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In recent years local authorities and hospitals within the UK have been subjected to substantial change, which has resulted in an explosion in the use of information systems (IS). IS managers, personnel and executives within local authorities and hospitals were interviewed in order to determine the effect of context and culture on the take‐up of IS. Context was considered at an external and internal level. Cultural issues were particularly important in the take‐up of IS. In both local authorities and hospitals the IT culture clashed with the subcultures it was supporting. Highlights three issues: the cultural decentralization of IS, which resulted in an unplanned proliferation of disparate systems; the over‐emphasis on operational systems by the IS function to the detriment of management information systems; and the reinforcing of barriers between subcultures through incompatible IS. Suggests that IS departments within the public sector need to be proactive in their support of subcultures and to enrol them in a common goal of the provision of integrated IS within the organization.

The tenuous financial viability of many of Georgia’s rural hospitals has driven increased scrutiny of the hospital authorities (HAs) that own and govern them. HAs are a type of “special district” established in state law to allow for specialization of function, while evading statutes that can limit local government borrowing and multi-year contracts. The paper aims to discuss this issue.

This paper uses a case example to introduce transparency and accountability in one local Georgia hospital and expands to include a descriptive analysis of transparency measures in 29 rural Georgia HAs.

Findings indicate that, like many other special districts in Georgia and the USA, Georgia’s rural HAs often act more like private entities than the public organizations they are. The lack of transparency demonstrated in this sector limits access to public information and reduces opportunities for citizen engagement, a necessary component of representative institutions.

This case study is limited to Georgia HAs; however, the data support the lack of accountability and transparency found in many special district governments.

The lack of transparency in all of the organizations reviewed in this study demonstrates blurred lines between between public matters and private interests and raises questions of transparency, a key value in democracies.

The terms are not synonymous; their differences are mainly of function and areas of administration. Community Health is used in national health service law; environmental health to describe the residuum of health functions remaining with local authorities after the first NHS/Local Government reorganization of 1974. Previously, they were all embraced in the term public health, known for a century or more, with little attention to divisions and in the field of administration, all local authority between county and district councils. In the dichotomy created by the reorganization, the personal health services, including the ambulance service, may have dove‐tailed into the national health service, but for the remaining functions, there was a situation of unreality, which has persisted. It is difficult to know where community health and environmental health begin and end. From the outside, the unreality may be more apparent than real. The Royal Commission on the NHS in their Report of last year state that leaving environmental health services with local authorities “does not seem to have caused any problems”—and this, despite the disparity in status of the area health authority and the bottom tier, local councils.

Examines the dynamics of change that operated following preparations for accreditation. The study was conducted from May 1995 to October 2001 in a university hospital center in France after the introduction in 1996 of mandatory accreditation. An embedded explanatory case study sought to explore the organizational changes: a theoretical framework for analyzing change was developed; semi‐structured interviews, focus groups, and questionnaires addressed to the hospital's professionals were used and documents were collected; and qualitative and quantitative analyses were carried out. Professionals from clinical and medico‐technical departments participated most. Preparations for accreditation provided an opportunity to reflect non‐hierarchically on the treatment of patients and on the hospital's operational modalities by creating a locus for exchanges and collegial decision making. These preparations also led to giving greater consideration to results of exit surveys and to committing procedures to paper, and were a key opportunity for introducing a continuous quality program.

A FACTOR which all industrialised countries must take into account is the general increase in the age of the world population. There are many reasons for this increase but one or two are self‐evident. There has been a spectacular drop in infant mortality. The fight against disease is progressively successful. Better living standards make for a sense of well‐being in the population.

Hospitals are all required to be prepared against crisis, while according to studies, most hospitals are not prepared enough to encounter disaster problems. Therefore, each hospital should have an established programme to face earthquake and other catastrophes. This paper aims to investigate this issue.

This descriptive study was carried out in teaching hospitals of Iran University of Medical Sciences. Data collection was done using a checklist including general information, as well as information on demography, security, supplies and equipment, evacuation and communication. This procedure was done through observation and interview with hospital managers, etc. and the data were analyzed by SPSS software.

In the hospitals four dimensions of planning were studied and the following mean scores were obtained. On security, Hazrat Rasul hospital scored the highest (88.4) while Navab Safavi, Haftome Tir and Ali Asghar hospitals scored the lowest (51.4). On supplies and equipment, Navab Safavi and Haftome Tir hospitals obtained the highest score (66.6) and Hasheminejad, Shafa Yahyaeian, Firoozgar and Hazrat Rasul hospitals got the lowest score (60.0). On evacuation, Hazrat Rasul and Haftome Tir hospitals scored the highest and lowest respectively (64.2), (47.0). On communication, Hasheminejad hospital scored the highest (63.2) while Firoozgar hospital scored the lowest (36.6). In general from among ten hospitals under study the most and the least prepared hospitals were Hazrat Rasul and Navab Safavi respectively (65.65), (54.3).

The paper shows that most hospitals under study were not prepared enough against crisis and communication is found to be the weakest aspect although it is regarded as a basic principle in planning. Hazrat Rasul hospital was well prepared against crisis due to its disaster plan.

It has proved useful in studies of the personal social services, and in other areas of social policy, to make a distinction between final and intermediate outputs. Final outputs measure changes in individual client well‐being compared with changes in well‐being in the absence of a caring intervention. In other words, final outputs measure the degree of success of a service or a care unit in meeting its client‐level policy objectives, where due consideration is paid to client states had care not been available. In contrast, intermediate outputs are operationally defined in terms of the care services themselves rather than the effects of these services on clients.

Investigates the opportunities for marketers within the newly reformed NHS and gives a personal view of where the marketing emphasis should be placed in the early years of a trust. Examines the nature of the marketing challenge and outlines a typical trust culture and surrounding political environment, within which any marketing activity must take place. Argues that marketing must be seen as a core philosophy that permeates throughout the organization, reflected in a “top ten” of marketing activities for a new trust. Explores alternative implementation structures and recommends that the chief executive takes the marketing lead. Concludes by predicting the growth in power of purchasers and future mergers among providers.

The purpose of this paper is to clarify the effects of the Iranian Hospital Accreditation Program (IHAP) on hospital processes from the viewpoint of the staff charged with establishing the program.

This qualitative study is based on the data collected in semi-structured interviews conducted in 2016, which involved eight questions. Interviews were held with 70 staff members at 14 hospitals. Managerial staff were purposively interviewed based on their familiarity and involvement with the program. The hospitals were divided into five groups, comprising public, private, charity, military and social service hospitals. A thematic analysis was carried out using the collected data.

Three themes emerged from the data, which together comprise a process management cycle: the establishment, implementation, and control phases of the program. For each phase, various positive trends, as well as hurdles for establishing the program, declared which were framed two sub-themes as positive effects and challenges.

The findings contribute to the body of evidence used by policy-makers and hospital managers to improve the change management processes related to the Iranian IHAP. Although positive changes in the process management cycles at Iranian hospitals were noted, successful implementation of the program demands a thorough assessment of the hospitals’ technical and financial needs (taking into account disparities between hospitals), and there is an urgent requirement for a plan to meet these needs.

The purpose of this paper is to explore how change processes are dependent on historical events, geographical conditions, strong stakeholders and social norms developed over long‐time periods. The paper poses the question: what is the role of path dependencies in mergers between hospitals when motives of the mergers are ambiguous and the context of the change initiatives is characterized by conflicting goals?

The primary objective of this study is to describe the experience of three hospitals that were merged into a hospital enterprise, with the focus on a change in activity from 2003 to 2006. This fieldwork allowed a longitudinal study. The empirical data were generated from observations, interviews, document studies and newspaper clippings.

The investigations showed that the merger forced the hospitals to change, but the new organization – the different components of the merged hospital – followed different pathways to handle the externally imposed changes. Parallel processes evolved, and these processes were rooted in the historical and geographical conditions. Further, the paper illuminates the unique strengths of qualitative research methods that allowed a deeper understanding of these change processes.

The paper's findings add to our knowledge on the complex relations between externally imposed organizational change and the nature of internal organizational behaviour when intertwined with strong stakeholders. The paper particularly highlights the possible consequences when there is little interaction between the changes of systems and the practices of the professionals in hospitals when the processes are heavily influenced by path dependencies rooted in historical and geographical traditions.