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Researchers often debate health service structure. Understanding of the practical implications of this debate is often limited by researchers' neglect to integrate participants' views on structural options with discourses those views represent. As a case study, this paper aims to discern the extent to which and how conceptual underpinnings of stakeholder views on women's health contextualize different positions in the debate over the ideal structure of health services.

The researchers chose a self-standing, comprehensive women's health service facing the prospect of being dispersed into “mainstream” health services. The researchers gathered perspectives of 53 professional and consumer stakeholders in ten focus groups and seven semi-structured interviews, analyzed through inductive thematic analysis.

“Women's marginalization” was the core theme of the debate over structure. The authors found clear patterns between views on the function of women's health services, women's health needs, ideal client group, ideal health service structure and particular feminist discourses. The desire to re-organize services into separate mainstream units reflected a liberal feminist discourse, conceiving marginalization as explicit demonstration of its effects, such as domestic abuse. The desire to maintain a comprehensive women's health service variously reflected post-structural feminism's emphasis on plurality of identities, and a radical feminist discourse, holding that womanhood itself constituted a category of marginalization – that is, merely being at risk of unmet health needs.

As a contribution to health organizational theory, the paper shows that the discernment of discursive underpinnings of particular stakeholder views can clarify options for the structure of health services.

The purpose of this paper is to describe a two-part study that has explored the organisational and leadership competencies required for successful service integration within a health consortia in Australia. Preliminary organisational and leadership competency frameworks were developed to serve as reference points as the consortia it expanded to cater for increased service demand in the midst of significant health reform.

The study design is outlined, which involved literature reviews and semi-structured interviews with key stakeholders to ascertain the key determinants of successful service integration at both organisational and leadership levels.

The literature reviews revealed little existing research specifically focused on the organisational and leadership competencies that underpin successful service integration. The themes from the literature reviews and semi-structured interviews informed the preliminary organisational and leadership competency frameworks. Both frameworks are outlined in the paper. Key determinants of successful service integration – at both an organisational and individual leadership level – are also presented.

This is a one-organisation case study and the competency frameworks presented are preliminary. However, the study findings provide a foundation for further research focusing on the longer-term success of service integration.

Service integration in health is a new and emerging area, and there is little extant research exploring the organisational and leadership competencies underpinning its success. The competency frameworks presented in the paper may be of interest to other consortia and organisations engaged in service integration and other forms of merger and collaboration.

The purpose of this article is to produce a taxonomy of organizational models of school health services (SHS) in the WHO European Region, and to reflect upon the potential of each model to be effective, equitable, responsive and efficient.

The authors used data from the WHO survey to identify organizational models. To produce a taxonomy of organizational models, three features of SHS organization were analyzed – the presence of health personnel specifically dedicated to school health services provision (school nurse and/or school doctor); the statutory involvement of other health professions in SHS provision; and the proximity of service provision to pupils (school-based or not school-based).

There are five organizational models of school health services in the Member States of the WHO European Region: dedicated school-based, dedicated community-based, integrated with primary care, mixed school-based, and mixed community-based. Preliminary reflections show that school based models are more likely to produce better outcomes in terms of effectiveness, equity, responsiveness, and efficiency.

The WHO European Region has 53 Member States; the data are therefore incomplete and conclusions are limited to the 37 respondent countries.

Knowledge on performance of various models of service provision may inform decision-makers in the process of reforms.

This is the first attempt to produce a taxonomy of organizational models of school health services based on data from 37 countries, and to investigate the potential of each model to achieve desirable health system objectives.

The paper aims to study the influence of three dimensions of workplace spirituality (inner life, meaningful work and sense of community) on perceived and objective organizational performance in two primary health care settings: health centres (HCs) and family health units (FHUs), differing in terms of work organization.

Data on workplace spirituality and perceived organizational performance were collected from a sample of 266 health care workers (doctors, nurses and administrative staff). Data on objective performance were obtained from the respective regional health authorities. Multiple regression, GLM, and tests of mediation were carried out.

In both groups, perceived and objective organizational performance are predicted by sense of community. Additionally, FHUs presented significantly higher values in perceived and objective organizational performance, as well as sense of community and meaningful work. Finally, workplace spirituality and sense of community were found to mediate the relationship between work group and perceived and objective organizational performance.

The study's limitations include the convenience sample, as well as lack of control for the social desirability effect. Patient satisfaction surveys as well as the inclusion of predictive variables such as leadership should be considered in future studies.

Primary health care services, and particularly FHUs, revealed the importance of workplace spirituality. Work teams with higher sense of community had higher performance results, which may therefore be an input in policy decisions regarding primary health care.

This study compared the scores of workplace spirituality and perceived and objective organizational performance in two types of primary health care services, in a setting that approximates the quasi-field experiment. Workplace spirituality emerged as significantly mediating the relationship between work unit type and organizational performance.

Sensory modulation is an emerging approach that aims to reduce distress and agitation in mental health service users and potentially avoid the necessity for coercive practices such as seclusion and restraint. Despite the growing use of this intervention, there has been limited research exploring the implementation of sensory modulation at an organisational level, both internationally and within the New Zealand context. The purpose of this study is to investigate the implementation of a sensory modulation programme in two New Zealand inpatient mental health services using an exploratory organisational case study design.

Organisational case study design methodology was used to explore the implementation of a sensory modulation programme in two New Zealand acute adult inpatient mental health services. This study explored how key organisational and staff factors (including policies and practices related to de-escalation and seclusion reduction) influence sensory modulation implementation. Cases were described and examined the pattern of findings.

Strategies found to support implementation were identified at environmental, organisational, group and individual staff levels. Aspects highlighted as being particularly important included taking an inter-professional approach in leadership and training, rostering flexibility and leeway in staffing levels to support training attendance and responsiveness to crises.

The facilitators and strategies highlighted in this study may be used to support the design and implementation of future sensory modulation programmes in New Zealand and internationally.

The complexity of factors that influenced the implementation of the sensory modulation approach within an inpatient setting made determining the effectiveness of the approach challenging. However, the general principles and strategies identified in this study offer useful insights for the design and implementation of future sensory modulation programmes.

To explore the shared experience of organizational change from centralized allocation and control of services and resources to an empowering partnership approach to service delivery in one Canadian home care program.

Applying an interpretive phenomenological design, data from in‐depth interviews with a purposeful sample (n=28) of providers, clients and informal caregivers were analysed using hermeneutic techniques, and validated by member checking and peer review.

The overall experience of change was comprised of two dynamic change patterns: extrinsically introduced organizational development, facilitated by contextual factors; and intrinsically developed transformational change, impeded by the same contextual factors. The patterns together comprised participants' enactment of an answer to the existential question, “To have or to be?”

While interpretive research does not elicit generalizable results, the findings of this study illuminate the importance of choosing change strategies appropriate for the intended change, addressing what the change may mean to all involved, and confronting the contextual factors that undermine the change.

New strategies are needed if engrained attitudes, values and beliefs about professional service delivery are to be changed.

The interpretation exposes the nature of professional practice in health and social services, the impact of this work context on practice, and concrete strategies for managing organizational change.

The purpose of this paper is to examine how factors associated with a sense of community in the workplace are connected with organizational commitment and the quality of services among frontline managers and middle managers in social and health care services in Finland.

A questionnaire designed specifically for this research was sent to 241 lower-level and middle-level managers in social and health care services in central Finland. A total of 136 managers completed the questionnaire (response rate 56 per cent). The results were analyzed using descriptive statistics, exploratory factor analysis, Spearman’s rank-order correlation coefficient and multiple linear regression analyses.

The study showed that feeling a sense of belonging, mutual trust and appreciation, and open interaction among colleagues were connected to organizational commitment for frontline managers and middle managers in social and health care services in Finland. Correspondingly, an open flow of information in the organization, job meaningfulness and appreciation received from managers’ superiors were connected to the quality of services.

This study provides information on the factors that influence social and health care managers’ organizational commitment and on items connected to their experience of the quality of services.

The purpose of the paper is to explore how the national, state and organisational health policies in Australia support the implementation of person-centred care in managing chronic care conditions.

A qualitative content analysis was performed regarding the national, state and organisational Queensland Health policies using Elo and Kyngas' (2008) framework.

Although the person-centred care as an approach is well articulated in health policies, there is still no definitive measure or approach to embedding it into operational services. Complex funding structures and competing priorities of the governments and the health organisations carry the risk that person-centred care as an approach gets lost in translation. Three themes emerged: the patient versus the government; health care delivery versus the political agenda; and health care organisational processes versus the patient.

Given that person-centred care is the recommended approach for responding to chronic health conditions, further empirical research is required to evaluate how programs designed to deliver person-centred care achieve that objective in practice.

This research highlights the complex environment in which the person-centred approach is implemented. Short-term programmes created specifically to focus on person-centred care require the right organisational infrastructure, support and direction. This review demonstrates the need for alignment of policies related to chronic disease management at the broader organisational level.

Given the introduction of the nurse navigator program to take up a person-centred care approach, the review of the recent policies was undertaken to understand how they support this initiative.

The aim of the paper is to describe the “organisational lifecycle” of the New Zealand Mental Health Commission (NZ MHC) including factors that led to it being established, the evolving phases of the work it undertook and its key achievements, the critical success factors, the rationale behind its disestablishment and transfer of its core functions to another entity.

The methodology is a review of relevant documents and interviews of previous Commissioners, and insights of the final two Chair Commissioners and authors.

The NZ MHC was established to provide government with independent advice on how to develop the capacity and capability of mental health and addictions services for those people with the highest and most complex needs, estimated to be approximately 3 percent of the population. Having successfully led changes to achieve this goal as set out in The Blueprint of 1998 it is now influencing government policy and services to achieve better mental health and well‐being for the whole population as per Blueprint II, published in 2012. The NZ Government clearly values the role of Mental Health Commissioner which has been transferred to the Office of the Health and Disability Commissioner from July 2012 at the time the Commission is disestablished.

The paper relies on insights of those in Commission leadership roles.

Other Commissions may gain insight into their own evolutionary pathways and proactively manage them.

Optimal mental health and wellbeing for society requires policy that simultaneously takes a “whole of society” approach and focuses on responding to people with the highest needs.

The paper shows that there are significant concerns about the disestablishment of the Mental Health Commission in New Zealand and little understanding of the underlying rationale for the organisational changes.

This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform and service integration as a knowledge management (KM) issue and analyse how KM appears and contributes in the context of integrated care, specifically in the process of integrating social and health care.

The article analyses the case organisation's KM initiatives in light of the integrated care literature and recognises the tasks and requirements for effective KM when building integrated health and social care system. The empirical research material for this qualitative study consisted of the case organisation's strategy documents, the results of an external maturity assessment, KM workshop materials and publicly available documentation of the Finnish health and social care reform.

This study identifies the mechanisms by which KM can support health and social services integration. At the macro level, national coordination and regional co-operation require common information structures. At the meso level, a shared regional strategy with shared objectives guides both organisational decision-making and collaboration between professionals. At the micro level, technology supported and data-driven planning of service chains complements the experiences of professionals and may help remove obstacles to integration.

This study contributes to the literature on integrated care by providing a more comprehensive view of the role and tasks of knowledge and KM when reforming health and social services than approaches focussing solely on health informatics and internal efficiency.