When small bandages fail:the field-level repair of severe and protracted institutional breaches

We present the first elaboration of the field-level institutional repair work enacted by government inquiry reports into severe and protracted breaches of the institution of medicine in the English National Health Service. Our examination of the interplay between the rhetorical argumentation strategies communicated, the modes and types of institutional work conveyed, and the institutional pillars targeted for repair enhances understanding of field-level institutional repair work in three ways. First, our analysis of forensic and deliberative rhetoric reveals how these communicate aligned ethos, logos, and pathos appeals in a tactical buttressing manner that simultaneously harnesses maintenance, adapted creative and disruptive modes of institutional work. Ensuing repair work is primarily directed to the regulatory and normative pillars of the breached institution, though their consequential effects seek to realign the cultural-cognitive pillar. Second, adapted creative and disruptive modes interact to generate elaborative and/or eliminative institutional work. This fosters a dynamic form of institutional maintenance, wherein the breached institution evolves in order to endure within the changing terrain of the field. Finally, our elaboration of field-level institutional repair work offers insight into the relative plasticity of the institution of medicine, and contributes to understanding of the dark side of institutional work

Building back better: Purpose-driven business schools

Despite their many achievements, business schools are criticised for prioritising the achievement of outcomes, such as revenue and rankings, over the pursuit of their purpose. Acknowledging the inherent variation among the world's many business schools, most were created with some idea of enhancing the public good by nurturing the management profession and conducting related scholarship. As business schools display inertia while corporations change to pursue purpose, a rift is emerging between the interests of participants in the business school industry. The P-School category comprises a diverse combination of seven business schools based at the universities of: Birmingham, Cardiff, Glasgow Caledonian, University of Arts London, Manchester, Queen Mary University of London, and Queen's Belfast

Towards purposeful business schools: Deepening and broadening external engagement

Building on recent suggestions that business schools’ instrumental (outcomes-focussed) strategies should be replaced by the pursuit of their purpose to enhance the public good, this paper answers the special edition’s call to consider business school futures by presenting a foresight exercise that first conceives, and then illustrates, ways that purpose-driven business schools can extend (deepen and broaden) their external engagement activity. From our review of previous research, we present a new typology of business school engagement approaches that has two dimensions: (a) strategic focus (instrumental-purposeful), and (b) engagement management (organic-co-ordinated). From our scan of the business school environment in the United Kingdom (UK) and France, we illustrate, with empirical examples, the two purposeful engagement approaches in our typology (organic and co-ordinated). These findings indicate a variety of ways that business schools of the future can better enhance the public good through extended engagement

What matters to me! User conceptions of value in specialist cancer care

This paper is the first to apply the services marketing framework of service-dominant logic (S-D logic) to enhance understanding of patient conceptualizations of value in the context of cancer health services. Using data from a case study, the findings reveal that ‘value’ is a temporal, experiential, and complex concept. Three dominant themes are identified as contributing to value creation; access to resources, quality of interactions, and resource use. Although these findings show a broad degree of support for the S-D logic framework, distinctive variations emerge from this application in a health-care context

Professional networks of middle managers: acting as social movements to achieve upwards engagement?

This paper is the first to apply social movement concepts to analyse processes by which middle managers (MMs) develop a common language (currency) to support their attempts to change organizational strategy. Conceptually, this paper extends literature on the strategic activities of MMs by concentrating on collective, rather than individual, activity. Empirically, we draw from a case study of UK public services to surface and illustrate how MMs try to promote changes in strategy concerning the delivery of integrated services to the elderly. This combination of social movement concepts and rich case data shows how MMs use professional networks to pursue strategic change through twin and reciprocal processes of: (1) framing issues inwards, towards movement members, and (2) issue selling upwards, to top managers

Value co-creation through patient engagement in health care: a micro-level approach and research agenda

Patient engagement has gained increasing prominence within academic literatures and policy discourse. With limited developments in practice, most extant academic contributions are conceptual, with initiatives in the National Health Service (NHS) concentrating at macro- rather than at micro-level. This may be one reason why the issue of ‘value co-creation’ has received limited attention within academic discussions of patient engagement or policy pronouncements. Drawing on emerging ideas in the services marketing and public management literatures, this article offers the first elucidation of the importance of studying ‘value co-creation’ as a basis for further empirical analysis of patient engagement in micro-level encounters

Co-created public value: The strategic management of collaborative problem-solving

This paper presents the first analysis of the way that co-creation can be used as the primary approach to problem-solving within organisations that operate a public value model of strategic management (co-created public value). We begin by drawing from previous scholarship to introduce a preliminary model of three activities required to co-create public value: defining public value, mobilizing support, and building capacity. After introducing the context of our empirical case and the research methods, we present our research findings as an elaborated model that illustrates ways that each of the three activities can be performed. We conclude by considering the research and practical implications of our model

Providing mental health first aid in the workplace: a Delphi consensus study

BACKGROUND: Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one\u27s approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace context. METHODS: A systematic search of websites, books and journal articles was conducted to develop a questionnaire with 246 items containing actions that someone may use to offer mental health first aid to a co-worker or employee. Three panels of experts from English-speaking countries were recruited (23 consumers, 26 managers and 38 workplace mental health professionals), who independently rated the items over three rounds for inclusion in the guidelines. RESULTS: The retention rate of the expert panellists across the three rounds was 61.7 %. Of the 246 items, 201 items were agreed to be important or very important by at least 80 % of panellists. These 201 endorsed items included actions on how to approach and offer support to a co-worker, and additional considerations where the person assisting is a supervisor or manager, or is assisting in crisis situations such as acute distress. CONCLUSIONS: The guidelines outline strategies for a worker to use when they are concerned about the mental health of a co-worker or employee. They will be used to inform future tailoring of Mental Health First Aid training when it is delivered in workplace settings and could influence organisational policies and procedures