Medicines reconciliation in comparison with NICE guidelines across secondary care mental health organisations

Background Medicines reconciliation-identifying and maintaining an accurate list of a patient's current medications-should be undertaken at all transitions of care and available to all patients. Objective A self-completion web survey was conducted for chief pharmacists (or equivalent) to evaluate medicines reconciliation levels in secondary care mental health organisations. Setting The survey was sent to secondary care mental health organisations in England, Scotland, Northern Ireland and Wales. Method The survey was launched via Bristol Online Surveys. Quantitative data was analysed using descriptive statistics and qualitative data was collected through respondents free-text answers to specific questions. Main outcomes measure Investigate how medicines reconciliation is delivered, incorporate a clear description of the role of pharmacy staff and identify areas of concern. Results Forty-two (52 % response rate) surveys were completed. Thirty-seven (88.1 %) organisations have a formal policy for medicines reconciliation with defined steps. Results show that the pharmacy team (pharmacists and pharmacy technicians) are the main professionals involved in medicines reconciliation with a high rate of doctors also involved. Training procedures frequently include an induction by pharmacy for doctors whilst the pharmacy team are generally trained by another member of pharmacy. Mental health organisations estimate that nearly 80 % of medicines reconciliation is carried out within 24 h of admission. A full medicines reconciliation is not carried out on patient transfer between mental health wards; instead quicker and less exhaustive variations are implemented. 71.4 % of organisations estimate that pharmacy staff conduct daily medicine reconciliations for acute admission wards (Monday to Friday). However, only 38 % of organisations self-report to pharmacy reconciling patients' medication for other teams that admit from primary care. Conclusion Most mental health organisations appear to be complying with NICE guidance on medicines reconciliation for their acute admission wards. However, medicines reconciliation is conducted less frequently on other units that admit from primary care and rarely completed on transfer when it significantly differs to that on admission. Formal training and competency assessments on medicines reconciliation should be considered as current training varies and adherence to best practice is questionable.

An interpretive approach to analysing the role and value of information systems in Jordanian financial organisations

Analysing investments in ISs in order to maximise benefits has become a prime concern, especially for private corporations. No formula of equilibrium exists that could link the injected amounts and accrued returns. The relationship is simply not straightforward. This thesis is based upon empirical work which involved sketching organisational ethnographies (four organographies and a sectography) into the role and value of information systems in Jordanian financial organisations. Besides deciphering the map of impacts, it explains the attributions of the variations in the impacts of ISs which were found to be related to the internal organisational processes: culturally and politically specific considerations, economically or technically rooted factors and environmental factors. The research serves as an empirical attempt to test out the applicability of adopting the interpretive paradigm to researching organisations in a developing country. The fieldwork comprised an exploratory stage, a detailed investigation of four case studies and a survey stage encompassing 16 organisations. Primary and secondary data were collected from multiple sources using a range of instruments. The evidence highlights the fact that little long term strategic planning was pursued; the emphasis was more focused on short term planning. There was no noticeable adoption of any strategic fit principle linking IS strategy to the corporate strategy. In addition, the benefits obtained were mostly intangible. Although ISs were central to the work of the organisations surveyed as the core technology, they were considered as tools or work enablers rather than weapons for competitive rivalry. The cultural specificity of IS impacts was evident and the cultural and political considerations were key factors in explaining the attributions of the variations in the impacts of ISs in JFOs. The thesis confirms that measuring the benefits of ISs is the problematic. However, in order to gain more insight, the phenomenon of "the use of ISs" has to be studied within its context.

The social cognitive neuroscience of organisations

Social cognitive neuroscience is an emerging branch of cognitive neuroscience that bridges together social psychology and neuroscience. At its core is an understanding of the relationship between the brain and social interaction. The social cognitive neuroscientist places empirical endeavor within a three–stage framework, and questions falling under the SCN rubric undergo interrogation at each of these three levels. Firstly, we seek to understand a neuroscience of social interactions at the social level. Here we need to understand the motivational and other social factors that drive our behavior and experience in the real world. It goes without saying that any study of the cognitive neuroscience of socially interactive behavior must first be informed by social psychological theory to maintain ecological validity. Second, the social cognitive neuroscientist must be an adroit cognitive psychologist and be able to examine interactive behavior from the cognitive level. It is here that information–processing models and theories are applied to the understanding of our social behavior. Finally, studies at the neural level seek to inform us about the cortical structures, as well as the way they interact with other, in the mediation of the previous cognitive level. This volume brings together contributions from leading thinkers in both the social cognitive neurosciences and business to provide a comprehensive introduction and overview of a social cognitive neuroscience of the business brain. NOTE: Annals volumes are available for sale as individual books or as a journal. For information on institutional journal subscriptions, please visit www.blackwellpublishing.com/nyas. ACADEMY MEMBERS: Please contact the New York Academy of Sciences directly to place your order (www.nyas.org). Members of the New York Academy of Science receive full–text access to the Annals online and discounts on print volumes. Please visit http://www.nyas.org/MemberCenter/Join.aspx for more information about becoming a member

Enterprise management:A new frontier for organisations

This paper reports on the theoretical foundations and the practical reasons for the increasing popularity of enterprise management. The research has specifically aimed to investigate the dependency between the prevailing type of core competence and the emergent enterprise structure. Empirical inductive research has been conducted in the German automotive industry using the grounded theory approach. This has involved an initial literature review, transcription and codification of interviews to derive tentative propositions, and the validation of the tentative propositions through a questionnaire survey. The research has resulted in the consolidation of the most valid propositions into a conceptual framework. This conceptual framework has been proposed to support enterprise managers who have to make strategic decisions. This study indicates that the prevailing type of core competence is a significant factor that influences the design and management of the enterprise structure. © 2006 Elsevier B.V. All rights reserved.

Comparing knowledge management between organisations:searching for good practice

This paper reports ongoing work that is attempting to find out ‘what is good practice for knowledge management’. The data we have to analyse this issue is 109 maps of knowledge (on knowledge management) which were built during 18 group workshops with 152 people from 15 different organisations. The maps contain data on the aspirations and action plans which UK managers have to improve knowledge management practices in their organisation. So far we have attempted a number of approaches to analysing this data, both inductive and deductive, but we still feel there is more to be learned from the rich data set we have. The paper presents a flavour of the work we have done, have considered doing, and have resisted doing. The aim of the paper is to stimulate debate on the strengths of our analyses and, more importantly, on amassing views of how it can be further strengthened, and the difficulties and dilemmas which might need to be overcome.

Information management for viable organisations

The recent global „credit crunch? has brought sharply into focus the need for better understanding of what it takes for organisations to survive. This research seeks to help organisations maintain their „viability? – the ability to maintain a separate existence and survive on their own. Whilst there are a multitude of factors that contribute to organisational viability, information can be viewed as the lifeblood of organisations. This research increases our understanding of how organisations can manage information effectively to help maintain their viability. The viable systems model (VSM) is an established modelling technique that enables the detailed analysis of organisational activity to examine how the structure and functions performed in an organisation contribute to its „viability?. The VSM has been widely applied, in small/large companies, industries and governments. However, whilst the VSM concentrates on the structure and functions necessary for an organisation to be viable, it pays much less attention to information deployment in organisations. Indeed, the VSM is criticised in the literature for being unable to provide much help with detailed information and communication structures and new theories are called for to explore the way people interact and what information they need in the VSM. This research analyses qualitative data collected from four case studies to contribute to our understanding of the role that information plays in organisational viability, making three key contributions to the academic literature. In the information management literature, this research provides new insight into the roles that specific information plays in organisations. In the systems thinking literature, this research extends our understanding of the VSM and builds on its powerful diagnostic capability to provide further criteria to aid in the diagnosis of viable organisations. In the information systems literature, this research develops a framework that can be used to help organisations design more effective information systems.

Intergroup conflict in organisations:predictors and relationships with team working effectiveness

This thesis begins with a review of the conflict literature. It continues with an illustration of the nature of intergroup conflict between British health care teams, by presenting results from an interview study using the critical incident technique. Within the theory testing part, drawing upon a sample of 53 British health care teams from five organisations, an empirical test of both intergroup contact and social identity theory is provided. In a next step, a measure of intergroup effectiveness, the effectiveness with which dyads of groups perform on collaborative tasks, is developed. Finally, the moderating role of both resource interdependence and group boundary spanners’ negotiation style for the relationship between intergroup competition and longitudinal change in group and intergroup effectiveness is examined.

A comparative and longitudinal analysis of the evolving relationship between the environment and the strategy, structure and performance of selected organisations in the British carpet industry 1959-1986:a firms in sector perspective of organisational adaptation

Orthodox contingency theory links effective organisational performance to compatible relationships between the environment and organisation strategy and structure and assumes that organisations have the capacity to adapt as the environment changes. Recent contributions to the literature on organisation theory claim that the key to effective performance is effective adaptation which in turn requires the simultaneous reconciliation of efficiency and innovation which is afforded by an unique environment-organisation configuration. The literature on organisation theory recognises the continuing confusion caused by the fragmented and often conflicting results from cross-sectional studies. Although the case is made for longitudinal studies which comprehensively describe the evolving relationship between the environment and the organisation there is little to suggest how such studies should be executed in practice. Typically the choice is between the approaches of the historicised case study and statistical analysis of large populations which examine the relationship between environment and organisation strategy and/or structure and ignore the product-process relationship. This study combines the historicised case study and the multi-variable and ordinal scale approach of statistical analysis to construct an analytical framework which tracks and exposes the environment-organisation-performance relationship over time. The framework examines changes in the environment, strategy and structure and uniquely includes an assessment of the organisation's product-process relationship and its contribution to organisational efficiency and innovation. The analytical framework is applied to examine the evolving environment-organisation relationship of two organisations in the same industry over the same twenty-five year period to provide a sector perspective of organisational adaptation. The findings demonstrate the significance of the environment-organisation configuration to the scope and frequency of adaptation and suggest that the level of sector homogeneity may be linked to the level of product-process standardisation.

Third sector organisations and social welfare : a study of the role of social service and charitable organisations in Taiwan

This study is about the role and operation of ‘third sector’ organisations (TSOs) within the Taiwanese social welfare context. TSOs have increased dramatically and become actively involved in social service provision. This phenomenon has not only had significant impact on the development and operation of TSOs in Taiwan but it is also of increasing interest to public policy academics. The latter are especially interested in the implications for the government-third sector relationship. This research examines the reasons why TSOs have been established, why they actively participate in social service provision, and their role and operation within the social welfare context of Taiwan. The study has both quantitative and qualitative data. It sampled ‘social service’ and ‘charitable’ organisations (SSCOs), which are the main type of TSOs in Taiwan, to examine their role, operation and interaction with government. Questionnaires were mailed to collect quantitative data first. After the quantitative data were collected and analysed, semi-structured interviews were undertaken to collect qualitative data. The study found that TSOs in Taiwan exist in a highly institutionalised environment, which is affected by traditional Confucian ideas and contemporary Western ideas such as social justice and civil rights. The rapid growth of TSOs has a strong connection with the desire to fill social service gaps left by government and family. TSOs mainly play the role of service provider rather than that of advocate. They cooperate with government in social service provision and have developed different types of symbiotic relationships with government. A ‘resonance effect’ between government and TSOs was also found as they implement social policy.

Time and professional work in public sector organisations: an examination of four occupational groups in education and medicine

The aim of this thesis is to examine the experience of time of four professional occupational groups working in public sector organisations and the factors affecting this experience. The literature on time and work is examined to delineate the key parameters of research in this area. A broad organisation behaviour approach to the experience of time and work is developed in which individual, occupational, organisational and socio-political factors are inter-related. The experience of secondary school teachers, further education lecturers, general medical practitioners and hosoital consultants is then examined. Multiple methods of data collection are used: open-ended interviews, a questionnaire survey and the analysis of key documents relating to the institutional settings in which the four groups work. The research aims to develop our knowledge of working time by considering the dimensions of the experience of time at work, the contexts in wlhich this experience is generated and the constraints these contexts give rIse to. By developing our understanding of time as a key feature of work experience we also extend our knowledge of organisation behaviour in general. In conclusion a model of the factors relating the experience of time to the negotiation of time at work is presented.

Virtual manufacturing:a study of some important issues relating to the transformation of traditional manufacturing organisations

This thesis starts with a literature review, outlining the major issues identified in the literature concerning virtual manufacturing enterprise (VME) transformation. Then it details the research methodology used – a systematic approach for empirical research. next, based on the conceptual framework proposed, this thesis builds three modules to form a reference model, with the purpose of clarifying the important issues relevant to transforming a traditional manufacturing company into a VME. The first module proposes a mechanism of VME transformation – operating along the VME metabolism. The second module builds a management function within a VME to ensure a proper operation of the mechanism. This function helps identify six areas as closely related to VME transformation: lean manufacturing; competency protection; internal operation performance measurement; alliance performance measurement; knowledge management; alliance decision making. The third module continues and proposes an alliance performance measurement system which includes 14 categories of performance indicators. An analysis template for alliance decision making is also proposed and integrated into the first module. To validate these three modules, 7 manufacturing organisations (5 in China and 2 in the UK) were investigated, and these field case studies are analysed in this thesis. The evidence found in these organisations, together with the evidence collected from the literature, including both researcher views and literature case studies, provide support for triangulation evidence. In addition, this thesis identifies the strength and weakness patterns of the manufacturing companies within the theoretical niche of this research, and clarifies the relationships among some major research areas from the perspective of virtual manufacturing. Finally, the research findings are summarised, as well as their theoretical and practical implications. Research limitations and recommendations for future work conclude this thesis.