Decision-making in an emergency department: A nursing accountability model

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Introduction Nurses that work in an emergency department regularly care for acute patients in a fast-paced environment, being at risk of suffering high levels of burnout. This situation makes them especially vulnerable to be accountable for decisions they did not have time to consider or have been pressured into. Research objective The objective of this study was to find which factors influence ethical, legal and professional accountability in nursing practice in an emergency department. Research design Data were analysed, codified and triangulated using qualitative ethnographic content analysis. Participants and research context This research is set in a large emergency department in the Midlands area of England. Data was collected from 186 nurses using participant observation, 34 semi-structured interviews with nurses and ethical analysis of 54 applicable clinical policies Ethical considerations Ethical approval was granted by two research ethics committees and the National Health Service Health Research Authority. Results The main result was the clinical nursing accountability cycle model, which showed accountability as a subjective concept that flows between the nurse and the healthcare institution. Moreover, the relations amongst the clinical nursing accountability factors are also analysed to understand which factors affect decision-making. Discussion The retrospective understanding of the factors that regulate nursing accountability is essential to promote that both the nurse and the healthcare institution take responsibility not only for the direct consequences of their actions but also for the indirect consequences derived from previous decisions. Conclusion The decision-making process and the accountability linked to it are affected by several factors that represent the holistic nature of both entities, which are organised and interconnected in a complex grid. This pragmatic interpretation of nursing accountability allows the nurse to comprehend how their decisions are affected, while the healthcare institution could act proactively to avoid any problems before they happen

The Sum of Its Parts: The Lawyer-Client Relationship in Initial Public Offerings

This Article examines the impact of the quality of a lawyer\u27s working relationship with his or her client on one of the most important types of capital markets deal in a company\u27s existence: its initial public offering (IPO). Drawing on data from interviews with equity capital markets lawyers at major law firms, and analyzing data from IPOs in the United States registered with the Securities and Exchange Commission between June 1996 and December 2010, this study finds a strong association between several measures of IPO performance and the familiarity between the lead underwriter and its counsel, as measured by the number of times a particular law firm serves as counsel to a managing underwriter within a relatively short time period. Performance is gauged according to a stock\u27s opening day returns, price performance over thirty, sixty, and ninety trading days, correct price revision, litigation rates, and the speed at which deals are completed. I also analyze the relationships between the lawyers for the lead underwriter and the lawyers for the issuer. The analysis shows some benefits from familiarity, albeit generally smaller than those associated with the underwriter-lawyer relationship. In all cases, the positive effects of repeated interaction diminish the further back in time the previous collaborations occurred. To rule out selection and reverse causality, I perform a number of tests using smaller subsets of the data to remove observations that are plausibly selection driven. I also show that the relationships between familiarity and deal quality occur independently of the level of the lawyers\u27 experience. These findings support the conclusion that lawyers\u27 relational skill can positively influence deal outcomes, independent even of substance and process knowledge. I hypothesize that the core advantage of repeated interaction is the formation of more effective lawyer-client team dynamics

Employee Screening : Theory and Evidence

Arguably the fundamental problem faced by employers is how to elicit effort from employees. Most models suggest that employers meet this challenge by monitoring employees carefully to prevent shirking. But there is another option that relies on heterogeneity across employees, and that is to screen job candidates to find workers with a stronger work ethic who require less monitoring. This should be especially useful in work systems where monitoring by supervisors is more difficult, such as teamwork systems. We analyze the relationship between screening and monitoring in the context of a principal-agent model and test the theoretical results using a national sample of U.S. establishments, which includes information on employee selection. We find that employers screen applicants more intensively for work ethic where they make greater use of systems such as teamwork where monitoring is more difficult. This screening is also associated with higher wages, as predicted by the theory : The synergies between reduced monitoring costs and high performance work systems enable the firm to pay higher wages to attract and retain such workers. Screening for other attributes, such as work experiences and academic performance, does not produce these results.Employee Screening, Monitoring, Work Ethic, High Performance Work Practices, Principal-Agent Model

Employee Screening: Theory and Evidence

Arguably the fundamental problem faced by employers is how to elicit effort from employees. Most models suggest that employers meet this challenge by monitoring employees carefully to prevent shirking. But there is another option that relies on heterogeneity across employees, and that is to screen job candidates to find workers with a stronger work ethic who require less monitoring. This should be especially useful in work systems where monitoring by supervisors is more difficult, such as teamwork systems. We analyze the relationship between screening and monitoring in the context of a principal-agent model and test the theoretical results using a national sample of U.S. establishments, which includes information on employee selection. We find that employers screen applicants more intensively for work ethic where they make greater use of systems such as teamwork where monitoring is more difficult. This screening is also associated with higher wages, as predicted by the theory: The synergies between reduced monitoring costs and high performance work systems enable the firm to pay higher wages to attract and retain such workers. Screening for other attributes, such as work experiences and academic performance, does not produce these results.Employee Screening, Monitoring, Work Ethic, High Performance Work Practices, Principal-Agent Model.

Leadership in a Military Criminal Investigative Organization: Perceptions of Authentic Leadership Among Special Agents

Genuine, effective leadership in law enforcement establishes the climate of the organization. Scholars have comprehensively explored the influence of different leadership styles in various criminal justice organizations from multiple facets; however, minimal information exists about how authentic leadership is perceived by special agents assigned to a military criminal investigative organization. This qualitative phenomenological study will provide an increased understanding of authentic leadership from the perspective of special agents assigned to the Criminal Investigation Division (CID), the U.S. Army\u27s primary criminal investigative organization, and the Department of Defense\u27s (DoD) premier investigative organization. The researcher will use a qualitative research design to explore the perceptions and lived experiences of special agents to understand authentic leadership’s role in a military criminal investigative organization. This research methodology analyzes the perception of military special agents, with emphasis on their experience while assigned as a case agent, regarding authentic leadership and how it influences the investigative process. This study contributes to the field of criminal justice leadership body of knowledge by providing an understanding of how special agents perceive authentic leadership at higher echelons in the organization and how this perception affects the quality of conducting criminal investigations. Extensive empirical research focuses on authentic leadership from a leader\u27s perspective in many criminal justice organizations. However, limited research focuses on authentic leadership within a military criminal investigative organization. This study addresses special agents who actively work cases that are not in a leadership position and their perceptions and insight concerning authentic leadership identified in recent leadership research and literature

HRD - the shapes and things to come

There has been limited critical review and development of Human Resource Development (HRD) theory in the past two decades. It is change, and especially the rate at which change occurs, that largely influences the HRD hybrid that any organisation adopts. This paper will systematically consider the professional discussions in a number of countries to trace HRD through four key phases: the 'duet', the 'trio', the 'quartet' and concluding with the 'orchestra'. In the past, Human Resource Development (HRD) was often polarized as focusing primarily on either performance or learning - a 'duet'. The relationship between HRD and change was then developed once the integral nature of work to both performance and learning was recognised - a 'trio'. A significant addition to the exploration of learning at work then came about when authors tackled the issue of quality - a 'quartet' of learning, performance, work and quality. However, the future of HRD now lies squarely in the need for the profession to embrace fully the inextricably interrelated paradigms of movement (where people have developed from); change (and especially the rate of change); dynamism (provided from leadership); harmony and unity (resulting from cohesive partnerships) - the 'orchestra'

Human resources and management in projects

When valuing an investment project, all the factors that affect its viability should be analysed. As such, not only financial aspects are important, but also non-financial aspects. In effect, in project appraisal we should analyse the human resources and the role of the project manager and his personal characteristics and attributes. We support the idea that human resources and project manager areas have to be analysed when determining a project’s viability.info:eu-repo/semantics/publishedVersio

Design Considerations for Real-Time Collaboration with Creative Artificial Intelligence

Machines incorporating techniques from artificial intelligence and machine learning can work with human users on a moment-to-moment, real-time basis to generate creative outcomes, performances and artefacts. We define such systems collaborative, creative AI systems, and in this article, consider the theoretical and practical considerations needed for their design so as to support improvisation, performance and co-creation through real-time, sustained, moment-to-moment interaction. We begin by providing an overview of creative AI systems, examining strengths, opportunities and criticisms in order to draw out the key considerations when designing AI for human creative collaboration. We argue that the artistic goals and creative process should be first and foremost in any design. We then draw from a range of research that looks at human collaboration and teamwork, to examine features that support trust, cooperation, shared awareness and a shared information space. We highlight the importance of understanding the scope and perception of two-way communication between human and machine agents in order to support reflection on conflict, error, evaluation and flow. We conclude with a summary of the range of design challenges for building such systems in provoking, challenging and enhancing human creative activity through their creative agency

Working with ELSA – How an Emotional Support Agent Builds Trust in Virtual Teams

Virtual collaboration is an increasing part of daily life for many employees. Despite many advantages, however, virtual collaborative work can lead to a lack of trust among virtual team members, e.g., due to spatial separation and little social interaction. Previous findings indicated that emotional support provided by a conversational agent (CA) can impact human-agent trust and the perceived social presence. We developed an emotional support agent called ELSA and conducted a between-subject online experiment to examine how CAs can provide emotional support in order to increase the level of trust among colleagues in virtual teams. We found that human-agent trust positively influences the level of calculus-based trust among team members and increases team cohesion, whereas perceived anthropomorphism and social presence towards a CA seems to be less important for trust among team members