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Health literate discharge practices meet patient and family health literacy needs in preparation for care transitions from hospital to home. The purpose of this paper is to measure health literate discharge practices in Ontario hospitals using a new organizational survey questionnaire tool and to perform psychometric testing of this new survey.

This survey was administered to hospitals in Ontario, Canada. Exploratory factor analysis and reliability testing were performed.

The participation rate of hospitals was 46 percent. Exploratory factor analysis demonstrated that there were five factors. The survey, and each of the five factors, had moderate to high levels of reliability.

There is a need to expand the focus of further research to examine the experiences of patients and families. Repeating this study with a larger sample would facilitate further survey development.

Measuring health literate discharge practices with an organizational survey will help hospital managers to understand their performance and will help direct quality improvement efforts to improve patient care at hospital discharge and to decrease hospital readmission.

There has been little research into how patients are discharged from hospital. This study is the first to use an organizational survey tool to measure health literate discharge practices.

To examine the evolution of health care integration strategies and associated conceptualization and practice through a review and synthesis of over 25 years of international academic research and literature.

A search of the health sciences literature was conducted using PubMed and EMBASE. A total of 114 articles were identified for inclusion and thematically analyzed using a strategy content model for systems-level integration.

Six major, inter-related shifts in integration strategies were identified: (1) from a focus on horizontal integration to an emphasis on vertical integration; (2) from acute care and institution-centered models of integration to a broader focus on community-based health and social services; (3) from economic arguments for integration to an emphasis on improving quality of care and creating value; (4) from evaluations of integration using an organizational perspective to an emerging interest in patient-centered measures; (5) from a focus on modifying organizational and environmental structures to an emphasis on changing ways of working and influencing underlying cultural attitudes and norms; and (6) from integration for all patients within defined regions to a strategic focus on integrating care for specific populations. We propose that underlying many of these shifts is a growing recognition of the value of understanding health care delivery and integration as processes situated in Complex-Adaptive Systems (CAS).

This review builds a descriptive framework against which to assess, compare, and track integration strategies over time.

The performance construct may be one of the most elusive in organization theory. Health care organizations are particularly complex owing to their dual lines of accountability, i.e. professional and administrative. This article examines the factors affecting performance indicator development and use at the technical/managerial and institutional levels, including the accreditation process and the relationship between levels. Using institutional and rational/goal theory, the motivations behind performance measurement behavior at different organizational levels was explored. Results show that the institutional level is motivated by legitimacy while the technical/managerial level is motivated by rationality. Tensions exist between the two levels and between indicator development and use.

Large-scale change involves modifying not only the structures and functions of multiple organizations, but also the mindsets and behaviours of diverse stakeholders. This paper focuses on the latter: the informal, less visible, and often neglected psychological and social factors implicated in change efforts. The purpose of this paper is to differentiate between the concepts of organizational culture and mental models, to argue for the value of applying a shared mental models (SMM) framework to large-scale change, and to suggest directions for future research.

The authors provide an overview of SMM theory and use it to explore the dynamic relationship between culture and cognition. The contributions and limitations of the theory to change efforts are also discussed.

Culture and cognition are complementary perspectives, providing insight into two different levels of the change process. SMM theory draws attention to important questions that add value to existing perspectives on large-scale change. The authors outline these questions for future research and argue that research and practice in this domain may be best served by focusing less on the potentially narrow goal of “achieving consensus” and more on identifying, understanding, and managing cognitive convergences and divergences as part of broader research and change management programmes.

Drawing from both cultural and cognitive paradigms can provide researchers with a more complete picture of the processes by which coordinated action are achieved in complex change initiatives in the healthcare domain.

Presents a number of papers from the Performance Measurement Association conference held in July 2002. Reveals that all the papers investigate developments in the field of performance measurement and management since the Kaplan and Norton Balanced Scorecard was first introduced.

The launch of the £80m Preventative Technology Grant in 2006 has resulted in a considerable interest in telecare. Yet where in this emerging area should efforts be concentrated, and what lessons can be learnt from previous trials to aid future deployments? Based on practical experience and the work of the Housing & Telecare Learning & Improvement Networks at the Care Service Improvement Partnership (CSIP), Department of Health, this paper presents some of the common issues experienced and identified when implementing telecare. It makes a number of useful suggestions on how organisations working across housing, health and social care can make best use of telecare when planning, commissioning and delivering services.

THERE have been official links for the past twelve years between the Institute of Incorporated Work Study Technologists and Time and Motion Study. Many of its members have been valued contributors to our pages and the Institute has had editorial space for its news.

This special “Anbar Abstracts” issue of the International Journal of Public Sector Management is split into six sections covering abstracts under the following headings: Culture, Strategy and Organizational Structure; Leadership, Management Styles and Decision Making; Personnel and HR Management; Training and Development; Information Technology; Marketing and Customer Service Strategy.