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The purpose of this paper is to reflect on the experience of the Advancing Quality Alliance's (AQuA) regional Integrated Care Discovery Community created to translate integrated care theory into practice at scale and to test ways to address the system enablers of integrated care.

Principles of flexibility, agility, credibility and scale influenced Community design. The theoretical framework drew on relevant complexity, learning community and change management theories. Co-designed with stakeholders, the discovery-based Community model incorporated emergent learning from change in complex adaptive environments and focused bespoke support on leadership capability building.

In total, 19 health and social care economies participated. Kotter's eight-step change model proved flexible in conjunction with large-scale change theories. The tension between programme management, learning communities and the emergent nature of change in complex adaptive systems can be harnessed to inject pace and urgency. Mental models and simple rules were helpful in managing participant's desire for a directive approach in the context of a discovery programme.

This is a viewpoint from a regional improvement organisation in North West England.

The Discovery Community was a useful construct through which to rapidly develop multiple integrated health and social care economies. Flexible design and bespoke delivery is crucial in a complex adaptive environment. Capability building needs to be agile enough to meet the emergent needs of a changing workforce. Collaborative leadership has emerged as an area requiring particular attention.

Learning from AQuA's approach may assist others in structuring large-scale integrated care or complex change initiatives.

This article outlines a model for gauging the quality of a partnership approach to research that was developed for use in a Research Centre in West Sweden. The Äldre Väst Sjuhärad Centre has as its main goal the promotion of partnerships between older people and their families, service providers and researchers. In pursuing these goals the Centre adopts a broadly‐constructivist approach to undertaking research that is ‘authentic’ and meaningful to those who take part. In order to make judgements about the quality of its activity the Centre has adapted the authenticity criteria originally suggested by Guba and Lincoln (1989), so that they are more readily understood by older people, carers and service providers. These criteria can be applied at all stages of research activity, and it is suggested here that they can be utilised more widely in order to make inferences about the effects of partnership working in other contexts.

This project engaged faculty, students, alumni and staff in re-visioning their university's learning, teaching and research framework. An extensive consultation process allowed participants to explore, discuss and critically reflect on effective practice.

This action research project provided a process for university community members to engage in practice conversations. In phase 1, focus groups and campus community discussions elicited the diverse perspectives of the community. The design-thinking process of discovery, ideation and prototyping aligned with the action research cycles to help a working group create a learning and teaching framework prototype based on the findings. In the second phase, surveys were used to elicit community members' responses to the prototype, which was then refined.

The prototype was organized into three overarching categories, each containing several attributes. The attributes of the “Applied and Authentic” category were: interdisciplinary and transdisciplinary; experiential and participatory; flexible and individualized; outcomes based; and openly practiced. The attributes of the “Caring and Community-Based” category were: inclusive and diverse; community-based; supportive; team-based; co-creative; and place and virtual space-based. The attributes of the “Transformational” category were socially innovative; respectful of Indigenous peoples and traditions; impactful; and reflective.

This article should interest higher education institutions seeking to engage faculty, staff, students and others in practice conversations to develop a learning, teaching and research strategy. This research demonstrated that fostering practice conversations among diverse community members can be a powerful process for creating a common and integrated vision of excellent learning, teaching and research practice.

This study examines factors related to audit committee membership for a sample of large New Zealand listed companies. This study reveals that non‐executive directors who are independent, and directors with financial expertise, are more likely to be members of audit committees. The results are consistent with the New Zealand Securities Commission’s corporate governance guidelines for audit committees of New Zealand listed companies. However, in the current New Zealand regulatory environment, directors with accounting expertise can include non‐executives affiliated with the firm. In these situations the financial expert is not independent. Remuneration committee members are found more likely to be members of the audit committee. This may be a result of their power and influence or be due to the skills they bring. The number of years that directors serve on the board, the number of other directorships they hold, and the number of shares they own in the company are not related to audit committee membership.

This study aims to contribute to the understanding of audit pricing and the competitiveness of the audit fee market by examining audit fee stickiness.

The authors explore the price behavior of audit fees in response to changes in the variables that are usually seen as their determinants, such as size, complexity, and risk in order to examine audit fee stickiness and the competitiveness of the market for audit services.

The authors find that audit fees are sticky, i.e. audit fees do not immediately or fully adjust to changes in their determinants. Audit fees also respond to changes leading to an increase more quickly than they respond to changes leading to a decrease. The difference between positive and negative fee adjustments declines over periods longer than one year and is no longer significant when four-year periods are considered.

The study is limited to companies in the USA from 2000 to 2008. Future research should examine this issue in other settings and periods.

The results suggest that the audit market is competitive, at least in the medium term.

The study helps to explain why the audit fee model does not fully explain the level of audit fees; why audit fees are more likely to be too high than too low; and why auditor switches are commonly associated with larger changes in audit fees. The findings provide evidence that may be useful to managers and audit committees when managing their audit fees, auditors when considering the risks and opportunities associated with changes in the determinants of audit fees, and regulators concerned with the competitiveness of the audit market.

‘WHAT A novel arrangement. Is any reason given?’

From the perspective of emergence, professors can facilitate and shape a class as a complex, adaptive, and living system. A case study illustrates phases of emergence in the classroom by tracing how a professor may use this perspective to empower students to share in the leadership of the classroom. Instead of presenting lessons, the professor facilitates emergent activity, creating a classroom structure where students practice leadership behaviors. In this classroom structure, the professor assumes the leadership roles of coach and facilitator. As a result students building the classroom culture together they connect with each other: they develop strong relationships, take initiative, and learn important lessons about leadership. This article concludes with design principles for establishing a classroom of shared leadership in any teaching environment in any subject.

The purpose of this paper is to explore the voice of the customer, key performance indicators, critical to quality characteristics, critical success factors, and commonly used tools and techniques for deploying the Lean Six Sigma (LSS) strategy in Indian private hospitals, with special attention to the medical records.

The study utilizes the action research methodology to obtain a greater understanding of the use of LSS in the Indian healthcare sector. Multiple case studies were designed and successfully deployed to understand and ascertain challenges in LSS implementation. Five case studies were carried out in the Medical Records Departments (MRD) of four private hospitals in India.

Patients perceive that waiting in queue harms their health, which can be rectified by addressing the cycle time of the system. The research also found that effective leadership, availability of data, involvement of cross-functional team and effective communication are critical to the success of LSS projects. In addition, control charts, cause and effect diagram, 5S, gemba, two-sample t-test, standardization, waste analysis and value stream mapping are some of the common tools used to improve healthcare systems.

The research was restricted to studying the impact of LSS on the workflow and resource consumption of the MRD in Indian allopathic hospitals only. The validity of the results can be improved by including more hospitals and more case studies from the healthcare sector in different countries.

The findings will enable researchers, academicians and practitioners to incorporate the results of the study in LSS implementation within the healthcare system to increase the likelihood of successful deployment. This will provide greater stimulus across other departments in the hospital sector for wider and broader application of LSS for creating and sustaining process improvements.

In the 1970s, the United States Congress enacted two statutes that have had dramatic and far‐reaching effects on the education of handicapped children by public schools. These two laws, Section 504 of the Rehabilitation Act of 1973 and the Education For All Handicapped Children Act of 1975 (known as Public Law 94–142), have required local public school agencies to provide new eductional programs for thousands of handicapped children not previously served by the public schools. Counselors, principals, and teachers were quickly informed of the law's requirements and willingly began the task of main‐streaming and assimilating these children into various curricula. Their physical needs were attended to rapidly; their societal and emotional needs, unfortunately, lagged behind. Within the past seven years, there has been an increase in books, articles, and films specifically addressed to counseling the handicapped. Unlike past literature which focused only on the vocational aspect of rehabilitation counseling, current writing emphasizes personal counseling meant to assist a disabled child to participate fully in the problems and joys of daily living.