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Hidden behind such frequently used phrases as “The system/policy requires …,” “The organization has decided…” is one simple fact. Systems/policies don't drop from the sky etched in stone tablets and organizations don't decide anything. People make decisions and design systems and write policies. Embracing this fact increases the likelihood that the provision of health care emanates from a “care dealership” in contrast to a “car dealership.” Ignoring this fact leads to less humane, less effective, and more costly health care. This chapter will challenge all of us concerned with caring for all of us – from Organizational Development (OD). Practitioners to CEOs to … to … all of us at some point in our lives – to step up to the need to transform our most basic paradigms. To remind ourselves that human beings give birth to, nurture, sustain, and care for that which we call an organization. In so doing, we will be able to begin to act from the premise that a health care organization is itself a living breathing human organism, a “Patient” in need of care. The quality of care we afford this “Patient” directly and inevitably impacts the quality of care we are afforded as patients. Acting from this premise will transform all of health care, all “care dealerships” … and potentially “car dealerships” as well. OD professionals, therefore, can propel us all to a fourth dimension of caring for all of us.

The purpose of this study is to provide insights into how accounting and accountability systems can contribute to transforming metrics used thus far in research performance evaluation. New metrics are needed to increase research impact on the challenges addressed by science. In particular, we document and reflect on accounting transformations towards responsible research and innovation (RRI).

The study draws on the European H2020 MULTI-ACT research project that focuses on the development of a collective research impact framework in the area of health research. We document, analyse and report our engagement in this project, which also included research funders, patient organizations, health researchers, accounting practitioners and health care providers. Drawing on RRI, Mode 2 knowledge production and accounting performativity, we inquire into the potential of accounting technologies to foster knowledge production and increase research impact.

The study shows how the engagement of accounting with other disciplines enables the development of new and relevant forms of research impact assessment. We document how accounting can be mobilised for the development of new forms of research impact assessment (i.e. indicators that evaluate key accountability dimensions to promote RRI) and how it helps to overcome the difficulties that can emerge during this process. We also show how the design of multiple accountabilities’ indicators, although chronically partial, produced a generative interrogation and discussion about how to translate RRI to research assessment in a workable setting, and the pivotal role of certain circumstances (e.g. the presence of authoritative actors) that appear during the knowledge production process for creating these generative opportunities.

This study illustrates the key role of accounts in the generation of knowledge. It also shows the value of considering the stakes of all affected actors in devising fruitful accounting approaches. This collective perspective is timely in the accounting discipline and could foster the connection between academics and practice which is so far under-reported. This perspective should be useful for policymakers such as the European Union and managers in the design of new policies, initiatives and practices.

Discussing and devising appropriate research assessment frameworks is strategic for the maximization of the social impact of research results. Accounting has a key role to play in optimizing a sustainable return on investment in research.

How to assess research impact in a more balanced way is in an early stage of development. The study provides empirical and practical material to advance further work and develop its potential to broaden the conceptualization of accountability.

Swedish society has systematically worked to improve children's health and well-being since the early twentieth century and is considered a leading figure globally in battling violence against children. Awareness of violence against children and its detrimental effects on development and health is generally high in Sweden. Violence is also broadly recognised as a violation of human rights. A ban on corporal punishment was enacted in 1948 in social childcare institutions, in 1958 in schools, and in 1979 at home. The more recent landmark was the United Nations Convention on the Rights of the Child, established as law on 1 January 2020. In line with convention's Article 12, stating that a child has the right to express their views in all matters affecting them, more attention to child participation has been paid since 2020. This chapter provides several recent examples of strategic measures that have been used to enhance child participation in governmental assignments and enquiries and state-funded research. We discuss the examples considering the United Nations convention and child participation methods and pinpoint opportunities and obstacles to further develop and consolidate child participation as a norm in publicly funded societal activities.

Most serious organizational change efforts of the last two decades have focused on change within groups or the socio‐technical system. Hard data on change efforts are both limited and present a mixed picture of the effectiveness of these efforts, particularly over an extended period of time. Presents ideas, notions and concepts about the role of the individual within organizations which may help to explain some of the failures and increase the probability of successful change. Like individuals, organizations consist of body (participants′ common goals, beliefs of background), and spirit (individuals′ ideas, assumption and thought processes). The artificial system of an organization (spirit) is man‐made and owes its continued existence to the ideas, assumptions and thought processes in the minds of the individual within the organization. Consistent with this notion, develops the concept that for real long‐term organizational change to occur, the systems existing within the minds of individuals must be altered. Further, proposes that language, values, norms and ethics are the factors which hold an organization together and, since these factors are developed within individuals, they must be accounted for in change efforts. Also focuses on leaders and managers and their roles in organizational change. Specific characteristics of leaders which enable them to promote and foster change are identified and discussed. It is noted that for leaders to be successful they must (1) free themselves from themselves, (2) free themselves from the artificial systems of organizations, and (3) take specific responsibility for their actions.

The following three articles form a sequence of sorts in addressing changes required in our prevailing health care organizations, changes of a magnitude comparable to F.W. Taylor's “scientific management” revolution at the beginning of the 20th century as we seek to “transform the fundamental O.D. paradigm.” All three are based on case studies. And each has its own prescription: three “movements” each with three “key actions” for “constructive disequilibrium”; three “essential elements” for “integrated networks”, and five “dimensions of key day-to-day behavioral practices.”

This article looks at the alignment of performance management system with the strategy, structure, and organizational outcome in Canadian health care organizations. In this study, balanced scorecard is the framework adopted for assessing the health care organization's performance management system (PMS) and outcome. CEO and clinical unit managers were surveyed for their perceptions on their organization's strategy, autonomy structure, PMS, and organizational performance. Path analysis was the methodology used in examining the relationship about the above organizational variables. The results indicate that patient satisfaction is the primary and most significant perspective of the depicted balanced scorecard in organizational performance. Patient satisfaction and research criteria, on the other hand, are the significant perspectives of a balanced scorecard in an organization's PMS, which are linked to strategy, autonomy structure, and organizational performance. Moreover, the results show that the strategy/structure links operated as suggested. Surprisingly, strategy on service innovation has a negative impact on the organizational outcome of patient satisfaction. Uncertainty from continuous development and organizational change in pursuing service innovation and cost-cutting measures in response to fiscal constraints are plausible explanations of the adverse impact reported.

In this paper, we contribute to the theorizing of patient involvement in organizational improvement by exploring concepts of “learning from patients” as mechanisms of organizational change. Using the concept of metaphor as a theoretical bridge, we analyse interview data (n = 20) from participants in patient engagement activities from two case study organizations in Ontario, Canada. Inspired by classic organizational scholars, we ask “what is the organization that it might learn from patients?”

Patient involvement activities are used as part of quality improvement efforts in healthcare organizations worldwide. One fundamental assumption underpinning this activity is the notion that organizations must “learn from patients” in order to enact positive organizational change. Despite this emphasis on learning, there is a paucity of research that theorizes learning or connects concepts of learning to organizational change within the domain of patient involvement.

Through our analysis, we interpret a range of metaphors of the organization, including organizations as (1) power and politics, (2) systems and (3) narratives. Through these metaphors, we display a range of possibilities for interpreting how organizations might learn from patients and associated implications for organizational change.

This analysis has implications for how the framing of the organization matters for concepts of learning in patient engagement activities and how misalignments might stymie engagement efforts. We argue that the concept and commitment to “learning from patients” would be enriched by further engagement with the sociology of knowledge and critical concepts from theories of organizational learning.

This study aims to highlight the processes that private organisations implement to improve access to health care services for low-income communities in Brazil.

A qualitative research based on a comparative case study was conducted in São Paulo. A for-profit organisation and a not-for-profit one were compared to scrutinise how they adapt themselves to the social context they are embedded in; while improving their service accessibility.

Both kinds of organisations have succeeded to reach their goal of improving the access and reducing the time frame of health care services to low-income populations. Their initial business model (BM) makes them face their own challenges that they face with different strategies. It affects their way of communicating, their organisational culture, the patients’ expectations and their level of inclusiveness.

The research is context-dependent because of the specific conditions of the health public system in Brazil. When shaping health care BMs, the national context must be taken into account and the service marketing components should be used to enhance patients’ value co-creation in the health care service delivery process.

The research gives insights to organisations that seek to adapt their BM to improve health-care access to low-income populations.

Health-care access plays a key role in improving populations’ living conditions and reach one of the sustainable development goals of the United Nation.

Health care services access at the bottom of the pyramid remains under-studied. The paper brings value by comparing for-profit and non-profit organisations, which have the same social goal of improving health-care access to low-income populations while developing different practices to deal with their own challenges.

To begin a process of understanding how palliative care organisations are configured to enable innovative multidisciplinary patient care teams and their management in an uncertain, complex and dynamic environment.

A range of literature was reviewed to suggest configuration and characteristics that were tested using semi‐structured interviews with the senior medical staff member at each of three Australian case study organisations. Data gathered from these interviews was supplemented with data gathered from semi‐structured interviews with multidisciplinary management teams and patient care teams dealing with inpatients and home‐care patients.

A hybrid configuration is suggested, based on Mintzberg's typology of organisations. Responses from interviews modify some characteristics of the suggested configuration, though generally appearing to support it. Characteristics of the external and internal environments are described.

Palliative care is rarely written off outside the healthcare literature and comparatively infrequently within it. Configuration is used to suggest the characteristics of innovative teams in an uncertain, dynamic, complex environment. The use and management of multidisciplinary patient care teams in palliative care offers interesting insights for a broad range of organisations.

A contribution to the discourse on the relationship between configuration and innovation based in organisations without commercial imperative, delivering multi‐level care for and by people involved in the end‐of‐life process.

The paper continues a line of publications, beginning in 2002, describing the management of innovation in multidisciplinary palliative care teams. The originality and value of this paper and this line of research is in taking a management view of a unique environment that offers insights and lessons to a broad range of organisations.

According to the Census, racial/ethnic minority populations are growing at such a fast rate that by 2050 more than 50% of the population will belong to a minority group (US Census, 2001). The increasing diversity of the U.S. population is one of the many changes that health care delivery organizations need to proactively address in order to better serve their community and improve their performance. In this paper, we argue that cultural competency not only is important from a societal perspective, i.e., reducing health disparities, but can also be a strategy for health care organizations to improve quality, lower cost, and attract customers. We provide detailed recommendations for health care leaders and managers to adopt in order to successfully serve a diverse patient population.