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Clinical governance is the linchpin of the UK government's quality improvement strategy for the country's National Health Service. Extending quality accreditation programmes from hospitals into the primary care sector — local general practice surgeries — presents a critical set of challenges. In this extract from Accreditation in Primary Care, Nicola Walsh and Kieran Walshe explore how to evaluate accreditation initiatives to assure the quality of primary care.

This paper aims to explore, for the first time, community perceptions of the relationship between age and social exclusion in rural areas of the Republic of Ireland and Northern Ireland.

The paper builds on learning from a previous baseline cross‐border rural ageing study and draws its methodology from a broader ecological multi‐level approach. The research was conducted through focus groups with community stakeholders, which were undertaken in ten communities in different rural settings (village, near‐urban, island, dispersed, and remote) in both the Republic of Ireland and Northern Ireland.

In total, four interconnecting thematic areas emerged as important in determining exclusion or inclusion for older people living in rural areas: place, economic circumstances, social provision, and social connectedness. Within these themes, various tipping points emerged as important for pathways into and out of exclusion, most notably local systems of social support and the mindset of older people themselves in relation to participation.

This research lays the foundations for understanding the lived experiences of older people on the island of Ireland and the pathways for their inclusion and exclusion in diverse rural areas, as seen through the lens of community stakeholders.

The aim of this paper is to assess the impact of e‐learning resources based on NICE guidelines in improving knowledge and changing practice among health professionals.

NICE in collaboration with BMJ Learning developed a series of e‐learning modules based on NICE recommendations relating to osteoarthritis, irritable bowel syndrome, urinary tract infection in children, and antibiotic prophylaxis against infective endocarditis. The impact of these modules was evaluated by looking at the knowledge and skills of the learners before and after they did the modules and also asking the learners about resultant practice change.

A total of 5,116 users completed the modules. Completing them enabled users to increase their knowledge and skills score from the pre‐test to the post‐test by a statistically significant amount (p < 0.001): from a mean of 65 per cent to 85 per cent. Qualitative feedback to the modules was overwhelmingly positive. To test long‐term effectiveness, users were e‐mailed six weeks after they had completed the modules to assess practice change. The response rate to the survey was 22.2 per cent. In total 88.6 per cent of those who had cared for patients with these problems since completing the module said that it had helped them put NICE guidelines into practice.

E‐learning modules have high uptake, are popular and effective at helping health professionals learn about NICE guidelines and help them to put these guidelines into practice.

The study is valuable as it shows how interactive and multimedia resources help health professionals learn about guidelines. No previous studies have been identified.

A method of systematically assessing the “first-round” impact of tax and transfer policy changes on the income distribution and the incidence of relative income poverty is proposed. It involves the construction of a “distributionally neutral” policy, which can be approximated by a policy that indexes tax allowances, credits and bands and welfare payment rates in line with a broad measure of income growth. The impact of actual policy changes in five EU countries over the 1998–2001 period is then measured against this benchmark, using the EUROMOD tax-benefit model.

The technical reports released by the National Transportation Safety Board, along with secondary data in the form of available public data, such as news reports, interviews and memos, were used to round out the synopsis of the case study.

This case explores the events that led up to the crash of United Airlines Flight 717 (for anonymity), in Sioux City, Iowa, on July 19, 1989, and the subsequent investigation. The case uses secondary sources to highlight the positive team interactions between the pilots that led to the crash landing not being as catastrophic as it might have been with 185 survivors in an extreme crisis scenario. The teaching note focuses on the importance of cognitive bias, psychological safety and teamwork in a crisis situation, and practical recommendations for managers at all levels.

Organizational Behavior at the undergraduate and graduate level. Leadership and Change at the graduate and graduate level.

The purpose of this paper is to review the cancellation of Australia's National Soccer League (NSL) competition and its replacement in 2004 with the corporatist A‐League which is based on the North American model of “one team one city”, no promotion and relegation, and private‐equity clubs. The authors believe that one of the aims of the A‐League and its “ground‐zero” ideology was to institute exclusion of the ethnic clubs that had formed the backbone of the NSL for 30 years.

Extensive literature search, participant‐observation, one personal interview and two group interviews were employed. People interviewed were the President of the Croatian community's Melbourne Knights Football Club, the Club Secretary of Melbourne Knights, and three leaders of Melbourne Knights’ MCF hooligan firm.

The authors observe the Football Federation Australia hiding behind the perceived scientific nature and technical veracity of budgeted accounting numbers to set the financial bar too high for the ethnic clubs to find a place in the brave new world that has been called “Modern Football”. However, capitalism creates its own discontents. Online forums and homemade fence banners are the new vehicles for dissent for the supporters of “Old Soccer”.

There is still only a small academic literature on Australian football and most of this has been written by humanities lecturers. The paper offers a business school perspective.

The critical input of middle managers as they make sense of the organisation's plans is paramount during the process of strategic change. Through the lens of middle manager sensemaking literature, this explorative research identifies key organisational practices that underpin sensemaking. An understanding of these practices will allow organisations better develop and support them, thereby enabling middle managers' contribution to strategic change.

This study employed an innovative diary methodology. 42 middle managers, across three organisations, completed a weekly, online diary for 12 weeks. A qualitative analysis of the final 355 diaries isolated and explained the sensemaking practices in which middle managers engaged as they sought to achieve the shared understanding required to progress strategic change.

This study identifies the key practice underpinning middle manager sensemaking as formal and frequent discourse opportunities between leaders and middle managers. Through leader participation beyond the initiation stages of strategic change, and the organisation's positive positioning of time and metrics, these discourse opportunities enable a form of sensemaking associated with a number of positive organisational outcomes. These include middle manager sensegiving across the organisation, the successful enactment of strategic change, positive perceptions of change outcomes and organisational climate among middle managers and middle manager well-being.

This study advances our theoretical understanding of the practice of sensemaking in organisations through the isolation and identification of its key practices. However, given the difficulty in obtaining access for such a lengthy and intrusive methodology, the study is confined to three organisations. Additionally, the focus on the practice of sensemaking did not fully explore any contextual factors within these organisations. Also, middle manager perceptions of successful organisational outcomes are not very reliable performance indicators. While the self-reporting of perceptions is a worthwhile means of gathering data, a measure and comparison of actual business performance indicators would significantly strengthen the findings.

From a practitioner perspective, this study not only underlines the importance for organisations of developing critical sensemaking practices for middle managers but also provides a clear pathway to achieving this. In approaching the intangible process of sensemaking from a practice perspective, it provides key stakeholders such as leaders, change agents and the HR department with a guide as to the types and forms of discourse practices which can be enabled. Maybe more importantly, it also highlights the practices which disable middle manager sensemaking. The study also provides organisations with insights into the positive outcomes stemming from middle manager sensemaking that should strengthen their case towards the development of sensemaking practices.

This paper responds to the call for new approaches to the study of sensemaking as an ongoing practice within organisations. The qualitative diary analysis provides rich insights into the specific organisational practices that can enable middle manager sensemaking, while also highlighting those practices that can disable their role during strategic change. These findings provide organisations with clear approaches for developing sensemaking as a practice, thereby engaging and supporting the multiple actors and levels required to deliver successful strategic change.

The ability to attract and retain volunteers is crucial for not-for-profit organizations, and consequently, the need to understand and manage volunteers’ engagement is paramount. The purpose of this paper is to investigate the role of five volunteer engagement dimensions (cognitive, affective, behavioral, social and spiritual engagement) on perceived value-in-context, and its subsequent role for volunteer retention. Thus, providing for the first time an understanding of how unique types of value are determined through different facets of volunteer engagement.

To establish the nature and consequences of volunteer engagement, the authors collaborated with an Australian not-for-profit service organization. Using a survey method, the authors studied the organization’s volunteer workforce resulting in 464 usable responses. To capture volunteers’ degree of spiritual engagement, this paper introduces a rigorously developed unidimensional measure.

The results demonstrate the importance of the five engagement dimensions on volunteers’ perceived value-in-context, while highlighting significant effect differences including some counterintuitive consequences. The authors also establish the role of spiritual engagement and demonstrate the impact of value-in-context for volunteer retention.

This research explores the volunteer engagement-retention chain, by empirically studying the role of value-in-context. The authors provide first evidence for the relationship between volunteer engagement and value-in-context, examining the independent yet relative effects of various facets of volunteer engagement. In doing so, the authors offer new insight into the dimensionality of the volunteer engagement construct, broadening its conceptualization to include spiritual engagement as a core constituent. The authors further demonstrate the impact of value-in-context on volunteer retention, helping organizations to better make sense of meaningful volunteer experiences with long-lasting impacts and mutual benefits.