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1 – 10 of over 12000Services for people with dementia in the UK have developed piecemeal in the context of wider agency agendas. Health and social care agencies located in rural areas face particular…
Abstract
Services for people with dementia in the UK have developed piecemeal in the context of wider agency agendas. Health and social care agencies located in rural areas face particular challenges if they are to be able to support people with dementia within their communities. This article describes a piece of work carried out in three rural counties in East Anglia designed to map services across the statutory, voluntary and private sectors, and to describe the ways in which national policy is being interpreted to meet local need. Examples of innovative practice, as well as gaps in service design and delivery, were identified through an examination of local policy documents and qualitative interviews with strategic managers, frontline managers and practitioners, and local carers of people with dementia. The findings confirm that services for older people with dementia are under‐developed in comparison with services for older people generally, and in comparison with mental health services for working age adults. There are particular gaps with respect to rarer types of dementia, services for people with learning difficulties, and services for people from minority ethnic groups. Historically, a lack of strategic planning has meant that service development has been patchy and unco‐ordinated. Carers have been affected by a shortage of joined‐up information, high eligibility criteria and a change to short‐term working by practitioners. Nevertheless, the potential for developing community‐based and inclusive services for people with dementia is apparent, and the adaptability required of rural areas may, subject to further evaluation, provide a template for service development elsewhere.
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Brenda Leese and Roland Petchey
Personal medical services pilots were introduced in England in 1998 to provide increased flexibility to general practitioners practising in deprived areas, to improve service…
Abstract
Personal medical services pilots were introduced in England in 1998 to provide increased flexibility to general practitioners practising in deprived areas, to improve service provision and reduce inequalities. The aim of this study was to identify health authority perspectives of the achievements of their pilots. Less than half of the health authorities agreed that their pilots’ original objectives had been completely achieved. Support, commitment and enthusiasm from within and outside the pilots, and the ability to be flexible, were helpful in promoting change management. Obstacles were financial difficulties and a lack of understanding of personal medical services. The opinion was that personal medical services had made a highly regarded contribution to the local health economy, especially in the provision of new services and the promotion of new staff roles. The results provide lessons for primary care organisations in England and elsewhere in terms of the factors required to successfully implement change.
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Marcia Terra da Silva and Graydon Davison
This paper aims to investigate whether an organisation's configuration, with regard to its operating environment, could have a bearing on the learning that occurs within the…
Abstract
Purpose
This paper aims to investigate whether an organisation's configuration, with regard to its operating environment, could have a bearing on the learning that occurs within the organisation because the configuration can be considered an artefact capable of enabling learning and capable of facilitating the storage and utilisation of the results of learning. This raises an interesting question about the ability of organisations to shape the configuration that enables and facilitates them, which in turn would shape the learning itself.
Design/methodology/approach
Reported in this paper is research in healthcare organisations in Brazil and Australia that use a multidisciplinary model of care delivery which test these relationships.
Findings
The paper's findings indicate that in the Brazilian case learning has to do with the formal acquisition of knowledge for use within professions, by professionals who are in practice and teaching. In the Australian case learning has to do with the flexible acquisition of knowledge across professions, within and between teams.
Originality/approach
This paper is useful to those wishing to facilitate learning in an organisation.
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Adrian J. Hayes, Daniel Pratt and Jenny Shaw
A new service was developed to provide transitional care between acute and secure services for people with serious mental illness who are considered “difficult to manage”. The…
Abstract
Purpose
A new service was developed to provide transitional care between acute and secure services for people with serious mental illness who are considered “difficult to manage”. The purpose of this paper is to evaluate the work of the service by examining referrals made, strategies employed for each referral, and patient outcomes, as well as investigating issues in the service's development and implementation.
Design/methodology/approach
A retrospective descriptive study by review of 38 case notes, and qualitative interviews of 47 staff within the service and those referring to the service.
Findings
In the first eight months, 38 patients were referred due to violence, aggression and management problems. Most interventions provided by the service involved working with referring staff, rather than direct patient contact. Subsequently, 16 per cent required referral to higher levels of security. Interviews showed the team's aims needed to be more clearly established, but that ward staff found the service to be a useful and productive resource.
Research limitations/implications
The study is descriptive and retrospective, but showed that the service provided appropriate interventions for managing patients with serious mental illness and challenging behaviour.
Practical implications
A transitional service may have value in keeping patients in the least restrictive setting. Careful planning is needed in designing novel interventions, ensuring clear aims and effective management.
Originality/value
The service under study was novel, and may be useful in facilitating successful transfer from, or preventing admission to, secure services.
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Kirti Sharda and Leena Chatterjee
There is an increasing recognition of outsourcing firms as new organizational forms with unique systems and practices. This paper seeks to use a configurational approach to…
Abstract
Purpose
There is an increasing recognition of outsourcing firms as new organizational forms with unique systems and practices. This paper seeks to use a configurational approach to integrate learning from outsourcing literature, organization and management theory, strategic management and strategic human resource management in order to understand similarities and differences between outsourcing firms and their performance. It aims to examine if certain combinations of work designs, strategic orientations, client relations and contexts could lead to better organizational performance within a sample of outsourcing firms.
Design/methodology/approach
A combination of descriptive and exploratory research design has been used to collect data from 60 outsourcing firms across India. Using survey and semi‐structured interviews, data have been collected from the top management team and non‐managerial employees in each organization (n=836 respondents). Principal components factor analysis, Ward's minimum variance method, K‐means cluster analysis, and χ2 have been used to arrive at configurations of outsourcing firms. Kruskal‐Wallis one‐way ANOVA and Tamhane's T2‐test have been used for further hypothesis testing.
Findings
Five dominant configurations of outsourcing firms emerge, namely, clear‐eyed strategists, adapting professionals, focalizing artisans, conservative controllers, and overambitious associates. Specific configurations of outsourcing firms are associated with better performance across a variety of organizational performance parameters (average attrition, growth in employment, growth in clients, growth in offered processes and overall satisfaction with organisational performance).
Research limitations/implications
Future research could include financial performance measures and could examine potential conflicts in performance outcomes. It would also be interesting to include client perspective in future studies on outsourcing firm success. Replicating the results of this study across countries would enhance their validity and generalizability.
Practical implications
It is hoped that the findings of this paper will contribute to theory building in the field of both outsourcing and configurational research. At the same time, the study is expected to help managers who are trying to move their outsourcing firms in the direction of sustainable success through the choice of appropriate strategies, designs, inter‐organizational relations and contexts.
Originality/value
This is one of the initial studies to classify outsourcing firms using organizational level variables. While most prior studies have examined outsourcing success from the client perspective, this paper provides an important shift towards studying organizational performance from the outsourcing firm's perspective. Since configurational membership can predict which firms will perform better than others on objective and subjective performance measures, this paper provides a useful framework to managers for structuring processes and inter‐organizational relations while making informed strategic choices.
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James Gavigan, Mario Zappacosta, Ken Ducatel, Fabiana Scapolo and Paola di Pietrogiacomo
A review of recent foresight exercises reveals some important drivers of research in Europe. In this editorial, we introduce five main areas where science and technology will be…
Abstract
A review of recent foresight exercises reveals some important drivers of research in Europe. In this editorial, we introduce five main areas where science and technology will be required to deliver tangible gains for society and the economy in the coming years. It is no longer enough for research agendas to be dictated by the supply of expertise from the science base. Increasingly, they must respond to social values like access and sustainability, and humanize the interface between technology and people.
Irina Farquhar and Alan Sorkin
This study proposes targeted modernization of the Department of Defense (DoD's) Joint Forces Ammunition Logistics information system by implementing the optimized innovative…
Abstract
This study proposes targeted modernization of the Department of Defense (DoD's) Joint Forces Ammunition Logistics information system by implementing the optimized innovative information technology open architecture design and integrating Radio Frequency Identification Device data technologies and real-time optimization and control mechanisms as the critical technology components of the solution. The innovative information technology, which pursues the focused logistics, will be deployed in 36 months at the estimated cost of $568 million in constant dollars. We estimate that the Systems, Applications, Products (SAP)-based enterprise integration solution that the Army currently pursues will cost another $1.5 billion through the year 2014; however, it is unlikely to deliver the intended technical capabilities.
Jihai Jiang, Rui Liu and Fengquan Wang
This paper aims to investigate how value drivers of internet medical business model affect value creation through a configurational approach. The internet medical business model…
Abstract
Purpose
This paper aims to investigate how value drivers of internet medical business model affect value creation through a configurational approach. The internet medical business model (IMBM) is such a business model that integrates online and offline medical services with the driving force of internet technologies covering prediagnosis, in-diagnosis and postdiagnosis. The outbreak of COVID-19 and the support of national policies have boosted the development of internet health care. However, there are still many challenges in practice, such as the unclear innovation path, as well as difficulties in landing and profiting. Academic research has not yet provided sufficient theoretical insights. Therefore, to better explain and guide practice, it is urgent to clarify the innovation path and mechanism of value creation for IMBM.
Design/methodology/approach
Based on the sample of 58 internet medical firms in China, this paper adopts fuzzy-set qualitative comparative analysis (fsQCA) to explore the configurational effects of IMBM’s value drivers on value creation.
Findings
Building on the business model canvas and the characteristics of internet health care, five value drivers of IMBM are identified, namely, functional value proposition, emotional value proposition, user involvement, resource capabilities and connection properties. And the five value drivers form three configurations, which are, respectively, labeled as resource-driven configuration, user-operated configuration and product-combined configuration. From the perspective of the integration of traditional and emerging theories, such as resource-based view, internet economics and value cocreation, each configuration leads to value creation and improves value results with different mechanisms behind it.
Originality/value
First, combined with the business model canvas and the characteristics of internet health care, this paper identifies five value drivers of IMBM, thus improving the relevant research on internet health care. Second, based on the configurational effects, this paper discusses the mechanism behind the configurational effects of IMBM’s value drivers on value creation, thus expanding relevant research on the value creation of business models. Third, applying fsQCA and combining the advantages of qualitative research and quantitative research, this paper adds to the configurations of IMBM’s value drivers that achieve high-value results.
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This study seeks to adopt the perspective of service (dominant) logic to investigate the impact of three resource inputs (service content, service process, and service…
Abstract
Purpose
This study seeks to adopt the perspective of service (dominant) logic to investigate the impact of three resource inputs (service content, service process, and service configurations) on the perceptions of value of e‐service customers.
Design/methodology/approach
An online study is conducted among 667 customers of a Finnish health‐care web site.
Findings
The study finds that content of various services have differential impacts on customers' perceptions of value. The study also finds that some service configurations (combinations of services) are more value‐enhancing than others.
Research limitations/implications
The empirical study was limited to a Finnish health‐care site. Future studies could use this research model to investigate different services and cultures to improve the generalisability of the findings.
Practical implications
Service providers should note that peer services (such as discussion groups) were more value‐enhancing than professional services (such as an advice database). Recognition of the most appealing services and service configurations enables managers to develop and market their services more effectively.
Originality/value
The study is one of the first to demonstrate how e‐service research and practice can benefit by taking a service logic perspective in which service content, service process, and service configurations are treated as input resources in the value‐creation processes of customers.