The impact of leadership and change management strategy on organizational culture and individual acceptance of change during a merger

This article reports a longitudinal study that examined mergers between three large multi-site public-sector organizations. Both qualitative and quantitative methods of analysis are used to examine the effect of leadership and change management strategies on acceptance of cultural change by individuals. Findings indicate that in many cases the change that occurs as a result of a merger is imposed on the leaders themselves, and it is often the pace of change that inhibits the successful re-engineering of the culture. In this respect, the success or otherwise of any merger hinges on individual perceptions about the manner in which the process is handled and the direction in which the culture is moved. Communication and a transparent change process are important, as this will often determine not only how a leader will be regarded, but who will be regarded as a leader. Leaders need to be competent and trained in the process of transforming organizations to ensure that individuals within the organization accept the changes prompted by a merger.

Determinants in the development of advanced nursing practice: a case study of primary-care settings in Hong Kong

Different factors have been shown to influence the development of models of advanced nursing practice (ANP) in primary-care settings. Although ANP is being developed in hospitals in Hong Kong, China, it remains undeveloped in primary care and little is known about the factors determining the development of such a model. The aims of the present study were to investigate the contribution of different models of nursing practice to the care provided in primary-care settings in Hong Kong, and to examine the determinants influencing the development of a model of ANP in such settings. A multiple case study design was selected using both qualitative and quantitative methods of data collection. Sampling methods reflected the population groups and stage of the case study. Sampling included a total population of 41 nurses from whom a secondary volunteer sample was drawn for face-to-face interviews. In each case study, a convenience sample of 70 patients were recruited, from whom 10 were selected purposively for a semi-structured telephone interview. An opportunistic sample of healthcare professionals was also selected. The within-case and cross-case analysis demonstrated four major determinants influencing the development of ANP: (1) current models of nursing practice; (2) the use of skills mix; (3) the perceived contribution of ANP to patient care; and (4) patients' expectations of care. The level of autonomy of individual nurses was considered particularly important. These determinants were used to develop a model of ANP for a primary-care setting. In conclusion, although the findings highlight the complexity determining the development and implementation of ANP in primary care, the proposed model suggests that definitions of advanced practice are appropriate to a range of practice models and cultural settings. However, the findings highlight the importance of assessing the effectiveness of such models in terms of cost and long-term patient outcomes.

Data-driven fuzzy analysis in quantitative mineral resource assessment

The integration of geo-information from multiple sources and of diverse nature in developing mineral favourability indexes (MFIs) is a well-known problem in mineral exploration and mineral resource assessment. Fuzzy set theory provides a convenient framework to combine and analyse qualitative and quantitative data independently of their source or characteristics. A novel, data-driven formulation for calculating MFIs based on fuzzy analysis is developed in this paper. Different geo-variables are considered fuzzy sets and their appropriate membership functions are defined and modelled. A new weighted average-type aggregation operator is then introduced to generate a new fuzzy set representing mineral favourability. The membership grades of the new fuzzy set are considered as the MFI. The weights for the aggregation operation combine the individual membership functions of the geo-variables, and are derived using information from training areas and L, regression. The technique is demonstrated in a case study of skarn tin deposits and is used to integrate geological, geochemical and magnetic data. The study area covers a total of 22.5 km(2) and is divided into 349 cells, which include nine control cells. Nine geo-variables are considered in this study. Depending on the nature of the various geo-variables, four different types of membership functions are used to model the fuzzy membership of the geo-variables involved. (C) 2002 Elsevier Science Ltd. All rights reserved.