Degree of value alignment : a grounded theory of rural nurse resignations

INTRODUCTION: The shortage of nurses willing to work in rural Australian healthcare settings continues to worsen. Australian rural areas have a lower retention rate of nurses than metropolitan counterparts, with more remote communities experiencing an even higher turnover of nursing staff. When retention rates are lower, patient outcomes are known to be poorer. This article reports a study that sought to explore the reasons why registered nurses resign from rural hospitals in the state of New South Wales, Australia. METHODS: Using grounded theory methods, this study explored the reasons why registered nurses resigned from New South Wales rural hospitals. Data were collected from 12 participants using semi-structured interviews; each participant was a registered nurse who had resigned from a rural hospital. Nurses who had resigned due to retirement, relocation or maternity leave were excluded. Interviews were transcribed verbatim and imported into NVivo software. The constant comparative method of data collection and analysis was followed until a core category emerged. RESULTS: Nurses resigned from rural hospitals when their personal value of how nursing should occur conflicted with the hospital's organisational values driving the practice of nursing. These conflicting values led to a change in the degree of value alignment between the nurse and hospital. The degree of value alignment occurred in three dynamic stages that nurses moved through prior to resigning. The first stage, sharing values, was a time when a nurse and a hospital shared similar values. The second stage was conceding values where, due to perceived changes in a hospital's values, a nurse felt that patient care became compromised and this led to a divergence of values. The final stage was resigning, a stage where a nurse 'gave up' as they felt that their professional integrity was severely compromised. The findings revealed that when a nurse and organisational values were not aligned, conflict was created for a nurse about how they could perform nursing that aligned with their internalised professional values and integrity. Resignation occurred when nurses were unable to realign their personal values to changed organisational values - the organisational values changed due to rural area health service restructures, centralisation of budgets and resources, cumbersome hierarchies and management structures that inhibited communication and decision making, out-dated and ineffective operating systems, insufficient and inexperienced staff, bullying, and a lack of connectedness and shared vision. CONCLUSIONS: To fully comprehend rural nurse resignations, this study identified three stages that nurses move through prior to resignation. Effective retention strategies for the nursing workforce should address contributors to a decrease in value alignment and work towards encouraging the coalescence of nurses' and hospitals' values. It is imperative that strategies enable nurses to provide high quality patient care and promote a sense of connectedness and a shared vision between nurse and hospital. Senior managers need to have clear ways to articulate and imbue organisational values and be explicit in how these values accommodate nurses' values. Ward-level nurse managers have a significant responsibility to ensure that a hospital's values (both explicit and implicit) are incorporated into ward culture.

eHealth-as-a-Service (eHaaS) : the industrialisation of health informatics, a practical approach

With the introduction of the Personally Controlled Health Record (PCEHR), the Australian public is being asked to accept greater responsibility for their healthcare. Although well designed, constructed and intentioned, policy and privacy concerns have resulted in an eHealth model that may impact future health information sharing requirements. Thus an opportunity to transform the beleaguered Australian PCEHR into a sustainable on-demand technology consumption model for patient safety must be explored further. Moreover, the current clerical focus of healthcare practitioners must be renegotiated to establish a shared knowledge creation landscape of action for safer patient interventions. To achieve this potential however requires a platform that will facilitate efficient and trusted unification of all health information available in real-time across the continuum of care. As a conceptual paper, the goal of the authors is to deliver insights into the antecedents of usage influencing superior patient outcomes within an eHealth-as-a-Service framework. To achieve this, the paper attempts to distil key concepts and identify common themes drawn from a preliminary literature review of eHealth and cloud computing concepts, specifically cloud service orchestration to establish a conceptual framework and a research agenda. Initial findings support the authors’ view that an eHealth-as-a-Service (eHaaS) construct will serve as a disruptive paradigm shift in the aggregation and transformation of health information for use as real-world knowledge in patient care scenarios. Moreover, the strategic value of extending the community Health Record Bank (HRB) model lies in the ability to automatically draw on a multitude of relevant data repositories and sources to create a single source of practice based evidence and to engage market forces to create financial sustainability.

On the efficacy of key corporate governance recommendations in mid-tier companies : window-dressing or value-adding?

This paper examins the relationship between firm performance and key board and audit committee variables in a sample of mid-tier listed Australian firms. Unlike the UK where the corporate governance Code specifically outlines special arrangements for companies outside the FTSE 350 index, the ASX Corporate Governance recommendations make no special provisions for mid-tier companies. Consequently, mid-tier Australian companies may be expending scarce resources in conforming with recommendations that are not value-creating.

Contextualising co-creation of value in electronic personal health records

This conceptual paper is a preliminary part of an ongoing study into take-up of electronic personal health records (ePHRs). The purpose of this work is to contextually ‘operationalise' Grönroos’ (2012) model of value co-creation in service for ePHRs. Using findings in the extant literature we enhance theoretical and practical understanding of the potential for co-creation of value with ePHRs for relevant stakeholders. The research design focused on the selection and evaluation of relevant literature to include in the discussion. The objective was to demonstrate which articles can be used to 'contextualise' the concepts in relation to relevant healthcare providers and patient engagement in the co-creation of value from having shared ePHRs. Starting at the service concept, that is, what the service provider wants to achieve and for whom, there is little doubt that there are recognised benefits that co-create value for both healthcare providers and healthcare consumers (i.e. patients) through shared ePHRs. We further highlight both alignments and misalignments in the resources and activities concepts between stakeholder groups. Examples include the types of functionalities as well as the interactive and peer communication needs perceived as useful for healthcare providers compared to healthcare consumers. The paper has implications for theory and practice and is an original and innovative approach to studying the co-creation of value in eHealth delivery.

CoWs, Google and online possibilities : creating digital posters to enhance student engagement

A new Bachelor of Science (BSc) course was introduced at Queensland University of Technology (QUT) in 2013 and focused on inquiry-based, collaborative and active learning. Two of the first year units required that students carry out a group poster assessment task. This poster provides a preliminary evaluation from an academic staff perspective of the assessment approach used, whereby students created digital posters to utilise the affordances of new learning spaces. The digital posters approach was first introduced to a group of academic staff from the Science and Engineering Faculty (SEF) in 2012 during a professional development program to explicitly develop skills and shared understandings of teaching in collaborative learning spaces (Steel & Andrews, 2012). Considerations were given to the pedagogical requirements of a poster assessment task, the affordances of the learning space and an identification of possible benefits of using Google Sites to create digital posters. Positive feedback from this group (as highlighted in the quotes shown) and subsequent approval from unit coordinators for two of the new first year BSc units meant that the approach was adopted for Semester 1, 2013 with approximately 360 students in each unit.

Shared values : diverse perspectives – engaging engineering educators in integrating Indigenous engineering knowledge into current curricula

BACKGROUND Engineering is a problem-based practically oriented discipline, whose practitioners aim to find effective solutions to engineering challenges, technically and economically. Engineering educators operate within a mandate to ensure that graduate engineers understand the practicalities and realities of good engineering practice. While this is a vital goal for the discipline, emerging influences are challenging the focus on ‘hard practicalities’ and requiring recognition of the cultural and social aspects of engineering. Expecting graduate engineers to possess communication skills essential for negotiating satisfactory outcomes in contexts of complex social beliefs about the impact of their work can be an unsettling and challenging prospect for engineering educators. This project identifies and addresses Indigenous engineering practices and principles, and their relevance to future engineering practices. PURPOSE This Office of Learning and Teaching (OLT) project proposes that what is known/discoverable about indigenous engineering knowledge and practices must be integrated into engineering curricula. This is an important aspect of ensuring that engineering as a profession responds competently to increasing demands for socially and environmentally responsible activity across all aspects of engineering activity. DESIGN/METHOD The project addresses i) means for appropriate inclusion of Indigenous students into usual teaching activities ii) assuring engineering educators have access to knowledge of Indigenous practices and skills relevant to particular engineering courses and topics iii) means for preparing all students to negotiate their way through issues of indigenous relationships with the land where engineering projects are planned. The project is undertaking wide-ranging research to collate knowledge about indigenous engineering principles and practices and develop relevant resource materials. RESULTS It is common to hear that such social issues as ‘Indigenous concerns’ are only of concern to environmental engineers. We challenge that perspective, and make the case that Indigenous knowledge is an important issue for all engineering educators in relation to effective integration of indigenous students and preparation of all engineering graduates to engage with indigenous communities. At the time of first contact, a rich and varied, technically literate, Indigenous social framework possessed knowledge of the environment that is not yet fully acknowledged in Australian society. A core outcome of the work will be development of resources relating to Indigenous engineering practices for inclusion in engineering core curricula. CONCLUSIONS A large body of technical knowledge was needed to survive and sustain human society in the complex environment that was Australia before 1788. This project is developing resource materials, and supporting documentation, about that knowledge to enable engineering educators to more easily integrate it into current curricula. The project also aims to demonstrate the importance for graduating engineers to appreciate the existence of diverse perspectives on engineering tasks and learn how to value - and employ - multiple paths to possible solutions.

Co-creating stories in social learning systems : The role of community media and cultural organisations in disseminating knowledge

This paper investigates how community based media organisations are co-creative storytelling institutions, and how they learn to disseminate knowledge in a social learning system. Organisations involved in story co-creation are learning to create in fluid environments.They are project based, with a constant turnover of volunteers or staff. These organisations have to meet the needs of their funding bodies and their communities to remain sustainable. Learning is seen as dialogical, and this is also reflected in the nature of storytelling itself. These organisations must learn to meet the needs of their communities, who in turn learn from the organisation’s expertise in a facilitated setting. This learning is participatory and collaborative, and is often a mix of virtual and offline interaction. Such community-based organisations sit in the realm of a hybrid-learning environment; they are neither a formal educational institution like a college, nor do their volunteers produce outcomes in a professional capacity. Yet, they must maintain a certain level of quality outcomes from their contributors to be of continued value in their communities. Drawing from a larger research study, one particular example is that of the CitizenJ project. CitizenJ is hosted by a state cultural centre, and partnered with publishing partners in the community broadcasting sector. This paper explores how this project is a Community of Practice, and how it promotes ethical and best practice, meets contributors’ needs, emphasises the importance of facilitation in achieving quality outcomes, and the creation of projects for wider community and public interest.

What is shared services?

Purpose This chapter discusses the constitution of Shared Services and the value of a consensual agreement of a definition for academe and practice. It explores the operating principles and services, the concepts of internal customer and internal service, and their importance for the practitioner and research communities. Methodology/approach This chapter employed a broad review of the literature to examine Shared Services. The research team used NVivo as a tool to create a database of key articles and books to analyze the key concepts and topics. Findings There is a lack of consensus on the definition of Shared Services in the research and practitioner community. Additionally, the concept of internal customer requires greater exploration and understanding within the context of Shared Services. How Shared Services provides competitive advantage to organizations is also not well understood. Research limitations/implications This discussion provides a challenge to the research community to focus on the contributions of shared services to business management theory. This requires a consensus that is currently nonexistent, to ensure the correct use of the terminology and model. Practical implications By establishing a clearer understanding of what is Shared Services, the academic and the practitioner community, in particular, will gain greater competencies on Shared Services to support change management programs during the implementation phases and minimize implementation costs by lowering organizational and people resistance. The variants in shared services terminology create confusion which is likely to result in ambiguity during implementation and have practical implications on governance, customers and service, benefits realization and performance. Originality/value of chapter This chapter addresses the lack of agreed definition of the term Shared Services and the role of the internal customer and consequent internal service delivery.

Creating heterogeneity: Evolving use of groupware in a network of freelancers

This contribution is a long-term study of the evolving use of the organization-wide groupware in a service network. We are describing the practices related to organization-wide groupware in conjunction with local groupware-related practices and how they have proceeded since the organization was established. In the discussion of these practices we are focussing on issues such as: 1. tendencies for proliferation and integration, 2. local appropriations of a variety of systems, 3. creative appropriations, including the creation of a unique heterogeneous groupware fabric, 4. the design strategy of multiple parallel experimental use an; 5. the relation between disparate local meanings and successful computer supported cooperative practice. As an overarching theme we are exploring the explanatory value of the concepts of objectification and appropriation as compared to the concepts of design vs. use.

Biorefineries – creating economic opportunities from biofuels and bio-products

Biorefineries, producing fuels, green chemicals and bio-products, offer great potential for improving the profitability and sustainability of tropical agricultural industries. Biomass from tropical crops like sugarcane, sweet sorghum, palm and cassava offer great potential because of the high biomass growth potential under favourable climatic conditions. Biorefineries aim to convert waste residues through biochemical and enzymatic processes to low cost fermentable sugars which are a platform for value-adding. Through subsequent fermentation utilising microbial biotechnologies or chemical synthesis, the sugars can be converted to fuels including ethanol and butanol, oils, organic acids such as lactic and levulinic acid and polymer precursors. Other biorefinery products can include food and animal feeds, plastics, fibre products and resins. Pretreatment technologies are a key to unlocking this potential and new technologies are emerging. This paper will address the opportunities available for tropical biorefineries to contribute to the future profitability of tropical agricultural industries. The importance of pretreatment technologies will be discussed.

Balancing entertainment and behaviour value: M-games as a social marketing agent of change

In a marketplace where millions of dollars are spent on the design of mobile games (m-games), social marketers are now using this technology as a tool for behaviour change. Despite high expenditure by governments and non-profits on social marketing m-games, little is known about their effectiveness in terms of creating value. Value creation has been demonstrated to have an important impact on satisfaction and behaviour. This paper reports the results of a qualitative study involving four focus groups with 23 participants to reveal two categories of experiential value, entertainment and behaviour. Additionally, it was discovered that entertainment could be characterised by amusement and social value dimensions. Whereas, behaviour could be made up of information, simulation and distraction value dimensions. The categories of value, as well as the dimensions of information, simulation and distraction are entirely new to the social marketing literature and thus represents a unique contribution to social marketing.

Creating the reasonable adventurer: The co-evolution of student and learning environment

Purpose: This paper seeks to address the issue of how are graduate skills developed. The focus is not on which skills, but rather what type of learning environments is required within Higher Education to support the development of skills valued and demanded by SMEs within Australia. Approach: This paper takes a step back to consider the underlying issue of how an individual student's habits of thought are altered. In doing so, the past works of Morgan, Dewey, Whitehead, and Tyler are synthesized with the modern work of Baxter Magolda, Heath, and Biggs. Findings: It is argued that that without the development of a student-centred learning environment, most graduates will not develop the types of skills demanded by SMEs in a meaningfully way. That the failure to treat knowledge and skills as equal drivers of curriculum design will result in an imbalance that relegates skill development to a secondary learning outcome. Practical Implications: By removing the distraction of what skills should be developed, a clearer focus is possible regarding how educators should assist students to develop a broad array of generic graduate skills. From this perspective, skills can be viewed as an essential element of the educational process, rather than a new element that must be squeezed in between content. Value of Paper: This paper extends recent discussion of skills development through the use of an evolutionary perspective. Viewed as a process of creating social change, education becomes increasingly connected to a world that lays beyond institutional boundaries, thus promoting the notion of developing graduates for the world that awaits them.

Disclosures of social value creation and managing legitimacy: A case study of three global social enterprises

This study seeks to fill the gap in the existing literature by examining at how and whether disclosure of social value creation becomes a part of legitimation strategies of social enterprises. By using Suchman’s (1995) moral dimension of legitimacy theory this study sets out that three global social organizations, Grameen Bank, Charity Water, and the Bill and Melinda Gates Foundation, disclose social value creation as if they conform to expectations of the broader community. The study finds that there is an apparent disconnection between disclosure and actions by social enterprises. With references to few incidents highlighted in this study, social enterprises, use disclosures as their managerial efforts, rather than creating moral legitimacy. The notion of apparent disconnection between disclosure and real action by the case social enterprises is common with the notion of the motivation behind disclosure practices by corporations as captured in extant disclosure literature. The finding suggest that when an organisation (whether it is a corporation or a social enterprise) face legitimacy crisis, it appears to disclose good news than bad news questioning organizational moral legitimacy.

Perspectives on knowledge creating inquiry in higher education

Higher education is faced with the challenge of strengthening students competencies for the constantly evolving technology-mediated practices of knowledge work. The knowledge creation approach to learning (Paavola et al., 2004; Hakkarainen et al., 2004) provides a theoretical tool to address learning and teaching organized around complex problems and the development of shared knowledge objects, such as reports, products, and new practices. As in professional work practices, it appears necessary to design sufficient open-endedness and complexity for students teamwork in order to generate unpredictable and both practically and epistemologically challenging situations. The studies of the thesis examine what kinds of practices are observed when student teams engage in knowledge creating inquiry processes, how the students themselves perceive the process, and how to facilitate inquiry with technology-mediation, tutoring, and pedagogical models. Overall, 20 student teams collaboration processes and productions were investigated in detail. This collaboration took place in teams or small groups of 3-6 students from multiple domain backgrounds. Two pedagogical models were employed to provide heuristic guidance for the inquiry processes: the progressive inquiry model and the distributed project model. Design-based research methodology was employed in combination with case study as the research design. Database materials from the courses virtual learning environment constituted the main body of data, with additional data from students self-reflections and student and teacher interviews. Study I examined the role of technology mediation and tutoring in directing students knowledge production in a progressive inquiry process. The research investigated how the scale of scaffolding related to the nature of knowledge produced and the deepening of the question explanation process. In Study II, the metaskills of knowledge-creating inquiry were explored as a challenge for higher education: metaskills refers to the individual, collective, and object-centered aspects of monitoring collaborative inquiry. Study III examined the design of two courses and how the elaboration of shared objects unfolded based on the two pedagogical models. Study IV examined how the arranged concept-development project for external customers promoted practices of distributed, partially virtual, project work, and how the students coped with the knowledge creation challenge. Overall, important indicators of knowledge creating inquiry were the following: new versions of knowledge objects and artifacts demonstrated a deepening inquiry process; and the various productions were co-created through iterations of negotiations, drafting, and versioning by the team members. Students faced challenges of establishing a collective commitment, devising practices to co-author and advance their reports, dealing with confusion, and managing culturally diverse teams. The progressive inquiry model, together with tutoring and technology, facilitated asking questions, generating explanations, and refocusing lines of inquiry. The involvement of the customers was observed to provide a strong motivation for the teams. On the evidence, providing team-specific guidance, exposing students to models of scientific argumentation and expert work practices, and furnishing templates for the intended products appear to be fruitful ways to enhance inquiry processes. At the institutional level, educators do well to explore ways of developing collaboration with external customers, public organizations or companies, and between educational units in order to enhance educational practices of knowledge creating inquiry.

A Model for Creating Strategic Alliances. A Study of Inter-firm Cooperation in the North European ICT Sector

In this study, it is argued that the view on alliance creation presented in the current academic literature is limited, and that using a learning approach helps to explain the dynamic nature of alliance creation. The cases in this study suggest that a wealth of inefficiency elements can be found in alliance creation. These elements can further be divided into categories, which help explain the dynamics of alliance creation. The categories –combined with two models brought forward by the study– suggest that inefficiency can be avoided through learning during the creation process. Some elements are especially central to this argumentation. First, the elements related to the clarity and acceptance of the strategy of the company, the potential lack of an alliance strategy and the elements related to changes in the strategic context. Second, the elements related to the length of the alliance creation processes and the problems a long process entails. It is further suggested that the different inefficiency elements may create a situation, where the alliance creation process is –sequentially and successfully– followed to the end, but where the different inefficiencies create a situation where the results are not aligned with the strategic intent. The proposed solution is to monitor and assess the risk for inefficiency elements during the alliance creation process. The learning, which occurs during the alliance creation process as a result of the monitoring, can then lead to realignments in the process. This study proposes a model to mitigate the risk related to the inefficiencies. The model emphasizes creating an understanding of the other alliance partner’s business, creating a shared vision, using pilot cooperation and building trust within the process. An analytical approach to assessing the benefits of trust is also central in this view. The alliance creation approach suggested by this study, which emphasizes trust and pilot cooperation, is further critically reviewed against contracting as a way to create alliances.