Outsourcing and downsizing: Processes of workplace change in public health

Throughout the 1990s, public hospitals embarked on a range of benchmarking exercises for support services, often accompanied by downsizing and, in some cases, outsourcing. These support services included clinical areas such as, radiology, pharmacy and pathology, and nonclinical areas of catering and cleaning, engineering and environmental services. The impetus for this trend was the introduction of the Federal Governments National Competition Policy with its rationale that private sector pressures and competition would make the public sector more efficient.
Through a case study approach, this paper discusses this process at two public hospitals, the aim being to investigate the reasons for outsourcing, outsourcings interconnectedness with downsizing, and the implications at the workforce level. Workplace issues discussed include consultation between management, unions and employees, changes to employee numbers and work practices, maintenance of workplace conditions, implications for staff recruitment and retention, and the relative power of management and unions. It concludes that benchmarking, outsourcing and downsizing have all been used to bring about workplace change. Whilst the choice between processes may be dependent on management perception of the workplace environment, implications for the workplace from each process have been similar.

The plasticity of professional boundaries: a case study of collaborative care in maternity services

A case study of twenty-nine midwives and nine obstetricians working in a regional, public sector Australian hospital demonstrates the plasticity of professional boundaries within a post-welfare state. Driven by new discourses of globalisation, marketisation, managerialism and consumerism, professional boundaries in health care are being blurred, reordered and reconstituted. Government policies that call for a new interdisciplinarity between maternity professionals may be seen as responses to the above pressures. However, there remain considerable barriers to achieving collaborative models including conflicting interpretations of risk, of women's bodies and of childbirth; the veto power of decision-making retained by obstetricians; questions of professional accountability; and diversity over appropriate styles of micro-interaction. Collaboration demands a new egalitarianism to eclipse the old vertical system of obstetric dominance and this means that midwives need to create a distinctive professional specialty, or new object of knowledge. Midwives' skill in 'emotion management' could provide this speciality in addition to their rational-technical knowledge and thus elevate midwifery to an equivalent professional status with obstetrics but as yet neither obstetrics nor midwifery have realised its professionalising potential

The role and theoretical evolution of knowledge translation and exchange in public health

Background There is an increased emphasis in public health research on effective models and strategies to support knowledge translation (KT), the exchange, synthesis and ethically sound application of research findings within a complex set of interactions among researchers and knowledge users. In other words, KT can be seen as an acceleration of the knowledge cycle—an acceleration of the natural transformation of knowledge into use (Canadian Institutes of Health Services Research. Knowledge Translation Strategy, 2004). The most recent conceptualizations consider the complexities of public health decision-making. The role of practitioners and communities is increasingly considered.

Methods We identify, describe and discuss the theoretical underpinnings of KT and recommend a way forward to build the evidence for more effective practice.

Results Theoretical perspectives increasingly influence research on KT in public health. A range of innovative work is being conducted to explore methods for KT using practical tools, often with the support of government.

Conclusions KT describes a crucial and to date under-developed element of the research process. There is an important gap in theoretically informed empirical studies of effectiveness of proposed approaches in public health, health promotion and preventive medicine, and thus much of the debate remains abstract. There is clearly an urgent policy need to establish the effectiveness of KT models in a range of contexts. This must include both the consideration of development and the utilization of knowledge.

The role of the print media in informing the community about safety in public hospitals in Victoria, Australia: the case of `golden staph`

Objective. In this article the authors explore how the print media contribute to information and education of the community on issues of safety and quality in the health services, since this is an important avenue of such information and education for many members of the community. Study design. The authors undertook a qualitative study of a random sample of articles in the Australian print press between 1996 and 2004 where ‘golden staph’ was presented as a major issue of risk to the safety of consumers of health services. The content of each article was examined with reference to several criteria including title, the source of the article, and the metaphorical language employed by the journalist.
Results. Results show that while the articles are substantially accurate as sources of information on concrete events, they do not serve as sources of education on issues of safety, typically apportioning blame and serving to maintain the status quo.
Conclusion. The authors conclude that print media are not a good source of community education in areas of safety and quality and do not assist members of the community to participate in addressing issues of safety in health services.

An overview of IT outsourcing in public secto agenices

For the past 15 years, governments in the developed, Western world have been contracting out, or outsourcing, services as a key part of public sector reforms. Outsourcing has been argued to lead to cost savings, improved discipline, better services, access to scarce skills, and the capacity for managers to focus more time on the core business of their organizations (Domberger, 1998). Government outsourcing initiatives have encompassed a range of services, but given the large sums of money invested in IT assets, the outsourcing of IT services (IT outsourcing, or ITO) has been a major initiative for many agencies. Lacity and Willcocks (1998, p. 3) defined ITO as "handing over to a third party [the] management of IS/IT assets, resources and/or activities for required results." For public-sector outsourcing, this handover is usually made by way of a competitive tender. Case studies have reported ITO successes and failures (e.g., Currie & Willcocks, 1998; Rouse & Corbitt, 2003; Willcocks & Currie, 1997; Willcocks & Lacity, 2001; Willcocks & Kern, 1998), but much of the evidence presented to public-sector decision makers to justify this reform is anecdotal and unsystematic, and when investigated in depth, does not necessarily support widespread conclusions.

Six sigma approach to improve quality in E-services : an empirical study in Jordan

In the last two decades, Six Sigma approach has found its success in manufacturing sectors. The relevance of Six Sigma methodologies in service sector has been realised more recently. This paper investigates the application of Six Sigma approach to improve quality in electronic services (e-services) as more and more countries are adopting e-services as a means of providing services to their community and people through the Web. In particular, this paper presents a case study about the use of Six Sigma model to measure the customer satisfaction and quality levels achieved in e-services that were recently launched by public sector organisations in a developing country, such as Jordan. An empirical study consisting of 280 participating customers of Jordan‘s e-services is conducted and the problems are identified through the DMAIC phases of Six Sigma. The service quality levels are measured and analysed using six main criteria, namely, Website Design, Reliability, Responsiveness, Personalization, Information Quality, and System Quality. The overall result of the study indicating a 74% customer satisfaction with a Six Sigma level of 2.12 has enabled the Greater Amman Municipality to identify the usability issues associated with their e-services offered by public sector organisations and to take the leads from the results of the study to improve customer satisfaction. The aim of the paper is not only to implement Six Sigma as a measurement-based strategy for improving e-customer service quality in a newly launched e-service programme, but also to help widen its scope in investigating other service dimensions and perform comparative studies in other developing countries as future research.

Changing vistas in public relations theory

Contemporary theorists are opening new ways to think about public relations. Public relations textbook authors have hitherto borrowed theories from the adjacent disciplines of communication, psychology, sociology, and organisation studies. At the end of the twentieth century, J. Grunig’s four-model concept of public relations was the only modern theoretical approach that could be said to have originated from within public relations scholarship. And as we will see, even J. Grunig’s perspective is rooted in political theory. But the 21st century’s burgeoning critical and professional interest in ethical public relations has produced a flurry of discipline-specific, theoretical initiatives.

Recruiting in public places : A strategy to increase diversity in qualitative research samples

For some research projects, recruiting in public places is an invaluable addition to sampling strategies. It complements the more traditional recruitment strategies by providing researchers with' opportunities to include people in the research who would otherwise be excluded. One of the limitations of selective and snowball sampling is that participants often come from the same social group. Participants from these social groups often share similar experiences and ways of thinking about those experiences. The aim of recruiting in public places is to move beyond this 'in group' to ensure a wider perspective. This paper illustrates how recruiting in public places can provide greater sample diversity for theoretical strength. The paper begins with a brief overview of recruiting in public places. It then describes the theoretical considerations associated with this recruiting strategy. The paper demonstrates how recruiting in public places facilitates grounded theory by providing comparisons that are informed by diverse experiences. Using examples and a case study, we illustrate how recruiting in public places can complement selective, snowball and theoretical sampling to ensure a more comprehensive sample.

Designing contemporary learning environments for excellence in public relations

Universities are striving to enhance the quality of the educational experience in the professions in response to external and internal pressures. The professional field of public relations (PR) is not immune to these forces. Previously, enhancements were often pursued through particular initiatives relating to curriculum, pedagogical or assessment redesign at the unit level. While such initiatives are valuable we argue for a strategic, integrated, programmatic approach. This requires the design of learning environments, with integrated virtual and physical dimensions, based on a relevant and meaningful curriculum, and student-centred approaches to learning. These learning environments enable quality learning in fields like public relations with diverse student cohorts studying on- and off-campus. The challenges involved in designing what we term ‘contemporary learning environments’ are illuminated through a case study of Deakin University’s Public Relations Program. Over the last three years redesigning PR online has led to changed curriculum, and pedagogical and assessment practices. We conclude by suggesting that a commitment to continuous quality improvement will be required to ensure the program’s learning environment remains relevant to the needs of students studying in the field.

Misuse of the term 'stakeholder' in public relations

This article queries the relatively recent adoption of the term 'stakeholder', borrowed from the UK political and the US business management spheres, in public relations academic writing. The article concludes that these spheres use the term in a normative or ideological manner that has worrying implications. The term frames people as having a pre-existing relationship with the governments or business organisations which name them as such. This process of incorporation prejudges and potentially obscures the real relations of groups of people vis-à-vis governments and business organisations which they may wish to have nothing to do with. An argument is mounted for the defence of the term 'publics'. It is pointed out that a key originator of stakeholder theory opposes the notion of 'publics' as closer to a notion of an uncontrolled audience. The article argues that the notion of 'publics' is more fitting than the notion of 'stakeholders' if public relations is about acknowledging this uncontrollability, and to do with advising organisations about their positioning in the democratic milieu. On the other hand, the notion 'stakeholders' may be the right one if public relations is simply aimed at immediately shaping people's behaviour, irrespective of longer term and wider political implications.

Personality, quality and satisfaction in airline services

This paper examines some issues related to the influence of consumers’ perception of service evaluation according to their personality characteristics. The paper discusses the application of personality traits, including the Jungian personality types, as a possible predictor of perceived satisfaction levels. The existing literature has not fully explored the relationship between airline flights’ service satisfaction levels and consumers’ personality characteristics. A well-known UK leisure airline allowed a survey to be conducted in 1998-2000. The findings suggest that there is a weak correlation between personality types and satisfaction levels, but a stronger relationship between perceptions of quality and satisfaction. The adaptation of the Jungian personality types, for use in the evaluation of leisure airlines’ service attributes, appears to be worthy of further examination.

Undoing men's privilege and advancing gender equality in public sector institutions

Discrimination against women in public sector organisations has been the focus of considerable research in recent years. While much of this literature acknowledges the structural basis of gender inequality, strategies for change are often focused on anti-discrimination policies, equal employment opportunities and diversity management. Discriminatory behaviour is often individualised in these interventions and the larger systems of dominance and subordination are ignored. The flipside of gender discrimination, we argue, is the privileging of men. The lack of critical interrogation of men's privilege allows men to reinforce their dominance. In this paper we offer an account of gender inequalities and injustices in public sector institutions in terms of privilege. The paper draws on critical scholarship on men and masculinities and an emergent scholarship on men's involvement in the gender relations of workplaces and organisations, to offer both a general account of privilege and an application of this framework to the arena of public sector institutions and workplaces in general.