contexts. – “The Light Between Us as interactions in our relationships”, “Seeing People’s Inner Light”, “Kindling the Spark of light and keeping it glowing”, “Lighting up the known and the yet to be known” and “Constellations of connected stars”.

This study has illuminated the a-theoretical nature of the relationships between contexts, mechanisms and outcomes in the existing leadership literature. There is more scope to develop the tentative programme theories developed in this study with NMAHP leaders in a variety of different contexts. The outcomes of leadership research mostly focussed on staff outcomes and intermediate outcomes that are then linked to ultimate outcomes in both staff and patients (supplemental). More consideration needs to be given to the impact of leadership on patients, carers and their families.

The study has developed additional important resources to enable NMAHP leaders to demonstrate their leadership impact in a range of contexts through the leadership impact self-assessment framework which can be used for 360 feedback in the workplace using the appreciative assessment and reflection tool.

Whilst policymakers note the increasing importance of leadership in facilitating the culture change needed to support health and care systems to adopt sustainable change at pace, there is still a prevailing focus on traditional approaches to individual leadership development as opposed to collective leadership across teams, services and systems. If this paper fails to understand how to transform leadership policy and education, then it will be impossible to support the workforce to adapt and flex to the increasingly complex contexts they are working in. This will serve to undermine system integration for health and social care if the capacity and capability for transformation are not attended to. Whilst there are ambitious global plans (WHO, 2015) to enable integrated services to be driven by citizen needs, there is still a considerable void in understanding how to authentically engage with people to ensure the transformation is driven by their needs as opposed to what the authors think they need. There is, therefore, a need for systems leaders with the full skillset required to enable integrated services across place-based systems, particularly clinicians who are able to break down barriers and silo working across boundaries through the credibility, leadership and facilitation expertise they provide.

The realist evaluation with additional synthesis from key stakeholders has provided new knowledge about the principles of effective NMAHP leadership in health and social care, presented in such a way that facilitates the use of the five guiding lights to inform further practice, education, research and policy development.

Interpersonal skills are increasingly important tools in long-term care with older people, especially against the backdrop of loneliness affecting older people and expectations for a person-centred, joined-up approach. However, the term is used as a composite and its definition lacks shape and focus. In existing literature, participants appear to be selected on the basis of specific illnesses rather than age. Better understanding of the features of everyday communication processes associated with person-centred care can lead to improvements in policy and practice.

A scoping review examined communication features associated with person-centred care for older adults. This identified the extent and nature of literature. Several databases were searched; after screening and hand-searching, 31 were included. Findings were analysed for patterns and contradictions, against the objectives of person-centred and integrated care.

Emotional intelligence and the ability to employ various communication styles are crucial skills of person-centred communication. Such approaches can have positive effects on the well-being of older people.

Some studies' validity was weakened by methodological designs being founded on value judgements.

Using personalised greetings alongside verbal and non-verbal prompts to keep residents emotionally connected during personal care is considered good practice. Stimulating feedback from people using services and their relatives is important.

The role of communication is highlighted in many professional guidance documents on person-centred and integrated care, but the process of implementation is decentralised to individual employers and workers. This paper draws on the findings of contemporary literature, grounded in naturalistic data, with implications for practice and policy.

This paper examines how certain care values permeate, legitimize and authorize hospitalized-older-adults’ care, technologies and practices. The purpose of this paper is to expose how values are not benign but operate discursively establishing “orders of worth” with significant effect on the ethics of the care-setting.

The paper draws from a discursive ethnography to see “up close” on a surgical unit how values influence nurse/older-adult-patient care occasions in the domain of older-adults and functional decline. Data are from participant observations, conversations, interviews, chart reviews and reviewed literature. Foucauldian discursive analytics rendered values recognizable and analyzable as discursive practices. Discourse is a social practice of knowledge production constituting and giving meaning to what it represents.

Analysis reveals how care values inhere discourses like measurement, efficiency, economics, risk and functional decline (loss of capacity for independent living) pervading care technologies and practices, subjugating older adults’ bodies to techniques, turning older persons into measurable objects of knowledge. These values determine social conditions of worth, objectifying, calculating, normalizing and homogenizing what it means to be old, ill and in hospital.

Seven older adult patients and attendant nurses were followed for their entire hospitalization. The ethnography renders visible how care values as discursive practices rationalize the social order and operations of everyday care. Analytic outcomes offer insights of how dominant care values enabled care technologies and practices to govern hospitalized-older-adults as a population to be ordered, managed and controlled, eliding possibilities of engaging humanistic patient-centered care.

Leadership can positively affect the work environment and health. Communication and dialogue are an important part in leadership. Studies of how dialogue is valued and handled in first‐line leadership have not so far been found. The aim of this study is to develop a theoretical understanding of how first‐line leaders at hospitals in western Sweden value and handle dialogue in the organisation.

The study design was explorative and based on grounded theory. Data collection consisted of interviews and observations. A total of 11 first‐line leaders at two hospitals in western Sweden were chosen as informants, and for four of them observation was also used.

One core category emerged in the analysis: leaders' communicative actions, which could be strategically or understanding‐oriented, and experienced as equal or unequal and performed equitably or inequitably, within a power relationship. Four different types of communicative actions emerged: collaborative, nurturing, controlling, and confrontational. Leaders had strategies for creating arenas and relationships for dialogue, but dialogue could be constrained by external circumstances or ignorance of the frameworks needed to conduct and accomplish dialogue.

First‐line leaders should be offered guidance in understanding the consequences of consciously choosing and strengthening the communication component in leadership.

The positive valuation of dialogue was not always manifest in practical action. One significant consequence of not using dialogue was that information with impact on organisational efficiency and finances was not communicated upwards in the management system.

Research-based knowledge on homecare nursing is scarce and further information is warranted about citizens’ perceptions of receiving home care under existing conditions. The purpose of this study was to investigate citizen experiences with health-care professionals in the time allotted for home care.

A questionnaire survey was distributed to 348 citizens receiving home care. The questionnaire consisted of questions whether the citizens experienced that enough time was available during the homecare visit and how the conversation and care relationship with the health-care professionals were experienced. The differences in responses were analysed using Fisher’s Exact Tests.

Overall, 94% of the citizens reported that sufficient time had been available and that care relationship and conversation with the health-care professionals had been positive during the homecare visit. However, the findings indicated that citizens aged more than +76 years and citizens with a high educational level were more prone to report that the nurses did not spend enough time during the home visit.

The findings offer useful insights for the professionals in delivering appropriate home care. Listening to citizens’ wishes and needs for home care could lead to better individualised care. Especially the youngest and oldest of the citizens seem to have specific experiences that call for further investigation.

The COVID-19 pandemic stressed the health care sector's longstanding pain points, including the poor quality of frontline work and the staffing challenges that result from it. This has renewed interest in technology-centered approaches to achieving not only the “Triple Aim” of reducing costs while raising access and quality but also the “Quadruple Aim” of doing so without further squeezing wages and abrading job quality for frontline workers.

How can we leverage technology toward the achievement of the Quadruple Aim? I view this as a “grand challenge” for health care managers and policymakers. Those looking for guidance will find that most analyses of the workforce impact of technological change consider broad classes of technology such as computers or robots outside of any particular industry context. Further, they typically predict changes in work or labor market outcomes will come about at some ill-defined point in the medium to long run. This decontextualization and detemporization proves markedly problematic in the health care sector: the nonmarket, institutional factors driving technology adoption and implementation loom especially large in frontline care delivery, and managers and policymakers understandably must consider a well-defined, near-term, i.e., 5–10-year, time horizon.

This study is predicated on interviews with hospital and home health agency administrators, union representatives, health care information technology (IT) experts and consultants, and technology developers. I detail the near-term drivers and anticipated workforce impact of technological changes in frontline care delivery. With my emergent prescriptions for managers and policymakers, I hope to guide sectoral actors in using technology to address the “grand challenge” inherent to achieving the Quadruple Aim.

Interpretive consumer researchers frequently devote months, if not years, to writing a new paper. Despite their best efforts, the vast majority of these papers are rejected by top academic journals. This paper aims to explain some of the key reasons that scholarly articles are rejected and illuminate how to reduce the likelihood of rejection.

This paper is a dialogical collaboration between a co-editor of the Journal of Consumer Research and two junior scholars who represent the intended audience of this paper. Each common reason for rejecting papers, labeled as Problems 1-8, is followed by precautionary measures and detailed examples, labeled as solutions.

The paper offers eight pieces of advice on the construction of interpretive consumer research articles: (1) Clearly indicate which theoretical conversation your paper is joining as early as possible. (2) Join a conversation that belongs in your target journal. (3) Conclude your review of the conversation with gaps, problems and questions. (4) Only ask research questions that your data can answer. (5) Build your descriptive observations about contexts into theoretical claims about concepts. (6) Explain both how things are and why things are the way that they are. (7) Illustrate your theoretical claims with data and support them with theoretical argumentation. (8) Advance the theoretical conversation in a novel and radical way.

The goal of this paper is to help interpretive consumer researchers, especially junior scholars, publish more papers in top academic journals such as the Journal of Consumer Research.

The aim of this paper is to understand how the role of an mHealth artifact plays out in home care settings. An mHealth artifact, in terms of a mobile app, was tested to see how the quality of home care work practice was enhanced and changed. The research question is: In what ways does an mHealth artifact re-shape a home care practice and how does this affect the interaction between caregivers and the elderly and learning opportunities for the caregivers?

An action research approach was taken and the study was conducted in a home care organization in a Swedish municipality. The data were collected through semi-structured interviews and observations that were conducted during home visits. Concepts of learning and boundary objects were used to analyze and distinguish interactions and conversations with the mHealth artifact.

The study shows how an mHealth artifact is re-shaping a home care practice and how this affects interactions and identifies learning opportunities. Views on the mHealth artifact as a designated boundary object as well as a boundary object-in-use must co-exist.

The study provides qualitative descriptions from using an mHealth artifact for home care, which is an emerging area of concern for both research and practice. It focuses on the interactional and organizational values generated from the actual use of the designed mobile application.

The purpose of this paper is to reflexively reconsider the effects of the author’s pre-understandings, both academic and non-academic, on the subject matter and the research setting. The unforeseen implications of this disjuncture on our research practice and the expected deliverables are discussed.

The paper engages in a critical, self-reflexive dialogue of a journey through a stimulating yet, uncomfortable piece of feminist, organizational ethnographic research drawing on the insights from the author's research diary.

The account presented in this paper describes the problematic nature of undertaking a collaborative, reciprocal research project in the distinctive and foreign cultural landscape of the military. The author shows the importance of delving into matters of positionality and preparedness for what might emerge, as a form of closure.

The paper provides insights into the importance of sponsors to access “the field” and our obligation as researchers to produce written deliverables.

This paper contributes to the emerging literature on the significance of reflexivity in feminist inspired organizational ethnographies in highly gendered settings such as the military.