The use of contracting out : a case study of decision-making and organisational learning in local government

One objective of government is to provide services at least cost whilst maintaining or improving service quality. While this may be an important objective, questions are being asked whether services can be provided more efficiently and effectively by the private rather than by the government sector. The shift of service provision from the public to the private sector is known as outsourcing or contracting out. The objective in this study is to critically examine whether the contracting out of services by local government to the private sector is an efficient management practice.

The contracting out of Parks and Grounds Maintenance services for the City of Kingston in the State of Victoria, Australia, is used as an exploratory case study to identify the variables associated with management decision-making in the contracting out process. Factors relevant to the contracting out decision such as the criteria used in selecting a contractor; the evaluation of a contractor’s performance; and any subsequent changes to management practice relating to the contracting out of the services are identified and discussed.

Political forces were found to be an important consideration in the initial contracting out decision, and the selection of a contractor was influenced by the potential to avoid costs. It was also found that under-bidding and associated cost /profit constraints lead to contractors engaging in non-sustainable environmental practices which resulted in the degradation of the local government’s Parks and Gardens assets. A sustainable asset management philosophy as opposed to an avoidable costs approach now underpins the contracting out process to ensure the preservation of such assets. Further, administrative processes have been revised to make tender specifications more prescriptive, critical components of services have been brought back in-house, and management practices have been amended so that a greater degree of control is exercised over contractors’ activities.

Corporate social responsibility in professional team sport organisations : towards a theory of decision-making

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Assumptions of decision-making capacity: the role supporter attitudes play in the realisation of Article 12 for people with severe or profound intellectual disability

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) was the first legally binding instrument explicitly focused on how human rights apply to people with disability. Amongst their obligations, consistent with the social model of disability, the Convention requires signatory nations to recognise that “…persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life” and mandates signatory nations to develop “…appropriate measures to provide access by persons with disability to the support they may require in exercising their legal capacity”. The Convention promotes supported decision-making as one such measure. Although Australia ratified the UNCRPD in 2008, it retains an interpretative declaration in relation to Article 12 (2, 3, 4), allowing for the use of substituted decision-making in situations where a person is assessed as having no or limited decision-making capacity. Such an outcome is common for people with severe or profound intellectual disability because the assessments they are subjected to are focused on their cognition and generally fail to take into account the interdependent nature of human decision-making. This paper argues that Australia’s interpretative declaration is not in the spirit of the Convention nor the social model of disability on which it is based. It starts from the premise that the intention of Article 12 is to be inclusive of all signatory nations’ citizens, including those with severe or profound cognitive disability. From this premise, arises a practical need to understand how supported decision-making can be used with this group. Drawing from evidence from an empirical study with five people with severe or profound intellectual disability, this paper provides a rare glimpse on what supported decision-making can look like for people with severe or profound intellectual disability. Additionally, it describes the importance of supporters having positive assumptions of decision-making capacity as a factor affecting supported decision-making. This commentary aims to give a focus for practice and policy efforts for ensuring people with severe or profound cognitive disability receive appropriate support in decision-making, a clear obligation of signatory nations of the UNCRPD. A focus on changing supporter attitudes rather than placing the onus of change on people with disability is consistent with the social model of disability, a key driver of the UNCRPD.

Clinicians’ perceptions of decision making regarding discharge from public hospitals to in-patient rehabilitation following trauma

Objective: The aim of the present study was to investigate the perceptions of consultant surgeons, allied health clinicians and rehabilitation consultants regarding discharge destination decision making from the acute hospital following trauma.Methods: A qualitative study was performed using individual in-depth interviews of clinicians in Victoria (Australia) between April 2013 and September 2014. Thematic analysis was used to derive important themes. Case studies provided quantitative information to enhance the information gained via interviews.Results: Thirteen rehabilitation consultants, eight consultant surgeons and 13 allied health clinicians were interviewed. Key themes that emerged included the importance of financial considerations as drivers of decision making and the perceived lack of involvement of medical staff in decisions regarding discharge destination following trauma. Other themes included the lack of consistency of factors thought to be important drivers of discharge and the difficulty in acting on trauma patients’ requests in terms of discharge destination. Importantly, as the complexity of the patient increases in terms of acquired brain injury, the options for rehabilitation become scarcer.Conclusions: The information gained in the present study highlights the large variation in discharge practises between and within clinical groups. Further consultation with stakeholders involved in the care of trauma patients, as well as government bodies involved in hospital funding, is needed to derive a more consistent approach to discharge destination decision making.

Role of knowledge and ability in student nurses` clinical decision-making

Little is known about the acquisition of decision-making skills in nursing students as a function of experience and academic ability. Knowing how experience and academic skills interact may help inform clinical education programs and formulate ways of assessing students' progress. The aims of the present study were to develop a problem-solving task capable of measuring clinical decision-making skills in novice nurses at different levels of domain-specific knowledge; and to establish the relative impact on decision-making of domain-specific knowledge and general ability as determinants of the acquisition of decision-making skills. Three types of clinical problems of increasing complexity were developed. Sixty second-year and third-year student nurses with high and low academic scores were studied in terms of their ability to generate hypotheses for a hypothetical case, recognize disconfirming information and the need to access additional information, and diagnostic accuracy. The results showed that general academic ability and knowledge function partly independently in the acquisition of expertise in nursing. Academic ability affects decision-making in low complexity tasks, but as case complexity increases, domain-specific knowledge and experience determines decision-making skills. There are important differences in the way novices with different levels of knowledge and ability make clinical decisions and these can be studied by systematically increasing the complexity of the decision task. These results have implications for the way in which clinical education is structured and evaluated.

The role of information and communication technology in the urgent decision making process : a work in progress report

This paper reports part of a study that examines how members of a senior management team in a public sector organisation make decisions under urgency. Four regional managers, who are geographically dispersed around New Zealand were interviewed, either face-to-face or via telephone, regarding their experiences of decision making under urgency.

Preliminary results indicate that only three out of a possible seven steps of a conventional decision making process are used during the urgent decision making process. The study also shows that participants do not fully utilise the information and communication technology available during the decision making process. The implications the findings have for practice and research are discussed.

Conceptual framework of the precautionary principle approach in the decision-making process

This article reviews the precautionary principle as an approach in addressing decisions with far reaching environmental consequences under scientific uncertainty. The precautionary principle is intended to assist with structuring environmentally risky decisions toward sustainable development. It responds to the lack of scientific evidence of a potential environmental problem. There is currently no framework to assist with the process indicating the areas of importance and stages of decisionmaking. This paper suggests a framework to assist with the process of decision-making for complex environmental problems. The main areas of concern are the issues relating to the costs, risks, and benefits assessments. The main stages of the framework includes; definition of the problem, analysis of the potential environmental risks, assessments of specific anticipated legal, social, economic, political, and technological impacts, review of the key players (social, organisation and government) obligations, comparison of alternatives available, determination of accountability, implementation, decision making, monitoring and control processes.

Psychic distance : antecedents, retail strategy implications and performance outcomes

The authors propose a conceptual model of the psychic distance–organizational performance relationship that incorporates organizational factors (international experience and centralization of decision making), entry strategy, and retail strategy implications. The findings suggest that when entering psychically distant markets, retailers should adopt low-cost/low-control entry strategies and adapt their retail strategy to a greater extent than in psychically close markets. However, the authors find that such strategic responses have an adverse effect on performance. They find that international experience, psychic distance, entry strategy, and retail strategy adaptation are significant drivers of organizational performance and factors that determine critical success in international retailing.

Decision making in health care: limitations of the substituted judgement principle

The substituted judgement principle is often recommended as a means of promoting the self-determination of an incompetent individual when proxy decision makers are faced with having to make decisions about health care. This article represents a critical ethical analysis of this decision-making principle and describes practical impediments that serve to undermine its fundamental purpose. These impediments predominantly stem from the informality associated with the application of the substituted judgement principle. It is recommended that the principles upon which decisions are made about health care for another person should be transparent to all those involved in the process. Furthermore, the substituted judgement principle requires greater rigour in its practical application than currently tends to be the case. It may be that this principle should be subsumed as a component of advance directives in order that it fulfils its aim of serving to respect the self-determination of incompetent individuals.

Naturalistic decision making: a model to overcome methodological challenges in the study of critical care nurses` decision making about patients` hemodynamic status

The quality of critical care nurses' decision making about patients' hemodynamic status in the immediate period after cardiac surgery is important for the patients' well-being and, at times, survival. The way nurses respond to hemodynamic cues varies according to the nurses' skills, experiences, and knowledge. Variability in decisions is also associated with the inherent complexity of hemodynamic monitoring. Previous methodological approaches to the study of hemodynamic assessment and treatment decisions have ignored the important interplay between nurses, the task, and the environment in which these decisions are made. The advantages of naturalistic decision making as a framework for studying the manner in which nurses make decisions are presented.