Loss of chance in medical negligence claims now a lost cause?

The question whether the loss of chance of a better medical outcome in cases of medical negligence should be recognised as actionable damage is ‘a question which has divided courts and commentators throughout the common law world.’ In April 2010, the High Court handed down its anticipated decision in the case of Tabet (by her Tutor Sheiban) v Gett (2010) 240 CLR 537. The issue considered by the court was whether the appellant could claim in negligence for the loss of a chance of a better medical outcome. This issue had not been considered by the High Court previously, the most relevant cases being Rufo v Hosking (2004) 61 NSWLR 678 and Gavalas v Singh (2001) 3 VLR 404. Claiming for a loss of chance in a personal injury action raises questions as to recognised damage and causation, and the members of the High Court considered both of these.

Risk-informed thinking in airports: the application of business continuity management in airport infrastructure

Airports worldwide represent key forms of critical infrastructure in addition to serving as nodes in the international aviation network. While the continued operation of airports is critical to the functioning of reliable air passenger and freight transportation, these infrastructure systems face a number of sources of disturbance that threaten their operational viability. Recent examples of high magnitude events include the eruption of Iceland’s Eyjafjallajokull volcano eruption (Folattau and Schofield 2010), the failure of multiple systems at the opening of Heathrow’s Terminal 5 (Brady and Davies 2010) and the Glasgow airport 2007 terrorist attack (Crichton 2008). While these newsworthy events do occur, a multitude of lower-level more common disturbances also have the potential to cause significant discontinuity to airport operations. Regional airports face a unique set of challenges, particularly in a nation like Australia where they serve to link otherwise remote and isolated communities to metropolitan hubs (Wheeler 2005), often without the resources and political attention received by larger capital city airports. This paper discusses conceptual relationships between Business Continuity Management (BCM) and High Reliability Theory, and proposes BCM as an appropriate risk-based management process to ensure continued airport operation in the face of uncertainty. In addition, it argues that that correctly implemented BCM can lead to highly reliable organisations. This is framed within the broader context of critical infrastructures and the need for adequate crisis management approaches suited to their unique requirements (Boin and McConnell 2007).

Can transfer of learning be enriched by valuing knowledge transformation and co-creation? Exploring new ways to improve training design

This paper argues that a possible cause of issues with management education outcomes is the fact that most training models operate from a limited ‘transfer’ metaphor. This theoretical paper contends that by reconceptualising existing models, specifically Holton’s transfer of learning model, to incorporate multiple processes and acknowledge the importance of educator- or trainer-student interaction in co-creating knowledge, there is potential to improve training design and ultimately achieve more satisfactory training outcomes.

Managing innovative change within organisations and project team environments

In an attempt to enhance the efficiency, productivity and competitiveness of today’s Architectural, Engineering, and Contractor (AEC) industry, this paper summarises the current status of an ongoing PhD research investigation in developing a sustainable AEC industry specific best-practice ‘Innovation-driven Change Framework’—more specifically a summation of the ‘fourth interrelated dynamic’ (culture). Leveraging off the outcomes of a two year industry and government supported Cooperative Research Centre for Construction Innovation (CRCCI) research project, as well as referring to recent internationally renowned case studies and related literature investigations, this research investigation includes further identifying, processing, analysing and categorizing various culture change methods, models, frameworks and processes utilized within the AEC and other industry sectors, and incorporating these findings in developing an AEC industry-specific ‘Innovation-driven Change Framework’

Foresight practice in Australia: a meta-scan of practitioners and organisations

This critical review of foresight professionals seeks to analyse their social interests, methodology, epistemological focal domains, capacitating focus, geography and organisational type. The call for a deeper understanding of the practice in the Australian context is made in order for the foundations for a National Foresight Strategy to be laid.

Motivating construction organisations through incentives : a case study for client managers

Client-side project manager face challenges in motivating project organisations to pursue exceptional design and construction performance. One approach to improving the motivation of project organisations is by offering a financial incentive reward for the achievement of voluntary performance standards above the minimum required standard. However, little investigation has been undertaken into the features of a successful incentive system as a part of an overall procurement strategy. In response to a lack of information available to client-side project managers tasked with the initial design of an incentive system, the paper explores motivation undera successful incentive and identifies key learnings for client-side project managers to consider when designing incentives. Our findings are based on the results of a large Australian case study which is interpreted against a conceptual framework based on both economic and psychological perspectives of motivation. The results suggest the motivation towards incentive goals is influenced by the value the project organisations place on the incentive reward as a commercial opportunity to increase their profit margins. However, perhaps more important are the relationship management processes that promote commitment to the project; and pride in the achievement of project goals. In the case study, these processes intensified the direct motivational effect of the incentive reward on offer. The findings also highlight the importance of ensuring that incentive goals and performance measurement processes remain relevant to the organisation throughout a project to continuously encourage motivation under changing project conditions.

Public relations management in organisations

Chapter aims By the end of your study of this chapter, you should be able to: - See public relations as a link between organisations and their environments - Use systems theory to guide your understanding and practical application of public relations - Understand the make up of a public relations management team within an organisation - Identify and understand how a range of internal forces including culture, and power affect the practice of public relations - Identify and understand how a range of external forces including conflict, activism and corporate social responsibility affect the practice of public relations.

Non-Governmental Organisations(NGOs) in Bangladesh : an assessment of their legal status

Despite multiple efforts, the amount of poverty in Bangladesh has remained alarmingly high by any standard. Two salient characteristics of poverty alleviation in Bangladesh are: their poor accessibility for the ‘target’ population (the rural poor), and lack of co-ordination between government and the Non-Government Organisations. The moment the state alone is unable to combat poverty then the NGOs come into the picture to fill the void. First Britain as a colonial power, then the East Pakistan Government and the Government of Bangladesh have promulgated Ordinances and Regulations for the practical regulation of NGOs. The loopholes and flaws within the legal framework have given the NGOs opportunities to violate the Ordinances and Regulations. A better situation could be achieved by modifying and strictly implementing such state rules, ensuring accountability, effective state control, and meaningful NGO-State collaboration and co-operation.

The GST Compliance Costs Of Nonprofit Organisations

On 2 December 1998, the Federal Government tabled their policy paper entitled Regulation Impact Statement for the Introduction of a Goods and Services Tax (RIS) in the House of Representatives. The Federal Government predicted that total gross GST compliance costs to Australian businesses in the first year of implementation would be approximately $1,912 million (or $1,195 per firm). Furthermore, it is estimated that the recurrent net compliance costs will be much lower at $131 per firm. Whilst the government made brief references to charitable organisations in their analysis, it stated that the compliance costs faced by nonprofits would, in substance, be no different to the compliance costs faced by businesses or government departments. This paper examines the RIS process in relation to nonprofit organisations in the context of recent taxation legislation affecting nonprofit organisations. It argues that the assumption that nonprofit compliance costs are similar to government and business costs is flawed and makes a case for the RIS process to be reformed to include more appropriate assessments of the impact of legislation on nonprofit enterprises.

Regulatory infrastructure for nonprofit organisations

The Australian economy has been transformed by bold federal government initiatives over the last decade. The political rhetoric is that without these reforms, the Australian economy will falter and be uncompetitive in a global market place. Despite the electoral disquiet that rapid systemic change brings, both sides of politics have adopted the broad starting point that it is imperative that our economy be transformed or Australian living standards will dramatically plummet...

'Nothing exists for one cause' : putting biology back into evolution

The opening phrase of the title is from Charles Darwin’s notebooks (Schweber 1977). It is a double reminder, firstly that mainstream evolutionary theory is not just about describing nature but is particularly looking for mechanisms or ‘causes’, and secondly, that there will usually be several causes affecting any particular outcome. The second part of the title is our concern at the almost universal rejection of the idea that biological mechanisms are sufficient for macroevolutionary changes, thus rejecting a cornerstone of Darwinian evolutionary theory. Our primary aim here is to consider ways of making it easier to develop and to test hypotheses about evolution. Formalizing hypotheses can help generate tests. In an absolute sense, some of the discussion by scientists about evolution is little better than the lack of reasoning used by those advocating intelligent design. Our discussion here is in a Popperian framework where science is defined by that area of study where it is possible, in principle, to find evidence against hypotheses – they are in principle falsifiable. However, with time, the boundaries of science keep expanding. In the past, some aspects of evolution were outside the current boundaries of falsifiable science, but increasingly new techniques and ideas are expanding the boundaries of science and it is appropriate to re-examine some topics. It often appears that over the last few decades there has been an increasingly strong assumption to look first (and only) for a physical cause. This decision is virtually never formally discussed, just an assumption is made that some physical factor ‘drives’ evolution. It is necessary to examine our assumptions much more carefully. What is meant by physical factors ‘driving’ evolution, or what is an ‘explosive radiation’. Our discussion focuses on two of the six mass extinctions, the fifth being events in the Late Cretaceous, and the sixth starting at least 50,000 years ago (and is ongoing). Cretaceous/Tertiary boundary; the rise of birds and mammals. We have had a long-term interest (Cooper and Penny 1997) in designing tests to help evaluate whether the processes of microevolution are sufficient to explain macroevolution. The real challenge is to formulate hypotheses in a testable way. For example the numbers of lineages of birds and mammals that survive from the Cretaceous to the present is one test. Our first estimate was 22 for birds, and current work is tending to increase this value. This still does not consider lineages that survived into the Tertiary, and then went extinct later. Our initial suggestion was probably too narrow in that it lumped four models from Penny and Phillips (2004) into one model. This reduction is too simplistic in that we need to know about survival and ecological and morphological divergences during the Late Cretaceous, and whether Crown groups of avian or mammalian orders may have existed back into the Cretaceous. More recently (Penny and Phillips 2004) we have formalized hypotheses about dinosaurs and pterosaurs, with the prediction that interactions between mammals (and groundfeeding birds) and dinosaurs would be most likely to affect the smallest dinosaurs, and similarly interactions between birds and pterosaurs would particularly affect the smaller pterosaurs. There is now evidence for both classes of interactions, with the smallest dinosaurs and pterosaurs declining first, as predicted. Thus, testable models are now possible. Mass extinction number six: human impacts. On a broad scale, there is a good correlation between time of human arrival, and increased extinctions (Hurles et al. 2003; Martin 2005; Figure 1). However, it is necessary to distinguish different time scales (Penny 2005) and on a finer scale there are still large numbers of possibilities. In Hurles et al. (2003) we mentioned habitat modification (including the use of Geogenes III July 2006 31 fire), introduced plants and animals (including kiore) in addition to direct predation (the ‘overkill’ hypothesis). We need also to consider prey switching that occurs in early human societies, as evidenced by the results of Wragg (1995) on the middens of different ages on Henderson Island in the Pitcairn group. In addition, the presence of human-wary or humanadapted animals will affect the distribution in the subfossil record. A better understanding of human impacts world-wide, in conjunction with pre-scientific knowledge will make it easier to discuss the issues by removing ‘blame’. While continued spontaneous generation was accepted universally, there was the expectation that animals continued to reappear. New Zealand is one of the very best locations in the world to study many of these issues. Apart from the marine fossil record, some human impact events are extremely recent and the remains less disrupted by time.

Nonprofit organisations in Australia : what do we know nine years later and what should we find out now?

I welcomed this chance to look back over the past nine years of third sector research in Australia and the opportunity to participate in this gathering to chart another nine years. There will be two parts to this paper. Part one will review what I said in 1991 (Lyons, 1991) and summarise what has happened since to see if my hopes were realised. Part two will attempt to sketch a framework for a research agenda, informed by the same motivation as my 1991 paper. It will conclude with some reflections about how to build a stronger institutional framework to sustain third sector research...

Fundraising and philanthropy : engaging research and practice

The social and corporate trends over five years (1996 - 2000) in Australia clearly demonstrate the need for the nonprofit sector to engage in predictability forecasting to build viable philanthropic partnerships. As business and private enterprise practices have become more common in the management of fundraising effectiveness, nonprofits are in danger of reducing the value of their cause and likewise the cause or need of corporate and individual donors. Shortterm partnerships with short-term objectives do not achieve an outcome of sustainability. This paper analyses the theories of fundraising and philanthropy in the context of the changing Australian environment, and proposes a value measurement approach to the inputs and outputs of nonprofit organisations. By engaging in research, nonprofits are more likely to achieve productivity in fundraising and philanthropic practice.

Root cause analysis with enriched process logs

In the field of process mining, the use of event logs for the purpose of root cause analysis is increasingly studied. In such an analysis, the availability of attributes/features that may explain the root cause of some phenomena is crucial. Currently, the process of obtaining these attributes from raw event logs is performed more or less on a case-by-case basis: there is still a lack of generalized systematic approach that captures this process. This paper proposes a systematic approach to enrich and transform event logs in order to obtain the required attributes for root cause analysis using classical data mining techniques, the classification techniques. This approach is formalized and its applicability has been validated using both self-generated and publicly-available logs.

Quality of work life and turnover intention in primary healthcare organisations : a cross-sectional study of registered nurses in Saudi Arabia

Purpose: The purpose of this study was to improve the retention of primary healthcare (PHC) nurses through exploring and assessing their quality of work life (QWL) and turnover intention. Design and methods: A cross-sectional survey design was used in this study. Data were collected using a questionnaire comprising four sections (Brooks’ survey of Quality of Nursing Work Life [QNWL], Anticipated Turnover Intention, open-ended questions and demographic characteristics). A convenience sample was recruited from 143 PHC centres in Jazan, Saudi Arabia. A response rate of 87% (n = 508/585) was achieved. The SPSS v17 for Windows and NVivo 8 were used for analysis purposes. Procedures and tests used in this study to analyse the quantitative data were descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression. Qualitative data obtained from responses to the open-ended questions were analysed using the NVivo 8. Findings: Quantitative findings suggested that PHC nurses were dissatisfied with their work life. Respondents’ scores ranged between 45 and 218 (mean = 139.45), which is lower than the average total score on Brooks’ Survey (147). Major influencing factors were classified under four dimensions. First, work life/home life factors: unsuitable working hours, lack of facilities for nurses, inability to balance work with family needs and inadequacy of vacations’ policy. Second, work design factors: high workload, insufficient workforce numbers, lack of autonomy and undertaking many non-nursing tasks. Third, work context factors: management practices, lack of development opportunities, and inappropriate working environment in terms of the level of security, patient care supplies and unavailability of recreation room. Finally, work world factors: negative public image of nursing, and inadequate payment. More positively, nurses were notably satisfied with their co-workers. Conversely, 40.4% (n = 205) of the respondents indicated that they intended to leave their current employment. The relationships between QWL and demographic variables of gender, age, marital status, dependent children, dependent adults, nationality, ethnicity, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to medium effect size of the variation in QWL scores. Using the GLM univariate analysis, education level was also significantly related to the QWL (p < .05). The relationships between turnover intention and demographic variables including gender, age, marital status, dependent children, education level, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to moderate effect size of the variation in the turnover intention scores. Using the GLM univariate analysis, the dependent adults’ variable was also significantly related to turnover intention (p < .05). Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by the QWL F (4,491), 43.71, p < .001, with R² = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, F (17.433) = 12.04, p < .001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables, R squared change =.19, F change (4, 433) = 30.190, p < .001. The work context variable makes the strongest unique contribution (-.387) to explain the turnover intention, followed by the work design dimension (-.112). The qualitative findings reaffirmed the quantitative findings in terms of QWL and turnover intention. However, the home life/work life and work world dimensions were of great important to both QWL and turnover intention. The qualitative findings revealed a number of new factors that were not included in the survey questionnaire. These included being away from family, lack of family support, social and cultural aspects, accommodation facilities, transportation, building and infrastructure of PHC, nature of work, job instability, privacy at work, patients and community, and distance between home and workplace. Conclusion: Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes. Improving these factors could lead to a higher QWL and increase retention rates and therefore reinforcing the stabilisation of the nursing workforce. Significance of the research: Many countries are examining strategies to attract and retain the health care workforce, particularly nurses. This study identified factors that influence the QWL of PHC nurses as well as their turnover intention. It also determined the significant relationship between QWL and turnover intention. In addition, the present study tested Brooks’ survey of QNWL on PHC nurses for the first time. The qualitative findings of this study revealed a number of new variables regarding QWL and turnover intention of PHC nurses. These variables could be used to improve current survey instruments or to develop new research surveys. The study findings could be also used to develop and appropriately implement plans to improve QWL. This may help to enhance the home and work environments of PHC nurses, improve individual and organisational performance, and increase nurses’ commitment. This study contributes to the existing body of research knowledge by presenting new data and findings from a different country and healthcare system. It is the first of its kind in Saudi Arabia, especially in the field of PHC. It has examined the relationship between QWL and turnover intention of PHC nurses for the first time using nursing instruments. The study also offers a fresh explanation (new framework) of the relationship between QWL and turnover intention among PHC nurses, which could be used or tested by researchers in other settings. Implications for further research: Review of the extant literature reveals little in-depth research on the PHC workforce, especially in terms of QWL and organisational turnover in developing countries. Further research is required to develop a QWL tool for PHC nurses, taking into consideration the findings of the current study along with the local culture. Moreover, the revised theoretical framework of the current study could be tested in further research in other regions, countries or healthcare systems in order to identify its ability to predict the level of PHC nurses’ QWL and their intention to leave. There is a need to conduct longitudinal research on PHC organisations to gain an in-depth understanding of the determents of and changes in QWL and turnover intention of PHC nurses at various points of time. An intervention study is required to improve QWL and retention among PHC nurses using the findings of the current study. This would help to assess the impact of such strategies on reducing turnover of PHC nurses. Focusing on the location of the current study, it would be valuable to conduct another study in five years’ time to examine the percentage of actual turnover among PHC nurses compared with the reported turnover intention in the current study. Further in-depth research would also be useful to assess the impact of the local culture on the perception of expatriate nurses towards their QWL and their turnover intention. A comparative study is required between PHC centres and hospitals as well as the public and private health sector agencies in terms of QWL and turnover intention of nursing personnel. Findings may differ from sector to sector according to variations in health systems, working environments and the case mix of patients.