Management

Re-creating Street Level Practice: The Role of Routines, Work Groups and Team Learning

Re-creating Street Level Practice: The Role of Routines, Work Groups and Team Learning
Journal of Public Administration Research and Theory

Foldy, E.G. & Buckley, T.R.
01/01/2010

Ample research documents the ubiquity of routines in street-level practice. Some individual-level and organizational-level research has explored how to break street-level routines, but little has looked at the work group level. Our study observed teams of state child welfare workers over 2.5 years, documenting whether they discarded old routines and learned new ones. Results suggest that team characteristics such as clear direction and reflective behaviors had greater influence on team learning than individual characteristics such as stress level, tenure, and educational level. We suggest that group-level factors be included in future models of what enables the re-creation of street-level practice.

Risk Communication for Catastrophic Events: Results from Focus Groups

Risk Communication for Catastrophic Events: Results from Focus Groups
Journal of Risk Reasearch

Zimmerman, R., Restrepo, C.E., Culpen, A., Remington, W.E., Kling, A., Portelli, I. & Foltin, G.
01/01/2010

Focus group methods are adapted here to address two important needs for risk communication: (1) to provide approaches to risk communication in very extreme and catastrophic events, and (2) to obtain risk communication content within the specific catastrophe area of chemical and biological attacks. Focus groups were designed and conducted according to well-established protocols using hypothetical sarin and smallpox attacks resulting in a chemical or biological release in a confined public space in a transit system. These cases were used to identify content for risk communication information and suggest directions for further research in this area. Common procedures for conducting focus groups were used based on an initial review of such procedures. Four focus groups - two for each type of release - each lasted about two hours. Participants were professionals normally involved in emergencies in health, emergency management, and transportation. They were selected using a snowball sampling technique. Examples of findings for approaches to communicating such risks included how information should be organized over time and how space, locations, and places should be defined for releases to anchor perceptions geographically. Examples of findings for risk communication content are based on how professionals reacted to risk communications used during the two hypothetical releases they were presented with and how they suggested using risk communications. These findings have considerable implications for using and structuring focus groups to derive risk communication procedures and types of content to be used in the context of catastrophes.

Substance Use Treatment Barriers for Patients with Frequent Hospital Admissions

Substance Use Treatment Barriers for Patients with Frequent Hospital Admissions
Journal of Substance Abuse Treatment

Billings, J., Raven, M., Carrier, E. et al.
01/01/2010

Substance use (SU) disorders adversely impact health status and contribute to inappropriate health services use. This qualitative study sought to determine SU-related factors contributing to repeated hospitalizations and to identify opportunities for preventive interventions. Fifty Medicaid-insured inpatients identified by a validated statistical algorithm as being at high-risk for frequent hospitalizations were interviewed at an urban public hospital. Patient drug/alcohol history, experiences with medical, psychiatric and addiction treatment, and social factors contributing to readmission were evaluated. Three themes related to SU and frequent hospitalizations emerged: (a) barriers during hospitalization to planning long-term treatment and follow-up, (b) use of the hospital as a temporary solution to housing/family problems, and (c) unsuccessful SU aftercare following discharge. These data indicate that homelessness, brief lengths of stay complicating discharge planning, patient ambivalence regarding long-term treatment, and inadequate detox-to-rehab transfer resources compromise substance-using patients' likelihood of avoiding repeat hospitalization. Intervention targets included supportive housing, detox-to-rehab transportation, and postdischarge patient support.

The Behavioral Dimension of Governing Inter-Organizational Goal Directed Networks: Managing the Unity/Diversity Tension

The Behavioral Dimension of Governing Inter-Organizational Goal Directed Networks: Managing the Unity/Diversity Tension
Journal of Public Administration Research and Theory Second Author with A. Saz-Carranza

Ospina, S.
01/01/2010

Network management research documents how network members engage in activities to advance their own goals. However, this literature offers little insight into the nature of work that aims to advance the goals of the network as a “whole.” By examining the behavioral dimension of network governance, this article identifies a specific tension that network leaders address to effectively govern networks: although unity and diversity are essential to network performance, each makes contradictory demands which require attention. Findings from four case studies of immigrant networks in the United States point to three activities representing mechanisms that staff of network administrative organizations use to address this (network level) managerial tension. The study proposes that unity versus diversity represents a distinct challenge to the governance of networks that requires strategic action at the whole-network level and merits further study.

Tous les systèmes de santé coûtent de plus en plus cher

Tous les systèmes de santé coûtent de plus en plus cher
Propos recueillis par Marc Rambuzet le 10 décembre 2009, Objectif méditerranée, n'lOB, Décembre-Janvier 2010, pg 4.

Rambuzet, M. & Rodwin, V.G.
12/10/2009

Victor G. Rodwin, qui tiendra une conférence à Marseille le 22 janvier prochain, explique en quoi la réforme
du système de santé est si difficile à mettre en oeuvre aux États-Unis. Si le Président Obama a surmonté
les premières difficultés, la course d'obstacles n'est pas pour autant terminée. Rodwin reconnaît l'excellence
du système médical français tout en contestant la première place attribuée par l'OMS à notre pays.

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative
Journal of Health Care for the Poor and Underserved. Vol. 20.4

Kaplan, S.A.
11/01/2009

The paper provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation.

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