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The purpose of the paper is to present an alternative to the supply chain model of health care delivery that currently informs most thinking about the design of care processes.

The paper draws on arguments from systems theories and public administration, to generate an analysis of the nature of health care processes. It sets out a model of services characterised by treatment and care needs that vary over time, that are inherently uncertain, involve frequent assessment and re‐assessment, and provide patients and service providers with choices about treatment and care. Evidence from an evaluation of intermediate care is used to illustrate the analysis.

The analysis suggests that both the supply chain and a more network‐like model of health care processes can help us to understand health care processes. The two are complementary.

Largely conceptual in nature. The empirical evidence is taken from one study. The ideas are presented to stimulate thinking rather than to prove an argument.

The conceptualisation of care processes as network‐like has implications for the way in which we think about the design and performance of health care systems.

There have been few publications that seek to use both systems and network approaches to understand health care processes.

There has been considerable discussion of the nature and scope of information that purchasers and providers must acquire and use in the post‐review NHS. Somewhat surprisingly, this has not been complemented by discussion of the potential for computer systems to support information management. This is in spite of the publication of the NHS Information Management and Technology Strategy, which seems set to shape the way in which purchasers and providers manage data into the next century, and expenditure on computer systems which will be in the order of hundreds of millions of pounds over the next few years. Discusses some of the key challenges involved in implementing an IT infrastructure across the NHS, and identifies five issues which will substantially determine the success of the strategy.

In a previous paper (LDR 11.2) we described the process of developing and implementing a relationship support service for people with learning disabilities. This was a pilot project funded for one year. In this paper, we update some of the outcomes of the project and focus on some case studies illustrating the challenges and benefits of setting up a service of this nature. Although the success of a relationship support service will undoubtedly be judged by the number of successful introductions made, there are many less tangible benefits and experiences for service users, including some valuable learning experiences in communication and respecting the view of others. Attracting funding for the service continues to be the biggest challenge.

Sharing knowledge of physicians in hospitals is critical and significant in terms of providing better healthcare services. Despite the significance of knowledge sharing in the healthcare setting, very few studies have empirically investigated knowledge sharing drivers among physicians. Particularly, the process of knowledge sharing through the interplay between individual characteristics, knowledge characteristics, and intention in a healthcare setting has received very little empirical support. In this study, the authors draw upon personality traits and knowledge characteristics theories to develop a theoretical model to empirically examine the effect of individual characteristics and knowledge characteristics on physicians' knowledge sharing behavior.

Based on a sample of 215 physicians from 20 hospitals in Jordan, the authors conducted data analysis using the partial least squares statistical technique.

The study revealed that the personality traits (Extraversion, Neuroticism, Agreeableness and Conscientiousness) significantly influence physician intention to share knowledge. Knowledge characteristic (Situatedness) was also found to affect the intention to share knowledge.

Very little is known about the effect of individual characteristics and knowledge characteristics on knowledge sharing behavior among physicians. The study contributes to the related literature by empirically investigating how individual characteristics and knowledge characteristics influence physicians' knowledge sharing behavior. The findings add to the understanding of the role of personality traits and knowledge characteristics in physicians' intention to share knowledge and give important insights for practice and theory.

Undergraduate leadership courses are becoming increasingly important venues to promote civic engagement. Despite their prominence, the nature of civic engagement in leadership courses has not been examined systematically. This study examined 77 introductory undergraduate leadership courses and the role of civic engagement in these courses. Results indicate that civic engagement components are not widely utilized, and when they are part of the curricula, their implementation and design vary. Recommendations for improving undergraduate leadership curricula are offered.