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This chapter draws on longitudinal case study research that focused on the experiences of hospitality employees working in a UK university who worked split shifts in the morning and evening while completing NVQ 2 and 3 apprenticeship training. We show how fragmented working time (Rubery, Grimshaw, Hebson, & Ugarte, 2015) rather than long hours led to the apprenticeship training further eroding an already blurred work-life boundary as workers were required to complete training activities in their non-work time which for them is during the middle of the day. We argue current depictions of the positive impact of training and development on low paid workers are decontextualized from the challenges and priorities of workers whose work-life interface is already complex because of working fragmented hours across the day. This is complicated even further by the dynamic and evolving experiences of workers themselves as they experience the highs and lows of combining paid work and training. We situate the research in the context of wider conceptual debates that call for a more inclusive approach to research on the work-life interface (Warren, 2021) and highlight implications for HR practitioners who want to offer such opportunities to low paid workers in sectors such as hospitality, while also recognizing the complex challenges such workers may face.

The purpose of this paper is to compare home care workers' views of their employment conditions by provider type – private for-profit vs public and non-profit – using the case study of Ireland.

An online survey was distributed to care workers (n = 350) employed by private for-profit, public and non-profit home care providers in Ireland. Returned questionnaires were analysed statistically in R using chi-squared tests to systematically compare key aspects of employment conditions.

Analysis shows that conditions are perceived to be significantly worse for those employed by private for-profit providers (and to a lesser extent non-profit organisations) compared to the public provider. There are wide disparities between public and private sector conditions in terms of contracts, pensions, unsocial hours pay and travel time allowances. The main area of convergence is in relation to employer support, where although the public sector performed better, the difference between the three provider types is smaller.

Relatively little research compares working conditions in private for-profit providers vs public and non-profit providers in Ireland and other countries. The findings can be understood in the context of marketisation reforms and may partly be explained by a lack of regulation in Ireland's home care sector and low unionisation rates amongst care workers employed by private for-profit providers.

Extensive human and animal research has examined approach and withdrawal motivation, which we define as the simple urge to move toward or away, respectively. In this chapter, we review seminal and recent research that showing that asymmetrical frontal cortical activity underlies approach and withdrawal motivation that occur during childhood, that characterize certain psychopathologies, and are present in everyday emotional experiences. Specifically, greater left-frontal activity is involved in approach motivation, including the expression and experience of anger, jealousy, desire, and joy. Conversely, greater right-frontal activity is involved in withdrawal motivation, including the expression and experience of some forms of sadness, crying, and depressed mood. We also review recent research suggesting that connectivity between the frontal and parietal cortices is a potential mechanism for the motivation-related effects of asymmetrical frontal activity.

Leaders derive their capacity for driving institutional change from their power over organizations, but prior research says little about how leaders with limited power over a dominant intraorganizational group can acquire such a capacity for institutional action. This chapter develops a multilevel model that helps to understand how leaders of public service organizations were able to introduce “contract organization” form of organizational governance that enabled them to outsource the provision of public services to private firms. By doing so, this chapter adds to existing accounts of how power and political processes can give rise to organizational and institutional change.

The purpose of this paper is to develop a framework for the application of evidence-based management to chronic disease healthcare.

Chronic healthcare is specially characterized by recursive patient-physician interactions in which evidence-based medicine (EBM) is applied. However, implementing evidence-based solutions to improve healthcare quality requires managers to effect changes in many different areas: organizational structure, procedures, technology and in physician/provider behaviors. To complicate matters further, they must achieve these changes using the tools of resource allocation or incentives. The literature contains many systematic reviews evaluating the question of physician and patient behavior under various types and structures of incentives. Similarly, systematic reviews have also been done regarding specific changes to the healthcare process and their effectiveness in improving patient outcomes. Yet, these reviews uniformly lament a lack of appropriate data from well-organized studies on the question of “Why?” solutions may work in one instance while not in another. The authors present a new theoretical framework that aids in answering this question.

This paper presents a new theoretical framework (Influence Model of Chronic Healthcare) that identifies: the critical areas in which managers can effect changes that improve patient outcomes; the influence these areas can have on each other, as well as on patient and physician behavior; and the mechanisms by which these influences are exerted. For each, the authors draw upon, and present the evidence in the literature. Ultimately, the authors recognize that this is a complex question that has not yet been fully researched. The contribution of this model is twofold: first, the authors hope to focus future research efforts, and second, provide a useful heuristic to managers who must make decisions with only the lesser-quality evidence the literature contains today.

This model can be used by managers as a heuristic either ex ante or ex post to determine the effectiveness of their decisions and strategies in improving healthcare quality. In addition, it can be used to analyze why actions or decisions taken achieved a given outcome, and how best to proceed to effect further improvements on patient outcomes. Last, the model serves to focus attention on specific questions for further research.

Audit and feedback (A&F) often underlie implementation projects, described as a circular process; i.e. an A&F cycle. They are widely used, but effect varies with no apparent explanation. We need to understand how A&F work in real-life situations. The purpose of this paper, therefore, is to describe and explore mental healthcare full A&F cycle experiences.

This is a naturalistic qualitative study that uses four focus groups and qualitative content analysis.

Staff accepted the initial A&F stages, perceiving it to enhance awareness and reassure them about good practice. They were willing to participate in the full cycle and implement changes, but experienced poor follow-up and prioritization, not giving them a chance to own to the process. An important finding is the need for an A&F cycle facilitator.

Research teams cannot be expected to be involved in implementing clinical care. Guidelines will keep being produced to improve service quality and will be expected to be practiced. This study gives insights into planning and tailoring A&F cycles.

Tools to ease implementation are not enough, and the key seems to lie with facilitating a process using A&F. This study underscores leadership, designated responsibility and facilitation throughout a full audit cycle.

Clinical guidelines aim to disseminate evidence and thus to change behaviour. This process is complex and needs a coherent approach. Aims to develop a model for implementing clinical guidelines in primary care and thus influencing prescribing by general practitioners (GPs). A total of 25 semi‐structured interviews were conducted with GPs and primary care academics. To enrich the model an ongoing literature review of guideline implementation and changing prescribing behaviour was used. A simple model was derived to guide primary care organisations and GPs in implementing guidelines for prescribing, which comprises six steps: choose the condition; choose the guideline; identify influential people; identify organisational factors; plan and adopt an implementation strategy; and monitor the resulting adherence. The model provides a framework for planning the implementation of guidelines, and recognising barriers that hinder adherence to guidelines. It may help to explain why clinical guidelines vary in their uptake.

The purpose of this paper is to provide a retrospective analysis of computer simulation’s role in accelerating individual innovation adoption decisions. The process innovation examined is Lean Systems Thinking, and the organizational context is the imaging department of an Australian public hospital.

Intrinsic case study methods including observation, interviews with radiology and emergency personnel about scheduling procedures, mapping patient appointment processes and document analysis were used over three years and then complemented with retrospective interviews with key hospital staff. The multiple data sources and methods were combined in a pragmatic and reflexive manner to explore an extreme case that provides potential to act as an instructive template for effective change.

Computer simulation of process change ideas offered by staff to improve patient-flow accelerated the adoption of the process changes, largely because animated computer simulation permitted experimentation (trialability), provided observable predictions of change results (observability) and minimized perceived risk.

The difficulty of making accurate comparisons between time periods in a health care setting is acknowledged.

This work has implications for policy, practice and theory, particularly for inducing the rapid diffusion of process innovations to address challenges facing health service organizations and national health systems.

The research demonstrates the value of animated computer simulation in presenting the need for change, identifying options, and predicting change outcomes and is the first work to indicate the importance of trialability, observability and risk reduction in individual adoption decisions in health services.

This chapter provides a critical analysis of the literature on individuals in cultural transitions in higher education, namely, international students in culturally unfamiliar contexts; teachers of international students and culturally more diverse classrooms; and local students in increasingly culturally diverse classes. All these individuals are actors exposed to new and shifting cultural experiences expected to impact their motivation and engagement. Two broad perspectives emerging from the literature were used to organize the chapter: a perspective of adaptation representing research grounded in unilateral, bilateral or reciprocal conceptualizations, and a perspective of transformation, capturing experiential learning research leading to personal and academic development. The analysis highlights how motivation is a critical, yet under-examined construct. This leads to numerous suggestions for future research including: addressing the neglected role of agency in research on international students' sociocultural adaptation and the lack of research on successful processes of adaptation; examining the confounding issue of socialization into new cultural-educational environments and level of proficiency in the medium of instruction, which impacts on engagement; and scrutinizing the posited link between deep-level motivated engagement in cultural transitions and the emergence of transformative experiences. A case is made for research on individuals' engagement and motivation in cultural transitions to be conceptually and methodologically stronger and broader, moving from studies of single groups of individuals in need of adaptation, to investigations of the co-regulated, reciprocal adaptations of actors and agents operating in complex sociocultural contexts where power dynamics related to knowledge and language affect participation and engagement with cultural 'others'.