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Quality of care in the residential aged sector has changed over the past decade. The purpose of this paper is to examine these changes from the perspectives of staff to identify factors influencing quality of residential aged care, and the role and influence of an aged care accreditation programme.

Focus groups were held with 66 aged care staff from 11 Australian aged care facilities. Data from semi-structured interviews were analysed to capture categories representing participant views.

Participants reported two factors stimulating change: developments in the aged care regulatory and policy framework, and rising consumer expectations. Four corresponding effects on service quality were identified: increasing complexity of resident care, renewed built environments of aged care facilities, growing focus on resident-centred care and the influence of accreditation on resident quality of life. The accreditation programme was viewed as maintaining minimum standards of quality throughout regulatory and social change, yet was considered to lack capacity of itself to explicitly promote or improve resident quality of life.

For an increasingly complex aged care population, regulatory and societal change has led to a shift in service provision from institutional care models to one that is becoming more responsive to consumer expectations. The capacity of long-established and relatively static accreditation standards to better accommodate changing consumer needs comes into question.

This is the first study to examine the relationship between accreditation and residential aged care service quality from the perspectives of staff, and offers a nuanced view of “quality” in this setting.

The study aimed to understand the significance of how employee personhood and the act of speaking up is shaped by factors such as employees' professional status, length of employment within their hospital sites, age, gender and their ongoing exposure to unprofessional behaviours.

Responses to a survey by 4,851 staff across seven sites within a hospital network in Australia were analysed to interrogate whether speaking up by hospital employees is influenced by employees' symbolic capital and situated subjecthood (SS). The authors utilised a Bourdieusian lens to interrogate the relationship between the symbolic capital afforded to employees as a function of their professional, personal and psycho-social resources and their self-reported capacity to speak up.

The findings indicate that employee speaking up behaviours appear to be influenced profoundly by whether they feel empowered or disempowered by ongoing and pre-existing personal and interpersonal factors such as their functional roles, work-based peer and supervisory support and ongoing exposure to discriminatory behaviours.

The findings from this interdisciplinary study provide empirical insights around why culture change interventions within healthcare organisations may be successful in certain contexts for certain staff groups and fail within others.

This paper discusses video ethnography as part of a multimethod study of the introduction of information technology to streamline pathology test order entry in hospitals and its effect on the work of pathology laboratory scientists. The paper opens with an overview of video research in health care settings. After acknowledging the limitations inherent in video data, the paper offers a description of how video footage served to enhance insight in three ways. First, the footage enhanced the researchers’ own appreciation of the significance of particular facets of the data, which led them to reassess information collected through interviewing, focus groups and research field notes. Second, the footage enhanced the pathology laboratory scientists’ appreciation of the problems they experienced when incorporating the new information technology into their daily work practice, by enabling them to articulate these problems to outside researchers. Third, by being watched (by the video camera) and by watching themselves perform their work they were enabled to redesign their practices. The paper suggests that, as a result of interactively performing their work in front of the camera, the scientists came to apprehend their practices ‘from under a different aspect’. The paper concludes that by allowing video ethnography as a research method to remain underdefined and emergent, the modality of engagement and uptake shown by participants in the video research can be considered as a further enriching aspect of video ethnography as a research process.

Health systems are changing at variable rates. Periods of significant change can create new challenges or amplify existing barriers to accreditation program credibility and reliability. The purpose of this paper is to examine, during the transition to a new Australian accreditation scheme and standards, challenges to health service accreditation survey reliability, the salience of the issues and strategies to manage threats to survey reliability.

Across 2013-2014, a two-phase, multi-method study was conducted, involving five research activities (two questionnaire surveys and three group discussions). This paper reports data from the transcribed group discussions involving 100 participants, which was subject to content and thematic analysis. Participants were accreditation survey coordinators employed by the Australian Council on Healthcare Standards.

Six significant issues influencing survey reliability were reported: accreditation program governance and philosophy; accrediting agency management of the accreditation process, including the program’s framework; survey coordinators; survey team dynamics; individual surveyors; and healthcare organizations’ approach to accreditation. A change in governance arrangements promoted reliability with an independent authority and a new set of standards, endorsed by Federal and State governments. However, potential reliability threats were introduced by having multiple accrediting agencies approved to survey against the new national standards. Challenges that existed prior to the reformed system remain.

Capturing lessons and challenges from healthcare reforms is necessary if improvements are to be realized. The study provides practical and theoretical strategies to promote reliability in accreditation programs.

The key aim of this narrative literature review, therefore, is to identify the key conceptual categories that inform the construction of positive person-centred culture within hospitals, and how these frameworks are brought to bear upon organisational culture within healthcare systems in Australia.

This narrative review presents a thematic synthesis of literature identified through a systematic search protocol undertaken across 19 academic databases and Google Scholar as an additional search tool. Thematic qualitative analysis was performed on the research results to determine the common themes within the diverse literature presented within this study.

Culture change interventions in hospitals attempt to address the problem of widespread unprofessional behaviour within healthcare systems. However, diverse definitions and seemingly fragmented approaches to understanding and enacting organisational culture change present a significant hurdle in achieving cohesive and sustainable healthcare reform. This narrative literature review offers a comprehensive conceptual view of the key approaches that inform positive person-centred culture within hospital settings. In total, three primary dimensions, belonging, behaving and being, aligned against organisational goals, individual behaviours and worker as well as organisational identity were identified. Other individual and group interactional dynamics that give rise to negative organisational culture are further analysed to understand the fault lines along which existing culture change interventions are typically operationalised.

This review is not exhaustive and is limited in its methodological scope. The central values and themes identified within the literature are integral to designing humanised healthcare systems. However, owing to the qualitative nature and contextual variability of these factors, these themes do not lend themselves to replicable quantification.

This analysis contributes to foundational research efforts towards transforming healthcare practice to be more aligned with humanised and equitable values within increasingly complex healthcare organisational settings. Designing culture change interventions that align more suitably with the values-driven categories identified in this literature review may increase the effectiveness and sustainability of these interventions and reform efforts at organisational and systemic levels.

This article presents a comprehensive framework to approach healthcare organisational reform through shared and equitable models of operation, management and governance rather than continuing to promote narrowly defined outcomes derived from commodified models of healthcare practice.

Pragmatism in the sense of harmonizing rules and reality for the sake of appropriate problem solving and overall performance is a ubiquitous phenomenon in organizational life. As such it has been generalized as an everyday requirement of making organizations work and a virtue of human decision making under the condition of complexity, strategic dilemmas or “wicked problems.” This chapter addresses both the theoretical and the normative dimensions of pragmatism in organizations, public administration in particular. The main statement is that the necessary theoretical clarification concerns the distinction between pragmatism and what is referred to as a logic of appropriateness while the normative limits of pragmatism refer to the necessity of ranking logics of appropriateness and related values plus the ability to act on the basis of accurate judgment which is primarily, even if not exclusively, a matter of leadership.

It has been argued that systems integration plays a central role when a company supplies complex technical and engineering intensive industrial projects. The purpose of this paper is to highlight the importance of customer integration as part of systems integration in industrial project business.

This paper develops the understanding of systems integration based on an empirical study, in two phases, of a global company providing large and complex solutions including demanding strategic and operational efforts, within the power and marine sectors. The paper analyzes the technical and social dimensions and describes how to systematically manage them.

The social dimension of integration can be achieved by making a direct change in policy towards the six supplier capabilities or integration mechanisms found critical: showing interest in the customer's needs and business requirements; promptly responding to and solving customer needs; having knowledge concerning the latest technical development; having the ability to listen to the customer and to reflect on what has been said; taking responsibility for the delivered installation after handing it over and having logistics competence to guarantee availability of parts.

The benefits of understanding and managing the social dimension, in terms of customer integration, of systems integration properly have a considerable financial impact on the project company's business.

Addressing the social dimension of systems integration is beneficial to a project company's business because the company can decrease its level of risk and uncertainty, and at the same time develop market opportunities by increasing the value of the offerings.

In 2020, the latest James Bond film will hit cinema screens. The film has been produced by Eon Productions, is based on Ian Fleming’s suave, sophisticated super spy and stars Daniel Craig in the title role. With a troubled production shoot well-documented in the media, Daniel Craig often seeming and contradictorily at odds of being both enamoured and loathing with the role, a director leaving through ‘creative differences’ and numerous screenwriters being drafted in as last-minute replacements or add-ons, it will be interesting to see how the latest Bond adventure fares both critically and financially.

At their heart, the Bond adventures – originally in Ian Fleming’s novels and short stories, and then in their film incarnations before spilling out into newer platforms – offer pure escapism for the reader, viewer, listener and gamer. Set against the backdrop of exoticism in a post-war climate, the stories centre around MI6 Agent, James Bond, stopping enemies of the British Empire in their attempts at world domination. They gave the reader a sense of both an attempt by Fleming/Bond to recapture Britain as an important power on the world stage. Whilst Bond may have sipped martinis as he coolly dispatched the latest despotic tyrant, they also offered up ideas about time, place, culture, the social climate of the period and gender.

This book will focus on numerous aspects of the Bond-catalogue, but in particular paying particular attention to how the portrayal of gender, both in the stories and behind the scenes, has helped shape one of the most significant, important and successful British franchises.