scholarly journals Faith in the 'cultural fix': limits to a planned cultural change program in a rural health service

2000 ◽  
Vol 23 (4) ◽  
pp. 187
Author(s):  
Kerry Mahony
Keyword(s):  
Health Service ◽  
Health Services ◽  
Rural Health ◽  
Cultural Change ◽  
Cultural Analysis ◽  
Cultural Control ◽  
Cultural Integration ◽  
Attitudes And Beliefs ◽  
Beliefs And Practices ◽  
Rural Health Service

This paper, by way of a narrative on the author's participation, explains the limits to a planned cultural changeprogram in a large rural health service. Cultural change was identified by the CEO as crucial to the success of a majorrestructuring of the service, and the attitudes and beliefs of the 'old guard' were considered to be constraining progress.Advocates of cultural integration contend that shared core values across an organisation can overcome such obstacles.This is a matter of faith. An application of Habermasian theory suggests that organisational leaders are drawing ontraditional/religious beliefs and practices to bolster their visions and missions at a time of motivational crisis.Though a need for cultural change in some sectors of the health services is acknowledged, the particular challenges inattempting to manipulate the traditionally embedded culture and sub-cultures of the health services is highlighted.An analysis of some of the ideas and beliefs surrounding authority, deference and discipline is undertaken. It is arguedthat the ritualistic reinforcement of these beliefs and the reproduction of sub-cultures along material and ideal interestsmilitate against the implementation of objectives delineated by the CEO.While cultural analysis has revealed the irrational face of organisations and can bring to conscious awareness the taken-for-granted beliefs which inform behaviour, the cultural integrationists have a further agenda. They aim tomanipulate organisational culture to subtly control employees' beliefs and hence behaviour. Cultural control is a covertform of top down authority that can be just as directive and centralising as bureaucratic control. The author alsomaintains that cultural change programs alone cannot fix a problem that arose in the macro-economic sphere: a chroniclack of resources ever since the state responded to the economic crisis by cutting funds to health and welfare services.

Rural health services and the task of community participation at the local community level: a case study

2018 ◽  
Vol 42 (1) ◽  
pp. 111 ◽  
Author(s):  
Elena Wilson ◽  
Amanda Kenny ◽  
Virginia Dickson-Swift
Keyword(s):  
Health Policy ◽  
Health Service ◽  
Health Services ◽  
Community Participation ◽  
Rural Health ◽  
Service Planning ◽  
Rural Health Services ◽  
Case Study Methodology ◽  
Rural Health Service

Community participation in health service decision making is entrenched in health policy, with a strong directive to develop sustainable, effective, locally responsive services. However, it is recognised that community participation is challenging to achieve. The aim of the present study was to explore how a rural health service in Victoria enacts community participation at the local level. Using case study methodology, the findings indicate that enactment of community participation is desired by the health service, but a lack of understanding of the concept and how to enact associated policy are barriers that are exacerbated by a lack of resources and community capacity. The findings reveal a disconnect between community participation policy and practice. What is known about the topic? The need to involve communities in health service planning, implementation and evaluation is a feature of health policy across major Western countries. However, researchers have identified a dearth of research on how community participation is enacted at the local service level. What does this paper add? The study that is presented herein addresses a gap in knowledge of community participation policy enactment within a rural health service. Insights are provided into the challenges faced by rural health services, with a disconnect between policy ideal and the reality of implementation. What are the implications for practitioners? Health service staff need clear direction from chief executive officers about the purpose of community participation policy and the expectations for individual roles. Community advisory committees need clarity about the community member role and the processes for making decisions. Services and their boards would benefit from targeted government funding to resource community participation activity.

First impressions: towards becoming a health-literate health service

2014 ◽  
Vol 38 (2) ◽  
pp. 190 ◽  
Author(s):  
Anne Johnson
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Rural Health ◽  
Health Information ◽  
First Impressions ◽  
Phone Call ◽  
Literacy Environment ◽  
Rural Health Service ◽  
Lack Of Information

A ‘health-literate organisation’ recognises that miscommunication is very common and can negatively affect consumer care and outcomes, and makes it easier for people to navigate, understand, and use health information and services. This paper reports on the First Impressions Activities conducted by consumers to assess aspects of the literacy environment of a rural health service. The First Impressions Activities consists of three tools to assist health services to begin to consider some of the characteristics of their organisation that help and hinder a consumer’s ability to physically navigate their way to and about the health service. The results show that navigation to and within the rural health service was made more complex due to lack of information, difficulty finding information, inconsistent terminology used in signage, missing signage, signage obscured by foliage, and incorrect signage. What is known about the topic? The environment of a health service represents the health literacy expectations, preferences and skills of those providing health information and services. What does this paper add? This case study offers insight into the literacy demands placed on consumers, as well as an effective tool to assess aspects of those health literacy demands. What are the implications for practitioners? Health services can use the First Impressions Activities to actively engage consumers in the assessment of their first impressions of the health service shaped by a phone call, a visit to the website and a walk to the entrance and to different destinations. These activities can assist a health service to begin to examine the navigation of the service through ‘fresh eyes’, using a structured process to identify ways to decrease the health literacy demands on consumers.

scholarly journals Radio back-up in rural health service

Nature ◽  
1978 ◽  
Vol 275 (5678) ◽  
pp. 264-264
Author(s):  
Zaka Imam
Keyword(s):  
Health Service ◽  
Rural Health ◽  
Rural Health Service

scholarly journals Has universal health insurance reduced socioeconomic inequalities in urban and rural health service use in Thailand?

2010 ◽  
Vol 16 (5) ◽  
pp. 1030-1037 ◽  
Author(s):  
Vasoontara Yiengprugsawan ◽  
Gordon A. Carmichael ◽  
Lynette L-Y Lim ◽  
Sam-ang Seubsman ◽  
Adrian C. Sleigh
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Rural Health ◽  
Service Use ◽  
Socioeconomic Inequalities ◽  
Health Service Use ◽  
Universal Health Insurance ◽  
Rural Health Service ◽  
Universal Health

scholarly journals The Value of Rural Isolated Practice Endorsed Registered Nurses in a Small Rural Health Service

2016 ◽  
Vol 1 (1) ◽  
pp. 58 ◽  
Author(s):  
Fiona Currie ◽  
Genevieve Nielsen ◽  
Kaye Ervin ◽  
Alison Koschel
Keyword(s):  
Health Service ◽  
Registered Nurses ◽  
Rural Health ◽  
Work Life ◽  
Scope Of Practice ◽  
Advanced Practice ◽  
Life Balance ◽  
Medical Practitioners ◽  
Rural Health Service ◽  
Negative Findings

<p><em>Three Registered Nurses (RN’s) undertook training and commenced practice as Rural Isolated Practice Endorsed Registered Nurses (RIPERNs) in a small rural Victorian health service, Australia. This advanced practice role is new to the health service and allows RIPERN’s to undertake some procedures usually performed by medical practitioners. As a form of evaluation, interviews were conducted with seven General Practitioners (GP’s) who have admitting privileges at the health service and three RIPERN’s who had commenced the extended scope of practice role. </em></p><p><em>Data was analysed and findings revealed strong benefits from the perspective of the GP’s and the RIPERN’s. These benefits included overall improved work-life balance for the GP’s, increased confidence and capabilities for the RIPERN’s and overall perceived improvement in the delivery of services at this small rural health service. Negative findings included misconceptions about the RIPERN extended scope of practice and increased demands experienced by RIPERN’s.</em></p>

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