Suchergebnisse

This e-book considers different aspects of power and how it affects and is affected by people involved in health care organization. The papers included tell a collective story, focusing variously on: trust and communication within health care encounters; adverse medical outcomes; power and new organizational types in healthcare; HRM and HRD in healthcare; and power inequalities and gender inequalities in the healthcare organization. The e-book also considers the influence of professional bodies, patients and the public, considering their importance and power in the healthcare dynamic. A must-read for all managers and HR professionals working in the healthcare arena.

This paper presents a novel and distinctive approach to the study of change within the NHS. Central to the paper's approach is the view that research on change in health care systems should be processual, comparative, pluralist, and historically based. Guiding such a view is a meta‐analytical framework which contends that theoretically sound and practically useful research on change should involve the continuous interplay between ideas about the context, the process, and the content of change together with skill in regulating the relations between the three (Pettigrew 1985a, 1985b). The paper has five sections. Section one examines some of the contemporary pressures for change in the NHS and draws attention to the gap which often exists between statements of strategic intention and their operational implementation. Section two reveals our distinctive analytical approach to the study of service changes and clarifies the theoretical underpinnings of our work. Section three offers an extended critical review of recent research and writing on change in health care organizations. Section four summarizes our findings from the literature review and reaffirms the novelty and significance of our chosen approach. Section five provides an overview.

Abstract

Children have long been acknowledged as playing an important role within family purchase decisions, with their ability to directly and indirectly influence decisions. The research discussed in this paper arose from an identified opportunity to develop knowledge surrounding the important role that children play within family purchasing by including them as direct research respondents. The methods adopted included an in‐depth interview with parents and children separately, and the completion of a decision mapping tool followed by a family interview. The findings address a specific and important aspect of the data, namely the influence behaviour adopted by children during high‐involvement family purchase decisions. The children in all of the respondent families were found to have direct influence over the purchases discussed. They demonstrated a range of sophisticated influence behaviours that included justifying and highlighting the benefits of purchases, forming coalitions, compromising and remaining persistent. These behaviours were underpinned and enhanced by the use of product‐related knowledge and information, which was viewed positively and encouraged by parents.


Copyright © 2007 John Wiley & Sons, Ltd.

This article discusses a comparative study of how local actors tackle health inequalities in England, Scotland and Wales. The main method used in this study was a thematic analysis of 200 interview transcripts. Its focus was on how health inequalities are framed for intervention by performance assessment systems and the challenge for these systems that their nature as a 'wicked issue' presents. The three different national contexts are described, including organizational structures and the use of targets, and the difficulty of making evaluative comparisons is considered. Reflecting on results from the study, it is concluded that both divergence and convergence in themes across the three countries reveal narrative patterns that draw on discourses rather than evidence. The nature of national performance audit regimes appears to play an important part in shaping these discourses, which are themselves evolving, partly in interaction with local feedback.

This article considers the background to one of the projects in the UK Economic and Social Research Council's Public Services Programme: a major; three-year investigation of how health inequalities are being framed for intervention at a local level in post-devolution England, Scotland and Wales. A particular interest is in the difference that performance assessment makes as it engages to a greater or lesser extent with health inequalities.