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To examine how public servants are depicted in film, I discuss the changes over time of Batmanʼs Commissioner Gordon, particularly his character arc in the contemporary The Dark Knight trilogy. An important aspect of Gordonʼs evolution is in contrast to the filmsʼ other prominent public servant, District Attorney Harvey Dent. The Gordon-Dent contrast illustrates aspects of the Friedrich-Finer debate over administrative discretion, a classic debate in public administration. The trilogyʼs verdict on public service is mixed: the flawed, rule-bending, expedient public servant survives while the fabricated hero is a sham. Commissioner Gordon is far more interesting than he had been for decades, but is he just an expedient bureaucrat ultimately pursuing self preservation? In contrast, the (pre-villain) Harvey Dent, who refuses to compromise his principles, is ultimately undone by his absolutism. For the complexity of his character and its centrality to the plot, I judge the depiction of Commissioner Gordon-warts and all-to be better than simplistic caricatures of bureaucrats and promising for future public servants in film.

The purpose of this paper is to compare and contrast traditional data collection methodologies employed in health care with more practical observational methods which are closely aligned with Lean thinking. When combined with problem solving, observational approaches achieve demonstrable improvements in clinical outcomes, productivity and efficiency. The paper aims to describe the changes in mindset and behaviour that are required to adopt the observational methods.

The approach is to describe and evaluate case study examples on the use of observational data in the National Health Service in the UK. This is then used to derive generic principles about the wider application of observational data in health care.

Traditional data collection methodologies are often insufficient to expose the root cause of a problem and therefore may result in little or no action. The observational methods identify the root cause and as such offer a much more practical and real‐time way of solving process‐related problems.

The observational methods of collecting data described here offer staff at all levels of the organisation practical approaches to preventing mistakes and errors in health care processes.

The case studies described here support the reintroduction of observational techniques used by the early pioneers of productivity. The originality of the paper is in the use of these observational methods in a wide range of clinical settings to provoke changes in working practices.

The purpose of the paper is to examine the care transitions of older people who transfer between home, acute and sub-acute care to determine if there were common transition types and areas for improvements.

A longitudinal case study design was used to examine care transitions of 19 older people and their carers as a series of transitions and a whole-of-system experience. Case study accounts synthesising semi-structured interviews with function and service use data from medical records were compared.

Three types of care transitions were derived from the analysis: manageable, unstable and disrupted. Each type had distinguishing characteristics and older people could experience elements of all types across the system. Transition types varied according to personal and systemic factors.

This study identifies types of care transition experiences across acute, sub-acute and primary care from the perspective of older people and their carers. Understanding transition types and their features can assist health professionals to better target strategies within and across the system and improve patient experiences as a whole.

Quality care transitions of older people across acute, sub-acute and primary care are critical to safety and cost, which is the reason interventions to improve practice are a priority. Yet, given the complexity of providers and services involved it is often difficult to know the types of tensions that arise in day-to-day transition work or how front-line workers will respond. To that end, this innovative study differs from the largely descriptive studies by conceptualising care transitions as street-level work in order to capture how transition practice takes shape within the complexities and dynamics of the local setting. The paper aims to discuss these issues.

Data were collected from 23 hospital health professionals and community service providers across primary, sub-acute and acute care through focus groups. A thematic analysis and interrogation of themes using street-level concepts derived three key themes.

The themes of risk logics and dilemmas of fragmentation make explicit both the local constraints and opportunities of care transitions and how these intersect to engender a particular logic of practice. By revealing the various discretionary tactics adopted by front-line providers, the third theme simultaneously highlights how discretionary spaces might represent both possibilities and problematics for balancing organisational and patient needs.

The study contributes to the knowledge of street-level work in health settings and specifically, the nature of transition work. Importantly, it benefits policy and practice by uncovering mechanisms that could facilitate and impede quality transitions in discrete settings.

The purpose of this paper is to outline a conceptual plan for innovative, integrated care designed for people living with long-term conditions (LTCs).

The conceptual plan delivers a partnership between the health system, the person with LTCs (chronic), their family, and the community. The partnership aims to support people at home with access to effective treatment, consistent with the New Zealand Government Health Strategy. This concept of people-owned care is provided by nurses with advanced practice skills, who coordinate care across services, locations and multiple LTCs.

With the global increase in numbers of people with multiple chronic conditions, health services are challenged to deliver good outcomes and experience. This model aims to demonstrate the effective use of healthcare resources by supporting people living with a chronic condition, to increase their self-efficacy and resilience in accordance with personal, cultural and social circumstance. The aim is to have a model of care that is replicable and transferable across a range of health services.

People living with chronic conditions can be empowered to manage their health and well-being, whilst having access to nurse-led care appropriate to individual needs.

Although there are examples of case management and nurse-led coordination, this model is novel in that it combines a liaison nursing role that works in partnership with patients, whilst ensuring that care across a number of primary and secondary care services is truly integrated and not simply interfaced.

Entrepreneurship is a source of innovation, job creation, and vibrancy for local and regional economies. As a direct result, there is a profound interest in creating an infrastructure that effectively encourages entrepreneurship and incubates entrepreneurial endeavors. Western State University has responded to this call by developing the Harvey Entrepreneurship Program, which is integrated in the Enterprise Residential College.The Harvey program provides a socially embedded experiential learning approach to entrepreneurial education. Faculty, students, entrepreneurs, and technical experts are drawn together in an environment that provides space for business incubators and an entrepreneurially focused curriculum. In this article, we present a case study in which we use qualitative research methods to explore the benefits and challenges of creating such a program.The delivery model that Enterprise Residential College provides for entrepreneurial education is examined through the perspectives of program administrators, faculty, and students. The findings reveal evidence that a residential college can form a powerful nexus of formal instruction, experiential learning, socialization, and networking to influence entrepreneurship. We discuss relevant findings that may aid others considering similar endeavors.

It is widely recognized by scholars that superhero stories tend to glorify vigilante justice; after all, these stories often maintain that extralegal acts of violence are necessary for combatting existential threats to personal and public safety. This scholarly common sense fosters a widespread dismissal of superhero stories as uncomplicated apologia for an authoritarian politics of law and order that is animated by hatred of unpopular people and ideas. However, some prominent contemporary Batman stories, including those told in the graphic novels of Grant Morrison and in the blockbuster movies of Christopher Nolan, are ambivalent: in their portraits of Batman and Joker as dark twins and secret colleagues, these stories both legitimize and challenge the countersubversive politics of American law and order.

This paper aims to explore a single-institution case study of partnership working between students, the University and Students’ Union, through four student-led sustainability projects. The paper analyses the role and value of these partnerships and provides advice for other institutions on effective partnership working between these stakeholders.

A single case study of partnership working with multiple embedded units of analysis (four projects) is presented based on reflections of practitioners involved in the projects who have different roles within the University and Students’ Union.

The longevity and effectiveness of student-led projects, and disciplinary-breadth of students engaged, can be enhanced by greater collaboration with, and integration into, University and Students’ Union systems. Partnership working between different stakeholders is key to overcoming challenges and the success of student-led projects, helped by key staff “enablers”. These projects provide myriad learning opportunities for developing change agency skills, even where projects are relatively short-lived and could be seen as failures in terms of longevity.

This analysis is based solely on practitioner reflections, with limited direct quantification or qualitative data on the projects’ impacts on the students themselves.

This paper draws together the experiences and reflections of four practitioners with different roles within the University and Students’ Union across four different projects and provides advice to generate student-led sustainability projects which have longevity and impact for wider student populations and future generations of cohorts.

Emergency care delivery is a process requiring input from various healthcare professionals within the hospital. To deliver efficient and effective emergency care, professionals must integrate rapidly at multiple interfaces, working across functional, spatial and professional boundaries. Yet, the interdisciplinary nature of emergency care presents a challenge to the optimization of patient flow, as specialization and functional differentiation restrict integration efforts. This study aims to question what boundaries exist at the level of professionals and explores how these boundaries may come to influence integration and operational performance.

To provide a more holistic understanding of the inherent challenges to integration at the level of professionals and in contexts where professionals play a key role in determining operational performance, the authors carried out an in-depth case study at a busy, Level 1 trauma center in The Netherlands. In total, 28 interviews were conducted over an 18-month period.

The authors reveal the existence of structural, relational and cultural barriers between (medical) professionals from different disciplines. The study findings demonstrate how relational and cultural boundaries between professionals interrupt flows and delay service processes.

This study highlights the importance of interpersonal and cultural dynamics for internal integration and operational performance in emergency care processes. The authors unveil how the presence of professional boundaries creates opportunity for conflict and delays at important interfaces within the emergency care process, and can ultimately accumulate, disrupting patient flow and increasing lead times.