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  • Articles  (281,161)
  • 2005-2009  (281,161)
  • Medicine  (281,161)
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  • 1
    Electronic Resource
    Electronic Resource
    Exhausting management work: conflicting identities (2005)
    Bradford : Emerald
    Journal of health, organisation and management 19 (2005), S. 204-218 
    Details
    ISSN: 1477-7266
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - The primary purpose of this paper is to critically explore managers' experience of work identity in the National Health Service (NHS). Design/methodology/approach - This paper is unconventional in that it uses an auto-ethnographic approach and poetry as the empirical data from which the conceptual framework evolves. The concepts of identity, power and self are analysed in relation to the narrative utilising a post-structuralist, critical management lens, particularly drawing from Foucault. Findings - The paper reflects and critiques the challenges of undertaking auto-ethnography, not least the publication and exposure of a "vulnerable aspect" of the author but also identifies this as a powerful method to explore how one uses narrative to create meaning and constitute oneself; the challenges of such textual representation and the various ways one adapts, resists and survives the challenge of the "multiphrenic" world. Originality/value - The contribution this paper makes is an "outing" of the dynamics of being a manager in the NHS and an opening of a debate on current management discourse and practice. The further value of this paper is the experimentation of critically evaluating an auto-ethnographic approach to researching management identity work.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777260510608943
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  • 2
    Electronic Resource
    Electronic Resource
    Examining leadership through critical feminist readings (2005)
    Bradford : Emerald
    Journal of health, organisation and management 19 (2005), S. 236-251 
    Details
    ISSN: 1477-7266
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - This paper seeks to explore a critique of the limitations of mainstream leadership research and publications and offers a critical management analysis through drawing on a feminist reading of leadership in organizations. Design/methodology/approach - There has recently been witnessed a growing interest in the promotion of effective leadership within both organizational studies literature and organisational policy as the route to ensuring employee commitment and enhanced organisational performance and the achievement of ever demanding goals and targets. This turn to leadership is represented in both an upsurge of research studies and a proliferation in the promotion of leadership as the organisational panacea. An analysis of the literature on leadership was undertaken, giving due consideration to mainstream and more critical accounts in relation to illustrations drawn from the UK National Health Service (NHS). Findings - This paper explores mainstream literature on leadership and finds it wanting, in terms of its failure to deliver a common understanding of the concept, in its generally uncritical accounts, and its inability to expose the androcentric nature of the core assumptions within hegemonic discourses of leadership. Drawing on critical feminist readings in relation to the UK NHS, a more critical account of leadership is presented. Practical implications - Greater awareness is required for the adoption of culturally sensitive and locally-based approaches that take account of individuals' experiences, identities and power relations and that allows for the presence of a range of masculine and feminine workplace behaviours. Originality/value - This paper provides an overview of the dominant themes within the literature on leadership as they relate to the UK NHS, and presents a feminist critique of the more subtle ways in which notions of leadership in organisations fail to consider their potential for bias.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777260510608961
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  • 3
    Electronic Resource
    Electronic Resource
    Organizing emotions in health care (2005)
    Bradford : Emerald
    Journal of health, organisation and management 19 (2005), S. 277-289 
    Details
    ISSN: 1477-7266
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - To introduce the articles in this special issue, discussing emotion in the in health-care organisations. Design/methodology/approach - Discusses such topics as what makes health care different, editorial perspectives, how health care has explored emotion so far, and the impact of emotion on patients and the consequences for staff. Findings - Health care provides a setting that juxtaposes emotion and rationality, the individual and the body corporate, the formal and the deeply personal, the public and the private, all of which must be understood better if changes in expectations and delivery are to remain coherent. Originality/value - The papers indicate a shared international desire to understand meaning in emotion that is now spreading across organizational process and into all professional roles within health care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777260510615332
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  • 4
    Electronic Resource
    Electronic Resource
    The meaning of emotion (2005)
    Bradford : Emerald
    Journal of health, organisation and management 19 (2005), S. 290-296 
    Details
    ISSN: 1477-7266
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - To describe the meaning of emotion. Design/methodology/approach - Describes how emotion has recently become a popular concept for discussion, but it is not often recognised that human beings are, in essence, meaning-creating creatures and that emotion is one of the forms of meaning they create. Findings - What one experiences as "I", "me", "myself", that is, one's sense of being a person, is a meaning-structure, which has developed through one's interaction with one's environment. One's physiological make-up is such that all the meanings are guesses about what is going on. Consequently the sense of being a person is always in danger of being invalidated by events. Emotions are meanings, which relate to the validation or invalidation of one's sense of being a person. It is necessary to survive both physically and as a person, but, if there is to be a choice between these two ways of surviving, one almost always chooses to survive as a person and let one's body go. This is seen in acts of heroism and in suicide. Originality/value - Emphasises how the need to survive as a person is so important that children as young as 16 months are able to understand and respond to the emotional meanings of their parents and siblings even though they do not develop an intellectual understanding of the theory of mind until they are about four years old. All interactions between people in health-care management involve validation and invalidation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777260510615341
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  • 5
    Electronic Resource
    Electronic Resource
    Emotion in health care: the cost of caring (2005)
    Bradford : Emerald
    Journal of health, organisation and management 19 (2005), S. 340-354 
    Details
    ISSN: 1477-7266
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - The purpose of this paper is to understand the centrality of emotion, and how that emotion both created and contributed to meaning, in the communication of health professionals who worked in a regional pilot program for cancer screening. Design/methodology/approach - As the third phase of a larger study, thematic analysis of semi-structured interviews was carried out with the 19 members of the professional groups, which comprised the service. Brief comments were included from the questionnaire survey in phases 1 and 2 of the study to demonstrate the overflow effects on those served by the organization. Findings - Emotion was found to be a critical component in the communication interface between the groups. The complexity of the way in which emotion was managed with the client group overflowed into the management of the communication process between the professional groups in the organization. However, it was not always recognised, and thus created difficulties for a number of staff. Research limitations/implications - Although the research was limited to one health-care organization, it is possible that other health professions are experiencing similar situations as they cope with the certainty of unending change. Also, although secondary interviews were carried out to ensure that themes were credible to participants, it is possible that carrying out the interviews in the work environment may have constrained some participants. Originality/value - Stresses the importance of the emotional component of communication and how it is recognised to facilitate effective working relationships and support staff coping with change and heavy workloads in health-care organizations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777260510615387
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  • 6
    Electronic Resource
    Electronic Resource
    Using operational information and information systems to improve in-patient flow in hospitals (2005)
    Bradford : Emerald
    Journal of health, organisation and management 19 (2005), S. 466-477 
    Details
    ISSN: 1477-7266
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - To consider how information and information systems can be used to support improving patient flow in acute hospitals (a key target for the National Health Service in England), and the potential role of the National Programme for Information Technology currently being developed. Design/methodology/approach - The literature plus past and present research, teaching and consulting experience with all levels of the National Health Service is drawn on to consider information provision and requirements. Findings - The National Programme for Information Technology specifies many features designed to support improving patient flows, though timescales for implementation are longer than those for the pledged flow improvements, and operational use of this type of information system has been problematic in the National Health Service. Research limitations/implications - The work is limited to the National Health Service and information systems in use and planned for it. The National Health Service access targets, flow improvement initiatives and the National Programme for Information Technology apply primarily to England. Practical implications - Some bed/flow management information systems currently in use incorporate tools and capabilities in advance of what is outlined in the National Programme for Information Technology, and some rare cases of culture changes in information system use have been achieved. One should learn from these to inform development and implementation of National Programme systems. These existing information systems and approaches may also be useful to hospitals considering systems prior to implementation of the National Programme for Information Technology. Originality/value - There has been very little consideration of the use of operational information and information systems for bed/flow management in the literature. Development and implementation of National Programme for Information Technology systems should build from an understanding of the practice and context of bed/flow management.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777260510629670
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  • 7
    Electronic Resource
    Electronic Resource
    Researchers' responses to research management and governance for primary care research in England: Persistent and escalating problems over time (2005)
    Bradford : Emerald
    Journal of health, organisation and management 19 (2005), S. 494-503 
    Details
    ISSN: 1477-7266
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - Research Governance has been introduced to regulate research involving National Health Service (NHS) patients and staff but the process is lengthy and bureaucratic and has improved little since its introduction. The paper seeks to investigate changes over time. Design/methodology/approach - A comparison between two studies, one in 2003-2004 and the second in 2004-2005, provided the opportunity of observing the process of Research Governance as it was developing. Both studies included postal questionnaire surveys and interviews with study participants. Findings - In order to achieve Research Governance approval, application forms have to be completed, reviews undertaken, sponsors and indemnity information identified and honorary contracts from individual PCTs applied for. Honorary contracts can require references and health and Criminal Records Bureau checks. The process reduces the time available for research and employs large numbers of people, yet is still inefficient. Some of the requirements reduce the quality of the research and researchers' rights are marginalised. Research limitations/implications - The studies took place in a rapidly changing research environment. Further studies should continue to assess the situation and report any progress in making Research Governance less onerous for researchers. Practical implications - There is an urgent requirement to investigate how procedures can be simplified and made less bureaucratic and costly, and to protect the rights of researchers. Without this, primary care research will be seriously disadvantaged and may become impossible to pursue. Originality/value - The study compares process over time and shows that achieving Research Governance approval is seriously limiting research in primary care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777260510629698
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  • 8
    Electronic Resource
    Electronic Resource
    Patient assessment of surgeons' interpersonal skills: A tool for appraisal and revalidation (2005)
    Bradford : Emerald
    Clinical governance 10 (2005), S. 212-216 
    Details
    ISSN: 1477-7274
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - Aims to assess the surgeons' communication skills with patients in the orthopaedic department of the authors' district general hospital. Design/methodology/approach - A departmental prospective audit was conducted involving all consultants and middle grade surgeons. Then authors used a validated questionnaire (Doctors' Interpersonal Skills Questionnaire (DISQ)) completed by patients and analysed independently. Feedback was obtained through individual confidential reports and a study group meeting. Findings - A total of 402 patient evaluations were received and the average interpersonal skills index was 72 per cent ranging between 55 per cent and 87 per cent. The highest scores were given for respect shown, warmth of greeting and patients' confidence in the surgeon's abilities. The lowest scores were given for time given to patients to express their concerns. Research limitations/implications - The research has an incomplete audit circle. A second audit is required following appropriate training to alleviate the deficiencies reported in the first audit and prove the benefit. Practical implications - This audit highlighted important deficiencies in our interpersonal skills that could potentially be addressed by way of targeted training. This kind of assessment should become an essential part of the annual appraisal process of all hospital doctors. Originality/value - This paper is the first to report the results of a departmental assessment process of hospital doctors using the DISQ.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777270510612857
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  • 9
    Electronic Resource
    Electronic Resource
    Copying patient letters - making it work (2005)
    Bradford : Emerald
    Clinical governance 10 (2005), S. 231-240 
    Details
    ISSN: 1477-7274
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - That patients should be able to receive a copy of any letter written about them is part of the British Government's policy to increase patients' involvement in their care and treatment. All National Health Service (NHS) organisations are expected to implement this by April 2005. This paper aims to describe how one acute Trust has used basic change management principles to implement the initiative. Design/methodology/approach - Examines the approach of the Salisbury Health Care NHS Trust, where initially a survey of all consultants, senior nurses and allied health professionals was carried out. Findings - Initial concerns that patients would not understand the letter were generally unfounded with 98.9 per cent of patients saying that they understood their letter. Of patients, 96.9 per cent said that they found receiving a copy letter useful. Originality/value - The research demonstrated a high percentage of patients wanting a copy letter, which has huge resource implications in terms of secretarial time, additional stationery and postage costs. Change is difficult and an emotionally charged issue however, using examples of good practice and taking a multi-faceted approach to the change process the initiative has been successfully implemented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777270510627590
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  • 10
    Electronic Resource
    Electronic Resource
    Foundation years training and patient safety - a comprehensive introduction? (2005)
    Bradford : Emerald
    Clinical governance 10 (2005), S. 254-260 
    Details
    ISSN: 1477-7274
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - To examine the content of the new Foundation Years Curriculum for newly-qualified medical graduates in terms of its patient-safety and risk-management emphases. To examine briefly the impact the curriculum will have on medical trainers responsible for such issues. Design/methodology/approach - Relevant sections of the curriculum are examined and reproduced within the article, along with the authors' reflections on theoretical and practical implications of its content, as applicable to current National Health Service (NHS) training of doctors. Areas of agreement with previous guidance given to the medical profession from other sources are discussed. Findings - The curriculum gives an appropriate emphasis to patient-safety issues. The practical achievement of its broad and ambitious aims will present major, though not insurmountable, challenges to those delivering the training of newly-qualified doctors within the NHS. Originality/value - This paper should help those involved in delivering the new curriculum consider the relevant patient-safety and risk-management issues that it raises and begin the process of practically achieving them. It should demonstrate the importance of maintaining a patient-safety outlook as the focus of training for newly-qualified doctors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14777270510612875
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