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1 – 10 of 35Paul Wankah, Mylaine Breton, Carolyn Steele Gray and James Shaw
The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in…
Abstract
Purpose
The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in integrated care models for older adults.
Design/methodology/approach
A multiple case study design in two urban centres in two jurisdictions in Canada, Ontario and Quebec. Data collection included 65 semi-structured interviews with policymakers, managers and providers and analysis of key policy documents. The institutional entrepreneur theory provided the theoretical lens and informed a reflexive iterative data analysis.
Findings
While each case faced unique challenges, there were similarities and differences in how managers enhanced a partnership’s institutional logic. In both cases, entrepreneurial healthcare managers created new roles, negotiated mutually beneficial agreements and co-located staff to foster inter-organisational partnerships between public, private and community organisations in the continuum of care for older adults. In addition, managers in Ontario secured additional funding, while managers in Quebec organised biannual meetings and joint training to enhance inter-organisational partnerships.
Originality/value
This study has two main implications. First, efforts to enhance inter-organisational partnerships should strategically include institutional entrepreneurs. Second, successful institutional changes may be supported by investing in integrated implementation strategies that target roles of staff, co-location and inter-organisational agreements.
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Felix Gradinger, Julian Elston, Sheena Asthana, Chloe Myers, Sue Wroe and Richard Byng
This integrated care study seeks to highlight how voluntary sector “wellbeing co-ordinators” co-located in a horizontally and vertically integrated, multidisciplinary community…
Abstract
Purpose
This integrated care study seeks to highlight how voluntary sector “wellbeing co-ordinators” co-located in a horizontally and vertically integrated, multidisciplinary community hub within one locality of an Integrated Care Organisation contribute to complex, person-centred, co-ordinated care.
Design/methodology/approach
This is a naturalistic, mixed method and mixed data study. It is complementing a before-and-after study with a sub-group analysis of people receiving input from the wider hub (including Wellbeing Co-ordination and Enhanced Intermediate Care), qualitative case studies, interviews, and observations co-produced with embedded researchers-in-residence.
Findings
The cross-case analysis uses trajectories and outcome patterns across six client groups to illustrate the bio-psycho-social complexity of each group across the life course, corresponding with the range of inputs offered by the hub.
Research limitations/implications
To consider the effectiveness and mechanisms of complex system-wide interventions operating at horizontal and vertical interfaces and researching this applying co-produced, embedded, naturalistic and mixed methods approaches.
Practical implications
How a bio-psycho-social approach by a wellbeing co-ordinator can contribute to improved person reported outcomes from a range of preventive, rehabilitation, palliative care and bereavement services in the community.
Social implications
To combine knowledge about individuals held in the community to align the respective inputs, and expectations about outcomes while considering networked pathways based on functional status, above diagnostic pathways, and along a life-continuum.
Originality/value
The hub as a whole seems to (1) Enhance engagement through relationship, trust and activation, (2) Exchanging knowledge to co-create a shared bio-psycho-social understanding of each individual’s situation and goals, (3) Personalising care planning by utilising the range of available resources to ensure needs are met, and (4) Enhancing co-ordination and ongoing care through multi-disciplinary working between practitioners, across teams and sectors.
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Marcelo Royo-Vela, Juan Carlos Amezquita Salazar and Francisco Puig Blanco
This paper aims to address research gaps with regard to the relationship between market orientation and marketing performance when small- and medium-sized enterprises (SMEs) are…
Abstract
Purpose
This paper aims to address research gaps with regard to the relationship between market orientation and marketing performance when small- and medium-sized enterprises (SMEs) are located within a service cluster. The three main objectives of this research are to determine the effect that the cluster can have on both the market orientation of clustered companies and their marketing performance and to furthermore evaluate the effect of the market orientation of companies in the cluster on their marketing performance.
Design/methodology/approach
This research used executive-level data that were obtained by carrying out a survey involving a unique dataset of 133 Colombian health-related businesses located in the city of Cali (Colombia) in 2014. A system of equations was modeled using SMART PLS. This analysis was complemented by a qualitative study that involved conducting in-depth interviews in six companies.
Findings
The results showed that, among the SMEs, membership in an urban services cluster did not significantly influence marketing performance or the implementation of marketing orientation practices. No differences were observed in internal managerial practices implemented between companies that were co-located and isolated. However, a higher level of competitor orientation was associated with greater marketing performance. Given the verified absence of moderating and mediating effects, our work provides a reasonable basis for proposing future research and practical recommendations.
Originality/value
While research has demonstrated the relationship between a company's market orientation and marketing performance, this type of analysis has not been carried out on service SMEs in geographic concentrations or clusters.
研究目的
本文旨在處理涉及市場導向與營銷績效間的關係的研究缺口. 當中小型企業處於服務群集內, 市場導向與其營銷績效間存在相互關係;本文旨在處理涉及這關係的研究缺口. 本研究有以下的主要目標:(1)找出群集對群集公司的市場導向及其營銷績效兩者的影響;(2)繼而評估在群集內公司的市場導向對其營銷績效的影響.
研究方法
本研究使用透過進行一項調查而取得的管理階層數據,而這調查涉及於2014年位於卡利市(哥倫比亞)133間與健康衛生有關的哥倫比亞企業的獨特資料集。一個方程式體系透過使用SmartPLS被模擬出來. 這分析有個補充輔助,就是一個涉及在六間公司內進行的深層訪談的質性研究.
研究結果
研究結果顯示,就有關的中小型企業而言,擁有城市服務群集身份並沒顯著地影響營銷績效或市場導向慣常做法的施行。對處於同一地點的公司,抑或是隔離的公司,其內部施行的管理慣常做法並沒觀察到有所不同。但是,高水平的競爭者導向與更佳的營銷績效兩者是相關的。考慮到調節及仲介效果被證實不存在,我們的研究為日後研究及實際建議的提出提供合理的基礎.
研究的原創性
從前的研究證實了公司的市場導向與營銷績效是相關的,唯這類研究分析從來沒有在地理集中或群集內的服務中小型企業上進行過.
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Andrea Caputo, Mariya Kargina and Massimiliano Matteo Pellegrini
The purpose of this study is to map the intellectual structure of the research concerning conflict and conflict management in virtual teams (VT), to contribute to the further…
Abstract
Purpose
The purpose of this study is to map the intellectual structure of the research concerning conflict and conflict management in virtual teams (VT), to contribute to the further integration of knowledge among different streams of research and to develop an interpretative framework to stimulate future research.
Design/methodology/approach
A data set of 107 relevant papers on the topic was retrieved using the Web of Science Core Collection database covering a period ranging from 2001 to 2019. A comparative bibliometric analysis consisting of the integration of results from the citation, co-citation and bibliographic coupling was performed to identify the most influential papers. The systematic literature review complemented the bibliometric results by clustering the most influential papers.
Findings
The results revealed different intellectual structures across several types of analyses. Despite such differences, 41 papers resulted as the most impactful and provided evidence of the emergence of five thematic clusters: trust, performance, cultural diversity, knowledge management and team management.
Research limitations/implications
Based on the bibliometric analyses an interpretative research agenda has been developed that unveils the main future research avenues. The paper also offers important theoretical contributions by systematizing knowledge on conflict in identifying VTs. Managerial contributions in the form of the identification of best practices are also developed to guide conflict management in VTs.
Originality/value
The uniqueness of this paper is related to its effort in studying, mapping and systematizing the knowledge concerning the topic of handling conflicts in VTs. Considering the current contingencies, this research is particularly timely.
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Therese Dwyer Løken, Marit Kristine Helgesen, Halvard Vike and Catharina Bjørkquist
New Public Management (NPM) has increased fragmentation in municipal health and social care organizations. In response, post-NPM reforms aim to enhance integration through service…
Abstract
Purpose
New Public Management (NPM) has increased fragmentation in municipal health and social care organizations. In response, post-NPM reforms aim to enhance integration through service integration. Integration of municipal services is important for people with complex health and social challenges, such as concurrent substance abuse and mental health problems. This article explores the conditions for service integration in municipal health and social services by studying how public management values influence organizational and financial structures and professional practices.
Design/methodology/approach
This is a case study with three Norwegian municipalities as case organizations. The study draws on observations of interprofessional and interagency meetings and in-depth interviews with professionals and managers. The empirical field is municipal services for people with concurrent substance abuse and mental health challenges. The data were analyzed both inductively and deductively.
Findings
The study reveals that opportunities to assess, allocate and deliver integrated services were limited due to organizational and financial structures as the most important aim was to meet the financial goals. The authors also find that economic and frugal values in NPM doctrines impede service integration. Municipalities with integrative values in organizational and financial structures and in professional approaches have greater opportunities to succeed in integrating services.
Originality/value
Applying a public management value perspective, this study finds that the values on which organizational and financial structures and professional practices are based are decisive in enabling and constraining service integration.
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Joy Akehurst, Paul Stronge, Karen Giles and Jonathon Ling
The aim of this action research was to explore, from a workforce and a patient/carer perspective, the skills and the capacity required to deliver integrated care and to inform…
Abstract
Purpose
The aim of this action research was to explore, from a workforce and a patient/carer perspective, the skills and the capacity required to deliver integrated care and to inform future workforce development and planning in a new integrated care system in England.
Design/methodology/approach
Semi-structured interviews and focus groups with primary, community, acute care, social care and voluntary care, frontline and managerial staff and with patients and carers receiving these services were undertaken. Data were explored using framework analysis.
Findings
Analysis revealed three overarching themes: achieving teamwork and integration, managing demands on capacity and capability and delivering holistic and user-centred care. An organisational development (OD) process was developed as part of the action research process to facilitate the large-scale workforce changes taking place.
Research limitations/implications
This study did not consider workforce development and planning challenges for nursing and care staff in residential, nursing care homes or domiciliary services. This part of the workforce is integral to the care pathways for many patients, and in line with the current emerging national focus on this sector, these groups require further examination. Further, data explore service users' and carers' perspectives on workforce skills. It proved challenging to recruit patient and carer respondents for the research due to the nature of their illnesses.
Practical implications
Many of the required skills already existed within the workforce. The OD process facilitated collaborative learning to enhance skills; however, workforce planning across a whole system has challenges in relation to data gathering and management. Ensuring a focus on workforce development and planning is an important part of integrated care development.
Social implications
This study has implications for social and voluntary sector organisations in respect of inter-agency working practices, as well as the identification of workforce development needs and potential for informing subsequent cross-sector workforce planning arrangements and communication.
Originality/value
This paper helps to identify the issues and benefits of implementing person-centred, integrated teamworking and the implications for workforce planning and OD approaches.
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Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke and Suzanne Guerin
This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented…
Abstract
Purpose
This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues.
Design/methodology/approach
A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis.
Findings
Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice.
Practical implications
The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice.
Originality/value
This study offers a unique insight into psychologists’ perceptions of seclusion and considers the implications of these views. Participants’ nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics.
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Farrukh Alam, Nat Wright, Paul Roberts, Sunny Dhadley, Joanne Townley and Russell Webster
The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England…
Abstract
Purpose
The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England and Wales.
Design/methodology/approach
A group of experts was convened to comment on current practices and to make recommendations for improving OST management in prison. Current practices were previously assessed using an online survey and a focus group with experience of OST in prison (Webster, 2017).
Findings
Disruption to the management of addiction and reduced treatment choice for OST adversely influences adequate provision of OST in prison. A key concern was the routine diversion of opiate substitutes to other prisoners. The new controlled drug formulations were considered a positive development to ensure streamlined and efficient OST administration. The following patient populations were identified as having concerns beyond their opioid use, and therefore require additional considerations in prison: older people with comorbidities and complex treatment needs; women who have experienced trauma and have childcare issues; and those with existing mental health needs requiring effective understanding and treatment in prison.
Originality/value
Integration of clinical and psychosocial services would enable a joint care plan to be tailored for each individual with opioid dependence and include options for detoxification or maintenance treatment. This would better enable those struggling with opioid use to make informed choices concerning their care during incarceration and for the period immediately following their release. Improvements in coordination of OST would facilitate inclusion of strategies to further streamline this process for the benefit of prisoners and prison staff.
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Ailsa Cameron, Eleanor K Johnson and Simon Evans
This paper explores residents' perceptions and experiences of extra care housing as an integrated model of housing with care.
Abstract
Purpose
This paper explores residents' perceptions and experiences of extra care housing as an integrated model of housing with care.
Design/methodology/approach
Data were collected in a longitudinal qualitative study based on four extra care housing schemes. Data from interviews with residents, care workers, managers and local commissioners were analysed thematically.
Findings
The integration of housing with care enabled many older people to manage their care proactively. However, the increasing number of residents with complex health and care needs, including chronic illness, led some residents to question the ability of the model to support residents to live independently.
Research limitations/implications
The study struggled to recruit sufficient residents from the specialist dementia setting who were able to communicate their consent to take part in the research. In addition, the quality of qualitative data collected in interviews with participants at this setting reduced over successive rounds of interviews.
Practical implications
The study suggests the need to ensure that residents are fully informed about levels of care and support is available when considering a move into extra care housing.
Originality/value
This paper provides a timely opportunity to consider extra care housing as an example of an integrated housing service, particularly in light of the current challenges facing the sector.
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Despite the potential for research institutes to advance interdisciplinary research on university campuses, There have been few studies on how interdisciplinary research centres…
Abstract
Purpose
Despite the potential for research institutes to advance interdisciplinary research on university campuses, There have been few studies on how interdisciplinary research centres integrate multiple disciplines in practice, how they influence the collaborative behaviours of scientists and how they establish collaborative communities. This study aims to provide a deeper understanding of how interdisciplinary research is being enabled at research institutes and offers signposts for how research institutes can further embed interdisciplinarity within their units.
Design/methodology/approach
Within this study, 30 interviews were conducted with leadership and faculty within 4 sustainability research institutes in the USA exploring how research institutes support interdisciplinary research within their units. A thematic analysis on the interview data revealed themes on how research institutes are enabling interdisciplinary research within their organisations and universities.
Findings
The study highlights eight themes on how research institutes are, and can further, enable interdisciplinary research within their organisations and universities. Some of the themes are fully implemented within the research institutes, whilst others are more aspirational and highlight where institutes can create additional capability and capacity for interdisciplinary research within their units and universities.
Research limitations/implications
Whilst the study is limited to four major sustainability research institutes the findings will be applicable to all research centres and institutes attempting to create interdisciplinary research environments.
Practical implications
The study will be of particular interest to research institutes and university leadership who wish to cultivate a deeper culture of interdisciplinary research within their organisations.
Social implications
The advancement of inter- and transdisciplinary research within universities are seen by many academic institutions, expert groups and funding bodies as essential for solving wicked problems and grand challenges facing society. The findings of this paper will help universities increase their capacity for interdisciplinary research.
Originality/value
There are few comparable publications in terms of methodology, approach and focus on research institutes.
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