Innovation sustainability in challenging health-care contexts : embedding clinically led change in routine practice

The need for organizational innovation as a means of improving health-care quality and containing costs is widely recognized, but while a growing body of research has improved knowledge of implementation, very little has considered the challenges involved in sustaining change – especially organizational change led ‘bottom-up’ by frontline clinicians. This study addresses this lacuna, taking a longitudinal, qualitative case-study approach to understanding the paths to sustainability of four organizational innovations. It highlights the importance of the interaction between organizational context, nature of the innovation and strategies deployed in achieving sustainability. It discusses how positional influence of service leads, complexity of innovation, networks of support, embedding in existing systems, and proactive responses to changing circumstances can interact to sustain change. In the absence of cast-iron evidence of effectiveness, wider notions of value may be successfully invoked to sustain innovation. Sustainability requires continuing effort through time, rather than representing a final state to be achieved. Our study offers new insights into the process of sustainability of organizational change, and elucidates the complement of strategies needed to make bottom-up change last in challenging contexts replete with competing priorities

Portrayals of Child Abuse Scandals in the Media in Australia and England: Impacts on Practice, Policy, and Systems

This article describes how the media have played a key role in placing the issue of child maltreatment and the problems associated with child protection high on public and political agendas over the last 50 years. It also describes how the influence of the media is far from unambiguous. Although the media has been crucial in bringing the problems into the open, it often does so in particular ways. In being so concerned with scandals and tragedies ∗ Correspondence concerning this article should be addressed to Bob Lonne, School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia. Electronic mail may be sent to [email protected]. in a variety of institutionalized and community settings, the media have portrayed the nature of child maltreatment in ways which deflect attention from many of its core characteristics and causes. A focus on the media is important because of the power the media have to help transform the private into the public, but at the same time, to undermine trust, reputation, and legitimacy of the professionals working in the field. This concern is key for those working in the child protection field and has been a source of tension in public policy in both Australia and England for many years

Meeting Agendas

Collection of meeting agendas for the U.S. Secretary of Labor\u27s Task Force on Excellence in State and Local Government Through Labor-Management Cooperation (1994-1996)

Bringing genetics into primary care: findings from a national evaluation of pilots in England

Objectives: Developments in genetic knowledge and clinical applications are seen as rendering traditional modes of organizing genetics provision increasingly inappropriate. In common with a number of developed world countries the UK has sought to increase the role of primary care in delivering such services. However, efforts to reconfigure service delivery face multiple challenges associated with divergent policy objectives, organizational boundaries and professional cultures. This paper presents findings from an evaluation of an English initiative to integrate genetics into 'mainstream' clinical provision in the National Health Service. Methods: Qualitative research in 11 case-study sites focusing on attempts by pilots funded by the initiative to embed knowledge and provision within primary care illustrating barriers faced and the ways in which these were surmounted. Results: Lack of intrinsic interest in clinical genetics among primary care staff was compounded by national targets that focused their attention elsewhere and by service structures that rendered genetics a peripheral concern demanding minimal engagement. Established divisions between the commissioning of mainstream and specialist services, along with the pressures of shorter-term targets, impeded ongoing funding. Conclusions: More wide-ranging policy and organizational support is required if the aim of entrenching genetics knowledge and practice across the Health Service is to be realized

Letters from Executive Director Jonathan Brock

Collection of letters from Jonathan Broch, the Executive Director of the U.S. Secretary of Labor\u27s Task Force on Excellence in State and Local Government Through Labor-Management Cooperation

Report Finds Labor Management Cooperation Critical To State and Local Government Success

News release announcing the final report of the U.S. Secretary of Labor\u27s Task Force on Excellence in State and Local Government Through Labor-Management Cooperation

An Act to Provide for the Nomination of Candidates of Political Parties by Primary Elections

Subtitle: Adopted by the qualified voters of the State of Maine at a special election held on the eleventh day of September, A.D. 1911, and on the twenty-eighth day of September, A.D. 1911 proclaimed by the Governor and to take effect thirty days after said proclamation.https://digicom.bpl.lib.me.us/books_pubs/1157/thumbnail.jp

Task Force Mission Statement

The economic success of our Nation, as well as the social well-being of its citizens, depend, in large measure, on the essential services and infrastructure provided by state and local government. The imperative to compete in an increasingly worldwide economy and to respond to increasing societal demands requires that governments at all levels perform in a timely and cost-effective manner. It is essential that public management and organizations of their employees work together in order to respond effectively to these fundamental needs. To this end, the Secretary of Labor has established a Task Force on Excellence in State and Local Government through Labor-Management Cooperation