Knowledge management and communities of practice in the private sector: lessons for modernising the National Health Service in England and Wales

The National Health Service (NHS) in England and Wales has embarked upon a radical and farreaching programme of change and reform. However, to date the results of organizational quality and service improvement initiatives in the public sector have been mixed, if not to say disappointing, with anticipated gains often failing to materialize or to be sustained in the longer term. This paper draws on the authors' recent extensive research into one of the principal methodologies for bringing about the sought after step change in the quality of health care in England and Wales. It explores how private sector knowledge management (KM) concepts and practices might contribute to the further development of public sector quality improvement initiatives in general and to the reform of the NHS in particular. Our analysis suggests there have been a number of problems and challenges in practice, not least a considerable naïvety around the issue of knowledge transfer and 'knowledge into practice' within health care organizations. We suggest four broad areas for possible development which also have important implications for other public sector organizations

Interaction of external, introjected, and identified regulation with intrinsic motivation in exercise: Relationships with exercise enjoyment

The present study examined the way in which the exercise-related motives of external regulation, introjected regulation, and identified regulation interacted with intrinsic motivation to relate to exercise enjoyment. The study was conducted to test the "additive relationship hypothesis" emanating from Vallerand and Fortier's (1998) theoretical position regarding the interplay between extrinsic and intrinsic motivation in exercise. Exercise participants (N = 516) responded to a self-report questionnaire assessing their reasons for exercise participation before the commencement of a single exercise class. One week later, and immediately prior to the corresponding class, participants reported on their levels of exercise enjoyment. Interactional analyses using linear regression showed a significant interaction between identified regulation and intrinsic motivation. Specifically, the coexistence of high levels of identified regulation with high levels of intrinsic motivation corresponded with higher scores on exercise enjoyment. External regulation and introjected regulation did not interact with intrinsic motivation, thus supporting the research hypotheses. Collectively, the present findings supported the validity of Vallerand and Fortier's theoretical propositions in the exercise domain and specifically the additive relationship hypothesis between identified regulation and intrinsic motivation with respect to exercise enjoyment

The face inhibition effect: Social contrast or motor competition?

Merely viewing the faces of famous athletes affects the observers' motor system, suggesting that actionbased information is a core feature of person representations, even when no specific action is visible (Bach & Tipper, 2006). Unexpectedly, these person-based motor priming effects were inhibitory. Foot responses were slower when identifying footballers, and hand responses for tennis players. Here, we demonstrate that these inhibitory effects are only evoked when action is implicitly associated with the athletes; when the athletes are seen performing their skilled actions the effect reverses towards facilitation. The contrast between inhibition evoked by implicit action priming and facilitation evoked by the explicit presentation of an action supports the notion of inhibitory control in the motor system. We hypothesise that when no specific action is perceived, a range of actions are activated triggering lateral inhibition, whereas when a specific action is viewed, there is no competition and excitation facilitates similar responses. © 2011 Psychology Press

The next phase of healthcare improvement: what can we learn from social movements?

To date, improvement in health care has relied mainly on a "top down" programme by programme approach to service change and development. This has spawned a multitude of different and often impressive improvement schemes and activities. We question whether what has been happening will be sufficient to achieve the desired scale of change within the time scales set. Is it a case of "more of the same" or are there new and different approaches that might now be usefully implemented? Evidence from the social sciences suggests that other perspectives may help to recast large scale organisational change efforts in a new light and offer a different, though complementary, approach to improvement thinking and practice. Particularly prominent is the recognition that such large scale change in organisations relies not only on the "external drivers" but on the ability to connect with and mobilise people?s own "internal" energies and drivers for change, thus creating a "bottom up" locally led "grass roots" movement for improvement and change

Hierarchical confirmatory factor analysis of the flow state scale in exercise

In this study, we examined the factor structure and internal consistency of the Flow State Scale using responses of exercise participants.This self-report questionnaire consists of nine subscales designed to assess flow in sport and physical activity. It was administered to 1231 aerobic dance exercise participants. Confirmatory factor analyses were used to test three competing measurement models of the flow construct: a single-factor model, a nine-factor model and a hierarchical model positing a higher-order flow factor to explain the intercorrelations between the nine first-order factors. The single-factor model showed a poor fit to the data. The nine-factor model and the hierarchical model did not show an adequate fit to the data. All subscales of the Flow State Scale displayed acceptable internal consistency (alpha > 0.70), with the exception of transformation of time (alpha = 0.65). Collectively, the present results do not provide support for the tenability of the single-factor, nine-factor or hierarchical measurement models in an exercise setting

Building information modelling (BIM) implementation and remote construction projects: issues, challenges, and critiques.

The construction industry has been facing a paradigm shift to (i) increase productivity, efficiency, infrastructure value; quality and sustainability (ii) reduce lifecycle costs, lead times and duplications via effective collaboration and communication of stakeholders in construction projects. This paradigm shift is becoming more critical with remote construction projects, which reveals unique and even more complicated challenging problems in relation to communication and management due to the remoteness of the construction sites. On the other hand, Building Informational Modelling (BIM) is offered by some as the panacea to addressing the interdisciplinary inefficiencies in construction projects. Although in many cases the adoption of BIM has numerous potential benefits, it also raises interesting challenges with regards to how BIM integrates the business processes of individual practices. This paper aims to show how BIM adoption for an architectural company helps to mitigate the management and communication problems in remote construction project. The paper adopts a case study methodology, which is a UK Knowledge Transfer Partnership (KTP) project of BIM adoption between the University of Salford, UK and John McCall Architects (JMA), in which the BIM use between the architectural company and the main contractor for a remote construction project is elaborated and justified. Research showed that the key management and communication problems such as poor quality of construction works, unavailability of materials, and ineffective planning and scheduling can largely be mitigated by adopting BIM at the design stage

Dynamics of Three Agent Games

We study the dynamics and resulting score distribution of three-agent games where after each competition a single agent wins and scores a point. A single competition is described by a triplet of numbers $p$, $t$ and $q$ denoting the probabilities that the team with the highest, middle or lowest accumulated score wins. We study the full family of solutions in the regime, where the number of agents and competitions is large, which can be regarded as a hydrodynamic limit. Depending on the parameter values $(p,q,t)$, we find six qualitatively different asymptotic score distributions and we also provide a qualitative understanding of these results. We checked our analytical results against numerical simulations of the microscopic model and find these to be in excellent agreement. The three agent game can be regarded as a social model where a player can be favored or disfavored for advancement, based on his/her accumulated score. It is also possible to decide the outcome of a three agent game through a mini tournament of two-a gent competitions among the participating players and it turns out that the resulting possible score distributions are a subset of those obtained for the general three agent-games. We discuss how one can add a steady and democratic decline rate to the model and present a simple geometric construction that allows one to write down the corresponding score evolution equations for $n$-agent games