Implementing change in practice: Part 2- the change process

Pain management in premature and sick babies has long been recognisedas a vital component of neonatal care; however practices pertaining to painassessment and administration of analgesia remain variable in Neonatal Units(NNU). Sucrose has been identified as an effective agent in reducing pain during minorpainful procedures in premature babies but the uptake has been modest.This article (part 2) follows on from an earlier article on evidence to support theimplementation of sucrose administration as a measure for pain relief for minorprocedures (part 1) and will centre on practice-based change in the NNU and reflecton the strategies used as well as the effectiveness of the proposed change. A theoreticalchange model will be used as a framework to help unpack the influencesinherent within the change process.

A change in behaviour — getting the balance right for research and policy.

Behaviour change interventions offer clinical pharmacists many opportunities to optimise the use of medicines. ‘MINDSPACE’ is a framework used by a Government-affiliated organisation in the United Kingdom to communicate an approach to changing behaviour through policy. The Theoretical Domains Framework (TDF) organises constructs of psychological theories that are most relevant to behaviour change into 14 domains. Both frameworks offer a way of identifying what drives a change in behaviour, providing a target for an intervention. This article aims to compare and contrast MINDSPACE and the TDF, and serves to inform pharmacy practitioners about the potential strengths and weaknesses of using either framework in a clinical pharmacy context. It appears that neither framework can deliver evidence-based interventions that can be developed and implemented with the pace demanded by policy and practice-based settings. A collaborative approach would ensure timely development of acceptable behaviour change interventions that are grounded in evidence.

From Crisis to Opportunity: Turnaround Strategies of Large Irish Construction Contractors During the Period 2007-2015.

The sudden change in environmental munificence level in the construction sector
during the period 2007 – 2015 provides a natural experiment to investigate strategic
and operating actions of firms, particularly during an environmental jolt. Statistics on
business failures corroborate that neither academics nor practitioners have succeeded
in guiding strategic action during periods of environmental jolt. Despite the recent
increase of turnaround research in the general management domain, its use in the
construction management realm remains underexplored. To address this research
gap, five exploratory case studies of an ongoing PhD study were used to examine the
turnaround strategies of construction contractors during a period of economic
contraction and growth. The findings show that, although retrenchment is often
considered to be a short-term strategy, this is clearly not the case; with the majority of
contractors maintaining the strategy for 6-7 years. During the same period,
internationalization became critical, with the turnaround process shifting towards
strategic reorientation that altered the firms' market domain. The case studies further
suggest that strategic and operational actions resonate quite well with contemporary
practice-based approaches to strategy making. The findings provide valuable
assistance for construction contractors in dealing with organisational decline and in
developing a successful turnaround response.