Degree of value alignment : a grounded theory of rural nurse resignations

INTRODUCTION: The shortage of nurses willing to work in rural Australian healthcare settings continues to worsen. Australian rural areas have a lower retention rate of nurses than metropolitan counterparts, with more remote communities experiencing an even higher turnover of nursing staff. When retention rates are lower, patient outcomes are known to be poorer. This article reports a study that sought to explore the reasons why registered nurses resign from rural hospitals in the state of New South Wales, Australia. METHODS: Using grounded theory methods, this study explored the reasons why registered nurses resigned from New South Wales rural hospitals. Data were collected from 12 participants using semi-structured interviews; each participant was a registered nurse who had resigned from a rural hospital. Nurses who had resigned due to retirement, relocation or maternity leave were excluded. Interviews were transcribed verbatim and imported into NVivo software. The constant comparative method of data collection and analysis was followed until a core category emerged. RESULTS: Nurses resigned from rural hospitals when their personal value of how nursing should occur conflicted with the hospital's organisational values driving the practice of nursing. These conflicting values led to a change in the degree of value alignment between the nurse and hospital. The degree of value alignment occurred in three dynamic stages that nurses moved through prior to resigning. The first stage, sharing values, was a time when a nurse and a hospital shared similar values. The second stage was conceding values where, due to perceived changes in a hospital's values, a nurse felt that patient care became compromised and this led to a divergence of values. The final stage was resigning, a stage where a nurse 'gave up' as they felt that their professional integrity was severely compromised. The findings revealed that when a nurse and organisational values were not aligned, conflict was created for a nurse about how they could perform nursing that aligned with their internalised professional values and integrity. Resignation occurred when nurses were unable to realign their personal values to changed organisational values - the organisational values changed due to rural area health service restructures, centralisation of budgets and resources, cumbersome hierarchies and management structures that inhibited communication and decision making, out-dated and ineffective operating systems, insufficient and inexperienced staff, bullying, and a lack of connectedness and shared vision. CONCLUSIONS: To fully comprehend rural nurse resignations, this study identified three stages that nurses move through prior to resignation. Effective retention strategies for the nursing workforce should address contributors to a decrease in value alignment and work towards encouraging the coalescence of nurses' and hospitals' values. It is imperative that strategies enable nurses to provide high quality patient care and promote a sense of connectedness and a shared vision between nurse and hospital. Senior managers need to have clear ways to articulate and imbue organisational values and be explicit in how these values accommodate nurses' values. Ward-level nurse managers have a significant responsibility to ensure that a hospital's values (both explicit and implicit) are incorporated into ward culture.

On the efficacy of key corporate governance recommendations in mid-tier companies : window-dressing or value-adding?

This paper examins the relationship between firm performance and key board and audit committee variables in a sample of mid-tier listed Australian firms. Unlike the UK where the corporate governance Code specifically outlines special arrangements for companies outside the FTSE 350 index, the ASX Corporate Governance recommendations make no special provisions for mid-tier companies. Consequently, mid-tier Australian companies may be expending scarce resources in conforming with recommendations that are not value-creating.

Contextualising co-creation of value in electronic personal health records

This conceptual paper is a preliminary part of an ongoing study into take-up of electronic personal health records (ePHRs). The purpose of this work is to contextually ‘operationalise' Grönroos’ (2012) model of value co-creation in service for ePHRs. Using findings in the extant literature we enhance theoretical and practical understanding of the potential for co-creation of value with ePHRs for relevant stakeholders. The research design focused on the selection and evaluation of relevant literature to include in the discussion. The objective was to demonstrate which articles can be used to 'contextualise' the concepts in relation to relevant healthcare providers and patient engagement in the co-creation of value from having shared ePHRs. Starting at the service concept, that is, what the service provider wants to achieve and for whom, there is little doubt that there are recognised benefits that co-create value for both healthcare providers and healthcare consumers (i.e. patients) through shared ePHRs. We further highlight both alignments and misalignments in the resources and activities concepts between stakeholder groups. Examples include the types of functionalities as well as the interactive and peer communication needs perceived as useful for healthcare providers compared to healthcare consumers. The paper has implications for theory and practice and is an original and innovative approach to studying the co-creation of value in eHealth delivery.

Power and paradigms : the Dutch response to pressures for shareholder value

In recent years, research aimed at identifying and relating the antecedents and consequences of diffusing organizational practices/ideas has turned its attention to debating the international adoption and implementation of the Anglo-American model of corporate governance, i.e., a shareholder-value-orientation (SVO). While financial economists characterize the adoption of an SVO as necessary and performance-enhancing, behavioral scientists have disputed such claims, invoking institutional contingencies in the appropriateness of an SVO. Our study seeks to provide some resolution to the debate by developing an overarching socio-political perspective that links the antecedents and consequences of the adoption of the contested practice of SVO. We test our framework using extensive longitudinal data from 1992-2006 from the largest listed corporations in the Netherlands, and we find a negative relationship between SVO adoption and subsequent firm performance, although this effect is attenuated when accompanied by greater SVO-alignment among major owners and a firm’s visible commitment to an SVO. This study extends prior research on the diffusion of contested organizational practices that has taken a socio-political perspective by offering an original contingency perspective that addresses how and why the misaligned preferences of corporate owners will affect (i) a company’s inclination to espouse an SVO, and (ii) the performance consequences of such misalignment.This study suggests when board members are considering the adoption of new ideas/practices (e.g., SVO), they should consider the contextual fitness of the idea/practice with the firm’s owners and their interests.

Examining the predictive value of combining the theory of planned behaviour and the volunteer functions inventory

The functions of the volunteer functions inventory were combined with the constructs of the theory of planned behaviour (i.e., attitudes, subjective norms, and perceived behavioural control) to establish whether a stronger, single explanatory model prevailed. Undertaken in the context of episodic, skilled volunteering by individuals who were retired or approaching retirement (N = 186), the research advances on prior studies which either examined the predictive capacity of each model independently or compared their explanatory value. Using hierarchical regression analysis, the functions of the volunteer functions inventory (when controlling for demographic variables) explained an additional 7.0% of variability in individuals’ willingness to volunteer over and above that accounted for by the theory of planned behaviour. Significant predictors in the final model included attitudes, subjective norms and perceived behavioural control from the theory of planned behaviour and the understanding function from the volunteer functions inventory. It is proposed that the items comprising the understanding function may represent a deeper psychological construct (e.g., self-actualisation) not accounted for by the theory of planned behaviour. The findings highlight the potential benefit of combining these two prominent models in terms of improving understanding of volunteerism and providing a single parsimonious model for raising rates of this important behaviour.

Rethinking the value of simulation methods in the information systems research field : a call for reconstructing contribution for a broader audience

The impact of simulation methods for social research in the Information Systems (IS) research field remains low. A concern is our field is inadequately leveraging the unique strengths of simulation methods. Although this low impact is frequently attributed to methodological complexity, we offer an alternative explanation – the poor construction of research value. We argue a more intuitive value construction, better connected to the knowledge base, will facilitate increased value and broader appreciation. Meta-analysis of studies published in IS journals over the last decade evidences the low impact. To facilitate value construction, we synthesize four common types of simulation research contribution: Analyzer, Tester, Descriptor, and Theorizer. To illustrate, we employ the proposed typology to describe how each type of value is structured in simulation research and connect each type to instances from IS literature, thereby making these value types and their construction visible and readily accessible to the general IS community.

Seeking better IT value conceptualization : some meta-theoretical considerations

Information Technology (IT) value is amongst the most important concepts in the Information Systems (IS) research field. Yet, a clear, well-formulated conceptualization of IT value, cumulatively built upon, is lacking. Drawing from the Facet Theory literature, this paper broaches several meta-theoretical considerations addressing an “ideal” conceptualization of IT value. We argue these considerations may shed light on the advancement of IT value conceptualization methodology.

Government grants - an abrogation or management of risks?

New public management (NPFM), with its hands-on, private sector-style performance measurement, output control, parsimonious use of resources, disaggreation of public sector units and greater competition in the public sector, has significantly affected charitable and nonprofit organisations delivering community services (Hood, 1991; Dunleavy, 1994; George & Wilding, 2002). The literature indicates that nonprofit organisations under NPM believe they are doing more for less: while administration is increasing, core costs are not being met; their dependence on government funding comes at the expense of other funding strategies; and there are concerns about proportionality and power asymmetries in the relationship (Kerr & Savelsberg, 2001; Powell & Dalton, 2011; Smith, 2002, p. 175; Morris, 1999, 2000a). Government agencies are under increased pressure to do more with less, demonstrate value for money, measure social outcomes, not merely outputs and minimise political risk (Grant, 2008; McGreogor-Lowndes, 2008). Government-community service organisation relationships are often viewed as 'uneasy alliances' characterised by the pressures that come with the parties' differing roles and expectations and the pressures that come with the parties' differing roles and expectations and the pressurs of funding and security (Productivity Commission, 2010, p. 308; McGregor-Lowndes, 2008, p. 45; Morris, 200a). Significant community services are now delivered to citizens through such relationships, often to the most disadvantaged in the community, and it is important for this to be achieved with equity, efficiently and effectively. On one level, the welfare state was seen as a 'risk management system' for the poor, with the state mitigating the risks of sickness, job loss and old age (Giddens, 1999) with the subsequent neoliberalist outlook shifting this risk back to households (Hacker, 2006). At the core of this risk shift are written contracts. Vincent-Jones (1999,2006) has mapped how NPM is characterised by the use of written contracts for all manner of relations; e.g., relgulation of dealings between government agencies, between individual citizens and the state, and the creation of quais-markets of service providers and infrastructure partners. We take this lens of contracts to examine where risk falls in relation to the outsourcing of community services. First we examine the concept of risk. We consider how risk might be managed and apportioned between governments and community serivce organisations (CSOs) in grant agreements, which are quasiy-market transactions at best. This is informed by insights from the law and economics literature. Then, standard grant agreements covering several years in two jurisdictions - Australia and the United Kingdom - are analysed, to establish the risk allocation between government and CSOs. This is placed in the context of the reform agenda in both jurisdictions. In Australia this context is th enonprofit reforms built around the creation of a national charities regulator, and red tape reduction. In the United Kingdom, the backdrop is the THird Way agenda with its compacts, succeed by Big Society in a climate of austerity. These 'case studies' inform a discussion about who is best placed to bear and manage the risks of community service provision on behalf of government. We conclude by identifying the lessons to be learned from our analysis and possible pathways for further scholarship.

Assessing the value of mandatory sleep/rest periods in early childhood education and care

In Australia while "appropriate provision for sleep and rest" in early education and care settings is legislated there is no research base to define appropriate practice. This study provided the first, comprehensive documentation of sleep practices in early education and care and assessed their impacts on child health and well-being. The evidence supports development of practice guidelines to manage the complex individual and organisational factors associated with provisions for sleep and rest. The thesis contributes to significant international debate in sleep science regarding the benefits of promoting day-sleep during a period characterized by decline in biological propensity to nap.

Can we get along better?

Queensland University of Technology, together with the Royal Melbourne Institute of Technology, the Alliancing Association of Australia, and the Australian Research Council, have recently commenced a 3 year research project which aims to explore the ways in which value for money can be optimised using collaborative contracting during delivery of Australian infrastructure projects.

The learning capability of construction organisations engaged in collaborative contracting - Literature Review [industry report]

Background Value for money (VfM) on collaborative construction projects is dependent on the learning capabilities of the organisations and people involved. Within the context of infrastructure delivery, there is little research about the impact of organisational learning capability on project value. The literature contains a multiplicity of often un-testable definitions about organisational learning abilities. This paper defines learning capability as a dynamic capability that participant organisations purposely develop to add value to collaborative projects. The paper reports on a literature review that proposes a framework that conceptualises learning capability to explore the topic. This work is the first phase of a large-scale national survey funded by the Alliancing Association of Australasia and the Australian Research Council. Methodology Desk-top review of leading journals in the areas of strategic management, strategic alliances and construction management, as well as recent government documents and industry guidelines, was undertaken to synthesise, conceptualise and operationalise the concept of learning capability. The study primarily draws on the theoretical perspectives of the resource-based view of the firm (e.g. Barney 1991; Wernerfelt 1984), absorptive capacity (e.g. Cohen and Levinthal 1990; Zahra and George 2002); and dynamic capabilities (e.g. Helfat et al. 2007; Teece et al. 1997; Winter 2003). Content analysis of the literature was undertaken to identify key learning routines. Content analysis is a commonly used methodology in the social sciences area. It provides rich data through the systematic and objective review of literature (Krippendorff 2004). NVivo 9, a qualitative data analysis software package, was used to assist in this process. Findings and Future Research The review process resulted in a framework for the conceptualisation of learning capability that shows three phases of learning: (1) exploratory learning, (2) transformative learning and (3) exploitative learning. These phases combine both internal and external learning routines to influence project performance outcomes and thus VfM delivered under collaborative contracts. Sitting within these phases are eight categories of learning capability comprising knowledge articulation, identification, acquisition, dissemination, codification, internationalisation, transformation and application. The learning routines sitting within each category will be disaggregated in future research as the basis for measureable items in a large-scale survey study. The survey will examine the extent to which various learning routines influence project outcomes, as well as the relationships between them. This will involve identifying the routines that exist within organisations in the construction industry, their resourcing and rate of renewal, together with the extent of use and perceived value within the organisation. The target population is currently estimated to be around 1,000 professionals with experience in relational contracting in Australia. This future research will build on the learning capability framework to provide data that will assist construction organisations seeking to maximise VfM on construction projects.

Saffman-Taylor fingers with kinetic undercooling

The mathematical model of a steadily propagating Saffman-Taylor finger in a Hele-Shaw channel has applications to two-dimensional interacting streamer discharges which are aligned in a periodic array. In the streamer context, the relevant regularisation on the interface is not provided by surface tension, but instead has been postulated to involve a mechanism equivalent to kinetic undercooling, which acts to penalise high velocities and prevent blow-up of the unregularised solution. Previous asymptotic results for the Hele-Shaw finger problem with kinetic undercooling suggest that for a given value of the kinetic undercooling parameter, there is a discrete set of possible finger shapes, each analytic at the nose and occupying a different fraction of the channel width. In the limit in which the kinetic undercooling parameter vanishes, the fraction for each family approaches 1/2, suggesting that this selection of 1/2 by kinetic undercooling is qualitatively similar to the well-known analogue with surface tension. We treat the numerical problem of computing these Saffman-Taylor fingers with kinetic undercooling, which turns out to be more subtle than the analogue with surface tension, since kinetic undercooling permits finger shapes which are corner-free but not analytic. We provide numerical evidence for the selection mechanism by setting up a problem with both kinetic undercooling and surface tension, and numerically taking the limit that the surface tension vanishes.