The Consultant-Client Relationship: A Systems-Theoretical Perspective

The aim of this paper is to explain consulting failure from a systems-theoretical perspective and to provide a new framework for analysing consultant–client relationships. By drawing on Luhmann’s systems theory, clients and consultants are conceptualised as two autopoietic communication systems that operate according to idiosyncratic logics. They are structurally coupled through a third system, the so-called “contact system”, which constitutes a separate discourse. Due to their different logics no transfer of meaning between the three discourses is possible. This contradicts the traditional notion of consulting as a means of providing solutions to the client’s problems: neither is the consultant able to understand the client’s problems nor is it possible to transfer any solutions into the client system. Instead, consulting interventions only cause perturbations in the client system. Consequently, the traditional functions of consulting are called into question. The paper discusses the implications of this analysis with relation to the traditional approach to consulting, and presents a tentative framework for a systemic concept of consulting

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

The Consultant-Client Relationship: A Systems-Theoretical Perspective

The aim of this paper is to explain consulting failure from a systems-theoretical perspective and to provide a new framework for analysing consultant–client relationships. By drawing on Luhmann’s systems theory, clients and consultants are conceptualised as two autopoietic communication systems that operate according to idiosyncratic logics. They are structurally coupled through a third system, the so-called “contact system”, which constitutes a separate discourse. Due to their different logics no transfer of meaning between the three discourses is possible. This contradicts the traditional notion of consulting as a means of providing solutions to the client’s problems: neither is the consultant able to understand the client’s problems nor is it possible to transfer any solutions into the client system. Instead, consulting interventions only cause perturbations in the client system. Consequently, the traditional functions of consulting are called into question. The paper discusses the implications of this analysis with relation to the traditional approach to consulting, and presents a tentative framework for a systemic concept of consulting.Consulting; Consultant-Client Relation; Consulting Failure; Systems Theory

East Midlands Research into Ageing Network (EMRAN) Discussion Paper Series

Academic geriatric medicine in Leicester . There has never been a better time to consider joining us. We have recently appointed a Professor in Geriatric Medicine, alongside Tom Robinson in stroke and Victoria Haunton, who has just joined as a Senior Lecturer in Geriatric Medicine. We have fantastic opportunities to support students in their academic pursuits through a well-established intercalated BSc programme, and routes on through such as ACF posts, and a successful track-record in delivering higher degrees leading to ACL post. We collaborate strongly with Health Sciences, including academic primary care. See below for more detail on our existing academic set-up. Leicester Academy for the Study of Ageing We are also collaborating on a grander scale, through a joint academic venture focusing on ageing, the ‘Leicester Academy for the Study of Ageing’ (LASA), which involves the local health service providers (acute and community), De Montfort University; University of Leicester; Leicester City Council; Leicestershire County Council and Leicester Age UK. Professors Jayne Brown and Simon Conroy jointly Chair LASA and have recently been joined by two further Chairs, Professors Kay de Vries and Bertha Ochieng. Karen Harrison Dening has also recently been appointed an Honorary Chair. LASA aims to improve outcomes for older people and those that care for them that takes a person-centred, whole system perspective. Our research will take a global perspective, but will seek to maximise benefits for the people of Leicester, Leicestershire and Rutland, including building capacity. We are undertaking applied, translational, interdisciplinary research, focused on older people, which will deliver research outcomes that address domains from: physical/medical; functional ability, cognitive/psychological; social or environmental factors. LASA also seeks to support commissioners and providers alike for advice on how to improve care for older people, whether by research, education or service delivery. Examples of recent research projects include: ‘Local History Café’ project specifically undertaking an evaluation on loneliness and social isolation; ‘Better Visits’ project focused on improving visiting for family members of people with dementia resident in care homes; and a study on health issues for older LGBT people in Leicester. Clinical Geriatric Medicine in Leicester We have developed a service which recognises the complexity of managing frail older people at the interface (acute care, emergency care and links with community services). There are presently 17 consultant geriatricians supported by existing multidisciplinary teams, including the largest complement of Advance Nurse Practitioners in the country. Together we deliver Comprehensive Geriatric Assessment to frail older people with urgent care needs in acute and community settings. The acute and emergency frailty units – Leicester Royal Infirmary This development aims at delivering Comprehensive Geriatric Assessment to frail older people in the acute setting. Patients are screened for frailty in the Emergency Department and then undergo a multidisciplinary assessment including a consultant geriatrician, before being triaged to the most appropriate setting. This might include admission to in-patient care in the acute or community setting, intermediate care (residential or home based), or occasionally other specialist care (e.g. cardiorespiratory). Our new emergency department is the county’s first frail friendly build and includes fantastic facilities aimed at promoting early recovering and reducing the risk of hospital associated harms. There is also a daily liaison service jointly run with the psychogeriatricians (FOPAL); we have been examining geriatric outreach to oncology and surgery as part of an NIHR funded study. We are home to the Acute Frailty Network, and those interested in service developments at the national scale would be welcome to get involved. Orthogeriatrics There are now dedicated hip fracture wards and joint care with anaesthetists, orthopaedic surgeons and geriatricians. There are also consultants in metabolic bone disease that run clinics. Community work Community work will consist of reviewing patients in clinic who have been triaged to return to the community setting following an acute assessment described above. Additionally, primary care colleagues refer to outpatients for sub-acute reviews. You will work closely with local GPs with support from consultants to deliver post-acute, subacute, intermediate and rehabilitation care services. Stroke Medicine 24/7 thrombolysis and TIA services. The latter is considered one of the best in the UK and along with the high standard of vascular surgery locally means one of the best performances regarding carotid intervention

Healthcare Management Primer

This primer was written by students enrolled in HMP 721.01, Management of Health Care Organizations, in the Health Management & Policy Program, College of Health and Human Services, University of New Hampshire. This course was taught by Professor Mark Bonica in Fall 2017

European governance challenges in bio-engineering : making perfect life : bio-engineering (in) the 21st century : final report

In the STOA project Making Perfect Life four fields were studied of 21st century bio-engineering: engineering of living artefacts, engineering of the body, engineering of the brain, and engineering of intelligent artefacts. This report describes the main results of the project. It shows how developments in the four fields of bio-engineering are shaped by two megatrends: "biology becoming technology" and "technology becoming biology". These developments result in a broadening of the bio-engineering debate in our society. The report addresses the long term views that are inspiring this debate and discusses a multitude of ethical, legal and social issues that arise from bio-engineering developments in the fields described. Against this background four specific developments are studied in more detail: the rise of human genome sequencing, the market introduction of neurodevices, the capturing by information technology of the psychological and physiological states of users, and the pursuit of standardisation in synthetic biology. These developments are taken in this report as a starting point for an analysis of some of the main European governance challenges in 21st century bio-engineering