Search results

In Canada, integrated care pilot projects are often implemented as a local reform strategy to improve the quality of patient care and system efficiencies. In the qualitative study reported here, the authors explored the experiences of healthcare professionals when first implementing integrated care pilot projects, bringing together physical and mental health services, in a community hospital setting.

Engaging a qualitative descriptive study design, semi-structured interviews were conducted with 24 healthcare professionals who discussed their experiences with implementing three integrated care pilot projects one year following project launch. The thematic analysis captured early implementation issues and was informed by an institutional logics framework.

Three themes highlight disruptions to established logics reported by healthcare professionals during the early implementation phase: (1) integrated care practices increased workload and impacted clinical workflows; (2) integrating mental and physical health services altered patient and healthcare provider relationships; and (3) the introduction of integrated care practices disrupted healthcare team relations.

Study findings highlight the importance of considering existing logics in healthcare settings when planning integrated care initiatives. While integrated care pilot projects can contribute to organizational, team and individual practice changes, the priorities of healthcare stakeholders, relational work required and limited project resources can create significant implementation barriers.

This paper aims to explore the learning needs of general practitioners (GPs) involved in commissioning mental health provision in England, and offer an evaluation of a leadership and commissioning skills development programme for Mental Health Commissioners.

Retrospective mixed method, including online mixed method survey, rating participants’ knowledge, skills, abilities, semi-structured telephone interviews and third-party questionnaires were used. Results were analysed for significant differences using the Wilcoxon Signed Ranks test. Open-ended responses and interview transcripts were analysed thematically.

Indicative results showed that participants perceived significant impacts in ability across eight key question groups evaluated. Differences were found between the perceived and observed impact in relation to technical areas covered within the programme which were perceived as the highest scoring impacts by participants.

The indicative results show a positive impact on practice has been both perceived and observed. Findings illustrate the value of this development programme on both the personal development of GP Mental Health Commissioners and commissioning practice. Although the findings of this evaluation increase understanding in relation to an important and topical area, larger scale, prospective evaluations are required. Impact evaluations could be embedded within future programmes to encourage higher participant and third-party engagement. Future evaluations would benefit from collection and analysis of attendance data. Further research could involve patient, service user and carer perspectives on mental health commissioning.

Results of this evaluation could inform the development of future learning programmes for mental health commissioners as part of a national approach to improve mental health provision.

This chapter establishes the conceptual and analytic framework for the book. It relates not only to much of the existing work in evolutionary and institutional economics, but also to work in cultural science and cultural semiotics domains as well as in media convergence and transmedia studies. The central concept it first deploys is ‘innovation systems’ as applied in national, regional, international and sectoral contexts. It then builds on the general theory of economic evolution by Kurt Dopfer and Jason Potts and reviews the tools this theory provides to carry out a meso-level analysis of industries co-innovating and converging. It then proposes a new concept – ‘cross-innovation’ – to refer to the emergence of new structures and ‘rules’ at the boundaries of existing industries.

The purpose of this paper is to enhance understanding of the conceptualisation and operationalisation of public value in practice by applying Moore's (1995) strategic triangle as an analytical framework to study strategic management and management control practices in relation to public value.

The paper uses an interpretative longitudinal case study approach including qualitative methods of document studies and interviews between 2017 and 2019.

In the strategic triangle, the three nodes of authorising environment, public value creation and operational capacity are interdependent, and alignment is a necessity for a strategy to be successful. But this alignment is vulnerable. The findings suggest three propositions: (1) strategic alignment is vulnerable to management control practices having a strong focus on performance measurements, (2) strategic alignment is vulnerable to standardised management control practices and (3) strategic alignment is vulnerable to politically driven management control practices.

With the strategic triangle as a base, this paper tries to understand what kind of management control practices enable and/or constrain public value, as there has been a call for this kind of research. In this way it adds to earlier research on public value, to the growing interest in the strategic triangle as an analytical framework in analysing empirical material and to the request for more empirical studies on the subject. The strategic triangle also embraces political factors, government agendas and political leadership for which there has also been a call for more research.