Investigating people management issues in a third sector health care organisation - an inductive approach

Objective : To explain use of inductive convergent interviewing to generate the perceived critical people management issues, as perceived by staff, as a prelude to longitudinal surveys in a third sector health care organisation.

Design : Convergent interviewing is a qualitative technique that addresses research topics that lack theoretical underpinning and is an inductive, flexible, evolving research approach. The key issues converged after six rounds of interviews as well as a further round to ensure that all of the common people management issues had been generated.

Setting : Studies in employee behaviour in the health care industry exist, but there is little in the way of tested models of predictors of such behaviour in third sector organisations in the Australian health care industry. The context is what differentiates this study covering a range of facilities and positions in hospitals and aged care situations within one third sector health care organisation.

Subjects : The study proposed twenty seven extensive interviews over a range of facilities and positions. Twenty one interviewees participated in the final convergent process.

Conclusions : Critical issues included: workload across occupational groups, internal management support, adequate training, the appropriate skill mix in staff, physical risk in work, satisfaction, as well as other issues. These issues confirm the proposition of sector‑ness in health organisations that are multi‑dimensional rather than uni‑dimensional.

People management issues in a third sector health care organisation: preliminary findings

Objective – To use inductive convergent interviewing to generate the perceived critical people management issues of the day as perceived by staff. This was used as preliminary to longitudinal ongoing survey in a third sector health care organisation.

Design – Convergent interviewing is a qualitative technique that addresses research topics that lack theoretical underpinning and is an inductive, flexible, evolving research instrument. The key issues converged after six rounds of interviews as well as a further round to ensure that all of the common people management issues had been generated.

Setting - There is very little in the way of tested models of predictors of employee behaviour in third sector organisations in the Australian health care industry. This study investigates a range of facilities and positions, in various hospitals and aged care facilities within the one third sector health care organisation.

Subjects – The study proposed twenty seven extensive interviews over a range of facilities and positions. Twenty one interviewees participated in the final convergent process.

Conclusions - Critical issues included: workload across occupational groups, internal management support, adequate training, the appropriate skill mix in staff, physical risk in work, satisfaction, as well as other issues. These issues confirm the proposition of sector-ness in health organisations that are multi-dimensional rather than uni-dimensional.

People management challenges to multinational companies in Asia

This book discusses the contextual factors such as cultural and institutional settings that impact on effective people management practices in Asia. The challenges of multinational companies (MNCs) in the particular areas of attraction and retention, training and career development of the local skilled labour workforce are analyzed using the data of 529 MNCs in six Asian countries (namely Indonesia, Malaysia, Philippines, Singapore, Taiwan and Thailand). The degree of challenges varies by country and sector. This book draws conclusions from the empirical research stating that cultural and institutional theories, as well as the convergence and divergence theses can explain at best, partially, reasons behind the different outcomes of people management or human resource management (HRM) practices across MNCs in different operations in the region.

Strategic people management of coal mining firms in Central Queensland

Purpose – This paper aims to propose a conceptual framework to explore the link between strategic human resource management (SHRM) and firm performance of the coal mining companies in Central Queensland (CQ), Australia.

Design/methodology/approach – The paper reviews literature relating to the process and issues of transforming human resource practices and industrial relations of the coal industry in Australia for the past decade. Theoretical development and empirical studies on the SHRM-performance linkage are discussed. Based on the literature review, the paper develops an integrated model for testing the relationship between SHRM and firm performance in the context of CQ's coalmines and proposes a number of research propositions.

Findings – Three perceivable outcomes are likely derived from application of this framework in the field. First, a testing of the linkage between strategic HRM and firm performance in the coal industry, using an integrated approach, would complement the empirical deficiency of treatments on the prior SHRM models. Second, data at firm level could be collected to develop a better understanding of how the adoption of strategic HRM practices in coal companies can affect firm performance. Third, the extent of flexibility practices, use of contractors and associated management practices could be identified.

Originality/value – The coal industry is central to economic development of regional Queensland. The industry contributes substantially to GDP via employment, investment and product export. An exploration of the impact of SHRM on the coal industry will likely result in identifying some best practices that could be potentially adopted in the wider business community to foster regional economic development in Australia and worldwide.

From ancient Chinese sages to modern people management practices

This chapter reviews the legacy of several ancient Chinese sages (i.e. Guanzi, Hanfeizi, Shangyang, Xunzi, and Yanzi) and explores their thinking of ruling the state and managing the people. The thoughts of the old are compared with those known in the mainstream Western management texts. Striking similarities in thoughts and key organization and management issues of old and new are identified. For contemporary organizations to be successful, essential people-management principles must be espoused to sustain organizations for a long term as to preserve ancient states. Nonetheless, the world is in ceaseless change, dynasties and nations rise and fall as organizations acquire, merge, die, or emerge as new. Despite perpetual principles, management techniques require constant adaptation to meet modern challenges.

Critiques and extensions of strategic international human resource management framework for dragon multinationals

This paper aims at critiquing several existing strategic international human resource management frameworks and discusses their inadequacy to apply directly to emerging multinational companies, especially those generated from Brazil, Russia, India, China and South Africa. To complement the existing strategic international human resource management frameworks, key variables relevant to emerging economies are identified and an extended model with reference to emerging multinational companies is developed with several research propositions. It is believed that the proposed model would better capture the current development of multinationals in transition, and alert emerging international managers to address several people management challenges in the global context.

HRM research in China : looking back and looking forward

Purpose – The purpose of this paper is to provide an overview of the field of human resource management (HRM) in China, with insights drawn from recent times to several millennia earlier, with a view to informing the further work that needs to be done to better understand managing people in China.
Design/methodology/approach – The authors examined Chinese ancient texts related to people management and drew on reviews of HRM research in China since the establishment of the People’s Republic of China in 1949 till current times, to draw lessons for HRM in China today and for the future.
Findings – The 2,500 year gap that separates the literatures studied as part of this review cannot hide the striking similarities between the conceptual views about the importance of people and their management in the two periods. Yet, there remains a lack of empirical studies of the Chinese style of HRM practices. The majority of recent research in the field of HRM in China is focussed on comparison between HRM practices in various types of enterprises operating in China and those in the west, with the apparent aim of better understanding the latter rather than the former.
Originality/value – As China is rapidly becoming a key global player, and its enterprises represent an increasing share of the global market, it is crucial to understand how Chinese firms have managed their people at home and globally to achieve performance outcomes. Are there lessons other firms, especially those in emerging markets could learn? What are the implications for building global
management and organisational knowledge? This paper provides some directions for future research about HRM in China, which may help gain a better understanding of the Chinese style of management and further develop management and organisation theories in the China context.

A Chinese style of HRM : exploring the ancient texts

Purpose – The purpose of this paper is to explore the relevant sayings and stories of the ancient Chinese sages in relation to the style of Chinese human resource management (HRM).

Design/methodology/approach – Related texts generated from the quotations and stories from four Chinese sages, Guanzi, Hanfeizi, Xunzi and Yanzi, were translated and analyzed and their thinking regarding ruling the state and managing the people was discussed in line with the thoughts from the mainstream and modern Western management gurus such as Warren Bennis, Peter Drucker, Mary Parker Follett, Douglas McGregor, Rosabeth Moss Kanter, Elton Mayo and Jeffrey Pfeffer.

Findings – It was found that there were striking similarities in thoughts and call for actions to address key issues in HRM by both old and contemporary, east and west thinkers across 2,500 years. The main concerns are to select the right leaders and managers and recruit the right people; create attractive organisational culture and environments that promote a participative management approach to encourage, empower and engage employees to achieve desirable outcomes; uphold the people-centred management principles; and focus on designing reward schemes that emphasise service and contribution instead of position and profits.

Originality/value – There is much to be learned from the past to address the present people management issues among modern organisations both inside China and perhaps from other parts of the world. It was as difficult to take seriously the principles-based ruling and management approaches in ancient times as it is today. However, if these principles had been put into practice, the world would have had fewer of the corporate corruption scandals and less of the mischievous behaviour in the state that are manifested in today's society, but more productive population, effective organisations, ethical governments and harmonious environment; hence less global human suffering.

The play of power and politics in innovation and HRM

This paper analyses the human resource management (HRM) practices involved in the implementation of a process innovation approach to product development (concurrent engineering (CE)) in the Australian subsidiary of a multinational firm engaged in military defence electronics. According to the research literature, almost all aspects of managing product development under a CE approach are linked to people management. Yet in this particular case, other than project team structure, the prescriptive HRM dimensions of CE were conspicuously absent in the implementation process. This absence is explained by the play of power and politics involving stakeholders analysed over an 18 month period. The implications of this analysis for understanding the embedded, interdependent and political nature of HRM and process innovation are addressed.

Medication knowledge and self-management by people with type 2 diabetes

Objective: To explore medication knowledge and self management practices of people with type 2 diabetes.

Design: A one-shot cross sectional study using in-depth interviews and participant observation.

Setting: Diabetes outpatient education centre of a university teaching hospital.

Subjects: People with type 2 diabetes, n=30, 17 males and 13 females, age range 33-84, from a range of ethnic groups.

Outcome measures: Ability to state name, main actions and when to take medicines. Performance of specific medication-related tasks; opening bottles and packs, breaking tablets in half, administering insulin, and testing blood glucose.

Results: Average medication use > or = 10 years. Respondents were taking 86 different medicines, mean 7 +/- 2.97 SD. Dose frequency included two, three and four times per day. All respondents had > or = 2 diabetic complications +/- other comorbidities. The majority (93%) were informed about how and when to take their medicines, but only 37% were given information about side effects and 17% were given all possible seven items of information. Younger respondents received more information than older respondents. Older respondents had difficulty opening bottles and breaking tablets in half. Twenty per cent regularly forgot to take their medicines. Increasing medication costs was one reason for stopping medicines or reducing the dose or dose interval. The majority tested their blood glucose but did not control test their meters and 33% placed used sharps directly into the rubbish.

Conclusion: Polypharmacy was common. Medication knowledge and self management were inadequate and could lead to adverse events.

Can a disease-specific education program augment self-management skills and improve Health-Related Quality of Life in people with hip or knee osteoarthritis?

Background: Patient education and self-management programs are offered in many countries to people with chronic conditions such as osteoarthritis (OA). The most well-known is the disease-specific Stanford Arthritis Self-Management Program (ASMP). While Australian and international clinical guidelines promote the concept of self-management for OA, there is currently little evidence to support the use of the ASMP. Several meta-analyses have reported that arthritis self-management programs had minimal or no effect on reducing pain and disability. However, previous studies have had methodological shortcomings including the use of outcome measures which do not accurately reflect program goals. Additionally, limited cost-effectiveness analyses have been undertaken and the cost-utility of the program has not been explored.

Methods/design: This study is a randomised controlled trial to determine the efficacy (in terms of Health-Related Quality of Life and self-management skills) and cost-utility of a 6-week group-based Stanford ASMP for people with hip or knee OA.

Six hundred participants referred to an orthopaedic surgeon or rheumatologist for hip or knee OA will be recruited from outpatient clinics at 2 public hospitals and community-based private practices within 2 private hospital settings in Victoria, Australia. Participants must be 18 years or over, fluent in English and able to attend ASMP sessions. Exclusion criteria include cognitive dysfunction, previous participation in self-management programs and placement on a waiting list for joint replacement surgery or scheduled joint replacement.

Eligible, consenting participants will be randomised to an intervention group (who receive the ASMP and an arthritis self-management book) or a control group (who receive the book only). Follow-up will be at 6 weeks, 3 months and 12 months using standardised self-report measures. The primary outcome is Health-Related Quality of Life at 12 months, measured using the Assessment of Quality of Life instrument. Secondary outcome measures include the Health Education Impact Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index (pain subscale and total scores), Kessler Psychological Distress Scale and the Hip and Knee Multi-Attribute Priority Tool. Cost-utility analyses will be undertaken using administrative records and self-report data. A subgroup of 100 participants will undergo qualitative interviews to explore the broader potential impacts of the ASMP.

Discussion: Using an innovative design combining both quantitative and qualitative components, this project will provide high quality data to facilitate evidence-based recommendations regarding the ASMP.

The Health Education Impact Questionnaire (heiQ): An outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions

Objective: This paper describes the development and validation of the Health Education Impact Questionnaire (heiQ). The aim was to develop a user-friendly, relevant, and psychometrically sound instrument for the comprehensive evaluation of patient education programs, which can be applied across a broad range of chronic conditions.

Methods: Item development for the heiQ was guided by a Program Logic Model, Concept Mapping, interviews with stakeholders and psychometric analyses. Construction (N = 591) and confirmatory (N = 598) samples were drawn from consumers of patient education programs and hospital outpatients. The properties of the heiQ were investigated using item response theory and structural equation modeling.

Results: Over 90 candidate items were generated, with 42 items selected for inclusion in the final scale. Eight independent dimensions were derived: Positive and Active Engagement in Life (five items, Cronbach's alpha (α) = 0.86); Health Directed Behavior (four items, α = 0.80); Skill and Technique Acquisition (five items, α = 0.81); Constructive Attitudes and Approaches (five items, α = 0.81); Self-Monitoring and Insight (seven items, α = 0.70); Health Service Navigation (five items, α = 0.82); Social Integration and Support (five items, α = 0.86); and Emotional Wellbeing (six items, α = 0.89).

Conclusion:The heiQ has high construct validity and is a reliable measure of a broad range of patient education program benefits.

Practice Implications: The heiQ will provide valuable information to clinicians, researchers, policymakers and other stakeholders about the value of patient education programs in chronic disease management.

Does self-management lead to sustainable health benefits in people with arthritis? A 2-year transition study of 452 Australians.

Objective: To evaluate the Arthritis Self-Management Course (ASMC) when applied in a nationwide context.

Methods: Four hundred fifty-two people who participated in the ASMC across Australian states took part in a longitudinal followup study. ASMC is a 6 week, 2 h group educational program designed to assist people with chronic illness to better manage their condition. Measures of program effectiveness included health status and service utilization. Data were collected on 3 occasions: before intervention (baseline) and 6 months and 2 years after the program.

Results: Several indicators of health status showed improvement at 6 months following the ASMC. These included reduction in pain (4%; p < 0.001), fatigue (3%; p < 0.01), and health distress (12%; p < 0.001) as well as increase in self-efficacy (6%; p < 0.001). Increased self-efficacy was a significant predictor of positive change in health status. Health-related behaviors such as aerobic exercise also increased, with the proportion of people who did little or no exercise decreasing by up to 8%. These changes were sustained at 2 years. There was an increase in use of analgesics at 6 months and an increase in use of nonsteroidal antiinflammatory drugs at 2 years. No changes in healthcare utilization (physician visits, allied health visits, and hospitalizations) were observed.

Conclusion: The ASMC is a widely applied program in which participants benefit through a reduction in pain, fatigue, and health distress. Although the absolute changes in health status are small, the low cost and wide application of the intervention suggests the program may have a substantial public health effect.

A critical look at the role of self-management for people with arthritis and other chronic diseases

Most patients with chronic conditions, such as osteoarthritis, only have contact with healthcare professionals for a few hours over the course of a year. Good self-management programs are, therefore, critical for patients to cope with their conditions on a daily basis. Drs Osborne, Jordan and Rogers discuss the importance of engaging patients, clinicians and policymakers in the development and implementation of self-management programs.