Pub Date : 2000-12-01DOI: 10.1108/02689230010362882
Jim Connelly
To date the practice of health sector management has not been sufficiently theorised. An adequate theory should be able to answer the pre-eminent critique of managerial rationality and ethics mounted by Alasdair MacIntyre in After Virtue and should also offer robust analytical and ethical resources to identify and engage with the social, political, economic and moral issues underlying health sector management. Critical realism with its ontology of generative mechanisms, agency-structure relationships, valorisation of activity and ideology critique offers such resources in an empirically orientated but adequately theorised realist framework. Rather than negate MacIntyre, critical realism incorporates and transcends his key arguments regarding the rationality and ethics of management. This article introduces the main elements of critical realism and clears a conceptual space for the cumulation of critical realist case-studies and managerial craft knowledge.
{"title":"A realistic theory of health sector management. The case for critical realism.","authors":"Jim Connelly","doi":"10.1108/02689230010362882","DOIUrl":"https://doi.org/10.1108/02689230010362882","url":null,"abstract":"To date the practice of health sector management has not been sufficiently theorised. An adequate theory should be able to answer the pre-eminent critique of managerial rationality and ethics mounted by Alasdair MacIntyre in After Virtue and should also offer robust analytical and ethical resources to identify and engage with the social, political, economic and moral issues underlying health sector management. Critical realism with its ontology of generative mechanisms, agency-structure relationships, valorisation of activity and ideology critique offers such resources in an empirically orientated but adequately theorised realist framework. Rather than negate MacIntyre, critical realism incorporates and transcends his key arguments regarding the rationality and ethics of management. This article introduces the main elements of critical realism and clears a conceptual space for the cumulation of critical realist case-studies and managerial craft knowledge.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 5-6 1","pages":"262-71"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010362882","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-12-01DOI: 10.1108/02689230010362891
D. Amyx, J. Mowen, R. Hamm
An experiment was conducted to examine the impact of patients' freedom to choose a physician and health locus of control on patient satisfaction. The experiment was set within the scenario of a patient suffering from a lengthy viral infection after visiting a health clinic for the first time. All constructs with corresponding measurements are discussed and their relationships with satisfaction are examined. Hypotheses are developed and tested for each relationship using pencil and paper scenarios of a patient's service encounter at a health clinic. A 2 x 2 full factorial between subjects experimental design was used with 99 subjects. Results of the experiment indicated different patterns of satisfaction among subjects based on measures of health locus of control (HLC). Individuals with an internal HLC were more satisfied with having a choice of a physician than not having a choice and were also more satisfied than external HLC individuals who had a choice. In contrast, individuals with an external HLC did not discriminate between having or not having the opportunity to choose a physician.
{"title":"Who really wants health-care choice?","authors":"D. Amyx, J. Mowen, R. Hamm","doi":"10.1108/02689230010362891","DOIUrl":"https://doi.org/10.1108/02689230010362891","url":null,"abstract":"An experiment was conducted to examine the impact of patients' freedom to choose a physician and health locus of control on patient satisfaction. The experiment was set within the scenario of a patient suffering from a lengthy viral infection after visiting a health clinic for the first time. All constructs with corresponding measurements are discussed and their relationships with satisfaction are examined. Hypotheses are developed and tested for each relationship using pencil and paper scenarios of a patient's service encounter at a health clinic. A 2 x 2 full factorial between subjects experimental design was used with 99 subjects. Results of the experiment indicated different patterns of satisfaction among subjects based on measures of health locus of control (HLC). Individuals with an internal HLC were more satisfied with having a choice of a physician than not having a choice and were also more satisfied than external HLC individuals who had a choice. In contrast, individuals with an external HLC did not discriminate between having or not having the opportunity to choose a physician.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 5-6 1","pages":"272-90"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010362891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-12-01DOI: 10.1108/02689230010363025
M. Stuart, M. Lucio
Drawing from original empirical data this paper compares the changing nature of employment relations in the health and private sectors. A key concern is to assess the extent to which the emergence of partnership-type arrangements between employers and trade unions lays the basis for the "renewal" of the traditional public sector concept of the model employer. Empirically, the paper draws on a survey of trade union representatives from 238 workplaces and a case study of a hospital trust. The data reveal that employment relations in the NHS are more collectivist when compared with the private sector. However, the development of partnership in the NHS is hamstrung by ongoing training and involvement gaps and widespread work intensification.
{"title":"Renewing the model employer. Changing employment relations and \"partnership\" in the health and private sectors.","authors":"M. Stuart, M. Lucio","doi":"10.1108/02689230010363025","DOIUrl":"https://doi.org/10.1108/02689230010363025","url":null,"abstract":"Drawing from original empirical data this paper compares the changing nature of employment relations in the health and private sectors. A key concern is to assess the extent to which the emergence of partnership-type arrangements between employers and trade unions lays the basis for the \"renewal\" of the traditional public sector concept of the model employer. Empirically, the paper draws on a survey of trade union representatives from 238 workplaces and a case study of a hospital trust. The data reveal that employment relations in the NHS are more collectivist when compared with the private sector. However, the development of partnership in the NHS is hamstrung by ongoing training and involvement gaps and widespread work intensification.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 5-6 1","pages":"310-25"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010363025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-12-01DOI: 10.1108/02689230010363052
Paul Featherstone, D. Baldry
This paper stresses the importance of the strategic integration of the organisational facilities management function as being an essential prerequisite towards facilities and organisational effectiveness. The impact of both the strategic and operational facilities management function on community health-care facility users is also documented. The value of the facilities management function in terms of other health-care related organisational core deliverables is also observed. Mechanisms for general organisational facilities management improvement are identified and a number of facilities management performance measuring tools outlined.
{"title":"The value of the facilities management function in the UK NHS community health-care sector.","authors":"Paul Featherstone, D. Baldry","doi":"10.1108/02689230010363052","DOIUrl":"https://doi.org/10.1108/02689230010363052","url":null,"abstract":"This paper stresses the importance of the strategic integration of the organisational facilities management function as being an essential prerequisite towards facilities and organisational effectiveness. The impact of both the strategic and operational facilities management function on community health-care facility users is also documented. The value of the facilities management function in terms of other health-care related organisational core deliverables is also observed. Mechanisms for general organisational facilities management improvement are identified and a number of facilities management performance measuring tools outlined.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 5-6 1","pages":"326-38"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010363052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-08-01DOI: 10.1108/JMM.2000.14.3_4.249.1
L. Bacharova
{"title":"Change‐promoting research for health care","authors":"L. Bacharova","doi":"10.1108/JMM.2000.14.3_4.249.1","DOIUrl":"https://doi.org/10.1108/JMM.2000.14.3_4.249.1","url":null,"abstract":"","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 1","pages":"249-250"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62119656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-07-01DOI: 10.1108/08876040010334565
J. Carman
Empirically investigates, using a conjoint methodology, the importance weights given to the attributes of quality for acute care hospital services. The study shows that consumers evaluated the technical dimensions of nursing care, physician care, and outcome as more important than the accommodation functions of hospital care, and there are significant interactions among the technical dimensions. Both sets of dimensions were important and significant, but technical quality evaluations were not influenced by the perceived quality level of the affective attributes. The relative importance of these attributes were quite stable among various subgroups of past patients.
{"title":"Patient perceptions of service quality. Combining the dimensions.","authors":"J. Carman","doi":"10.1108/08876040010334565","DOIUrl":"https://doi.org/10.1108/08876040010334565","url":null,"abstract":"Empirically investigates, using a conjoint methodology, the importance weights given to the attributes of quality for acute care hospital services. The study shows that consumers evaluated the technical dimensions of nursing care, physician care, and outcome as more important than the accommodation functions of hospital care, and there are significant interactions among the technical dimensions. Both sets of dimensions were important and significant, but technical quality evaluations were not influenced by the perceived quality level of the affective attributes. The relative importance of these attributes were quite stable among various subgroups of past patients.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 5-6 1","pages":"339-56"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/08876040010334565","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62292993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-05-01DOI: 10.1108/02689230010346411
D. Preston, J. Loan-Clarke
The changing role of the manager has been a growing area of both academic and popular literature over recent years. In addition, the interest of the popular press has made terms like "grey suit" and "fat cat" common terminology. Management roles and managerial authority within today's organisations have seen many changes. This has led to frustration and anxiety for managers as they have watched their role change. In the NHS, like other sectors, managers have become a target for organisational redundancies and have experienced increased responsibility, closer monitoring of performance and heightened job insecurity. This paper aims to offer a contribution to the empirical data on managers by investigating one group of NHS managers' own perceptions of how others see their role. The findings suggest that NHS managers are very aware of the largely negative perceptions that surround them but accept this as an integral part of their role.
{"title":"The NHS manager. A view from the bridge.","authors":"D. Preston, J. Loan-Clarke","doi":"10.1108/02689230010346411","DOIUrl":"https://doi.org/10.1108/02689230010346411","url":null,"abstract":"The changing role of the manager has been a growing area of both academic and popular literature over recent years. In addition, the interest of the popular press has made terms like \"grey suit\" and \"fat cat\" common terminology. Management roles and managerial authority within today's organisations have seen many changes. This has led to frustration and anxiety for managers as they have watched their role change. In the NHS, like other sectors, managers have become a target for organisational redundancies and have experienced increased responsibility, closer monitoring of performance and heightened job insecurity. This paper aims to offer a contribution to the empirical data on managers by investigating one group of NHS managers' own perceptions of how others see their role. The findings suggest that NHS managers are very aware of the largely negative perceptions that surround them but accept this as an integral part of their role.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 2 1","pages":"100-8"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010346411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-04-01DOI: 10.1108/14684520010330319
Isidro F. Aguillo
Although the Internet is already a valuable information resource in medicine, there are important challenges to be faced before physicians and general users will have extensive access to this information. As a result of a research effort to compile a health-related Internet directory, new tools and strategies have been developed to solve key problems derived from the explosive growth of medical information on the Net and the great concern over the quality of such critical information. The current Internet search engines lack some important capabilities. We suggest using second generation tools (client-side based) able to deal with large quantities of data and to increase the usability of the records recovered. We tested the capabilities of these programs to solve health-related information problems, recognising six groups according to the kind of topics addressed: Z39.50 clients, downloaders, multisearchers, tracing agents, indexers and mappers. The evaluation of the quality of health information available on the Internet could require a large amount of human effort. A possible solution may be to use quantitative indicators based on the hypertext visibility of the Web sites. The cybermetric measures are valid for quality evaluation if they are derived from indirect peer review by experts with Web pages citing the site. The hypertext links acting as citations need to be extracted from a controlled sample of quality super-sites.
{"title":"A new generation of tools for search, recovery and quality evaluation of World Wide Web medical resources","authors":"Isidro F. Aguillo","doi":"10.1108/14684520010330319","DOIUrl":"https://doi.org/10.1108/14684520010330319","url":null,"abstract":"Although the Internet is already a valuable information resource in medicine, there are important challenges to be faced before physicians and general users will have extensive access to this information. As a result of a research effort to compile a health-related Internet directory, new tools and strategies have been developed to solve key problems derived from the explosive growth of medical information on the Net and the great concern over the quality of such critical information. The current Internet search engines lack some important capabilities. We suggest using second generation tools (client-side based) able to deal with large quantities of data and to increase the usability of the records recovered. We tested the capabilities of these programs to solve health-related information problems, recognising six groups according to the kind of topics addressed: Z39.50 clients, downloaders, multisearchers, tracing agents, indexers and mappers. The evaluation of the quality of health information available on the Internet could require a large amount of human effort. A possible solution may be to use quantitative indicators based on the hypertext visibility of the Web sites. The cybermetric measures are valid for quality evaluation if they are derived from indirect peer review by experts with Web pages citing the site. The hypertext links acting as citations need to be extracted from a controlled sample of quality super-sites.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"26 1","pages":"240-8"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/14684520010330319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62043177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-03-01DOI: 10.1108/02689230010340552
T. Proctor
Organisations operate within a three-tiered environment--internal, micro and macro. The environment is a powerful force acting upon the effectiveness of strategic decision making. Failure to take cognisance of the influence of the three-tiered environment can have disastrous consequences. The cross-impact matrix and the TOWS matrix are two strategic decision-making aids that improve effective decision making. When used in conjunction with creative problem solving methods they can provide the basis of a powerful management tool.
{"title":"Strategic marketing management for health management: cross impact matrix and TOWS (threats, opportunities, weaknesses, strengths).","authors":"T. Proctor","doi":"10.1108/02689230010340552","DOIUrl":"https://doi.org/10.1108/02689230010340552","url":null,"abstract":"Organisations operate within a three-tiered environment--internal, micro and macro. The environment is a powerful force acting upon the effectiveness of strategic decision making. Failure to take cognisance of the influence of the three-tiered environment can have disastrous consequences. The cross-impact matrix and the TOWS matrix are two strategic decision-making aids that improve effective decision making. When used in conjunction with creative problem solving methods they can provide the basis of a powerful management tool.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 1","pages":"47-56"},"PeriodicalIF":0.0,"publicationDate":"2000-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010340552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-03-01DOI: 10.1108/JMM.2000.14.1.77.2
S. Evans
{"title":"Perspectives in Public Health","authors":"S. Evans","doi":"10.1108/JMM.2000.14.1.77.2","DOIUrl":"https://doi.org/10.1108/JMM.2000.14.1.77.2","url":null,"abstract":"","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 1","pages":"77-80"},"PeriodicalIF":0.0,"publicationDate":"2000-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62119578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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