Enhancing the dietary management of general practice patients through collaborative care: perspectives of general practitioners and dietitians

Aim:  To describe how general practitioners and dietitians view their role in the dietary management of cardiac patients and to provide insights on how to facilitate collaborative care.
Methods:  Two studies were conducted in Victoria (Australia) 2005–2006. Study One: semi-structured interviews with general practitioners. Study Two: cross-sectional quantitative surveys of general practitioners and dietitians. Study One: texts were analysed using the grounded theory approach. Study Two: frequency analysis was conducted and chi-squared test for independence was used to explore the impact of age, sex and consultation time on the role and reporting scales.
Results:  Study One: Themes arising from the interviews with 30 general practitioners showed their involvement in dietary management fell into three broad roles: ‘Influencing’, ‘Coordinator’ of referrals and dietary ‘Educator’. They described dietetic education as a process that included dietary assessment, education, application of behavioural change techniques and reporting back to general practitioners. Study Two: Respondents were 248 general practitioners (30% response) and 180 dietitians (60% response). General practitioners' counselling consisted mostly of advocating for dietary change, coordinating dietetic referrals and reinforcing dietitians' recommendations. General practitioners considered dietary education as the role of dietitians. Dietitians reported a much broader role in the management of patients with some overlap with general practitioners' roles.
Conclusions:   The findings indicate the need: (i) for more structured reporting to ensure general practitioners receive appropriate information to enable them to reinforce dietetic counselling and recommendations; and (ii) to streamline the communication process in order to expedite dietitians' reports to general practitioners.

Writing as tribal practice : revisiting online collaborative writing

Many teachers encourage sharing ideas and knowledge through collaborative group writing to build self-confidence in developing writers. However, some students do not appear to gain a sense of belonging in the collaborative experience. This evolving study explores online collaborative writing with the purpose of creating a 'third author' - the group (tribal) voice. One aim is to reclaim writing as a conscious collaborative act where meaning is attained only at the end of the thought-sharing process. Therefore, the process of writing is seen as more important than the product. A further aim is to observe how intensive writing collaboration will affect both the writers and the writing during the process. A group of language teachers from Singapore, Australia, New Zealand and the USA meet every two weeks in cyberspace for a two-hour intensive writing session. The group has met for the past three months. Different discourses appear to be fusing into a metamorphosed new hybrid author - the tribal group voice. These early findings suggest that such practices may assist learners who experience difficulty entering or contributing to collaborative writing or group-work tasks. Additionally, online group work may benefit, as no physical human contact exists to gain a sense of 'group'.

Daring to Care : is spirituality sustainable in organizations providing healthcare?

Healthcare workers are challenged to dare to care enough to provide a service that is holistic. This involves being in tune with their own spirituality and the spiritual needs of their patients or clients. Spirituality and compassion are important concepts in the ministry of nurses and other health professionals. Compassion also has links with mercy, although there is debate as to whether mercy is the same as compassion for deserving or undeserving sufferers. However, healthcare workers need to care for sufferers even if their suffering is not deserved, where such compassion is intrinsic and/or out of duty. It involves acting altruistically. Faith-based organizations are best equipped to undertake this holistic ministry but as they are becoming increasingly reliant on government funding to help finance expensive health services they encounter rationalistic pressures from these funding sources may restrict the way they deliver these services. Decision and policymakers are encouraged to embrace altruistic values rather than the egoistic values of economic rationalism, not least because the nature of healthcare has an inherent emphasis on altruistic emotions, especially compassion.

From continuous improvement to collaborative innovation : the next challenge in supply chain management

This paper considers the growing importance of inter-company collaboration, and develops the concept of intra-company continuous improvement through to what may be termed collaborative innovation between members of an extended manufacturing enterprise (EME). The importance of ICTs to such company networks is considered but research has shown that no amount of technology can overcome a lack of trust and ineffective goal setting between key partners involved in the cross-company projects. Different governance models may also impact on the success or otherwise of the network. This paper provides an overview of the main topics considered in this Special Issue

Collaborative improvement : interplay but not a game

Collaboration literally means working together. Collaborative improvement is an extension of continuous improvement and can be defined as a purposeful inter-company interactive process that focuses on continuous incremental innovation aimed at enhancing the collaboration’s overall performance. Developing collaborative improvement is a protracted and difficult process. Previous research has identified a number of factors affecting that process and suggested that it is not so much the individual factors, but rather their interplay that determines the successful development of collaborative improvement. This article reports research aimed at developing a deeper understanding of that interplay. Ten relationships between ten factors are presented and discussed. It appears that vision, approach, trust and commercial reality are the strongest factors. These factors are, however, influenced by, or affect the other factors, notably national culture, partner characteristics and competences, the use of power, individual behaviour and commitment. The way this interplay develops varies from case to case and has great influence on the development of collaborative improvement.

A decision-making model to choose business intelligence platforms for organizations

In recent time, technology applications in different fields, especially Business Intelligence (BI) have been developed rapidly and considered to be one of the most significant uses of information technology with special position reserved. The application of BI systems provides organizations with a sense of superiority in the competitive environment. Despite many advantages, the companies applying such systems may also encounter problems in decision-making process because of the highly diversified interactions within the systems. Hence, the choice of a suitable BI platform is important to take the great advantage of using information technology in all organizational fields. The current research aims at addressing the problems existed in the organizational decision-making process, proposing and implementing a suitable BI platform using Iranian companies as case study. The paper attempts to present a solitary model based on studying different methods in BI platform choice and applying the chosen BI platform for different decisionmaking processes. The results from evaluating the effectiveness of subsequently implementing the model for Iranian Industrial companies are discussed.

Challenges of international design chain integration and cultural diversity : organisational reflexive capability

Increasingly project teams on international mega projects are composed of multiple partners from different countries forming joint ventures to achieve a higher level of strategic flexibility. Establishing and maintaining local business networks are critical to ensure the success of exporting firms. Firms who achieve competitive advantage in international markets and long term economic sustainability constantly adapt their business practices to achieve client satisfaction by a combination of self, market and project needs assessment. Successful firms ultimately achieve this in local markets but in international market this is intensified with the complexity of barriers grounded in cross-cultural contexts. The need for flexibility, adaptability and continual reassessment is enhanced as the market evolves in various localities. Reflexivity theory was used to develop a conceptual model to explain the way in which firms develop awareness, responsiveness and adaptability for long term success in diverse international markets. This paper summarizes the initial Australian study which developed the model grounded in empirical observations of design construction firms working on projects in developing countries and a second study of Malaysian firms which validated the model. The aim of this study was to develop a performance measurement framework for capabilities assessment of international collaborative partnerships. The study explored the joint venture partnerships between Australian and Malaysian property and construction professionals. Four Malaysian organizations were examined as case studies and two key activities of design management and knowledge management were analyzed in relation to social, cultural and intellectual capital transformation within the Reflexivity Capability Maturity Assessment Framework.

Health consumer organizations and the pharmaceutical industry : is transparency the answer?

This book examines the important role of consumer activism within health policy in different national contexts. In an age of shifting boundaries between state and civil society, consumer groups are potentially drivers of democratization in the health domain. The expert contributors explore how their activities bring new dynamics to relations between service providers, the medical profession, government agencies, and other policy actors. This book is unique in comprehensively analysing the opportunities and dilemmas of this type of activism, including ambiguous partnerships between consumer groups and stakeholders such as the pharmaceutical industry. These themes are explored within an internationally comparative framework, with case studies from various countries. Students and researchers in the fields of health policy and sociology, public policy and social movements will find this relevant and path-breaking book enlightening. It will also prove invaluable for participants and activists in patient and health consumer organizations.