What does it take to deliver brilliant home-based palliative care? Using positive organisational scholarship and video reflexive ethnography to explore the complexities of palliative care at home

BACKGROUND::Despite the increasing number of people requiring palliative care at home, there is limited evidence on how home-based palliative care is best practised. AIM::The aim of this participatory qualitative study is to determine the characteristics that contribute to brilliant home-based palliative care. DESIGN::This study was inspired by the brilliance project - an initiative to explore how positive organisational scholarship in healthcare can be used to study brilliant health service management from the viewpoint of patients, families, and clinicians. The methodology of positive organisational scholarship in healthcare was combined with video-reflexive ethnography. SETTING/PARTICIPANTS::Home-based specialist palliative care services across two Australian states participated in the study. Clinicians were able to take part in the study at different levels. Pending their preference, this could involve video-recording of palliative care, facilitating and/or participating in reflexive sessions to analyse and critique the recordings, identifying the characteristics that contribute to brilliant home-based palliative care, and/or sharing the findings with others. RESULTS::Brilliance in home-based palliative care is contingent on context and is conceptualised as a variety of actions, people, and processes. Care is more likely to be framed as brilliant when it is epitomised: anticipatory aptitude and action; a weave of commitment; flexible adaptability; and/or team capacity-building. CONCLUSION::This study is important because it verifies the characteristics of brilliant home-based palliative care. Furthermore, these characteristics can be adapted for use within other services.Aileen Collier, Michael Hodgins, Gregory Crawford, Alice Every, Kerrie Womsley, Catherine Jeffs, Pat Houthuysen, Srey Kang, Elizabeth Thomas, Valerie Weller, Cindy Van, Caroline Farrow and Ann Dadic

Environmental Management Accounting: A Case Study Research on Innovative Strategy

The aim of this paper is to conduct an in-depth study on environmental management systems developed in the ceramic tiles sector. This study is conceived as an improvement on a previous survey related to an environmental diagnosis of the ceramic tiles sector where some incongruities between environmental explicit speeches and environmental actions were detected. Such incongruities revealed that firms assumed to be highly environmental committed while from facts this commitment was not so high proved. So, it was necessary to introduce case study research methodology to clarify and to understand the reasons of these inconsistencies. The main objectives of our case study research are two. The first one consists in determining the relationship between firms and environment, analysing environmental positions in companies assumed in their environmental strategy and their environmental behaviour reflected in facts, while the second one attempts to establish the role played by the accounting information system in the environmental management systems of the companies in the sector. Our case study research reveals the elaboration of a larger amount of environmental accounting information for internal use than for external one. This fact is due not only to the inexistence of regulations about environmental disclosures in Spain, at that time, but also to the importance of environmental internal accounting information for management which supports the prevalence of decision-usefulness theory in the implementation of environmental management systems. Copyright Springer Science+Business Media, Inc. 2006accounting information systems, case study research, environmental accounting, environmental awareness, environmental communication, environmental management, innovative strategy,