The English National Health Service (NHS) is a public sector organisation with a longstanding objective to deliver high quality healthcare that is free at the point of use. In order to achieve this, the NHS has endured an evocative and controversial theme of reform across many decades. Despite such high levels of reform, the recent Operating Efficiency Framework declared that the NHS is about to enter its toughest ever financial climate. This paper will illustrate the complexities and tensions of implementing service improvement in the NHS in a climate of persistent policy reform, reduced budgets and tough regulation. The paper reports findings of three case studies of hospital trusts in the UK in relation to the implementation of Lean improvement methodologies, highlighting key complexities of a hospital context and the corresponding tension with service improvement activity.

This study intends to explore the impact of the customer knowledge integration capability, customer knowledge absorptive capability, customer knowledge creation capability, and customer relationship capability on new service development (NSD) performance for Taiwan's hospitals from customer knowledge and customer relationship perspectives. We employ the self-administered mail survey to collect research data and select self-pay medical service managers or top managers as key informants. After testing the fitness of sample representativeness, non-response error, common method variance, reliability, and validity, we adopt structure equation model to test the research model. Empirical results indicate the customer knowledge absorptive capability of a hospital is positively associated with NSD performance, and the customer knowledge integration capability of a hospital fully mediates the relationship between customer knowledge absorptive capability and NSD performance. However, customer relationship capability and customer knowledge absorptive capability both have positive influence on customer knowledge creation capability. Managerial and theoretical implications are discussed.

The aim of this study was to investigate the challenges that nurse unit managers (NUMs) face while working in acute care settings, the strategies they use to deal with these challenges, and the effectiveness of these strategies from the perspectives of NUMs and their supervisors. NUMs (N = 22) and directors of nursing (N = 3) were interviewed for this study. Thematic analysis revealed 14 challenges relating primarily to NUMs interactions with others, both within and outside of their wards/units. These challenges related to the managerial, but not clinical, aspects of their roles; 16 strategies for managing these challenges were identified, the effectiveness of which seemed dependent on how well they were executed. The strategies are: seeking assistance and support; trial and error; satisficing; taking responsibility for own professional development; scheduling of time; working longer hours; delegation; adaptive staffing and rostering; being a visible presence on the ward; team development; facilitating professional development for staff; being available for staff; negotiation and collaboration; communication; working with the processes of a large organisation; and complying with the demands of others, The findings make a strong case for NUMs to be supported in undertaking comprehensive management education.

This qualitative study was undertaken with a diverse sample of Australian health managers to examine their perceptions regarding the health system and to understand how they learned to become health managers. The findings showed that they viewed the health system as one of constant change, mostly non-adaptive, and a system of parts controlled by bureaucrats and political interests. While the respondents enjoyed their managerial role, they see it as contested between the professions. This study concluded that greater emphasis on the education and training of health managers and their continuing professional development is required if they are to manage increasingly complex, dynamic and changing health systems. In Australia, the health debate continues with the recently announced national health reform agenda. The perceptions of health managers in health reform and change management are important given that they are said to be central to the implementation of health reform and the management of change.

In the Australian healthcare sector, many changes in the public sector have affected nurse management and thereby, nurses. Yet it is unclear whether such efficiency measures, based on private sector business models, have impacted private sector nurses in similar ways. This paper examines four important issues for nurses: supervisor–subordinate relationships; perceptions of autonomy; role clarity in relation to patients; and job satisfaction. The paper uses an embedded mixed methods research design to examine the four issues and then compares similarities and differences between public and private sector nurses. The findings suggest supervisor–subordinate relationships, patient role clarity and autonomy significantly predict job satisfaction. The private sector nurses reported more satisfaction than public sector nurses with their supervisor–subordinate relationships, plus higher perceptions of patient role clarity and autonomy, and hence, higher levels of job satisfaction. The findings raise questions about whether present management practices (especially public sector) optimise service delivery productivity.

The researchers use established measures of job satisfaction (JS) and organizational citizenship behavior (OCB) to analyze data obtained from nurses in an Australian hospital (N = 573), and to discuss implications for human resource management. In this study the researchers seek to understand the links between nurses' JS, OCB and their perceptions of the values espoused by the organization. Changes in JS and OCB as length of service increases are also examined. Findings suggest that JS and OCB are both significant predictors of nurses' perceptions of organizational values. The findings also suggest that nurses more readily internalize organizational values when levels of JS and OCB are high. A further finding is that the tendency to engage in OCB declines significantly as length of service increases.

The study focused on mentoring relationship effectiveness (RE) from the perspective of protégé in the healthcare environment. The purpose tried to examine the effects of interpersonal attraction, self-efficacy and transformational leadership (TL) on RE respectively, to test mentoring function as a mediator, and to verify the effect of RE on protégé work outcomes. Self-administered questionnaires were employed and 306 questionnaires from hospital nurses were collected in total. Structural equation model was used to test the research model. The results indicated that interpersonal attraction and TL do have positive effects on RE while self-efficacy was not; RE also showed a significant effect on job satisfaction and organizational commitment, which verified that the formal mentoring among nurses was good for improving relationship quality and relationship learning between mentors and protégés. Accordingly, to strengthen the antecedent variables would be helpful for mentoring RE, and also the protégé's work outcomes.

As a transformative service, aged care has the capacity to create uplifting changes and improvements to the quality of life for individuals and communities. Recent studies have, however, highlighted the pressures faced by aged care workers and the impact that these pressures have on employee wellbeing and quality of care. This paper explores the relationship between employee wellbeing and service quality. We present a model for the aged care sector which suggests that by identifying and implementing appropriate HRM strategies both employee wellbeing and service quality will be enhanced thus ensuring that this transformative service meets the needs of its many stakeholders. Essentially, we argue that employee wellbeing is directly linked to service delivery outcomes and overall business performance and that HR practices that address issues such as learning and development, employee voice and involvement and workplace health and safety play a significant role in enhancing and maintaining employee wellbeing.

The current study examined the use of biographical data to predict errors, tardiness, policy violations, overall job performance, and turnover among nurses. The results of the study indicate that biodata measures are valid selection devices for nurses and effective at predicting nurse errors, tardiness, policy violations, and overall job performance, but the instrument was not an effective predictor of turnover, voluntary or involuntary. Additionally, examination of group differences revealed that White subjects scored significantly higher on the biodata instrument compared to Black subjects but produced group differences considerably smaller than typically found with measures of cognitive ability. Future research directions and implications for practice are discussed.

This study was conducted to verify the relationship between organizational cultural types, social capital and organizational effectiveness in South Korean dental clinics. The findings suggest that consensual culture is the best fit with social capital. Also, high level of organizational identification, trust and cohesiveness increases job satisfaction and lowers turnover intention. If applying the results practically, organizational identification, improvement of welfare system, stress control, and coaching program for personal development are the most optimal solution.

This quantitative study explores the perceptions of 379 nurses using a survey to assess awareness of, participation in, and effectiveness of 28 workforce retention strategies offered by Queensland Health. Perceptions of workforce retention strategies were also examined to determine if any aspects of the strategy (retention factors) had an influence on turnover intention. The major findings were that respondents were more aware and had participated to a greater extent in those strategies that were included in Queensland Health policy or were part of the nursing Enterprise Bargaining Agreement. Strategies ranked as most effective included those that provided a monetary advantage and to a lesser extent, a professional development opportunity. A positive relationship was found between retention factors and decreased turnover intention.