The role of human resource management in moderating the relationship between organisational culture and TQM adoption

Culture has been considered as one of the factors that influences the TQM adoption process of organisations. Based on Hofstede’s cultural dimensions, we suggest that individualist organisations would find difficulties in adopting TQM, which tends to reflect a more collectivist than individualist culture. We, however, believe that individualist organisations can overcome this problem by establishing collectivist HRM policies by creating collectivistic TQM environment. This paper thus fills the gap between literature on culture, HRM and TQM. Notably, based upon the examination of the impact individualist versus collectivist culture have on HRM policies and TQM adoption, this paper proposes collectivist HRM policies as the significant moderating variable on the relationship between the culturally diverse members and the TQM adoption within the organisational context. Based upon the theoretical framework developed in this paper, implications for future research are outlined.

Managing FM (support services): business risks in the healthcare sector

This paper presents research findings of 365 NHS Trust executives in the UK and builds on work carried out on risk perceptions and treatment in facilities management operations and business support activities in the NHS Trusts. The research utilises a business approach of viewing healthcare facilities not only as fixed “assets” occupying hospital sites and space, but it also considers them as that “tangible” part of the service chain process underpinning the provision of clinical services to both internal (departments or directorates) and external customers. The research found that customer satisfaction, service delivery certainty, customer involvement, service quality reliability, health and safety are highly rated by the NHS executives. The paper classifies healthcare related risk constructs into seven elements namely: customer care, corporate, legal, commercial finance and economics, business transfer, and facilities transmitted

Challenges in health services and health systems research

The relationship between emerging trends in healthcare systems and the consequent research priorities will be explored.

Governments and policy makers in developed countries are increasingly focused on the management of chronic disease, reflecting demographic changes and shifts in the burden of disease. Systems of quality improvement and reward are increasingly based on performance in chronic disease management. There is some evidence that countries with well-developed systems of primary care, such as Australia, achieve better health outcomes at less cost. In the past 15 years, almost all developed countries have undergone some type of health care reform. There has been a major focus on reducing costs; often involving shifting services from secondary to primary care. While there are few international comparisons, most suggest a complex relationship between the strength of primary care within the overall health services system and good performance, particularly with regard to lower costs of care and particularly relevant measures of health.

Aims for 21st century health systems
What, then, are the issues which are shaping contemporary general practice in developed countries? There are several imperatives: Safety, effectiveness, patient-centredness, timeliness, efficiency and equity. A study by the Nuffield Trust (Dargie, 1999) projected the shape of healthcare for the first fifteen years of this century. The study identified six issues that need to be addressed in the process of formulating health systems policies:

• Peoples’ expectations and financial sustainability
• Demography and ageing
• Information and knowledge management
• Scientific advance and new technology
• Workforce education and training
• Systems performance and quality (efficiency, effectiveness, economy
and equity)

Each of these six issues requires innovative thinking and priority setting on the part of the health sector, such as the delivery of health services in new and creative ways. Furthermore, there is a clear need for a finely tuned research, development and evaluation strategies to match these goals.

Knowledge transfer and utilization: implications for home healthcare pain management

Implementation of research evidence into clinical practice is a complex and dynamic process that has become the subject of investigation in the field of "translation science" or "knowledge utilization." Research shows how individuals, units, and organizations all influence the rate and extent of adoption of research evidence. Environmental factors also play an important role in this process. This article summarizes key lessons from translation science and examines the implications for the organization and delivery of home healthcare. The implementation of pain management guidelines is used as an example.

Business to employee (B2E) e-business model : service to employees or organisational management?

This paper is a discussion of the B2E e-business model from the perspectives of employee services and organisational management. It includes literature to support B2E as employee services and organisational management with benefits to both. Intranets and portals are technologies supporting the implementation of the B2E e-business model which are also discussed. A case study is included to understand the application of the B2E model in a large organisation. Case study analysis indicates that the B2E e-business model is a service to the employees, however, these services are to support organisational efficiencies.

Knowledge management : the fundamental component for delivery

This paper seeks to examine the link between Knowledge Management (KM) and Quality Management (QM) with a particular focus on the role of a Quality Culture. The authors propose that as Knowledge Management reaches its maturity in terms of acceptance as an important part of doing business in the modern world, that quality will again become the mantra of successful companies. This time, however, quality will not only be defined in terms of the properties of the product and/or services that the organisation provides, but in a more holistic manner that is subject to rapid change and shifting customer preferences. This increasingly dynamic knowledge-driven environment will require companies to pay close adherence to quality in order to satisfy demand and stay ahead of the competition. A national survey of 1000 quality certified organisations in Australia was distributed with a 23% response rate. The survey asked questions pertaining to the organisations' use of Knowledge Management, their quality culture, as well as their quality performance measures. As a result of an analysis of the data, the authors suggest that, in order to survive in such a dynamic environment, organisations will have to embrace Knowledge Management as a fundamental component of delivery of a quality culture.

The influence of strategic HRM and sector on perceived performance in health services organizations

In this study, we examine a variety of management characteristics of for-profit and not-for-profit organizations in the health services (HS) industry. Data collected from Australian senior executives are used to test the relationships between managerial constructs such as employee commitment, customer demandingness, strategic HRM orientation and the adoption of human capital-enhancing human resource (HR) practices and perceived overall performance. Data analysis conducted using the Partial Least Square Modeling show a statistically significant path from commitment to employees, customer demandingness and strategic HRM orientation to the adoption of human capital-enhancing HR practices (such as selective staffing, comprehensive training, and performance appraisal) to perceived organizational performance. The results also show that private sector health service organizations have a higher level of perceived performance.

Applying critical discourse analysis in strategic management research

Critical discourse analysis has become an increasingly popular methodology in organization and management studies. In this article, the authors explore the potential for this methodology to be more widely used in strategic management research. They begin by identifying three research approaches that, to a greater or lesser extent, share a concern with the relationship between language and the formulation and implementation of strategy—strategy as a system of shared meaning, strategy as text and talk, and strategy as truth. They then discuss how critical discourse analysis can be used to extend and develop these approaches by exploiting their underlying complementarities. Finally, using the example of a recently completed case study of strategic change in a large banking and financial services institution, they explore the practical implications of applying critical discourse analysis in strategic management research.

Enhancing patient engagement in chronic disease self-management support initiatives in Australia : the need for an integrated approach

♦ Although emphasis on the prevention of chronic disease is important, governments in Australia need to balance this with continued assistance to the 77% of Australians reported to have at least one long-term medical condition.

♦ Self-management support is provided by health care and community services to enhance patients’ ability to care for their chronic conditions in a cooperative framework.

♦ In Australia, there is a range of self-management support initiatives that have targeted patients (most notably, chronic disease self-management education programs) and health professionals (financial incentives, education and training).

♦ To date, there has been little coordination or integration of these self-management initiatives to enhance the patient–health professional clinical encounter.

♦ If self-management support is to work, there is a need to better understand the infrastructure, systems and training that are required to engage the key stakeholders — patients, carers, health professionals, and health care organisations.

♦ A coordinated approach is required in implementing these elements within existing and new health service models to enhance uptake and sustainability.

The role of loneliness in prison suicide prevention and management

Suicide in prisons has been seen as a public health concern reaching crisis proportions around the world. In this study, data from 60 inmates in a South Australian remand facility were used to examine the relationship between loneliness and known predictors of self-harm, such as depression and hopelessness. As predicted, the results suggested that prisoners who scored higher on a measure of loneliness reported higher levels of depression, hopelessness and indicators of suicidal behaviour. The implications of these findings for suicide management are discussed. It is concluded that whilst specialist mental health services are needed to treat problems such as depression, loneliness is something that may be managed by correctional staff with no professional experience or training.

Supporting self-management of chronic health conditions : Common approaches

Objective : The aims of this paper are to provide a description of the principles of chronic condition self-management, common approaches to support currently used in Australian health services, and benefits and challenges associated with using these approaches.
Methods : We examined literature in this field in Australia and drew also from our own practice experience of implementing these approaches and providing education and training to primary health care professionals and organizations in the field.
Results : Using common examples of programs, advantages and disadvantages of peer-led groups (Stanford Courses), care planning (The Flinders Program), a brief primary care approach (the 5As), motivational interviewing and health coaching are explored.
Conclusions : There are a number of common approaches used to enhance self-management. No one approach is superior to other approaches; in fact, they are often complimentary.
Practice implications : The nature and context for patients’ contact with services, and patients’ specific needs and preferences are what must be considered when deciding on the most appropriate support mode to effectively engage patients and promote self-management. Choice of approach will also be determined by organizational factors and service structures. Whatever self-management support approaches used, of importance is how health services work together to provide support.