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Objective

To identify the predominant culture of an organisation which could then assess readiness for change.

Design

An exploratory design using the Competing Values Framework (CVF) as a self-administered survey tool.

Setting

The Maternity Unit in one Australian metropolitan tertiary referral hospital.

Subjects

All 120 clinicians (100 midwives and 20 obstetricians) employed in the maternity service were invited to participate; 26% responded.

Main outcome measure

The identification of the predominant culture of an organisation to assess readiness for change prior to the implementation of a new policy.

Results

The predominant culture of this maternity unit, as described by those who responded to the survey, was one of hierarchy with a focus on rules and regulations and less focus on innovation, flexibility and teamwork. These results suggest that this unit did not have readiness to change.

Conclusion

There is value in undertaking preparatory work to gain a better understanding of the characteristics of an organisation prior to designing and implementing change. This understanding can influence additional preliminary work that may be required to increase the readiness for change and therefore increase the opportunity for successful change. The CVF is a useful tool to identify the predominant culture and characteristics of an organisation that could influence the success of change.  相似文献   
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The paper discusses the problem of design and analysis of large scale communication systems. An iterative process, composed of a minimum cost network design algorithm and a network performance algorithm, is presented for the solution of these problems. Computational considerations, using these algorithms, are discussed.  相似文献   
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Background

Breastfeeding has many known benefits yet its support across Australian health systems was suboptimal throughout the 20th Century. The World Health Organization launched a global health promotion strategy to help create a ‘breastfeeding culture’. Research on the programme has revealed multiple barriers since implementation.

Aim

To analyse the sociopolitical challenges associated with implementing a global programme into a national setting via an examination of the influences on the early period of implementation of the Baby Friendly Hospital Initiative in Australia.

Methods

A focused historical document analysis was attended as part of an instrumental case study. A purposeful sampling strategy obtained a comprehensive sample of public and private documents related to the introduction of the BFHI in Australia. Analysis was informed by a ‘documents as commentary’ approach to gain insight into individual and collective social practices not otherwise observable.

Findings

Four major themes were identified: “a breastfeeding culture”; “resource implications”; “ambivalent support for breastfeeding and the BFHI” and “business versus advocacy”. “A breastfeeding culture” included several subthemes. No tangible support for breastfeeding generally, or the Baby Friendly Hospital Initiative specifically, was identified. Australian policy did not follow international recommendations. There were no financial or policy incentives for BFHI implementation.

Conclusions

Key stakeholders’ decisions negatively impacted on the Baby Friendly Hospital Initiative at a crucial time in its implementation in Australia. The potential impact of the programme was not realised, representing a missed opportunity to establish and provide sustainable standardised breastfeeding support to Australian women and their families.  相似文献   
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MJ Foster  DN Foster 《Omega》1982,10(1):19-23
This paper describes a method for assessing the effectiveness of strategic planning systems in terms of the results actually observed subsequent to planning activity. The paper explains in particular how, in making the assessment, one might cope with the fact of environmental change subsequent to the setting of planned goals. This ends oriented approach to measuring effectiveness is shown to be complementary to process oriented approaches and is illustrated by an example from the coal industry.  相似文献   
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Elissen AMJ, Van Raak AJA, Derckx EWCC, Vrijhoef HJM. Improving homeless persons' utilisation of primary care: lessons to be learned from an outreach programme in The Netherlands Faced with rising homelessness, countries around the world are in need of innovative approaches to caring for those without shelter, who, more often than not, suffer from severe health problems. We conducted a case study of an innovative Dutch Primary Care for the Homeless (PCH) programme to gain insight into clients' demographic characteristics, health problems and service use, and to develop an explanation for its success in increasing the latter. Our analyses are based on a combination of quantitative and qualitative data. The results of the study suggest that the success of the PCH programme can be explained by the providers' pragmatism and will to adapt their mode of care provision to the behavioural patterns and needs of their homeless clients.  相似文献   
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