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This paper proposes investigating a model of service recovery performance in a public health‐care setting.

Frontline hospital staff (administrative and nursing staff) representing a range of out‐patient departments/clinics in a New Zealand inner‐city public hospital completed a self‐administered questionnaire on organizational variables affecting their service recovery efforts, job satisfaction and intention to resign. Data obtained from the hospital were analyzed using the SEM‐based partial least squares (PLS) methodology.

The results show significant relationships between perceived managerial attitudes, work environment perceptions, service recovery performance and outcomes variables.

Limitations of the study are noted including the generalizability of the findings within a public health‐care environment. Suggestions for future research include an examination of other variables potentially important in service recovery efforts. A patient perspective would also be valuable.

The research advances understanding of frontline service recovery performance in a health‐care setting and the findings indicate that health‐care managers can take actions on a number of fronts to assist progress toward the achievement of frontline service recovery excellence.

Very little attention has been given to understanding the antecedents and outcomes of service recovery performance in the health‐care literature. By expanding earlier research in private sector industries, the study investigates a model of service recovery performance in a public health‐care setting.

The purpose of this paper is to shed light on how actors within, on the surface, similar organizations cope and work with imposed institutional changes.

This research is based on an ethnographic field study addressing why, despite being exposed to the same institutional demands, organizational actors respond by developing diverging institutional orders of appropriate organizational conduct. This research examines how middle managers and frontline staff in two similar Danish social care organizations respond to demands to adopt a New Public Management (NPM)‐based logic of individualized service delivery.

The study shows how institutional diversity may underlie apparently similar organizational structures and responses. NPM‐style modernization efforts partly converged with diverse professional motives and rationales around, on the surface, similar organizational changes. The findings illustrate how differential institutional orders are maintained by middle managers and frontline staff despite exposure to the same demands.

There are different limitations to this ethnographic field study due to the character of the methodology, the limited number of organizations, informants and time span covered. Attending to micro‐level processes within organizations provides a rich understanding of how particular forms of organization and action emerge in response to institutional demands. This calls for more ethnographic research on how actors within organizations cope and work institutional change.

Relatively little organizational research has addressed how individual actors at the lower levels of organizations cope and work with institutional changes using ethnographic methodology.

The purpose of this paper is to explore the nature and impact of leadership in relation to the local implementation of quality improvement interventions in health care organisations.

Using empirical data from two studies of the implementation of The Productive Ward: Releasing Time to Care™ in English hospitals, the paper explores leadership in relation to local implementation. Data were attained from in-depth interviews with senior managers, middle managers and frontline staff (n=79) in 13 NHS hospital case study sites. Framework Approach was used to explore staff views and to identify themes about leadership.

Four overall themes were identified: different leadership roles at multiple levels of the organisation, experiences of “good and bad” leadership styles, frontline staff having a sense of permission to lead change, leader's actions to spread learning and sustain improvements.

This paper offers useful perspectives in understanding informal, emergent, developmental or shared “new” leadership because it emphasises that health care structures, systems and processes influence and shape interactions between the people who work within them. The framework of leadership processes developed could guide implementing organisations to achieve leadership at multiple levels, use appropriate leadership roles, styles and behaviours at different levels and stages of implementation, value and provide support for meaningful staff empowerment, and enable leader's boundary spanning activities to spread learning and sustain improvements.

The purpose of this paper is to propose an organisational structure not based on power and control but on the organic and functional processes of the front line.

These ideas arose from discussions about the roles and training needs of frontline managers, and frequent conflict between their organisational and functional roles.

Organisations that emphasise power and control functions, as symbolised in the organisational chart, often view solutions to efficiency, productivity and change in terms of the ability of senior managers to impose solutions on frontline staff, and the appointment of frontline managers for their ability to implement those solutions. However, more efficient, effective and creative solutions often result from developing dynamic and creative frontline teams, who can use their awareness of production, customer service and staffing issues to provide innovative organisational changes.

Organisations should appoint staff to frontline management positions based not on their ability to control but on their ability to provide leadership, functional facilitation and support to meet the purposes of the team.

The value of the paper lies in a proposed paradigm shift in organisational thinking from a model based on control to one based on functional team building.

This study aims to examine the emotional and cognitive responses of frontline homelessness service support staff to the highly insecure attachment styles (AS) exhibited by people experiencing multiple exclusion homelessness (MEH), that is, a combination of homelessness and other forms of deep social exclusion.

Focus groups were conducted with frontline staff (N = 19) in four homelessness support services in Scotland. Hypothetical case vignettes depicting four insecure AS (enmeshed, fearful, withdrawn and angry-dismissive) were used to facilitate discussions. Data is analysed thematically.

Service users with AS characterised by high anxiety (enmeshed or fearful) often evoked feelings of compassion in staff. Their openness to accepting help led to more effective interactions between staff and service users. However, the high ambivalence and at times overdependence associated with these AS placed staff at risk of study-related stress and exhaustion. Avoidant service users (withdrawn or angry-dismissive) evoked feelings of frustration in staff. Their high need for self-reliance and defensive attitudes were experienced as hostile and dismissing. This often led to job dissatisfaction and acted as a barrier to staff engagement, leaving this group more likely to “fall through the net” of support.

Existing literature describes challenges that support staff encounter when attempting to engage with people experiencing MEH, but provides little insight into the causes or consequences of “difficult” interactions. This study suggests that an attachment-informed approach to care can promote more constructive engagement between staff and service users in the homelessness sector.

Centralization, mergers and cost reductions have generally led to increasing levels of span of control (SOC), and thus potentially to lower leadership capacity. The purpose of this paper is to explore how a large SOC impacts hospital staff and their leaders.

The study is based on a qualitative explorative case study of three large inpatient wards.

The study finds that the nursing staff and their frontline leaders experience challenges in regard to visibility and role of the leader, e.g., in creating overview, coordination, setting-up clear goals, following up and being in touch. However, large wards also provide flexibility and development possibilities.

The authors discuss the implications of these findings for decision makers in deciding future SOC and for future SOC research.

Only few studies have qualitatively explored the consequences of large SOC in hospitals.

Research has established the prevalence and relevance of moral injury in healthcare workers, though less attention has been paid to the different classes of potentially morally injurious events (PMIEs) experienced by this population and their impact. This exploratory study sought to examine the frequency of self- and other-generated PMIE classes and their associations with demographic characteristics and well-being outcomes among mental healthcare staff.

Secondary analysis of data drawn from two cross-sectional surveys of 267 frontline and leadership staff from mental healthcare settings in the UK was conducted. Responses on the Moral Injury Events Scale and the Short Professional Quality of Life Scale were extracted for analysis.

Betrayal by others was most frequently endorsed (61.8%), whilst self-transgressions were least frequently reported (25.5%). After controlling for the number of PMIE classes experienced, betrayal significantly predicted secondary traumatic stress (p = 0.01) and burnout (p = 0.04). Additionally, other transgressions significantly predicted secondary traumatic stress (p = 0.008). The predictive effects of self-transgressions on burnout, secondary traumatic stress and compassion satisfaction were all nonsignificant after controlling for the number of PMIE classes experienced.

Findings highlight differences in the frequency and impact of self and other PMIEs experienced by healthcare professionals. Reducing cumulative exposure to differential PMIE classes appears to be of critical importance to improving occupational well-being in this group.

To our knowledge, this study is the first to explore the associations between PMIE classes and occupational well-being in a mental healthcare population, inclusive of frontline and leadership staff.

The purpose of this paper is to explore the reaction of customer facing staff and their attitude to the introduction of high profile corporate social responsibility (CSR) programmes; in particular their level of awareness and willingness to implement them.

Conducted using a series of site visits and interviews with managers working within the licensed trade, this was followed up with structured interviews of “front line” staff.

Despite high levels of awareness of both the social problems relating to alcohol consumption and the legislative changes, engagement with operational CSR was limited and often disinterested. Legal and societal expectations regarding drunkenness are of little concern.

This paper is concerned with nascent legislation, the full impact and success of which has not yet emerged. Reviewing this study in five years would add to the strength of the results. Limited to Scotland due to its devolved licensing laws, however, it clearly highlights lack of employee engagement with CSR.

Despite placing CSR issues at the forefront of day to day operations within the licensed trade there is little empirical evidence around customer facing staff engagement. CSR is a dynamic process that relies on the involvement of employees for its successful implementation.

A new CSR implementation matrix is presented which allows hospitality businesses to be positioned according to levels of both management and employee engagement with CSR policies.

Delivering services that create memorable luxury accommodation experiences rely on frontline staff to engage guests on a sensory level rather than merely a functional one. This engagement includes cognitive, emotional, relational and behavioural. Hospitality and tourism industries are people-orientated – people are needed to serve people in order to create desired experiences – and it is very difficult to create satisfaction or to revisit intention in every interaction that takes place. It is this intangible characteristic of the industries, provisions and tangible cues that play an important part in enhancing the overall luxury accommodation experience. Guests are very clear as to what they expect from luxury accommodation experiences: they feel that they are paying for a service that should be personalised, and that staff should realise what they want and need. The human interaction component and the co-creation that occurs between staff and guests is an essential dimension of the industry. The influence of these interactions on guest experiences and the delivery of services will be explored in this chapter.

To investigate the association between implementation of clinical governance and patient safety.

A pre-post study was conducted in an Australian health service following the implementation of clinical governance systems (CGS) in the inpatient wards in 2016. Health service audit data from 2017 on CGS implementation and the rate of adverse patient safety events (PSE) for 2015 (pre-implementation) and 2017 (post-implementation), across 45 wards in six hospitals were collected. CGS examined compliance with 108 variables, based on the Australian National Safety and Quality Health Service standards. Patient safety was measured as PSE per 100 bed days. Data were analysed using odds ratios to explore the association between patient safety and CGS percentage compliance score.

There was no change in PSE between 2015 and 2017 (MD 0.04 events/100 bed days, 95% CI -0.11 to 0.21). There were higher odds that wards with a CGS score >90% reported reduced PSE, compared to wards with lower compliance. The domains of leadership and culture, risk management and clinical practice had the strongest association with the reduction in PSE.

Given that wards with a CGS score >90% showed increased odds of reduced PSE health service boards need to put in place strategies that engage frontline managers and staff to facilitate full implementation of clinical governance systems for patient safety.

The findings provide evidence that implementation of all facets of CGS in a large public health service is associated with improved patient safety.