Leadership for change management : critical success factors in leading change in medical imaging departments in major teaching hospitals in NSW

Successfully leading change in public medical imaging departments is an enigma that has eluded most public health practitioners particularly in the Australian healthcare context. Research in other contexts has shown that at least 70% of change projects fail to achieve their intended objectives. The area of leadership in medical imaging is an under researched area of healthcare leadership. While various scholars have proposed that strong leadership is required for change management, none of them have fully discussed what this means. This study setting is the medical imaging departments of public hospitals in a New South Wales Local Health District. The primary purpose of this research was to explore the leadership styles and critical success factors that led to successful change management projects or processes. The research utilised a mixed methods approach in a longitudinal study to answer six research questions. There is scant evidence of similar Australian studies utilising the same approach in medical imaging in NSW. In this research, leadership style changes of medical imaging leaders were studied as leaders undertook cycles of successive change management projects over a three-year period. Five data collection rounds were undertaken with the same participant cohort, including two leadership style inventories and three rounds of semi structured interviews. The research found that the dominant leadership style for successful change management in medical imaging in NSW was consultative leadership, contrary to the pre-existing literature on the widely practised leadership styles in healthcare situational, transactional, and transformational styles were the other prominent leadership styles found in this research. This research further found that the use of the key strategies of consultation and engagement; workload management; education and training; communication and planning were critical enablers to project success. Similarly, stakeholder engagement; planning; education and training; resetting expectations and processes and procedures were the key reasons that drive project success in medical imaging. This research also found that the nature of leadership impacted on change management processes in healthcare. For example, a consultative leadership approach positively influenced the change management processes. Following previous change management projects, this research found that medical imaging leaders’ leadership styles were influenced by prior experience. Their leadership style was reshaped by learned experience of past change management. This meant that learning leaders achieved better outcomes in successive change management processes

A Critical Assessment of Quality Education in Community Day Schools in Malawi: A Case Study of Mulanje District

Distance Education Centers (DECs) were intended to provide alternative formal secondary school education to school going age children who had passed their standard eight examinations but had failed to gain access to Conventional Secondary Schools (CSSs) due to limited places. However, despite increasing access, DECs did not offer appropriate instruction and usually produced poor results in national examinations. Among other things, there were acute shortages of teaching and learning materials in these schools. In addition, the majority of teachers in DECs were drawn from primary schools and, therefore, not qualified to teach at a secondary school. In December 1998, the Malawi Government and the Ministry of Education, Science and Technology converted a large number of DECs to CDSSs. This upgrading was meant to unify secondary education system with the aim of improving quality in DECs. In addition, it also meant that the ministry would take full control of the DECs. This would involve, among other things, purchasing and disseminating of relevant teaching and learning materials, the supply of properly trained teachers, and improving and strengthening inspection and supervision services in these schools. This study, therefore, was aimed at assessing the current situation in Community Day Secondary Schools (CDSSs) with regard to quality education. The study used mixed methods design approach. Thus, both quantitative and qualitative data collection methods were used in order to have a comprehensive analysis and understanding of the problem understudy. Qualitative data were collected through interviews, observations, and review of school documents and records. Quantitative data were collected through questionnaire survey and observations. Although the policy on CDSSs was a welcome development in that it was intended to improve the quality of education in these schools, the present study has found that the implementation of the policy has not made much impact due to lack of basic resources. The study has found that 92 percent of teachers in CDSSs are not qualified to teach at a secondary school. In addition, there is shortage of teaching and learning materials. Furthermore, these schools have inadequate infrastructure and classroom facilities. In some schools pupils are still learning in temporary shelters and borrowed premises. The study also foun dthat there is evidence of community participation through school management committees (SMCs), but this has little impact as seen from the unfinished development projects. The above scenario, therefore, cannot facilitate quality teaching and learning processes in CDSSs that lead to attainment of much need quality education

Qualitative Systematic Review of Barber-Administered Health Education, Promotion, Screening and Outreach Programs in African-American Communities

The barbershop has been portrayed as a culturally appropriate venue for reaching Black men with health information and preventive health screenings to overcome institutional and socio-cultural barriers. The purpose of this review is to synthesize the peer-reviewed literature on barbershop-based health programs to provide lessons learned for researchers and practitioners. A literature search was conducted to identify articles for the review. Inclusion criteria specified that studies had to be based in the United States and reported about research where barbers were either being assessed for the feasibility of their participation or recruited to administer health education/screening outreach or research activities. The literature search produced 901 unique bibliographic records from peer-reviewed publications. After eliminating articles not meeting the inclusion criteria, 35 articles remained for full-text review. The final article sample consisted of 16 articles for complete abstraction to assess characteristics of studies, role and training of barbers, outcomes targeted, effectiveness, and key findings. All barbershop-based studies reviewed targeted Black men in urban settings. Common study designs were cross-sectional studies, feasibility studies, needs assessments, and one-shot case studies. Barber administered interventions addressed primarily prostate cancer and hypertension, and barbers provided health education, screening, and referrals to health care. Nonintervention studies focused mostly on surveying or interviewing barbers for assessing the feasibility of future interventions. Barbershops are a culturally appropriate venue for disseminating health education materials in both print and media formats. Barbershops are also acceptable venues for training barbers to conduct education and screening. In studies where barbers received training, their knowledge of various health conditions increased significantly and knowledge gains were sustained over time. They were also able to increase knowledge and promote positive health behaviors among their customers, but these outcomes were variable and not consistently documented.https://link.springer.com/article/10.1007/s10900-013-9744-

The decline of the mining industry and the response of the mining unions

Abstract The report examines the response of three trade unions, the National Union of Mineworkers (NUM), the United Associations of South Africa (UASA) and Solidarity – to the economic, political and social changes over the past decade in the mining industry. In particular the report is concerned with union responses to the decline in the gold mining industry. The report concludes that the NUM was conscious about the decline and developed coherent strategies for dealing with it, whereas both Solidarity and UASA did not pay attention to the decline. Instead their interventions were directed at countering the impact of legislative changes that accorded blacks the right to organise and join unions, and the competition that went with this opening. The NUM remains a social movement union which balances community and workplace struggles. It is the strongest and most influential union in the industry. It is the only union in the industry that is politically active and has a strategy that deploys and supports members as political activists. UASA is a business union relying on benefits and services to retain members. It is politically neutral with a minimum interest in the developments in communities around them. Solidarity, on the other hand, is a service union which is a hybrid of business and social movement unionism. It is investing resources in improving its service delivery and mobilises its members for action with more visible militancy now than since the 1920s

The Construction of the A650 Bingley Relief Road Adjacent to an Unstable Tied Sheet Pile Retaining Structure

The proposed A650 Bingley Relief Road in West Yorkshire, UK, required the construction of a new dual carriageway to relieve traffic congestion in the town of Bingley. Part of the scheme involved constructing the road adjacent to an existing tied sheet pile wall, the “Canal Tied Wall” that had a history of movement. In this area the road passes over a kettlehole with peat and soft silts between 10 m and 14 m deep. The Canal Tied Wall forms the boundary between the realigned canal and the proposed new trunk road. It consists of two sets of steel sheet piles approximately 3.5 m apart with stainless steel tie-bars and mass concrete shear walls connecting them at the top. In May 1994 following the completion of the Canal Tied Wall construction and during excavation of material on the roadside of the wall, a 45 m length of wall moved horizontally in excess of 200 mm (into excavation) with associated maximum vertical movement at the top of the wall of 230 mm. The wall was monitored from 1994 until 2001 and subsequently through the construction of the new road. The Highways Agency\u27s requirement for the Canal Tied Wall was to carry out stabilisation works ....... together with any remedial works required to the structure to overcome current and future settlement problems . It was originally envisaged by the Highways Agency that a piled solution would be required. The basis of the Tender design was to reduce the load on the wall and hence stabilise the rate of movement towards the canal. The proposed design consisted of excavating the existing fill (originally placed at the time of construction of the wall) to a level about 0.8 m above its base, and constructing a reinforced earth wall with a gap between it and the sheet pile wall. The geotechnical solution that was eventually adopted was to reduce the load exerted on the wall by the ground behind it, and to surcharge the soft deposits to reduce long term settlements. The system adopted used a mass wall constructed of precast lightweight concrete blocks built behind the tied wall. This solution realised savings to the anticipated cost of the scheme whilst meeting the performance requirements of the specification. Numerical analysis was used to assess the anticipated performance of the ground, the existing structure, and the behaviour of the adjacent railway line during the construction operation and into the future. The lateral movements realised in practice were significantly smaller than those predicted using even relatively sophisticated modelling even though the modelling had been calibrated using data gathered during the advance works. This was as a result of changes to the construction sequence made on site. Whilst these were relatively minor the effect on the movements appears to have been significant. Interpretation of consolidation tests proved to be difficult even with the benefit of quite extensive settlement monitoring during and after the advance works. Several possible combinations of parameters gave an equally good fit to the data. The Observational Method was therefore adopted to provide a framework for adjusting the design during construction, subject to the observed behaviour of the ground. The flexibility this provided enabled necessary changes to the surcharge design to be made during construction, while maintaining control over the stability of the wall

Communicating health decisions: an analysis of messages posted to online prostate cancer forums

Background  Experiential websites such as message forums and blogs allow Prostate Cancer (PCa) patients to communicate their health decisions to peers. The issues surrounding this form of indirect involvement in public health are little understood. Objective  This paper explores the types of decision-making processes that people are exposed to on PCa online message boards. The kinds of treatment choices patients are making and the reports of their decision-making processes to peers through an online environment are examined in the context of the Heuristic Systematic Model. Method  Messages about treatment decision making were collected from four PCa websites. In total, 137 messages were selected from blogs and online forums and their decision-making processes coded. Results  Men looking online for information about treatment options for PCa are exposed to a range of decision-making processes. Just under half (49.6%) of the messages reported non-systematic decision processes, with deferral to the doctor and proof of cancer removal being the most common. For systematic processing (36.5%), messages most commonly considered treatment outcomes and side-effects. Processes did not vary between the blogs and online forums. Discussion and conclusion  Compared to previous studies far fewer messages reported non-systematic decision processes and only a small number of messages reflected lay beliefs or misbeliefs about PCa treatment. Implications for men and their clinicians of seeking health information online are discussed

Advantages, Disadvantages, and Lessons Learned in Conducting Telephone Focus Groups to Discuss Biospecimen Research Concerns of Individuals Genetically at Risk for Cancer

Advances in telecommunication technology allow biomedical researchers to explore new, inexpensive opportunities for conducting focus group research. This article reports our experiences using such technology to engage individuals genetically at risk for cancer about biospecimen research. Telephone-based focus groups were conducted with a total of 40 individuals, and participants were asked about their experiences and perceived benefits and limitations of participating in a telephone focus group about biospecimen research. The lessons learned can effectively be applied to other areas of health research. In particular, this method may be most useful to engage individuals who are less apt to speak in public, and/or when there are concerns over privacy if face-to-face discussions methods are used

Use of Semi-Structured Interviews to Explore Competing Demands in a Prostate Cancer Prevention Intervention Clinical Trial (PCPICT)

In this paper we report on findings from the first known study using qualitative methods to explore factors influencing physicians’ participation in an ongoing federally-funded prostate cancer chemoprevention clinical trial. We sought to identify ways to improve collaboration between researchers and physicians and enhance the success of future projects and employed purposive sampling to recruit physician/investigators who were involved or invited to participate in the trial. Using the data from open-ended semi-structured interviews, we examined patterns in their languaging and created themes. We found that individual and structural factors served as barriers and facilitators to participation. Willingness and desire to participate in the trial (individual factors) were not always enough to result in actual participation due to practice environment (structural) constraints. Our research provides a better understanding of the complex intersection of factors in this setting and through our findings we extend the theory of competing demands into the arena of prostate cancer prevention clinical trials, moving the science towards solutions to current challenges in recruitment to this type of trial

Ethics of Clear Health Communication: Applying the CLEAN Look Approach to Communicate Biobanking Information for Cancer Research

Cancer innovations, such as biobanking technologies, are continuously evolving to improve our understanding and knowledge about cancer prevention and treatment modalities. However, the public receives little communication about biobanking and is often unaware about this innovation until asked to donate biospecimens. It is the researchers’ ethical duty to provide clear communications about biobanking and biospecimen research. Such information allows the public to understand biobanking processes and facilitates informed decision making about biospecimen donation. The aims of this paper are 1) to examine the importance of clear communication as an ethical imperative when conveying information about cancer innovations and 2) to illustrate the use of an organizing framework, the CLEAN (Culture, Literacy, Education, Assessment, and Networking) Look approach for creating educational priming materials about the topic of biobanking

Adaptation of a Community Health Advisor Intervention to Increase Colorectal Cancer Screening Among African Americans in the Southern United States

Community health advisor (CHA) interventions increase colorectal cancer (CRC) screening rates. Focus groups and learner verification were used to adapt National Cancer Institute CRC screening educational materials for delivery by a CHA to African American community health center patients. Such academic-community collaboration improves adoption of evidence-based interventions. This short article describes the adaptation of an evidence-based cancer education intervention for implementation in an African American community