Comic relief: Subversion and catharsis in organizational comedic theatre

There has been a growth of interest in the role of humour in organizations from both practitioner and academic perspectives. Various claims for the functionality of humour have been made, ranging from stress reduction to helping form and cement corporate cultures. Latching on to these presumed benefits, businesses and consultants have begun to employ humour and comedy in a direct and explicit manner. However, there is a counterpoint, which suggests that humour cannot always be managed and in fact has subversive qualities. This article addresses the issue of the subversive potential of comedy in organizational contexts. It draws illustratively on the case of a successful corporate comedian to do so. The article argues, through an analysis of the case, the history and philosophy of comedy, and theories of the comedic, that while comedy has inherent subversive potential, it most often is contained. Indeed, it suggests that comedy works by intruding as a potential threat to mundane reality, but offers comic relief when it is apparent that the threat will not be actualized and the status quo ante prevails. Implications for using corporate comedy are drawn..

Audit of consultant physicians' reply letters for referrals to clinics in a tertiary teaching hospital

Background: Doctors referring patients to consultant physicians seek reply letters which both educate and assist in ongoing patient management. Highly desirable attributes in specialist letters include clearly stated and justified: (i) diagnostic formulations, (ii) management regimens, (iii) use of clinical investigations, (iv) prog-nostic statements, (v) contingency plans and (vi) follow-up arrangements. Aim: To explicitly evaluate the quality of reply letters for new patients referred to clinics at a tertiary teaching hospital. Methods: Letters were sampled from outpatient clinics of 10 different medical specialties at Princess Alexandra Hospital in Brisbane, Australia. Reply letters for new patient referrals between 1 August 2000 and 31 October 2000 were retrieved, from which data were abstracted to calculate the proportion of letters satisfying prespecified quality attributes. Results: Of 297 new patient referrals, reply letters were retrieved for 204 (69%). Of these, 147 (72%) referrals were accompanied by a referral letter, mostly (113/147; 77%) from general practitioners. For 120 referrals involving diagnostic issues, 69 (56%) letters stated a diagnostic formulation. Of 114 letters recommending further clinical investigations, 61 (53%) described a rationale for such testing. In 125 cases where therapy was a key issue, 83 (66%) letters recommended changes to current treatment for which reasons were specified in 46 (55%) cases, and contingency plans provided in 13 (16%). Prognosis was mentioned in only 18 (9%) cases. Follow-up arrangements were detailed in 123 (60%) letters. Assessments of patient understanding and likely adherence to therapy were stated in less than 15% of -letters. Conclusions: Opportunities exist for improving quality of consultant physicians' reply letters in terms of greater use of problem lists, contingency plans, prognostic statements and patient-centred assessments, as well as more frequent enunciation of consultants' reasoning behind requests for further tests and changes to current management. Use of structured letter templates may facilitate more consistent inclusion of key information to referring doctors.

Diagnostic accuracy of and patient satisfaction with telemedicine for the follow-up of paediatric burns patients

Videoconferencing has become a routine technique for the post-acute burns care of children in Queensland. We compared the agreement between clinical assessments conducted via videoconference and assessments conducted in the conventional, face-to-face manner (FTF). A total of 35 children with a previous burn injury were studied. Twenty-five children received three consecutive assessments: first FTF by a consultant in the outpatient department, then by a second consultant who reviewed the patient via videoconference, and then by the second consultant in person. The second consultant also reviewed another 10 children twice. At each review, the following variables were measured: scar colour, scar thickening, contractures, range of motion, the patient's level of general activity, any breakdown of the graft site, and adequacy of the consultation. Agreement between the two consultants when seeing patients FTF was moderately high, with an overall concordance of 85%. When videoconferencing was used, the level of agreement was almost the same, at 84%. If one consultant reviewed patients FTF first and then via videoconference, the overall concordance was 98%; if the process was reversed, the overall concordance was 97%. This study confirms that the quality of information collected during a videoconference appointment is comparable to that collected during a traditional, FTF appointment for a follow-up burns consultation.

Telemedical support for Iraq

The Swinfen Charitable Trust (SCT) provided two kinds of telemedical support to Iraq during 2004. Starting in January 2004, the Al-Yarmouk Teaching Hospital in Baghdad was able to refer cases into the well established global e-health network that the SCT has operated for the last five years. (In the first quarter of 2004, the SCT dealt with a total of 57 referrals from 15 hospitals in eight countries.) Two cases were referred from Baghdad in March 2004, both gynaecological, which were dealt with by consultants from the UK and Australia. The SCT administrators visited Basrah during April 2004 and met Iraqi doctors at the Shaibah Hospital as part of the international initiatives to improve health care there. Following this visit, the SCT network expanded to include another four hospitals in Iraq (Table 1). In addition, the SCT provided an electronic health records (EHR) system to support the rebuilding of maternity services, which has been led by the British Royal Colleges. The maternity records system is a Web-based EHR system, running on a secure server, which allows integrated access from antenatal clinics, from hospitals and from postnatal clinics in Iraq. Patients can view their own notes, thus promoting ownership of medical information, and doctors can view the notes of their own patients, from any Internet-connected PC. No special software is required by the user.

Wireless telemedicine for the delivery of specialist paediatric services to the bedside

A mobile interactive online health system was used to conduct virtual ward rounds at a regional hospital which had no specialist paediatrician. The system was wireless, which allowed telepaediatric services to be delivered direct to the bedside. Between December 2004 and May 2005, 43 virtual ward rounds were coordinated between specialists based in Brisbane and local staff at the Gladstone Hospital. Eighty-six consultations were provided for 64 patients. The most common conditions included asthma (27%), chest infections (12%), gastroenteritis (10%) and urinary tract infections (10%). In the majority of cases, there were partial (67%) or complete changes (11%) in the clinical management of patients. Specialist services were offered by a team of 13 clinicians at the Royal Children's Hospital: 10 general paediatricians, two physiotherapists and one registered nurse. Feedback from all consultants involved in the service and local staff in Gladstone was extremely positive. In 43 videoconference calls there were three technical problems, probably due to an intermittent mains power supply at the regional hospital. There appears to be potential for other rural and regional hospitals to adopt this model of service delivery.

Enabling change for corporate sustainability: An integrated perspective

This article explores the processes of change that enable corporations to move towards sustainable practices, focusing on the human resource and business strategies that support rather than diminish global ecology and human/social capabilities. We argue that this unified approach is necessary to bring about a change in the interpretation of corporate sustainability and to support the activities of change agents (managers, consultants, and community activists) in managing the massive corporate change needed to move corporations toward sustainable practices in a systematic way. We propose a schema in the form of an integrated phase model for understanding how corporations move from compliance modes to the attainment of strategic sustainability and beyond to the ‘ideal’ or sustaining corporation. We discuss the leadership of change and the roles and strategies that corporate change agents can employ to bring about both incremental and transformational change for sustainability.

Facilitating IPM: The role of participatory workshops

Successful, long-term implementation of Integrated Pest Management (IPM) requires the integration of key technical and management activities and the participation of a wide range of stakeholders including farmers, researchers, extension officers, crop consultants, government agencies, and industry. A key issue that needs urgent attention is how to achieve the high quality interaction between these different groups which is necessary for sustained IPM. Problem specification and planning workshops (PSPWs) provide one means of facilitating an integrated strategy for tackling complex pest management issues. Since 1992, the Cooperative Research Centre for Tropical Pest Management has facilitated over 20 PSPWs, focusing on different farming systems in Australia. This paper describes the philosophy, the process involved, and the impact that these PSPWs have had. It examines three specific cases to describe the relationship between plans and results and ways of improving impact. The results reinforce the major role that social scientists can play in providing mechanisms for collaborating with technical researchers and other partners to facilitate effective, participatory ventures in IPM.

Tempus: Barriers, Borders, Boundaries: Proceedings of the 2001 Australian Archaeological Association Annual Conference

The conference aimed to provide a forum for the exploration of barriers, borders and boundaries in Australian archaeological methods and practice, frameworks of interpretation and epistemological structures. Sessions were designed to have broad appeal to a range of archaeological stakeholders including academics, consultants, Indigenous peoples, students, cultural heritage managers and policy formulators.