Roles of the non-medical prescribing leads within organisations across a Strategic Health Authority: perceived functions and factors supporting the role

Objectives Extending the roles of nurses, pharmacists and allied health professionals to include prescribing has been identified as one way of improving service provision. In the UK, over 50 000 non-medical healthcare professionals are now qualified to prescribe. Implementation of non-medical prescribing ( NMP) is crucial to realise the potential return on investment. The UK Department of Health recommends a NMP lead to be responsible for the implementation of NMP within organisations. The aim of this study was to explore the role of NMP leads in organisations across one Strategic Health Authority (SHA) and to inform future planning with regards to the criteria for those adopting this role, the scope of the role and factors enabling the successful execution of the role. Methods Thirty-nine NMP leads across one SHA were approached. Semi-structured telephone interviews were conducted. Issues explored included the perceived role of the NMP lead, safety and clinical governance procedures and facilitators to the role. Transcribed audiotapes were coded and analysed using thematic analytical techniques. Key findings In total, 27/39 (69.2%) NMP leads were interviewed. The findings highlight the key role that the NMP lead plays with regards to the support and development of NMP within National Health Service trusts. Processes used to appoint NMP leads lacked clarity and varied between trusts. Only two NMP leads had designated or protected time for their role. Strategic influence, operational management and clinical governance were identified as key functions. Factors that supported the role included organisational support, level of influence and dedicated time. Conclusion The NMP lead plays a significant role in the development and implementation of NMP. Clear national guidance is needed with regards to the functions of this role, the necessary attributes for individuals recruited into this post and the time that should be designated to it. This is important as prescribing is extended to include other groups of non-medical healthcare professionals.

Requirements analysis for an e-government system to support multi-organisational collaborative groups

We present a conceptual architecture for a Group Support System (GSS) to facilitate Multi-Organisational Collaborative Groups (MOCGs) initiated by local government and including external organisations of various types. Multi-Organisational Collaborative Groups (MOCGs) consist of individuals from several organisations which have agreed to work together to solve a problem. The expectation is that more can be achieved working in harmony than separately. Work is done interdependently, rather than independently in diverse directions. Local government, faced with solving complex social problems, deploy MOCGs to enable solutions across organisational, functional, professional and juridical boundaries, by involving statutory, voluntary, community, not-for-profit and private organisations. This is not a silver bullet as it introduces new pressures. Each member organisation has its own goals, operating context and particular approaches, which can be expressed as their norms and business processes. Organisations working together must find ways of eliminating differences or mitigating their impact in order to reduce the risks of collaborative inertia and conflict. A GSS is an electronic collaboration system that facilitates group working and can offer assistance to MOCGs. Since many existing GSSs have been primarily developed for single organisation collaborative groups, even though there are some common issues, there are some difficulties peculiar to MOCGs, and others that they experience to a greater extent: a diversity of primary organisational goals among members; different funding models and other pressures; more significant differences in other information systems both technologically and in their use than single organisations; greater variation in acceptable approaches to solve problems. In this paper, we analyse the requirements of MOCGs led by local government agencies, leading to a conceptual architecture for an e-government GSS that captures the relationships between 'goal', 'context', 'norm', and 'business process'. Our models capture the dynamics of the circumstances surrounding each individual representing an organisation in a MOCG along with the dynamics of the MOCG itself as a separate community.

Relational architecture and relational capability: organisational levers to support strategic supplier relationships

The resource based view of strategy suggests that competitiveness in part derives from a firms ability to collaborate with a subset of its supply network to co-create highly valued products and services. This relational capability relies on a foundational intra and inter-organisational architecture, the manifestation of strategic, people, and process decisions facilitating the interface between the firm and its strategic suppliers. Using covariance-based structural equation modelling we examine the relationships between internal and external features of relational architecture, and their relationship with relational capability and relational quality. This is undertaken on data collected by mail survey. We find significant relationships between both internal and external relational architecture and relational capability and between relational capability and relational quality. Novel constructs for internal and external elements of relational architecture are specified to demonstrate their positive influence on relational capability and relationship quality.

Supporting multi-organisational collaborative groups in the public sector

In this paper, the issues that arise in multi-organisational collaborative groups (MOCGs) in the public sector are discussed and how a technology-based group support system (GSS) could assist individuals within these groups. MOCGs are commonly used in the public sector to find solutions to multifaceted social problems. Finding solutions for such problems is difficult because their scope is outside the boundary of a single government agency. The standard approach to solving such problems is collaborative involving a diverse range of stakeholders. Collaborative working can be advantageous but it also introduces its own pressures. Conflicts can arise due to the multiple contexts and goals of group members and the organisations that they represent. Trust, communication and a shared interface are crucial to making any significant progress. A GSS could support these elements.

A Conceptual Model for Group Support Systems in Local Councils

This paper proposes a conceptual model of a context-aware group support system (GSS) to assist local council employees to perform collaborative tasks in conjunction with inter- and intra-organisational stakeholders. Most discussions about e-government focus on the use of ICT to improve the relationship between government and citizen, not on the relationship between government and employees. This paper seeks to expose the unique culture of UK local councils and to show how a GSS could support local government employer and employee needs.

Customer satisfaction and organisational justice

Applies organisational justice theory to facilities management with the aim of increasing customer satisfaction with the service received. Provides an overview of organisational justice theory, and reviews the numerous different forms that this may take. Although there is strong theoretical support for participative decision making, in practice it often leads to conflict and delays. Two-way communication appears to represent the most effective form. The conclusions are based upon theoretical support as well as semi-structured interviews and observations in an organisational setting. The conclusions drawn do not have the benefits of more objective quantitative research methods. Contributes to practical understanding of how to maintain customer satisfaction in the facilities management industry and the theoretical reasons why the proposed methods will be effective. Argues that the impact of organisational justice on employee satisfaction can be applied to customer satisfaction with specific reference to facilities management.

A conceptual model for group support systems in local councils

This paper proposes a conceptual model of a context-aware group support system (GSS) to assist local council employees to perform collaborative tasks in conjunction with inter- and intra-organisational stakeholders. Most discussions about e-government focus on the use of ICT to improve the relationship between government and citizen, not on the relationship between government and employees. This paper seeks to expose the unique culture of UK local councils and to show how a GSS could support local government employer and employee needs.

A multi-agent architect for CSCW systems: from organisational semiotics perspective

This paper describes a multi-agent architecture to support CSCW systems modelling. Since CSCW involves different organizations, it can be seen as a social model. From this point of view, we investigate the possibility of modelling CSCW by agent technology, and then based on organizational semiotics method a multi-agent architecture is proposed via using EDA agent model. We explain the components of this multi-agent architecture and design process. It is argued that this approach provides a new perspective for modelling CSCW systems.

Changing building user attitude and organisational policy towards sustainable resource use in healthcare

Health care provision is significantly impacted by the ability of the health providers to engineer a viable healthcare space to support care stakeholders needs. In this paper we discuss and propose use of organisational semiotics as a set of methods to link stakeholders to systems, which allows us to capture clinician activity, information transfer, and building use; which in tern allows us to define the value of specific systems in the care environment to specific stakeholders and the dependence between systems in a care space. We suggest use of a semantically enhanced building information model (BIM) to support the linking of clinician activity to the physical resource objects and space; and facilitate the capture of quantifiable data, over time, concerning resource use by key stakeholders. Finally we argue for the inclusion of appropriate stakeholder feedback and persuasive mechanism, to incentivise building user behaviour to support organisational level sustainability policy.

An organisational semiotics inspired information architecture: pervasive healthcare as a case study

Information architecture (IA) is defined as high level information requirements of an organisation. It is applied in areas such as information systems development, enterprise architecture, business processes management and organisational change management. Still, the lack of methods and theories prevents information architecture becoming a distinct discipline. Healthcare organisation is always seen as information intensive organisation, moreover in a pervasive healthcare environment. Pervasive healthcare aims to provide healthcare services to anyone, anywhere and anytime by incorporating mobile devices and wireless network. Information architecture hence plays an important role in information provisioning within the context of pervasive healthcare in order to support decision making and communication between clinician and patients. Organisational semiotics is one of the social technical approaches that contemplate information through the norms or activities performed within an organisation prior to pervasive healthcare implementation. This paper proposes a conceptual design of information architecture for pervasive healthcare. It is illustrated with a scenario of mental health patient monitoring.

Developing green supply chain management taxonomy-based decision support system

The aim of this paper is to develop a comprehensive taxonomy of green supply chain management (GSCM) practices and develop a structural equation modelling-driven decision support system following GSCM taxonomy for managers to provide better understanding of the complex relationship between the external and internal factors and GSCM operational practices. Typology and/or taxonomy play a key role in the development of social science theories. The current taxonomies focus on a single or limited component of the supply chain. Furthermore, they have not been tested using different sample compositions and contexts, yet replication is a prerequisite for developing robust concepts and theories. In this paper, we empirically replicate one such taxonomy extending the original study by (a) developing broad (containing the key components of supply chain) taxonomy; (b) broadening the sample by including a wider range of sectors and organisational size; and (c) broadening the geographic scope of the previous studies. Moreover, we include both objective measures and subjective attitudinal measurements. We use a robust two-stage cluster analysis to develop our GSCM taxonomy. The main finding validates the taxonomy previously proposed and identifies size, attitude and level of environmental risk and impact as key mediators between internal drivers, external drivers and GSCM operational practices.

Blending systems thinking approaches for organisational analysis: reviewing child protection in England

This paper concerns the innovative use of a blend of systems thinking ideas in the ‘Munro Review of Child Protection’, a high-profile examination of child protection activities in England, conducted for the Department for Education. We go ‘behind the scenes’ to describe the OR methodologies and processes employed. The circumstances that led to the Review are outlined. Three specific contributions that systems thinking made to the Review are then described. First, the systems-based analysis and visualisation of how a ‘compliance culture’ had grown up. Second the creation of a large, complex systems map of current operations and the effects of past policies on them. Third, how the map gave shape to the range of issues the Review addressed and acted as an organising framework for the systemically coherent set of recommendations made. The paper closes with an outline of the main implementation steps taken so far to create a child protection system with the critically reflective properties of a learning organisation, and methodological reflections on the benefits of systems thinking to support organisational analysis.