'Nurse entrepreneurs' a case of government rhetoric?

INTRODUCTION: Nursing has come to play a prominent role in government health policy since 1997. Extending the scope of nursing practice into activities previously carried out by doctors can assist a managerialist and 'modernizing' project of increasing National Health Service (NHS) efficiency by removing demarcations between professional groups. METHODS: Drawing on elements of poststructuralist linguistics, this paper presents an analysis of a key government speech in the context of a discussion of overall policy intentions. RESULTS: The speech can be seen as an example of how government has attempted to use rhetoric to make its goals attractive to nurses. CONCLUSION: Policy-makers have to make their policies acceptable to those whom they expect to implement them. In this case, organizational efficiency, chiefly in terms of broader access to NHS services, as well as role substitution, is aligned with government policy promoting social enterprise and 'sold' to the nursing profession as enhancing its status compared with medicine

Modernising healthcare - is the NPfIT for purpose.

This paper responds to the findings of the research by Currie and Guah on the introduction of the National Programme for Information Technology through an institutional theory perspective. It considers both the appropriateness and applicability of the method chosen in the light of what is already known about UK healthcare organisations and the complex and changing process that is involved in both the organisation and any research that takes place. This is further confounded by an unstable political environment both nationally and locally and a failure to understand the changing location, role and status of the medical record. Only when this is resolved will a transformational change occur, in line with the new patient-focused government agenda and the external world of technology that must engage with the emotional as well as the rational role that both technology and health play in people's lives

Measuring Errors and Adverse Events in Health Care

In this paper, we identify 8 methods used to measure errors and adverse events in health care and discuss their strengths and weaknesses. We focus on the reliability and validity of each, as well as the ability to detect latent errors (or system errors) versus active errors and adverse events. We propose a general framework to help health care providers, researchers, and administrators choose the most appropriate methods to meet their patient safety measurement goals

Reasons for the Failure of Incident Reporting in the Healthcare and Rail Industries

Incident reporting systems have recently been established across the UK rail and healthcare industries. These initiatives have built on the perceived success of reporting systems within aviation. There is, however, a danger that the proponents of these schemes have signi#cantly over-estimated the impact that they can have upon the operation of complex, safety-critical systems. This paper, therefore, provides a brief overview of the problems that limit the utility of incident reporting in the the rail and healthcare industries

Notes from a small island: researching organisational behaviour in healthcare from a UK perspective.

This paper considers the development of research in organisational behaviour within the UK healthcare system since its foundation in 1948. It looks at the location and context of such work, given the unique setting provided in this national organisation. Contextual barriers that are both historical, political ontological and epistemological, are considered in the light of recent research developments in both academia, notably the bienniel international conference Organisational Behaviour in Healthcare (OBHC), where a search for comparative work has engaged with both the wider organisational and international communities, and government, notably the National Service Delivery and Organisation Research Programme. Confounding much of this is the absence of a way of understanding the complexity of the domain of healthcare in different contexts. The application of the Cynefin framework is then discussed as a way to aid understanding of both the organisational and research tasks, and to provide a forum for collaborative understanding to allow appropriate research and practice interventions to occur. Copyright © 2006 John Wiley & Sons, Ltd