Components of teamwork that influence the successful implementation of a total quality management program in a Saudi Arabian healthcare setting

Many health organisations in Saudi Arabia have adopted total quality management (TQM) programs as a strategy to enhance quality and efficiency. Among the many factors that influence the successful implementation of TQM programs are teamwork and its components. This study aimed to investigate the components of teamwork that influence the successful implementation of the TQM program in King Fahad Medical City (KFMC). The study also aimed to explore interactions between teamwork elements and the TQM program that influence employees' engagement in implementation of the program - elements such as task reflexivity, participative trust, team learning behaviour, team efficacy and stability, leadership and decision-making, effective communication and management support. The final aim was to explore KFMC employees' experiences, challenges and opportunities that might influence successful implementation of teamwork within the TQM program

Patients’ and family members’ views on how clinicians enact and how they should enact incident disclosure: the “100 patient stories” qualitative study

Objectives To investigate patients’ and family members’ perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure

MPPUPM Pantau Harga Makanan

Majlis Perwakilan Pelajar Universiti Putra Malaysia (MPPUPM) giat memantau harga makanan yang dikatakan meningkat dengan ketara sehingga menimbulkan kegelisahan mahansiswa

The insurance implications of open disclosure in healthcare

In contrast to as little as a decade ago, open disclosure is now regularly the subject of government policies, professional conferences and academic publications Open disclosure has been advocated since the late 1980s for a variety of reasons, including organisational and legal risk management considerations and, more recently, the need to show respect for the feelings and dignity of victims of adverse events. This article examines the insurance and other legal implications of open disclosure in Australia

Council cooperation in New South Wales: Why have some councils not joined joint organisations?

In common with many other municipal systems in Australia and abroad, New South Wales (NSW) local government confronts formidable challenges, not least maintaining a viable level of financial sustainability (Grant and Drew, 2017; Kuhlmann and Bouckaert, 2016). This has led the NSW Government to embark on a sweeping local government reform program, which centred on structural change through a controversial forced amalgamation process over the period 2011–2017. A significant motivation for the compulsory council consolidation program was the quest for ‘adequate scale and capacity’ through the establishment of larger merged municipal entities (Independent Pricing and Regulatory Tribunal IPART, 2015b), notwithstanding the weight of empirical evidence that forced amalgamation has generally failed to reduce operational costs (see, for example, Dollery et al., 2012; Lago-Penas and Martinez-Vazquez, 2013; Allers and Geertsema, 2016). In addition, recent empirical studies have investigated the system-wide effects of municipal mergers, with comparisons of the performance merged and unmerged cohorts of local authorities through time. In this vein, Bell et al. (2016) demonstrated no statistical differences in performance in NSW local government between councils amalgamated in 2004 and their unmerged counterparts after ten years. When the municipal merger program was abruptly abandoned on 27 July 2017, the NSW Government continued its pursuit of scale in local government by establishing a voluntary network of Joint Organisations of Council (JOs) throughout NSW, except for the Greater Sydney region, with councils invited to join a JO. JOs became operational on 1 July 2018 supported by a solid legislative framework and NSW Government seed grants. Additional funding has subsequently been provided to JOs to stimulate regional collaboration between local authorities. With its explicit emphasis on fostering regional cooperation by constellations of councils, including the provision of shared services, the JO program rests on sound evidential foundations, which point inter alia to potentially significant scale economies in service provision (see, for instance, Tomkinson, 2007; Dollery et al., 2012; Henderson, 2015). Council collaboration is ubiquitous across the globe, including Australia (Dollery et al., 2012), Europe (Henderson, 2015), Japan (Jacobs, 2004) and North America (Holzer and Fry, 2011). Moreover, it has a long history in NSW local government (Audit Office of NSW, 2018). Inter-municipal cooperation assumes numerous different institutional forms, including delegation, resource-sharing and shared services (Dollery and Akimov, 2009). However, in contrast to both municipal mergers (Lago-Penas and Martinez-Vazquez, 2013; Allers and Geertsema, 2016) and outsourcing through contracting out, privatisation and other market-orientated methods (Warner and Hefetz, 2008; Bel et al., 2010), significantly less empirical work has examined the impact of council collaboration on local government performance. Furthermore, comparatively little is known about the performance characteristics of alternative models of intermunicipal cooperation (Holzer and Fry, 2011). In addition, while some effort has been directed at the determinants of participation by local authorities in council collaboration programs in the United States and other countries (see, for example, Hawkins, 2009), almost no empirical work has been undertaken in the Australian local government milieu (Dollery et al., 2012), with a single recent exception (Audit Office of NSW, 2018). There is thus an urgent need for empirical research into the rationale for participation in intermunicipal collaboration in Australia, especially the current JO program in NSW local government. The present paper seeks to address this gap in the Australian literature by examining empirically the reasons why some NSW councils have decided not to participate in JOs. While most of the local councils which were at first hesitant in joining a JO have subsequently overcome their initial doubts and assumed membership, it is nonetheless important to consider why this hesitation existed and why a few councils still remain outside the JO network, despite the generous funding offered by the NSW Government to JOs. The paper is divided into six main sections. Section 2 provides a synoptic account of the literature on council collaboration in the local government. Section 3 provides a brief summary of the NSW Fit for the Future policy process which has culminated in the establishment of a network of JOs across NSW. Section 4 considers the nature of the new JO network as well as prior experience with council collaboration in NSW local government leading up to the formation of JOs, especially with regard to participation decision-making by individual councils. Section 5 outlines the empirical research strategy employed in the paper, including a description of councils which have not joined a JO. A discussion of the results is provided in Section 5. The paper ends with some brief comments on its policy implications in Section 6

Do Patients Want and Expect Compensation following Harm?

Australian Lawyers Alliance Having now interviewed close to 150 patients and relatives involved in hospital-caused harm, we know that the principal gestures that patients expect are: an apology; timely and honest communication and information flow; acknowledgement of the error and for responsibility to be taken; reassurance that the incident will not happen again and that the service seeks to improve as a result of the incident; and emotional support. One other important expectation is financial support. Where reparative gestures are predominantly communicative in nature, financial support has, besides a communicative dimension (as gesture), also a material dimension (as resources, for example, money). Deciding what is appropriate financial compensation is challenging for a number of reasons. Australian health services, by and large, tend to shy away from offering compensation outside of a finding of legal liability. This may be because the service's insurer refuses to repay the service for monies paid in this way. It may also be because the service lacks the necessary bureaucratic-administrative mechanisms for making money available to patients who are harmed , or for determining amounts to pay for non-hospital related costs. Or it may be that the service's lawyer advises against awarding payments lest they be converted into attributions of legal liability under our fault-based system of compensation. In some states - for example, Queensland - public system monies have now been made available by the health bureaucracy to allow services to make limited 'ex gratia' payments. Findings from our Open Disclosure studies indicate that both clinicians and patients want a better method of providing compensation, including 'ex gratia' payments, for expenses incurred as a result of adverse incidents