Value creation disclosure: the international integrated reporting framework revisited in the light of stakeholder theory

Purpose The paper aims to propose an integrated reporting (IR) framework rooted in Freeman’s stakeholder theory (ST). The proposed framework modifies the international integrated reporting framework (IIRF) and aims to overcome criticisms related to its focus on investors and the abandonment of sustainability. Design/methodology/approach The paper develops a modified IIRF based on an in-depth analysis of the IR and ST literature. The framework was then applied to a non-profit health-care organisation to verify its theoretical assumptions. Findings The modified IIRF was conceived as a ready-to-use tool. By applying it to a business case, it was validated with respect to whether and how it could help achieve better and more stakeholder-oriented reporting. The findings enabled us to validate the use of the tool not only for reporting but also for the self-assessment of organisations with respect to embedding ST. Research limitations/implications The modified IIRF was implemented only in one case, and further implementations are needed to comprehensively identify its strengths and weaknesses, both in for-profit and non-profit organisations. Practical implications The revised IIRF represents an updated tool for reporting and disclosing the value created by an organisation for itself and for its stakeholders including the external entities affected by the impacts engendered by the organisation. In this way, the IIRF can give visibility to all value created and the value creation process, including sustainability matters. This allows integrated thinking processes to be incorporated accordingly, supporting better management. Originality/value This paper suggests three adjustments to improve the IIRF’s ability to incorporate ST as a theoretical foundation. The adjusted IIRF is a ready to-use-tool specifically highlighting what value or values an organisation delivers (its outcomes), for whom (its stakeholders) and how (its specific business processes) within a business model effectively connecting them. From this point of view, it fits the rising stream about the evolution of the sustainability reporting fostered jointly by the international integrated reporting council and sustainability accounting standard board, and by the European Union.

Digitally Enabled Health Service for the Integrated Management of Hypertension: A Participatory User-Centred Design Process

This article describes a user-centred approach taken by a group of five procurers to set specifications for the procurement of value-based research and development services for IT-supported integrated hypertension management. The approach considered the unmet needs of patients and health systems of the involved regions. The procurers established a framework for requirements and a solution design consisting of nine building blocks, divided into three domains: service delivery, devices and integration, and health care organisation. The approach included the development of questionnaires, capturing patients’ and professionals’ views on possible system functionalities, and a template collecting information about the organisation of healthcare, professionals involved and existing IT systems at the procurers’ premises. A total of 28 patients diagnosed with hypertension and 26 professionals were interviewed. The interviewees identified 98 functional requirements, grouped in the nine building blocks. A total of nine use cases and their corresponding process models were defined by the procurers’ working group. As result, a digitally enabled integrated approach to hypertension has been designed to allow citizens to learn how to prevent the development of hypertension and lead a healthy lifestyle, and to receive comprehensive, individualised treatment in close collaboration with healthcare professionals.

Improving Customisation in Clinical Pathways by Using a Modular Perspective

A standardised system of clinical pathways often conflicts with providing patient-centred heterogeneous care. Mental health care organisations are searching for new methods to become responsive towards unique treatment needs. Modularity is a method increasingly suggested to reconcile standardisation and customisation. The aim is to investigate the extent to which modularity can be applied to make clinical pathways in specialist mental health care more flexible in order to stimulate shared decision making (SDM) and thereby customise care processes to patient contexts while maintaining evidence-based standards. Methods consist of literature research and a theory-based case study including document analysis and semi-structured interviews, which were performed at a Dutch specialist mental health care organisation. The results show that in current literature two modularity-based structures are proposed that support flexibility and customisation, i.e., ‘Prototype’ and ‘Menu-based’. This study reveals that departments tend to use the prototype method if they have predictable patient needs, evidence-based methods are available and there is sequency in treatment components. The menu-based method is preferred if there are unpredictable needs, or the evidence needed to create interconnectedness in treatment is lacking. In conclusion, prototype or menu-based methods are both suitable for applying SDM and reaching customisation in practice. The choice is determined by three characteristics: predictability of needs, availability of evidence and the interconnectedness of treatment components.

Nursing Leadership Role in Pandemic

A Pandemic is an epidemic of disease that has spread across a large region, multiple continents orworldwide, COVID-19 is a large issue worldwide. A good nurse leader is someone who can inspireothers to work together in pursuit of a common goal, such as enhanced patient care. An effectiveleader has a distinctive set of personal qualities; integrity, courage, initiative and an ability to handlestress, and also taking the effort to think critically, set goals and skilfully communicates andcollaborate. Nurse’s leaders are faced with a variety of challenges in pandemics, including managingresources, advanced planning and goal setting, collaborating with other hospital and communityleaders, improving quality measures, cost-effectiveness, reporting to the board of directors, andmany more. Nurses as effective partners of the health care team, of necessity, have to meet thedemands of these changes adequately and appropriately in respect of their expanded and enrichedroles and responsibilities. Nurse leaders, however, are still confined within their nursing orbit, but,today they have to be visible and interactive members of the multi-disciplinary health team with avision and voice that can be heard. Methods: For the present review article collected a databasefrom Google scholar; search and scrutinize studies related to nurse’s leadership role duringpandemic and article related to Covid-19 outbreak, government, community effort and mitigationstrategies in reducing transmission. Result: Because it is a novel pandemic; results suggest thatmore researches are needed in this field related to driven factors, mitigation strategies and supportof governmental and non-governmental organizations. This review article is aimed that nursingleaders must continue to develop plans that can slow or prevent the progress of widespread illnessesand ensures that all client care provided by the team is carried out in keeping with the objectives ofthe health care organisation.

Leaving early or staying on? Retirement preferences and motives among older health-care professionals

There is a need for improved knowledge about how workplace conditions and organisational factors may obstruct or facilitate work in late life. By means of both quantitative and qualitative data, this study aims to explore retirement preferences among employees (aged 55 and older) in a large Swedish health-care organisation and to identify work-related motives influencing their retirement preferences. The quantitative analysis showed large variation in retirement preferences in the organisation. The qualitative results were summarised into two overarching types of motives for late and early retirement preferences, general and group-specific. The general motives were shared by the early and late preference groups, and included recognition, flexibility, health and work motivation. The group-specific motives were exclusively related to either an early or a late retirement preference. Criticism towards the organisation and strenuous working conditions were specific motives for an early retirement preference, while positive accounts of work and a wish to utilise one's own competencies as well as being financially dependent on work was stated as specific motives for wanting to retire late. The results illustrate the need to improve organisational practices and routines, as well as working conditions, in order to make an extended working life accessible for more than already-privileged groups of employees.

Resilience and Empowerment through Higher Education in Kakuma Refugee Camp: A Conversation

Resilience and empowerment are concepts that recently have become popularised in the world of forced displacement management policy and practice. Often undervalued and dismissed as being buzzwords, these concepts have become bound up in the burgeoning study of higher education in refugee contexts. This article explores these themes in the frame of a real-world experience of studying a blended learning medical studies course in Kakuma refugee camp and the impact it has had on an individual’s life and that of his community. Building on the academic discourse, we present a case study of the individual’s experience of studying an online and face-to-face course in Kakuma refugee camp and subsequently undertaking an internship with a local health care organisation. Through a discursive conversation, the subject of the case study reveals the positive impact this educational experience has fostered in his life by instilling resilience and empowering him to become a force for positive change in his community.

Building Indigenous health workforce capacity and capability through leadership – the Miwatj health leadership model

Aim: In the crowded field of leadership research, Indigenous leadership remains under-researched. This article explores the Leadership Model of an Aboriginal Community Controlled Primary Health Care Organisation providing services to the Yolngu people of remote northern Australia: the Miwatj Health Aboriginal Corporation (Miwatj). Background: The limited research which does exist on Indigenous leadership points to unique challenges for Indigenous leaders. These challenges relate to fostering self-determination in their communities, managing significant community expectations, and navigating a path between culturally divergent approaches to management and leadership. Methods: Guided by Indigenous methodology and using a mixed methods approach, semi-structured interviews, self-reported health service data, organisational and publicly available documents, and literature were analysed using a framework method of thematic analysis to identify key themes of the Miwatj Leadership Model. Findings: The Miwatj Leadership Model is underpinned by three distinctive elements: it offers Yolngu people employment opportunities; it supports staff who want to move into leadership positions and provides capacity building through certificates and diplomas; and it provides for the physical, emotional, and cultural wellbeing of all Yolngu staff. Furthermore, the model respects traditional Yolngu forms of authority and empowers the community to develop, manage and sustain their own health. The Miwatj Leadership Model has been successful in providing formal pathways to support Indigenous staff to take on leadership roles, and has improved the accessibility and acceptability of health care services as a result of Yolngu employment and improved cultural safety. Conclusions: Translating the Miwatj Leadership Model into other health services will require considerable thought and commitment. The Miwatj Leadership Model can be adapted to meet the needs of other health care services in consideration of the unique context within which they operate. This study has demonstrated the importance of having a formal leadership model that promotes recruitment, retention, and career progression for Indigenous staff.

Perceived work stress, overcommitment, balance in everyday life, individual factors, self-rated health and work ability among women and men in the public sector in Sweden – a longitudinal study

Background The aim was to investigate whether perceived work stress, overcommiment, balance in everyday life, individual factors and self-rated health in combination predict work ability among women and men in the public sector in Sweden. Methods A sample was randomly selected from the employee records of the participating public health care organisation in Western Sweden. In total, 2223 employees were included and answered a postal survey twice, at a 2 year interval. The survey included questions about work ability, perceived work stress, overcommitment, balance in everyday life, individual factors and self-rated health. Odds ratios with 95% confidence intervals for work ability were estimated using logistic regression. Results Imbalance in everyday life and overcommitment predicted reduced work ability in women and imbalance in everyday life and low educational level predicted reduced work ability in men. However, when poor self-rated health was added to the models this was the strongest predictor of work ability for both genders. Conclusion A combination of poor self-rated health, imbalance in everyday life, and overcommitment predicted reduced work ability. This multifactorial nature of work ability should be taken into account in health promotion programmes.

Implementation of Sustainable Complex Interventions in Health Care Services: The Triple C Model

Background The changing and evolving healthcare means organisations are under increasing pressure to deliver value-based, high quality care to patients through enabling access, reducing costs and improving outcomes. These factors result in an increased pressure to deliver efficient and beneficial interventions to improve patient care and ensure sustainability beyond the scope of the implementation of such interventions. This paper discusses the development of a triple C model for implementation that ensures sustainability of complex interventions in health care services. Methods In order to develop the proposed implementation model, we adapted the formal tradition of theory building that is described in sociology. Firstly, through a review of the literature on complex interventions and the available implementation models used to embed these interventions. Secondly, devising a framework that encompassed these findings into a simple and workable model that can be easily embedded into everyday practice. This proposed model uses clear, systemic explanation, adds to the current knowledge in this area and is fit for purpose, providing healthcare workers with a simple easy-to-follow framework to embed practice change. Results A three-stage implementation model was devised based on the findings of the literature and named the Triple C model (Consultation, Collaboration and Consolidation). The three stages are interconnected and overlap to ensure sustainability is considered at all levels of the project ensuring its greater success. This model considers the sustainability within any implementation project. Sustainability of interventions are a key consideration for continuous and successful change in any health care organisation. A set of criteria were developed for each of the three stages to ensure adaptability and sustainment of interventions are maintained throughout the life of the intervention.Conclusion Ensuring sustainability of interventions requires continuing effort and embedding the need for sustainability throughout all stages of an implementation project. The Triple C model offers a new approach for healthcare clinicians to ensure sustainability of organizational change.