Search results

The purpose of this paper is to explore what happens when changes to clinical practice are proposed and introduced in healthcare organisations. The authors use the implementation of Treatment Escalation Plans to explore the dynamics shaping the translational journey of a complex intervention from research into the everyday context of real-world healthcare settings.

A qualitative instrumental collective case study design was used. Data were gathered using qualitative interviews (n = 36) and observations (n = 46) in three English acute hospital trusts. Normalisation process theory provided the theoretical lens and informed data collection and analysis.

While each organisation faced the same translational problem, there was variation between settings regarding adoption and implementation. Successful change was dependent on participants' ability to manage and shape contexts and the work this involved was reliant on individual capacity to create a new, receptive context for change. Managing contexts to facilitate the move from research into clinical practice was a complex interactive and iterative process.

The paper advocates a move away from contextual factors influencing change and adoption, to contextual patterns and processes that accommodate different elements of whole systems and the work required to manage and shape them.

The paper addresses important and timely issues of change in healthcare, particularly for new regulatory and service-oriented processes and practices. Insights and explanations of variations in implementation are revealed which could contribute to conceptual generalisation of context and implementation.

De-escalation training for police has received widespread attention as a method for reducing unnecessary and excessive use of force. There is virtually no research on de-escalation, and as a result, there is little understanding about what it is, what it includes and whether it is effective. The current study compares attitudes about the importance and use of de-escalation among officers who were randomly assigned to participate (or not) in de-escalation training.

The current study draws from a larger randomized controlled trial of de-escalation training in the Tempe, Arizona Police Department (TPD). Approximately 100 officers completed a survey in June–July 2019 and again in June–July 2020. TPD delivered the de-escalation training to half the patrol force in February–March 2020. The authors compare treatment and control officers' attitudes about the importance of specific de-escalation tactics, how often they use those tactics and their sentiments de-escalation training. The authors employ an econometric random-effects model to examine between-group differences post-training while controlling for relevant officer attributes including age, race, sex, prior training and squad-level pretraining attitudes about de-escalation.

Treatment and control officers reported positive perceptions of de-escalation tactics, frequent use of those tactics and favorable attitudes toward de-escalation before and after the training. After receiving the training, treatment officers placed greater importance on compromise, and reported more frequent use of several important tactics including compromise, knowing when to walk away and maintaining officer safety.

Only a few prior studies have has examined whether de-escalation training changes officer attitudes. The results from the current study represent an initial piece of evidence suggesting de-escalation training may lead to greater use of those tactics by officers during encounters with citizens.

Purpose – This chapter compares the stability of the U.S. Dual Banking system's two bank groups, national and state banks, in light of the current financial crisis. The goal of the chapter is to answer three distinct questions: first, is there a difference in the (balance sheet) fragility between the two groups and, second, to what extent has the balance sheet fragility of both groups changed after the escalation of the financial crisis beginning in August 2007? Building on that, the third question asks to whether or not the respective regulatory agencies of both bank groups are responsible for these changes in balance sheet fragility in light of the financial crisis.

Methodology – To answer these questions the chapter uses U.S. Call Report data containing full quarterly balance sheets and P&Ls of all U.S. commercial banks over the period 2005–2008. Anecdotal evidence as well as univariate and multivariate difference-in-difference methodology focusing on the immediate pre-crisis period Q1/2005–Q3/2007 and the crisis period Q3/2007–Q4/2008 are applied.

Results – Highly significant and robust results show that, ceteris paribus, national banks reduced their potential balance sheet fragility after the escalation of the crisis in August 2007 by reducing lending and liquidity creation stronger than state banks. Anecdotal evidence supports the empirical findings. Although both FDIC and OCC did not anticipate the adverse effects of the crisis, the OCC publicly showed an earlier reaction to liquidity-related problems than the FDIC.

Originality – The chapter is the first of its kind to analyze bank fragility around the escalation of the financial crisis and the role of the regulatory agencies. The chapter holds especially interesting policy implications in the light of the current discussion about the future regulation of the banking markets.

The response management of the Kobe earthquake in 1995 provides practitioners and theorists of crisis and disaster management with much to consider. As in other efforts around the world the Kobe response management appeared slow and less than optimal in performance. Focuses on the effects of magnitude of impact and degree of strategic preparedness that may affect response. Magnitude of impact is the degree to which impact damage seems random in occurrence, the size of the impact area, the severity of impact, the ratio of visible to invisible damage, the number of major sub‐event crises triggered by the impact of the event, and the degree of psychological distortion caused by (or accelerated by) the impact of the event. The degree of strategic preparedness depends on the degree to which response managers can successfully translate meta‐strategic missions and objectives into operational strategies that are realistic and achievable in any given crisis or disaster event. Components of strategic preparedness include the provision of escalation triggers, establishing cascaded priorities, and having and maintaining a dynamic reserve. Planning and preparing for crises and disasters needs to include cascade strategic priority profiles for communities, consideration of cultural features of organizations and communities in developing plans and preparedness, establishing quantifiable escalation triggers for response management, and developing and maintaining a working dynamic reserve.

This purpose of this study is to further the study of escalation of commitment by considering the supportive role of accountants in providing reports that favour continuation of unprofitable projects and whether this role is influenced by culture. Research on the escalation of commitment suggests that the decision to commit resources to a failing project is due to several factors that include sunk costs, personal responsibility and culture.

This study employs a between-subjects design to examine accountants’ willingness to provide a report that facilitates continuation of an unprofitable project. The manipulated independent variables are sunk cost (present or absent), the level of reporting responsibility (high or low) and culture (Pacific Islands or Australia).

Our results show that the presence of sunk cost is a motivation for accountants to provide reports that favour continuation of an unprofitable project. The results on cultural difference are also consistent with the contention that culture is influential in decision-making with respect to providing reports that favour continuation of an unprofitable project. We do not, however, find evidence consistent with a personal responsibility affect using the manipulation defined in this study.

Consistent with this type of research, the results must be interpreted with respect to the specific design choices used in the experiment.

Continued research is needed to examine the impact of sunk costs and specific attributes of culture, such as the willingness to follow superiors, on the escalation of commitment to unprofitable projects. The mitigation of such effects through education of accountants to provide reports that do not favour continuation of unprofitable projects would, for example, be of interest to aid agencies and others investing in projects in developing economies in particular.

While previous research generally examines the decision-making role of managers in escalation of commitment to unprofitable projects, this study examines the supportive role that accountants play in facilitating managers’ escalation decisions. This issue is studied within a context examining the potential cultural impact of respect for authority.

Escalation of commitment is one of the most important decision-making biases among entrepreneurs and may deprive them of valuable resources and even result in their eventual failure. Many entrepreneurs become escalated to their ongoing plans by allocating more resources, even after receiving negative feedbacks regarding those plans. Although the escalating behavior is an inherent part of the entrepreneurial cognition, previous studies have mostly ignored its antecedents among entrepreneurs. This dearth of studies is more severe regarding women entrepreneurs, whose biases have rarely been investigated. Therefore, this paper aims to explore the antecedents of the escalation of commitment among women entrepreneurs.

To explore the antecedents of the escalation of commitment in women entrepreneurs’ decisions based on their lived experiences, this paper used a narrative inquiry. The data were collected by conducting in-depth interviews with three Iranian women entrepreneurs running small businesses and analyzed by narrative data analysis.

According to the findings, bitter memories of previous failures, overconfidence and familial pressure are the main antecedents of the escalation of commitment in women entrepreneurs.

This study has a very important managerial implication for women entrepreneurs, who should know that while decision-making biases may occur unintentionally, they are able to reduce the harmful effects and enhance the benefits of biases by knowing their most common signs.

This study is a pioneer in exploring women entrepreneurs’ biases and took a novel approach by conducting a narrative analysis of women entrepreneurs’ escalation of commitment.

This article describes the design and implementation of the management of aggression care plans (MOACAP) in a secure service for people with learning disability and severe challenging behaviour. The MOACAP is a five‐part document, which has sections for descriptions of challenging behaviour, escalation patterns of the behaviour, non‐physical interventions, physical interventions and post‐incident briefing.Preliminary evaluations suggest that use of MOACAP leads to a reduction in aggressive incidents in the service. The approach should also be relevant to other forensic, mental health and challenging behaviour services and brain injury units. The MOACAP may also be relevant to services that will be affected by the National Institute for Clinical Excellence (NICE) and the National Institute for Mental Health in England (NIMHE) guidelines on the short‐term management of disturbed (violent) behaviour.

The heavy civil engineering industry (railways, sewage treatment, chemical and pharmaceutical facilities, oil and gas facilities, etc.) is one of the major contributors to the British economy and generally involves a high level of investment. Clients in this industry are demanding accurate cost estimate, proper analysis of out‐turn cost and cost escalation and a high quality risk analysis throughout the construction processes. Current practice in the industry has suggested that there is a lack of structured methodologies and systematic cost escalation approach to achieve an appropriate cost analysis at the outset of projects and throughout the construction processes. In this context the prime objective of this research work is to develop a structured cost escalation methodology for improving estimating management and control in the heavy engineering industry construction processes. The methodology is composed of a forecasting model to predict cost indices of major items in industry and a risk knowledge base model for identifying and quantifying causes of cost escalations. This paper, as part of the research, reviews and discusses a knowledge‐based model for applying a cost escalation factor. The cost escalation factor is made up of market variation, a risk element and a component for bias. A knowledge elicitation strategy was employed to obtain the required knowledge for the model. The strategy included questionnaires, interviews and workshops and deliverables came in the form of influences and their effect on project cost escalation. From these deliverables, the concepts of a decision support model and system specification for applying cost escalation to base estimates is proposed.

The management of violence and aggression is an important aspect of any service in the NHS and has been rightly tackled as a whole organisational approach. De-escalation is one such aspect of the organisation approach relating foremost to the safety of people and as such is a central part of relational security, personal safety and the therapeutic relationship.

The paper explores the evidence and policies around de-escalation.

The paper recommends that a randomised-controlled trial be designed, comparing different de-escalation techniques to establish an evidence base for this routine practice.

The paper is limited to discussing de-escalation as an approach and the policy that directs it, and does not consider individual theories on aggression and management. It makes recommendations for policy, research and practice.

There is a lack of high-quality evidence around de-escalation policy and principles which staff may believe is evidence-based practice because training is often mandatory. This obviously impacts upon the patient experience and aspects of safety. The paper is valuable to practitioners working in secure environments, or with offenders that may require management of violence and aggression.

There are many policies and guidelines from the government and from professional bodies that seems to have tailored off since 2005 (Muralidharan and Fenton, 2006; UKCC, 2002). Forensic staff are constrained by such guidance which is further complicated by debates concerning care/coercion and forensic environments, some of which is alluded to here.

The purpose of this paper is to investigate commitment escalation tendencies and magnitude in groups of entrepreneurship-minded decision makers.

The paper uses a software-based management simulation to expose 447 graduate business students in the USA and India to research stimuli under conditions that resemble important aspects of entrepreneurs’ business environment, such as a focus on overall firm performance. Unlike most previous escalation research that studied individuals, the primary unit of analysis is a three-person group.

The paper demonstrates a positive relationship between the groups’ entrepreneurial intentions and escalation magnitude. The paper also finds a direct relationship between sunk costs and subsequent investment amounts, suggesting an additional route through which sunk costs may impact escalation behavior – anchoring and insufficient adjustment.

The authors hope that the findings will stimulate further research on commitment escalation modalities and mechanisms among entrepreneurship-minded decision makers and provide impetus for efforts to develop effective debiasing strategies.

The study addresses a long-standing gap in entrepreneurship research, by demonstrating a significant positive relationship between entrepreneurial intentions and escalation behaviors. Also noteworthy, the results are generated using a different research method (simulation) than the experimental approach used in most extant escalation research. As such, the exploration provides important triangulating evidence that is currently lacking from the rich escalation literature.