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Article
Publication date: 14 August 2023

Manas Pokhrel, Dayaram Lamsal, Buddhike Sri Harsha Indrasena, Jill Aylott and Remig Wrazen

The purpose of this paper is to report on the implementation of the World Health Organization (WHO) trauma care checklist (TCC) (WHO, 2016) in an emergency department in a…

Abstract

Purpose

The purpose of this paper is to report on the implementation of the World Health Organization (WHO) trauma care checklist (TCC) (WHO, 2016) in an emergency department in a tertiary hospital in Nepal. This research was undertaken as part of a Hybrid International Emergency Medicine Fellowship programme (Subedi et al., 2020) across UK and Nepal, incorporating a two-year rotation through the UK National Health Service, via the Medical Training Initiative (MTI) (AoMRC, 2017). The WHO TCC can improve outcomes for trauma patients (Lashoher et al., 2016); however, significant barriers affect its implementation worldwide (Nolan et al., 2014; Wild et al., 2020). This article reports on the implementation, barriers and recommendations of WHO TCC implementation in the context of Nepal and argues for Transformational Leadership (TL) to support its implementation.

Design/methodology/approach

Explanatory mixed methods research (Creswell, 2014), comprising quasi-experimental research and a qualitative online survey, were selected methods for this research. A training module was designed and implemented for 10 doctors and 15 nurses from a total of 76 (33%) of clinicians to aid in the introduction of the WHO TCC in an emergency department in a hospital in Nepal. The quasi-experimental research involved a pre- and post-training survey aimed to assess participant’s knowledge of the WHO TCC before and after training and before the implementation of the WHO TCC in the emergency department. Post-training, 219 patients were reviewed after four weeks to identify if process measures had improved the quality of care to trauma patients. Subsequently six months later, a qualitative online survey was sent to all clinical staff in the department to identify barriers to implementation, with a response rate of 26 (n = 26) (34%) (20 doctors and 6 nurses). Descriptive statistics were used to evaluate quantitative data and the qualitative data were analysed using the five stepped approach of thematic analysis (Braun and Clarke, 2006).

Findings

The evaluation of the implementation of the WHO TCC showed an improvement in care for trauma patients in an emergency setting in a tertiary hospital in Nepal. There were improvements in the documentation in trauma management, showing the training had a direct impact on the quality of care of trauma patients. Notably, there was an improvement in cervical spine examination from 56.1% before training to 78.1%; chest examination 125 (57.07%) before training and 170 (77.62%) post-training; abdominal examination 121 (55.25%) before training and 169 (77.16%) post-training; gross motor examination 13 (5.93%) before training and 131 (59.82%) post-training; sensory examination 4 (1.82%) before training and 115 (52.51%) post-training; distal pulse examination 6 (2.73%) before training and 122 (55.7%) post-training. However, while the quality of documentation for trauma patients improved from the baseline of 56%, it only reached 78% when the percentage improvement target agreed for this research project was 90%. The 10 (n = 10) doctors and 15 (n = 15) nurses in the Emergency Department (ED) all improved their baseline knowledge from 72.2% to 87% (p = 0.00006), by 14.8% and 67% to 85%) (p = 0.006), respectively. Nurses started with lower scores (mean 67) in the baseline when compared to doctors, but they made significant gains in their learning post-training. The qualitative data reported barriers, such as the busyness of the department, with residents and medical officers, suggesting a shortened version of the checklist to support greater protocol compliance. Embedding this research within TL provided a steer for successful innovation and change, identifying action for sustaining change over time.

Research limitations/implications

The study is a single-centre study that involved trauma patients in an emergency department in one hospital in Nepal. There is a lack of internationally recognised trauma training in Nepal and very few specialist trauma centres; hence, it was challenging to teach trauma to clinicians in a single 1-h session. High levels of transformation of health services are required in Nepal, but the sample for this research was small to test out and pilot the protocol to gain wider stakeholder buy in. The rapid turnover of doctors and nurses in the emergency department, creates an additional challenge but encouraging a multi-disciplinary approach through TL creates a greater chance of sustainability of the WHO TCC.

Practical implications

International protocols are required in Nepal to support the transformation of health care. This explanatory mixed methods research, which is part of an International Fellowship programme, provides evidence of direct improvements in the quality of patient care and demonstrates how TL can drive improvement in a low- to medium-income country.

Social implications

The Nepal/UK Hybrid International Emergency Medicine Fellowships have an opportunity to implement changes to the health system in Nepal through research, by bringing international level standards and protocols to the hospital to improve the quality of care provided to patients.

Originality/value

To the best of the authors’ knowledge, this research paper is one of the first studies of its kind to demonstrate direct patient level improvements as an outcome of the two-year MTI scheme.

Details

Leadership in Health Services, vol. 37 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Open Access
Article
Publication date: 25 July 2023

Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke and Suzanne Guerin

This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented…

Abstract

Purpose

This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues.

Design/methodology/approach

A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis.

Findings

Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice.

Practical implications

The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice.

Originality/value

This study offers a unique insight into psychologists’ perceptions of seclusion and considers the implications of these views. Participants’ nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics.

Details

Mental Health Review Journal, vol. 29 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

Open Access
Article
Publication date: 19 February 2024

Cristina-Alexandra Trifan, Roxane de Waegh, Yunzi Zhang and Can-Seng Ooi

This paper explores the collaborative dynamics and dimensions within a virtual multi-cultural and interdisciplinary workplace. The study focusses on the use of online…

Abstract

Purpose

This paper explores the collaborative dynamics and dimensions within a virtual multi-cultural and interdisciplinary workplace. The study focusses on the use of online communication technologies to enhance social inclusion and networking within academia.

Design/methodology/approach

This study uses an autoethnographic approach to draw on the personal experiences of a team of four scholars, including three early-career researchers and a senior scholar. Their reflections on their academic positionality and the institutional constraints reveal both the strengths and vulnerabilities of collaborating in a virtual workplace.

Findings

The findings offer insights into the complexities of navigating social dynamics, such as delegating responsibilities, organising meetings across various time zones and encouraging continuous collaboration, inclusivity and effective communication during an extensive timeline. As a result, their experiences revealed that a virtual workplace culture with similar and different attributes to a “normal” workplace emerged.

Originality/value

The paper demonstrates how to create an effective and inclusive virtual workplace by exemplifying best practices in academia and providing practical guidance for individuals and institutions based on honest, co-produced autoethnographic reflections of the authors’ lived experiences.

Details

Journal of Organizational Ethnography, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2046-6749

Keywords

Article
Publication date: 20 March 2024

Abigail Newton, Megan Robson and Darren Johnson

Young offender mentoring programmes aim to support young people’s desistance from offending, but despite the importance, there remains limited exploration into mentor experiences…

Abstract

Purpose

Young offender mentoring programmes aim to support young people’s desistance from offending, but despite the importance, there remains limited exploration into mentor experiences of supporting the young people. This study aims to explore how a community-based mentoring intervention supports desistance in young offenders by understanding the mentor's experiences, with a specific reflective focus on facilitators and barriers to their work.

Design/methodology/approach

Semi-structured interviews were conducted with seven mentors from Northumbria Coalition against Crime, a youth and community service. Interview transcripts were analysed using interpretative phenomenological analysis, with external auditing conducted by the research supervisor.

Findings

Two superordinate themes resulted: “Factors for engagement” and “Personal experiences”, with participant disclosures reflecting professional reward and a sense of success. This was interwoven with “burnout”, emotional investment and challenges linked to barriers to effectiveness. Challenges included the young people having external negative influences, multiple individuals involved in a person’s care and the barrier of in person activities during the coronavirus pandemic. The clinical importance of mentoring programmes, implications for future working practice and research limitations are considered.

Practical implications

The clinical importance of mentoring programmes, implications for future working practice and research limitations are considered.

Originality/value

These findings contribute to understanding mentors’ experiences of working with young people in the community, offering critical insight into the mentorship and wider service dynamics. Furthermore, it provides an inaugural evaluation of the Northumbria Coalition against Crime services.

Details

Journal of Criminological Research, Policy and Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-3841

Keywords

Article
Publication date: 7 December 2023

Julie Feather, Axel Kaehne and Joann Kiernan

Drawing on the experiences of healthcare professionals in one paediatric hospital, this paper explores the influence of context and organisational behaviour on the implementation…

Abstract

Purpose

Drawing on the experiences of healthcare professionals in one paediatric hospital, this paper explores the influence of context and organisational behaviour on the implementation of a person-centred transition programme for adolescents and young adults (AYA) with long-term conditions.

Design/methodology/approach

A single embedded qualitative case study design informed by a realist evaluation framework, was used. Participants who had experience of implementing the transition programme were recruited from across seven individual services within the healthcare organisation. The data were gathered through semi-structured interviews (n = 20) and analysed using thematic analysis.

Findings

Implementation of the transition programme was influenced by the complex interaction of macro, meso and micro processes and contexts. Features of organisational behaviour including routines and habits, culture, organisational readiness for change and professional relationships shaped professional decision-making around programme implementation.

Originality/value

There exists a significant body of research relating to the role of context and its influence on the successful implementation of complex healthcare interventions. However, within the area of healthcare transition there is little published evidence on the role that organisational behaviour and contextual factors play in influencing transition programme implementation. This paper provides an in-depth understanding of how organisational behaviour and contextual factors affect transition programme implementation.

Details

Journal of Health Organization and Management, vol. 38 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 29 September 2023

Susan Jain, Kathy Dempsey, Stephanie Wilcox, Patricia Bradd, Joanne Travaglia, Deborah Debono, Linda Justin and Su-yin Hor

This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19…

Abstract

Purpose

This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme’s aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles.

Design/methodology/approach

The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners’ interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences.

Findings

The authors’ evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another’s experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face.

Research limitations/implications

Despite a small sample size, the authors’ results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted.

Practical implications

The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations.

Originality/value

ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

Details

Leadership in Health Services, vol. 37 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 7 March 2024

Péter Kristóf and Chander Nagpal

Exponential organizations (ExOs) are purpose-driven companies that leverage exponential technologies and exponential business practices to grow and scale rapidly, transform…

20

Abstract

Purpose

Exponential organizations (ExOs) are purpose-driven companies that leverage exponential technologies and exponential business practices to grow and scale rapidly, transform industries and create massive value and impact. In contrast, non-ExOs follow a linear approach to business and organizational strategy design and execution. This study aims to validate the hypothesis, based on financial metrics, that ExOs outperform their competitors and linear counterparts. Furthermore, it also brings a new understanding of the gap raised in the past eight years about how ExOs can achieve significantly better performance, measured with financial metrics.

Design/methodology/approach

For measuring how exponential an organization is, this study elaborated a completely new assessment tool called Exponential Quotient (ExQ). This study applied ExQ to the 100 largest US headquartered companies as ranked by Fortune magazine in 2014. Calculating the ExQ enabled this study to rank these Fortune 100 companies and identify the most and the least exponential firms. This study tracked these companies as to how they performed on different financial metrics over the eight years of 2014–2021 and analyzed the results.

Findings

Through the analysis, this study revealed that the top 10 ExOs have significantly outperformed their bottom 10 non-exponential peers, delivering 40x higher shareholder returns, 2.6x better revenue growth, 6.8x higher profitability and 11.7x better asset turnover. Furthermore, this study could identify commonalities and similarities between the two groups. This means that ExOs can thrive even in tough times and that accelerating technologies unlock abundance and allow every organization to become a disruptive innovator and stay ahead of the competition. These are novel results in the research focusing on the gap between exponential and traditional organizations.

Research limitations/implications

Using the ExQ diagnostics tool, every organization can see how flexible, scalable and agile they are, which is the starting point for an exponential transformation program. Although this approach has already found its way into practice and is applied globally by thousands of organizations (startups, scaleups and incumbents), so far, the academic establishment is in its nascent phase. With this research, the authors wanted to extend this field of science. On the other hand, because of its novelty, no appropriate previous studies existed to compare the results.

Practical implications

The possible implications showed that there is a plannable way for significantly increasing an organization’s ExQ and advance it from a linear toward an exponential organizational model.

Originality/value

The results validated the robustness of the ExO framework and philosophy and shed light on the importance of exponential transformation – a proven method to increase an organization’s ExQ. This framework is not a “how to be successful” guide. Instead, it uncovered some of the previously unknown and universal mechanisms of scalability – which, in turbulent times, make companies successful (based on financial metrics). To the best of the authors’ knowledge, this study was among the first kind of in-depth analyses to validate the whole ExO model.

Details

International Journal of Organizational Analysis, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1934-8835

Keywords

Open Access
Article
Publication date: 13 February 2024

Andrew Cram, Stephanie Wilson, Matthew Taylor and Craig Mellare

This paper aims to identify and evaluate resolutions to key learning and teaching challenges in very large courses that involve practical mathematics, such as foundational finance.

Abstract

Purpose

This paper aims to identify and evaluate resolutions to key learning and teaching challenges in very large courses that involve practical mathematics, such as foundational finance.

Design/methodology/approach

A design-based research approach is used across three semesters to iteratively identify practical problems within the course and then develop and evaluate resolutions to these problems. Data are collected from both students and teachers and analysed using a mixed-method approach.

Findings

The results indicate that key learning and teaching challenges in large foundational finance courses can be mitigated through appropriate consistency of learning materials; check-your-understanding interactive online content targeting foundational concepts in the early weeks; connection points between students and the coordinator to increase teacher presence; a sustained focus on supporting student achievement within assessments; and signposting relevance of content for the broader program and professional settings. Multiple design iterations using a co-design approach were beneficial to incrementally improve the course and consider multiple perspectives within the design process.

Practical implications

This paper develops a set of design principles to provide guidance to other practitioners who seek to improve their own courses.

Originality/value

The use of design-based research and mixed-method approaches that consider both student and teacher perspectives to examine the design of very large, foundational finance courses is novel.

Details

Journal of Work-Applied Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2205-2062

Keywords

Article
Publication date: 26 March 2024

Valérie Mérindol and David W. Versailles

Innovation management in the healthcare sector has undergone significant evolutions over the last decades. These evolutions have been investigated from a variety of perspectives…

Abstract

Purpose

Innovation management in the healthcare sector has undergone significant evolutions over the last decades. These evolutions have been investigated from a variety of perspectives: clusters, ecosystems of innovation, digital ecosystems and regional ecosystems, but the dynamics of networks have seldom been analyzed under the lenses of entrepreneurial ecosystems (EEs). As identified by Cao and Shi (2020), the literature is silent about the organization of resource allocation systems for network orchestration in EEs. This article investigates these elements in the healthcare sector. It discusses the strategic role played by entrepreneurial support organizations (ESOs) in resource allocation and elaborates on the distinction between sponsored and nonsponsored ESOs in EEs. ESOs are active in network orchestration. The literature explains that ESOs lift organizational, institutional and cultural barriers, and support entrepreneurs' access to cognitive and technological resources. However, allocation models are not yet discussed. Therefore, our research questions are as follows: What is the resource allocation model in healthcare-related EEs? What is the role played by sponsored and nonsponsored ESOs as regards resource allocation to support the emergence and development of EEs in the healthcare sector?

Design/methodology/approach

The article offers an explanatory, exploratory, and theory-building investigation. The research design offers an abductive research protocol and multi-level analysis of seven (sponsored and nonsponsored) ESOs active in French healthcare ecosystems. Field research elaborates on semi-structured interviews collected between 2016 and 2022.

Findings

This article shows explicit complementarities between top-down and bottom-up resource allocation approaches supported by ESOs in the healthcare sector. Despite explicit originalities in each approach, no network orchestration model prevails. Multi-polar coordination is the rule. Entrepreneurs' access to critical technological and cognitive resources is based on resource allocation modalities that differ for sponsored versus nonsponsored ESOs. Emerging from field research, this research also shows that sponsored and nonsponsored ESOs manage their roles in different ways because they confront original issues about organizational legitimacy.

Originality/value

Beyond the results listed above, the main originalities of the paper relate to the instantiation of multi-level analysis operated during field research and to the confrontation between sponsored versus nonsponsored ESOs in the domain of healthcare-related innovation management. This research shows that ESOs have practical relevance because they build original routes for resource allocation and network orchestration in EEs. Each ESO category (sponsored versus nonsponsored) provides original support for resource allocation. The ESO's legitimacy is inferred either from the sponsor or the services delivered to end-users. This research leads to propositions for future research and recommendations for practitioners: ESO managers, entrepreneurs, and policymakers.

Details

International Journal of Entrepreneurial Behavior & Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1355-2554

Keywords

Article
Publication date: 20 December 2023

Ian Davis

The interview documents early days in the field of disaster risk reduction.

Abstract

Purpose

The interview documents early days in the field of disaster risk reduction.

Design/methodology/approach

The transcript and video were developed in the context of a United Nations Office for Disaster Risk Reduction (UNDRR) project on the History of DRR.

Findings

The transcript presents important developments during the 1980s with valuable lessons about risk reduction.

Originality/value

It takes the readers on a history of the journey of DRR over three decades.

Details

Disaster Prevention and Management: An International Journal, vol. 33 no. 1
Type: Research Article
ISSN: 0965-3562

Keywords

1 – 10 of 106