Search results

This study explores citizen activism in the articulation of a politicised counter-account of Aboriginal rights. It aims to uncover the enabling factors for a successful challenge to established political norms and the obstacles to the fullest expression of a radical imagining.

Laclau and Mouffe's theory of hegemony and discourse is used to frame the movement's success in challenging the prevailing system of urbanised healthcare delivery. Empirical materials were collected through extensive ethnographic fieldwork.

The findings from this longitudinal study identify the factors that predominantly influence the transformational success of an Yaṉangu social movement, such as the institutionalisation of group identity, articulation of a discourse connected to Aboriginal rights to self-determination, demonstration of an alternative imaginary and creation of strong external alliances.

This study offers a rich empirical analysis of counter-accounting in action, drawing on Aboriginal governance traditions of non-confrontational discourse and collective accountability to conceptualise agonistic engagement. These findings contribute to the practical and theoretical construction of democratic accounting and successful citizen activism.

Effective voice behavior in healthcare workers is critical for patient safety, quality improvement and workforce well-being. A review of the literature on voice behavior in healthcare highlights that little is known about the voice behaviors of new graduates in allied health and that current theory, from medical and nursing research, does not adequately apply to this sector. New knowledge about voice behavior for this sector of the workforce will support education and healthcare institutions in building and sustaining a healthy voice behavior culture.

This paper reports on phase two of a two-phase study looking at the voice behavior experiences of new allied health graduates over one year. Using a realist perspective and narrative analysis, we uncover and illustrate what works, with whom and under what conditions.

Four synthesized narratives outline the contexts and mechanisms that result in different voice behavior outcomes – speaking up effectively, speaking up with unmet expectations, not speaking up and a reduction in speaking up over time. Experiences of positive interprofessional collaboration and reflective supervision supported effective voice behavior.

This study used a case study approach, focusing on healthcare providers within a large New Zealand city and a cohort of 10 participants. Some researchers argue that small numbers limit the generalization of findings to different populations. Realists argue that, given the way in which knowledge is developed using realist methodologies, the resultant theory is portable. Interviews were conducted online during the COVID-19 pandemic. This may have impacted the connection between the interviewer and interviewee, causing the interviewees to not express their true thoughts. However, the interviewer did take time to connect with the interviewees and build trust over the three interviews over one year. Participants did not capture the diversity in the allied health workforce – most identified as female and none identified as Māori/Indigenous. And finally, participants could inhibit or exaggerate information due to the influence of social desirability. This does not appear to be a significant limitation in this study, given the many examples shared by the participants highlighted their challenges.

This study provides an in-depth exploration of how new graduates in allied health experience speaking up. Our findings enrich the knowledge of speaking up by using synthesized narratives to provide insights into what factors can enable a healthy speaking up culture within the new graduate allied health workforce. This is new knowledge that will be of interest at the individual, team and organizational levels of healthcare. The findings will support curriculum design and new graduate support frameworks for the education and health sectors. Highlighted in this study are the importance of the following factors in supporting speaking up for allied health new graduates: the employment of reflective supervision, purposeful facilitation of team belonging and interprofessional collaboration and tailored speaking up training for allied health new graduates and leaders in healthcare.

By taking a realist perspective and using narrative analysis, we gain an understanding of the voice behavior experiences of new graduates in allied health and the contextual factors and mechanisms that activate effective voice behavior in sub-acute and rehabilitation settings. These findings differ from nursing and medicine and highlight the benefits of reflective supervision and interprofessional collaborative practice.

Workflow optimisation is crucial for establishing a viable acute stroke (AS) intervention programme in a large tertiary care centre. This study aims to utilise Lean Six Sigma (LSS) principles to enhance the hospital's workflow.

The Action Research methodology was used to implement the project and develop the case study. The study took place in a large tertiary care academic hospital in India. The Define-Measure-Analyse-Improve-Control approach optimised the workflow within 6 months. Lean tools such as value stream mapping (VSM), waste audits and Gemba were utilised to identify issues involving various stakeholders in the workflow. Sigma-level calculations were used to compare baseline, improvement and sustainment status. Additionally, statistical techniques were effectively employed to draw meaningful inferences.

LSS tools and techniques can be effectively utilised in large tertiary care hospitals to optimise workflow through a structured approach. Sigma ratings of the processes showed substantial improvement, resulting in a five-fold increase in clinical outcomes. Specifically, there was a 43% improvement in outcome for patients who underwent acute stroke revascularisation. However, certain sigma ratings deteriorated during the control and extended control (sustainment) phases. This indicates that ensuring the sustainability of quality control interventions in healthcare is challenging and requires continuous auditing.

The article presents a single case study deployed in a hospital in India. Thus, the generalisation of outcomes has a significant limitation. Also, the study encounters the challenge of not having a parallel control group, which is a common limitation in quality improvement studies in healthcare. Many studies in healthcare quality improvement, including this one, are limited by minimal data on long-term follow-up and the sustainability of achieved results.

This study pioneers the integration of LSS methodologies in a large Indian tertiary care hospital, specifically targeting AS intervention. It represents the first LSS case study applied in the stroke department of any hospital in India. Whilst most case studies discuss only the positive aspects, this article fills a critical gap by unearthing the challenges of applying LSS in a complex healthcare setting, offering insights into sustainable quality improvement and operational efficiency. This case study contributes to the theoretical understanding of LSS in healthcare. It showcases its real-world impact on patient outcomes and process optimisation.

This paper aims to explore the intricate relationship between artificial intelligence (AI) and health information literacy (HIL), examining the rise of AI in health care, the intersection of AI and HIL and the imperative for promoting AI literacy and integrating it with HIL. By fostering collaboration, education and innovation, stakeholders can navigate the evolving health-care ecosystem with confidence and agency, ultimately improving health-care delivery and outcomes for all.

This paper adopts a conceptual approach to explore the intricate relationship between AI and HIL, aiming to provide guidance for health-care professionals navigating the evolving landscape of AI-driven health-care delivery. The methodology used in this paper involves a synthesis of existing literature, theoretical analysis and conceptual modeling to develop insights and recommendations regarding the integration of AI literacy with HIL.

Impact of AI on health-care delivery: The integration of AI technologies in health-care is reshaping the industry, offering unparalleled opportunities for improving patient care, optimizing clinical workflows and advancing medical research. Significance of HIL: HIL, encompassing the ability to access, understand and critically evaluate health information, is crucial in the context of AI-driven health-care delivery. It empowers health-care professionals, patients and the broader community to make informed decisions about their health and well-being. Intersection of AI and HIL: The convergence of AI and HIL represents a critical juncture, where technological innovation intersects with human cognition. AI technologies have the potential to revolutionize how health information is generated, disseminated and interpreted, necessitating a deeper understanding of their implications for HIL. Challenges and opportunities: While AI holds tremendous promise for enhancing health-care outcomes, it also introduces new challenges and complexities for individuals navigating the vast landscape of health information. Issues such as algorithmic bias, transparency and accountability pose ethical dilemmas that impact individuals’ ability to critically evaluate and interpret AI-generated health information. Recommendations for health-care professionals: Health-care professionals are encouraged to adopt strategies such as staying informed about developments in AI, continuous education and training in AI literacy, fostering interdisciplinary collaboration and advocating for policies that promote ethical AI practices.

To enhance AI literacy and integrate it with HIL, health-care professionals are encouraged to adopt several key strategies. First, staying abreast of developments in AI technologies and their applications in health care is essential. This entails actively engaging with conferences, workshops and publications focused on AI in health care and participating in professional networks dedicated to AI and health-care innovation. Second, continuous education and training are paramount for developing critical thinking skills and ethical awareness in evaluating AI-driven health information (Alowais et al., 2023). Health-care organizations should provide opportunities for ongoing professional development in AI literacy, including workshops, online courses and simulation exercises focused on AI applications in clinical practice and research.

This paper lies in its exploration of the intersection between AI and HIL, offering insights into the evolving health-care landscape. It innovatively synthesizes existing literature, proposes strategies for integrating AI literacy with HIL and provides guidance for health-care professionals to navigate the complexities of AI-driven health-care delivery. By addressing the transformative potential of AI while emphasizing the importance of promoting critical thinking skills and ethical awareness, this paper contributes to advancing understanding in the field and promoting informed decision-making in an increasingly digital health-care environment.

Biotech companies stand as key actors in pharmaceutical innovation. The high risk and long timelines inherent with their R&D investments might hinder their access to funding, potentially stifling innovation. This study aims to explore into the appeal of biotech companies to capital market investors, whose financial backing could bolster the growth of the biotechnology sector.

This paper uses a dataset of 774 US publicly listed biotech firms to investigate their risk and return characteristics by comparing them to pharmaceutical firms and a sample of matched non-biotech R&D-intensive firms over the sample period 1980–2021. Tests show that the conclusions remain consistent across diverse methodological approaches.

The paper shows that biotech companies are riskier than the average firm in the market index but outperform on a risk-adjusted basis both the market and a matched group of R&D-intensive firms. This is particularly true for large capitalization biotech, which is also shown to provide a diversification benefit by reducing the downside risk in past crisis periods.

This paper provides insight relevant to the current debate about the overall performance of the biotech industry in terms of policy changes and their impact on small, early-stage biotech firms. While small and early-stage biotech firms are playing an increasing role in scientific innovation, this study confirms their greater vulnerability to financial risks and the importance of access to capital markets in enabling those companies to survive and evolve into larger biotech.

This study aims to examine the conceptual and empirical operations of hospitality at its intersections with health care, which includes medical and senior care.

This study conducts a systematic review of literature on hospitality in health care published in hospitality, tourism and leisure journals spanning from 1990 to 2023. A total of 50 studies meeting the inclusion criteria are reviewed, providing insights into how hospitality is conceptualized, its practical implementation and the proposed outcomes in health-care settings.

Hospitality in health care is conceptualized by hospitality scholars in three main ways: as service functions, as a service exchange and as an organizational culture. There is a significant overlap between the notion of hospitality and the concept of person-centered care in gerontology and health-care literature. Also, hospitality contributes positively to patient/resident experiences, organizational performance and societal impacts.

The study is limited by its focus solely on the theoretical and practical aspects of hospitality in health care within hospitality, tourism and leisure journals, excluding relevant literature from gerontological and health-care journals.

Interdisciplinary research requires scholars from different disciplines to develop a common language and understanding of key concepts. This study presents the conceptual and practical domains of hospitality and its relevancy to health-care research and offers future directions to strengthen the interdisciplinary research between hospitality, health care and gerontology.

The aim of this study was to explore and understand the leadership experiences of medical consultants prior to a major hospital move. Health and care is becoming increasingly complex and there is no greater challenge than the move to a new hospital. Effective leadership has been identified as being essential for successful transition. However, there is very little evidence of how medical consultants experience effective leadership.

A qualitative methodology was utilized with one-to-one semi-structured interviews conducted with ten medical consultants. These were transcribed verbatim and analyzed using inductive thematic analysis. The research complied with the consolidated criteria for reporting qualitative research (COREQ).

Four themes were found to influence medical consultants’ experience of leadership: collaboration, patient centredness, governance and knowledge mobilization. Various factors were identified that negatively influenced their leadership effectiveness. The findings suggest that there are a number of factors that influence complexity leadership effectiveness. Addressing these areas may enhance leadership effectiveness and the experience of leadership in medical consultants.

This study provides a rich exploration of medical consultants’ experience of collective leadership prior to a transition to a new hospital and provides new understandings of the way collective leadership is experienced in the lead up to a major transition and makes recommendations for future leadership research and practice.

The findings suggest that there are a number of factors that influence complexity leadership effectiveness. Addressing these areas may enhance leadership effectiveness and the experience of leadership in medical consultants.

Clinical leadership is associated with better outcomes for patients therefore any interventions that enhance leadership capability will improve outcomes for patients and therefore benefit society.

This is the first research to explore medical consultants’ experience of collective leadership prior to a transition to a new hospital.

There is evidence that quality improvement projects developed with the participation of patients and family members are more likely to result in a sustainable change. To identify the intervening factors is an important step in promoting and supporting patient and family members’ engagement.

A survey was carried out with 90 hospitals. A total of 35 intervening factors were evaluated by the healthcare professionals from the quality area using a Likert scale. Factor analysis was applied to identify the relationship among the factors and cluster analysis and the standardized scores for each new latent variable were obtained to observe the association between them and hospitals profile. Cluster analysis allowed to group the hospitals with similar responses and to analyze whether there was any association with the profile of the institutions.

A total of ten intervening factors are identified: two in the financial dimension, five in the structural and three in the personal and cultural. The standardized scores of latent variables suggest that the financial factors could be affected by the hospital capacity. The structural factors could be impacted by the accreditation status, location (region) and administrative control (ownership). And the personal and cultural factors could be by the location and dominant organizational culture. All of factors are influenced by the performed quality management activities. The cluster analysis allowed the identification of three groups in the financial dimension, and four in the other two dimensions. Except for the accreditation status in the personal and cultural dimension, no evidence of association between the groups and the variables raised to characterize the profile of the hospitals was found.

The study contributed to identify the relationship among the intervening factors turning possible to simplify and reduce them more comprehensively than those originally identified in the literature and at the same time maintaining the representativeness of the original variables.

An important finding of the Safeguarding Adults Review into events at Cawston Park was that the views of patients and their families were systematically ignored by the hospital. The purpose of this paper is to report on a review of people’s experiences of residential and secure in-patient services in Norfolk for those with learning disabilities and autistic people. It discusses overall reported levels of satisfaction, how well people and their families felt they were listened to by services and what people valued most in services.

The main research tools were visits to services to talk to people and observe them receiving care, along with listening sessions outside homes and interviews with relatives.

Most people spoken to were happy with how they were listened to, but there is room for improvement. People particularly valued connections with staff based on reciprocity, long-term relationships and, for some, family-like relationships, and were unhappy when these were inconsistent or absent. People also enjoyed the opportunity to develop relationships with people outside their service, and especially with non-disabled people, something that was rare for most people. Relatives appreciated transparency of communication and openness to negotiation in home managers, especially when problems or disagreements arose.

The findings suggest that the severe problems with listening at Cawston Park are not more widespread across the sector in Norfolk. However, progress is needed to improve the consistency of listening across services and to develop services informed by what people value most in services around quality relationships, communication and social inclusion.

Drawing on interviews with two types of essential workers – wound clinicians and care workers – the chapter examines stigma management in dirty care work through the lens of emotion management. The study combines two dimensions of dirty work: physical taint in relation to bodywork and social taint linked to working in close proximity to socially stigmatized clients. Hence, stigma management extends to dealing with the physically and socially dirty features of essential care work. In addition, the authors’ assessment of social stigma includes how essential care workers also sought to alleviate the social stigma encountered by their clients. In so doing, the authors extend the literature on dirty work to identify how emotion management skills are central to the stigma management strategies of the essential care workers in this study. The authors demonstrate how both groups deal with their stigma by emphasizing the emotion management skills in ‘doing’ dirty work and in the ‘purpose’ of this work, which includes acknowledging how the authors attempt to address the social taint encountered by their clients. Additionally, by comparing two occupations with different contexts and conditions of work, the authors show how complex emotion management skills are gendered in care work to expand the understanding of gender and stigma management. Furthermore, these emotion management skills emanate from the deep relational work with clients rather than through occupational communities. The authors argue that by focussing on emotion management, the hidden skills of dirty work in gendered care work are illuminated and contribute to contemporary debates about whether stigma can be overcome.