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The purpose of this paper is to explore the nature of industrial relations (IR), and IR conflict in the Irish healthcare sector.

The paper is based on a thematic analysis of Labour Court cases concerning hospitals over a ten‐year period.

The findings of the paper indicate that the nature of IR conflict is changing in healthcare. The paper suggests that alternative manifestations of IR conflict evident in the Irish healthcare sector include: absenteeism as a form of temporary exit; and resistance. The key groups in the sector are discussed in the context of their contrasting disputes. The themes which characterise negotiations are identified as precedent, procedure and partnership.

The research was conducted in the healthcare sector, and thus its transferability is limited. Caution is also required as the research pertains to one national setting, which despite sharing some structural similarities with other health and IR systems, is a unique context. The paper highlights the importance of recognising IR conflict in its various forms. It is further suggested that managing the process of IR conflict may be significant in furthering change agendas.

The value of the paper centres on the investigation of alternative manifestations of IR conflict in the healthcare sector.

This paper reviews the literature on the implementation of quality programs in the Irish hotel industry. Through a review of the literature in service quality, empowerment, and strategy implementation, key issues that affect the achievement of quality are identified. Many quality programs fail from lack of commitment on the part of senior management, middle management, and front‐line employees. Quality management is focused on involvement, communication, and teamwork; but studies show that the management of quality in contemporary hospitality organisations is lacking in these dimensions. The integrative nature of the European Foundation for Quality Management model for business excellence might provide a useful framework for quality implementation in Irish hotels, and it is concluded that further research should be conducted to consider the potential of such frameworks in an Irish context.

The purpose of this paper is to integrate Greenberg's perspective on the connection between injustice and stress in order to clarify the role of organisational justice, burnout and organisational commitment in the understanding of absenteeism.

The study was carried out among 457 workers of a large healthcare establishment in the Canadian public healthcare sector. The model was tested using structural equation methods.

The results reveal that procedural and interactional justices have an indirect effect on exhaustion through distributive injustice. Moreover, it was found that distributive injustice is indirectly linked to short‐term absences through exhaustion. By contrast, the relationship between distributive injustice and long‐term absence can be explained by two mediating variables, namely, exhaustion and psychosomatic complaints.

In spite of the non‐longitudinal nature of this study, the results suggest that the stress model and the medical model best explain the relationship between organisational injustice and absenteeism, while the withdrawal model via organisational commitment is not associated in this study with absenteeism.

Healthcare managers should consider the possibility of better involving employees in the decision‐making process in order to increase their perception of procedural and interactional justice, and indirectly reduce exhaustion and absenteeism through a greater perception of distributive justice.

For the healthcare sector, the need to reduce absenteeism is particularly urgent because of budget restrictions and the shortage of labour around the world.

This is one of the first studies to provide a complete model that analyses the stress process in terms of how organisational justice affects short‐ and long‐term absences, in a bid to understand the specific process and factors that lead to shorter and longer episodes of absence.

While there has been substantial discussion about the potential for clinical leadership in improving quality and safety in healthcare, there has been little robust study. The purpose of this paper is to present the results of a qualitative study with clinicians and clinician managers to gather opinions on the appropriate content of an educational initiative being planned to improve clinical leadership in quality and safety among medical, nursing and allied health professionals working in primary, community and secondary care.

In total, 28 clinicians and clinician managers throughout the state of Victoria, Australia, participated in focus groups to provide advice on the development of a clinical leadership program in quality and safety. An inductive, thematic analysis was completed to enable the themes to emerge from the data.

Overwhelmingly the participants conceptualised clinical leadership in relation to organisational factors. Only four individual factors, comprising emotional intelligence, resilience, self‐awareness and understanding of other clinical disciplines, were identified as being important for clinical leaders. Conversely seven organisational factors, comprising role clarity and accountability, security and sustainability for clinical leaders, selective recruitment into clinical leadership positions, teamwork and decentralised decision making, training, information sharing, and transformational leadership, were seen as essential, but the participants indicated they were rarely addressed. The human resource management literature includes these seven components, with contingent reward, reduced status distinctions and measurement of management practices, as the essential organisational underpinnings of high performance work systems.

The results of this study propose that clinical leadership is an organisational property, suggesting that capability frameworks and educational programs for clinical leadership need a broader organisation focus.

The paper makes clear that clinical leadership was not perceived to be about vesting leadership skills in individuals, but about ensuring health care organisations were equipped to conceptualise and support a model of distributive leadership.

The purpose of this paper is to examine National Health Service (NHS) employee perspectives of how high performance human resource (HR) practices contribute to their performance.

The paper draws on an extensive qualitative study of the NHS. A novel two‐part method was used; the first part used focus group data from managers to identify high‐performance HR practices specific to the NHS. Employees then conducted a card‐sort exercise where they were asked how or whether the practices related to each other and how each practice affected their work.

In total, 11 high performance HR practices relevant to the NHS were identified. Also identified were four reactions to a range of HR practices, which the authors developed into a typology according to anticipated beneficiaries (personal gain, organisation gain, both gain and no‐one gains). Employees were able to form their own patterns (mental models) of performance contribution for a range of HR practices (60 interviewees produced 91 groupings). These groupings indicated three bundles particular to the NHS (professional development, employee contribution and NHS deal).

These mental models indicate employee perceptions about how health services are organised and delivered in the NHS and illustrate the extant mental models of health care workers. As health services are rearranged and financial pressures begin to bite, these mental models will affect employee reactions to changes both positively and negatively.

The novel method allows for identification of mental models that explain how NHS workers understand service delivery. It also delineates the complex and varied relationships between HR practices and individual performance.

Against a backdrop of increased work intensification within maternity hospitals, the purpose of this paper is to examine the role of work engagement in the quality of care delivered to patients and in general health of the midwives delivering care, as reported by midwives and nurses.

Quantitative questionnaires consisting of standardised measures were distributed to midwives in two large maternity hospitals. These questionnaires assessed levels of work engagement, supervisor and colleague support, general health and quality of care.

Structural equation modelling analysis revealed a best‐fit model that demonstrated work engagement to be a significant partial mediator between organisational and supervisor support and quality of care, and as a significant predictor of self‐reported general health. Together, supervisor support, social support and organisational resources, mediated by work engagement, explained 38 per cent of the variance in quality of care at the unit level and 23 per cent of variance in general health among midwives (χ²(67)=113; p<0.01, CFI=0.961, RMSEA=0.06).

The study is limited in that it uses self‐report measures of quality of care and lacks objective indicators of patient outcomes. The cross‐sectional design also does not allow for causal inferences to be drawn from the data.

This study provides evidence for the links between individual levels of work engagement and both health and self‐reports of unit level quality of care. The results support the importance of health services organisations and managers deploying organisational resources to foster employee work engagement. The results also highlight the significant role of the immediate nurse manager and suggest training and development for such roles is a valuable investment.

These results are the first to link work engagement and performance in health care contexts and point to the value of work engagement for both unit performance and for individual employee well‐being in health organisations.

The purpose of this paper is to evaluate the outcomes of a workplace learning intervention on organizational learning and to identify factors influencing the creation of organizational learning in residential care of older people.

The study consisted of a quasi‐experimental intervention for outcome evaluation. In addition, a case study design was used to identify factors influencing organizational learning. Outcomes were evaluated using the validated Dimensions of the Learning Organization Questionnaire at three time points, and interviews were conducted with nursing staff and managers.

The intervention had some effects on the individual level, but no improvements in organizational learning were found. Hindering factors for creating organizational learning were poor initial learning climate, managers' uncertainty about their role, lack of ownership and responsibility among staff and managers, managers' views of personality being a more important component than staff development in older people's care, and a lack of systems for capturing acquired knowledge.

The study offers suggestions for the transfer of individual‐level learning to organizational learning in older people's care.

The purpose of this paper is two-fold. First, it sets the context for the special issue by considering conceptions of patients and their roles in service delivery and improvement. Second, it introduces the contributions to the special issue, and identifies thematic resonance.

The paper utilises a literature synthesis and thematic analysis of the special issue submissions. These emanated from the Ninth International Organisational Behaviour in Healthcare Conference, hosted by Copenhagen Business School on behalf of the Learned Society for Studies in Organizing Healthcare.

The articles evidence a range of perspectives on patients’ roles in healthcare. These range from their being subject to, a mobilising focus for, and active participants in service delivery and improvement. Building upon the potential patient roles identified, this editorial develops five “ideal type” patient positions in healthcare delivery and improvement. These recognise that patients’ engagement with health care services is influenced both by personal characteristics and circumstances, which affect patients’ openness to engaging with health services, as well as the opportunities afforded to patients to engage, by organisations and their employees.

The paper explores the relationally embedded nature of patient involvement in healthcare, inherent in the interdependence between patient and providers’ roles. The typology aims to prompt discussion regarding the conceptualisation patients’ roles in healthcare organisations, and the individual, employee, organisational and contextual factors that may help and hinder their involvement in service delivery and improvement. The authors close by noting four areas meriting further research attention, and potentially useful theoretical lenses.

Sexual crime in the Irish Free State was more than an issue of law, it carried ideological importance in a nation that legitimised itself as a beacon of Celtic Catholicism whilst struggling to maintain credibility in a contested post-colonial landscape. The nation’s police force, An Garda Síochána, had a central role in preserving the nation’s reputation for piety. This chapter explores the views of two of An Garda Síochána’s most senior officers regarding female sexuality and sexual crime; features that were to influence the level of protection and justice Ireland’s women and children were afforded under law.