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Article
Publication date: 21 March 2008

Chris G. Collins and Pauline Joyce

The purpose of this paper is to summarise the recent debates and issues on the healthcare system in Ireland, which have come to the fore through media exposure. The…

3039

Abstract

Purpose

The purpose of this paper is to summarise the recent debates and issues on the healthcare system in Ireland, which have come to the fore through media exposure. The implications for these debates on quality are suggested and questions are raised to stimulate further debate.

Design/methodology/approach

Recent reports and media opinion articles are reviewed in the light of the health reform programme and the increased prosperity due to the Celtic Tiger era in Ireland.

Findings

The Health Service in Ireland is not what it should be. Progress has been made but resistance at all levels is significant due to the mistrust and miscommunication between the managerial and clinical personnel which have built up during the past number of years. The trust of the public is at an all‐time low. However, once patients are within the system they are satisfied with their care.

Originality/value

This is a discussion paper which raises more questions than answers and is timely with the focus on quality in healthcare, particularly now as Ireland prepares for a general election for a new government with healthcare a priority issue.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 14 June 2011

Catherine Hogan, Maria Barry, Mary Burke and Pauline Joyce

The purpose of this paper is to report on a study that explores healthcare professionals' experiences of the implementation of integrated care pathways (ICPs).

2005

Abstract

Purpose

The purpose of this paper is to report on a study that explores healthcare professionals' experiences of the implementation of integrated care pathways (ICPs).

Design/methodology/approach

This study used a phenomenological research approach with a purposive sample of ten multi‐disciplinary healthcare professionals across two acute hospitals in Ireland. Data were collected via semi‐structured interviews and analysed using Colazzi's framework.

Findings

The findings of the study are presented under four themes: buy‐in from all disciplines, multidisciplinary communication, service‐user involvement, and audit of ICPs. These themes emanated from the questions asked at interview.

Research limitations/implications

The limitations of the study include the small sample size and the use of two different interviewers across the sites. The inexperience of the interviewers is acknowledged as a limitation as the probing of some questions could have been improved. In addition the themes of the findings were predetermined by the use of the interview guide.

Practical implications

Changes in existing institutional structures and cultures are required when introducing ICPs. It is necessary for senior management in organisations to lead by example. They also need to identify where support can be offered, such as in the provision of an ICP facilitator, education sessions in relation to ICPs and the development of strategies to improve multi‐disciplinary buy‐in and participation.

Originality/value

The findings of this study respond to a gap in the literature in Ireland on the experiences of healthcare professionals who have implemented ICPs. Key findings of the study are the perception that the doctor is pivotal in driving the implementation of ICPs, yet the doctor was not always interested in this responsibility.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Open Access
Article
Publication date: 5 July 2019

Rod Sheaff, Joyce Halliday, Mark Exworthy, Alex Gibson, Pauline W. Allen, Jonathan Clark, Sheena Asthana and Russell Mannion

Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural…

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Abstract

Purpose

Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons?

Design/methodology/approach

An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary care; and hospital planned orthopaedics and ophthalmology providers (n=12 cases). The framework of comparison was the ownership theory mentioned above.

Findings

The connection between ownership (on the one hand) and organisation structures and managerial regimes (on the other) differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations, the doctors’, but not other occupations’, work was controlled and coordinated in a more-or-less democratic, self-governing ways.

Research limitations/implications

This study was empirically limited to just one sector in one country, although within that sector the case-study organisations were typical of their kinds. It focussed on formal structures, omitting to varying extents other technologies of power and the differences in care processes and patient experiences within differently owned organisations.

Practical implications

Type of ownership does appear, overall, to make a difference to at least some important aspects of an organisation’s governance structures and managerial regime. For the broader field of health organisational research, these findings highlight the importance of the owners’ agency in explaining organisational change. The findings also call into question the practice of copying managerial techniques (and “fads”) across the public–private boundary.

Originality/value

Ownership does make important differences to healthcare providers’ top-level governance structures and accountabilities and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use power within them, and system-wide policy interventions, for instance to improve care coordination and for the correspondingly required foci of healthcare organisational research.

Details

Journal of Health Organization and Management, vol. 33 no. 7/8
Type: Research Article
ISSN: 1477-7266

Keywords

Book part
Publication date: 1 April 2004

Lenora Ledwon

The law-oriented short stories and novels of lawyer/English professor John William Corrington are receiving increasing attention from legal scholars. However, no one has…

Abstract

The law-oriented short stories and novels of lawyer/English professor John William Corrington are receiving increasing attention from legal scholars. However, no one has analyzed the science fiction screenplays he co-wrote with his wife, Joyce, from a legal perspective. This article analyzes two such screenplays and concludes that they are “Socratic” texts whose narrative structures and epistemological processes work in much the same way that the traditional participatory exchange works in law school. My analysis explores the links between law, allegory and science fiction as intersecting methods to imagine the possibilities for the future.

Details

Studies in Law, Politics and Society
Type: Book
ISBN: 978-1-84950-262-7

Book part
Publication date: 19 May 2021

Rebecca Strating

This chapter examines narratives and representations of rural Australia deployed by political actors. At both federal and state levels in Australia, political parties tend…

Abstract

This chapter examines narratives and representations of rural Australia deployed by political actors. At both federal and state levels in Australia, political parties tend to focus their attention on metropolitan electorates in their public discussions, particularly during election campaigns. This has led to accusations from minor parties and independents that rural areas are ignored by governments based in capital cities. The Nationals, for example, presents itself as the party whose primary motivation is to protect the interests of rural voters. Rural sites are political spaces shaped by particular types of narrative and rhetoric. Engaging with how the ‘rural’ is represented through rhetoric and image is useful for understanding how crime is positioned. This chapter uses rhetorical political analysis and representation to understand how political ideas about rurality are expressed through language and imagery. The political context outlined in this chapter is one factor that affects the nature and complexities of rural crime and responses to it. Rural Australia is at its own political crossroad, reflected in the emergence of competing narratives for the bush, defined here as a contest between ‘rural centrism’ and ‘rural populism’.

Article
Publication date: 1 February 1984

Joyce Payne and Aurelia Stephen

If you are 30 or older, you are middle‐aged by someone's criteria. When the college students of the 1970s declared “Don't trust anyone over 30,” did you think they would…

Abstract

If you are 30 or older, you are middle‐aged by someone's criteria. When the college students of the 1970s declared “Don't trust anyone over 30,” did you think they would be someday talking about you? And what about those who say “Life begins at 40”? Did you ever believe them?

Details

Collection Building, vol. 6 no. 1
Type: Research Article
ISSN: 0160-4953

Abstract

Details

The Emergence of Teacher Education in Zambia
Type: Book
ISBN: 978-1-78756-560-9

Abstract

Details

Using Subject Headings for Online Retrieval: Theory, Practice and Potential
Type: Book
ISBN: 978-0-12221-570-4

Article
Publication date: 1 May 1983

In the last four years, since Volume I of this Bibliography first appeared, there has been an explosion of literature in all the main functional areas of business. This…

14752

Abstract

In the last four years, since Volume I of this Bibliography first appeared, there has been an explosion of literature in all the main functional areas of business. This wealth of material poses problems for the researcher in management studies — and, of course, for the librarian: uncovering what has been written in any one area is not an easy task. This volume aims to help the librarian and the researcher overcome some of the immediate problems of identification of material. It is an annotated bibliography of management, drawing on the wide variety of literature produced by MCB University Press. Over the last four years, MCB University Press has produced an extensive range of books and serial publications covering most of the established and many of the developing areas of management. This volume, in conjunction with Volume I, provides a guide to all the material published so far.

Details

Management Decision, vol. 21 no. 5
Type: Research Article
ISSN: 0025-1747

Keywords

Article
Publication date: 1 April 1980

Not many weeks back, according to newspaper reports, three members of the library staff of the School of Slavonic and East European Studies in London were dismissed. All…

Abstract

Not many weeks back, according to newspaper reports, three members of the library staff of the School of Slavonic and East European Studies in London were dismissed. All had refused to carry out issue desk duty. All, according to the newspaper account, were members of ASTMS. None, according to the Library Association yearbook, was a member of the appropriate professional organisation for librarians in Great Britain.

Details

Library Review, vol. 29 no. 4
Type: Research Article
ISSN: 0024-2535

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