Search results

The Voice of the Clinician project commenced during an era when practitioner burnout, dissatisfaction, and turnover became an increasingly global health workforce concern. One key problem is clinical staff not being empowered to voice their concerns to decision-makers, as was found in this case study of an Australian public health organization. The following research question informed the present study: What is a better committee system for clinician engagement in decision-making processes? The paper aims to discuss this issue.

The Mid North Coast Local Health District in New South Wales aspired to improve engagement between frontline clinicians and decision-makers. Social network analysis methods and mathematical modeling were used in the discovery of how committees are connected to each other and subsequently to other committee members.

This effort uncovered a hidden organizational architecture of 323 committees of 926 members which overall cost 84,729 person hours and AUD$2.923 million per annum. Furthermore, frontline clinicians were located far from centers of influence, just 37 percent of committees had terms of reference, and clinicians reported that meeting agendas were not being met.

In response to the findings, a technological platform was created so that the board of directors could visually see all the committees and the connections between them, thus creating ways to further improve communication, transparency of process, and – ultimately – clinician engagement.

The breakthrough idea is that all organizational meetings can be seen as a system of engagement and should be analyzed to determine and describe the points and pathways where clinician voice is blocked.

The nonprofit sector has come to deliver the majority of state-funded social services in the United States. Citizens depend on nonprofit organizations for these services, and nonprofits depend on government for financial support. Scholars have begun to ask important questions about the political and civic implications of this new organizational configuration. These questions have direct ramifications for the anti-prison movement given the explosive growth of nonprofit prison reentry organizations in recent years. To see how such organizations may impact political engagement and social movements, this chapter turns its focus on the intricate dynamics of client-staff interactions. Leveraging a yearlong ethnography of a government-funded prison reentry organization, I describe how such organizations can be politically active and at the same time contribute to their clients' political pacification. Staff members engaged in political activities in surrogate representation of their clients. While staffers advocated on their behalf, clients learned to avoid politics and community life, accept injustices for what they are, and focus instead on individual rehabilitation. By closely studying what goes on within a nonprofit service provider, I illustrate the nonprofit organization's dual political role and its implications for social movements and political change.