Public Services Programme

Christopher Hood’s presentation at the Guardian Public Services Summit 2010

Rikki Dean — Tue, 23 Feb 2010 10:46:24 +0000

Christopher Hood presented a talk on Resistance to change across the public sector at the Guardian Public Services Summit in February 2010.

Chistopher’s PowerPoint presentation is available here.

Christopher Hood’s presentation at the Guardian Public Services Summit 2010

Rikki Dean — Tue, 23 Feb 2010 10:41:12 +0000

Christopher Hood presented a talk on Resistance to change across the public sector at the Guardian Public Services Summit in February 2010.

Information and ‘post-event content’ from the Summit can be found here and Janet Dudman comments on the event here.

Chistopher’s PowerPoint presentation is available here.

Programme Newsletter No 9, Winter 2010

Rikki Dean — Wed, 17 Feb 2010 02:34:12 +0000

Number 9, Winter 2010 (pdf)

The ESRC Public Services Programme Newsletter - twice-yearly issues reporting on Programme developments and keeping you up-to-date on our activities, outputs, and how you can get involved in shaping the future of the Programme.

If you would like to request a paper copy please e-mail public-services@poltics.ox.ac.uk with your postal address.

Absorptive Capacity in a Non-Market Environment: A knowledge-based approach to analysing the performance of sector organizations

Rikki Dean — Wed, 17 Feb 2010 02:13:45 +0000

Abstract: Improved performance by public sector organizations is a political imperative in numerous countries. There are particular challenges in turnaround of poorly performing organizations. Theoretical explanations of the performance trajectories of public organizations, and especially the causes of failure, highlight the importance of knowledge processes, often from an organizational learning perspective. Absorptive capacity provides an alternative way of theorizing the relationships between organizational performance and knowledge processes, derived from the resource-based view of the firm and the broader concept of dynamic capabilities. The article reviews the conceptual, theoretical, and methodological implications of applying absorptive capacity to the performance of public organizations. It concludes that the approach has value and presents a number of propositions to be tested through empirical study, alongside some more general challenges for researchers who wish to study the concept further. The high political salience of public organizations’ performance, and the costs of failure, mandates a major research effort on these issues.

Harvey G., Skelcher C., Spencer E., Jas P and Washe K. (2010) ‘Absorptive Capacity in a Non-Market Environment: A knowledge-based approach to analysing the performance of sector organizations’ Public Management Review, Vol 12 (1): 77 - 97

Analysis of the Validity of the Vignette Approach to Correct for Heterogeneity in Reporting Health System Responsiveness

Rikki Dean — Wed, 17 Feb 2010 01:37:52 +0000

Abstract: Despite the growing popularity of the vignette methodology to deal with self-reported, categorical data, the formal evaluation of the validity of this methodology is still a topic of research. Some critical assumptions need to hold in order for this method to be valid. In this paper we analyse the assumption of “vignette equivalence” using data on health system responsiveness contained within the World Health Survey. We perform several tests to check the assumption of vignette equivalence. First, we use a test based on the global ordering of the vignettes. A minimal condition for the assumption of vignette equivalence to hold is that individual responses are consistent with the global ordering of vignettes. Secondly, using the HOPIT model on the pool of countries, we undertake sensitivity analyses, stratifying countries according to the Inglehart-Welzel scale and the Human Development Index. The results of this analysis are robust, suggesting that the vignette equivalence assumption is not contradicted. Thirdly, we model the reporting behaviour of the respondents through a two-step regression procedure to evaluate whether the vignettes construct is perceived by respondents in different ways. Overall, across the analyses the results do not contradict the assumption of vignette equivalence and accordingly lend support to the use of the vignette methodology when analysing self-reported data and health system responsiveness.

Rice, Nigel, Robone, Silvana, Smith, Peter.C (2009) Analysis of the Validity of the Vignette Approach to Correct for Heterogeneity in Reporting Health System Responsiveness, HEDG Working Paper 09/28

Vignettes and health systems responsiveness in cross-country comparative analyses

Rikki Dean — Wed, 17 Feb 2010 01:33:55 +0000

Abstract: This paper explores the use of anchoring vignettes as a means to adjust survey reports of health system performance for differential reporting behaviour using data contained within the World Health Survey (WHS). Survey respondents are asked to rate their experiences of health systems across a number of domains on a five-point categorical scale. Using data provided through a set of vignettes we investigate variations in reporting of interactions with health services across both socio-demographic groups and countries. We show how the method of anchoring vignettes can be used to enhance cross-country comparability of performance. Our results show large differences in the rankings of country performance once adjustment for systematic country-level reporting behaviour has been undertaken compared to a ranking based on raw unadjusted data.

Rice, Nigel, Robone, Silvana, Smith, Peter.C (2009) Vignettes and health systems responsiveness in cross-country comparative analyses, HEDG Working Paper 09/29:

Why do people cooperate with medical research? Findings from three studies

Rikki Dean — Wed, 17 Feb 2010 00:47:40 +0000

Abstract: In this paper, we distinguish decisions about cooperation with medical research from decisions about research participation. We offer an empirical and theoretical exploration of why people in three different UK-based medical research projects chose to cooperate. Data analysis of the accounts of 128 participants across the three studies was based on the constant comparative method. Participants’ cooperation was engaged by a perception that they would be contributing to the ‘public good’, but they also wanted to justify their decision as sensible and safe. Critical to their cooperation was their belief that researchers would fulfil their side of the cooperative bargain, by not exposing participants to risks of harm or exploitation. Although participants were generally unaware of the details of the regulatory regime for research, they demonstrated a generalised reliance on regulation as a feature of everyday life that would provide a safe context for cooperation. In their assessment of particular projects, participants made judgements about whether to cooperate based on more specific cues, which acted as signs to assure them that researchers shared their cooperative intentions. These cues included organisational and professional credentials, the role identities and perceived trustworthiness of those involved in recruiting to research, and visible signs of reasonable practice mandated by regulatory systems. Thus participants drew on their understandings of an institutional field that was much broader than that of research alone. We propose that the social organisation of research is fundamental to the judgements people make about cooperation with research. Cooperation may be a more useful way of thinking about how people come to engage in collaboratively oriented actions such as research participation, rather than currently dominant individualistic models. Attention to the institutional context of research is critical to understanding what makes cooperation possible, and has important implications for the design of regulatory regimes for research.

Dixon-Woods and Tarrant C (2009) Why do people cooperate with medical research? Findings from three studies, Social Science and Medicine, Vol 374 (9688): 2215-2222

Reality check for checklists

Rikki Dean — Wed, 17 Feb 2010 00:39:39 +0000

Abstract: Catheter-related blood stream infections in the intensive care unit (ICU) are common, costly, and potentially lethal. The Dec 28, 2006, issue of The New England Journal of Medicine reported that an evidence-based intervention in 103 intensive care units in the Michigan Keystone ICU programme had resulted in a large sustained reduction in rates of these infections. The study was widely reported in the popular media and elsewhere as a triumph of the “simple checklist” as a solution to patients’ safety…

C. Bosk, M. Dixon-Woods, C. Goeschel, P. Pronovost (2009) Reality check for checklists, The Lancet, Vol 374, Issue 9688,: 444-445

Why is patient safety so hard? : a selective review of ethnographic studies

Rikki Dean — Wed, 17 Feb 2010 00:35:33 +0000

Abstract: Ethnographic studies are valuable in studying patient safety. This is a narrative review of four reports of ethnographic studies of patient safety in UK hospitals conducted as part of the Patient Safety Research Programme. Three of these studies were undertaken in operating theatres and one in an A&E Department. The studies found that hospitals were rarely geared towards ensuring perfect performances. The coordination and mobilization of the large number of inter-dependent processes and resources needed to support the achievement of tasks was rarely optimal. This produced significant strain that staff learned to tolerate by developing various compensatory strategies. Teamwork and inter-professional communication did not always function sufficiently well to ensure that basic procedural information was shared or that the required sequence of events was planned. Staff did not always do the right things, for a wide range of different reasons, including contestations about what counted as the right thing. Structures of authority and accountability were not always clear or well-functioning. Patient safety incidents were usually not reported, though there were many different reasons for this. It can be concluded that securing patient safety is hard. There are multiple interacting influences on safety, and solutions need to be based on a sound understanding of the nature of the problems and which approaches are likely to be best suited to resolving them. Some solutions that appear attractive and straightforward are likely to founder. Addressing safety problems requires acknowledgement that patient safety is not simply a technical issue, but a site of organizational and professional politics.

Dixon-Woods M. (2010) Why is patient safety so hard? : a selective review of ethnographic studies, Journal of Health Services Research & Policy, 15:11-16

Divergence or convergence? Health inequalities and policy in a devolved Britain,

Rikki Dean — Wed, 17 Feb 2010 00:26:18 +0000

Abstract: Since the advent of political devolution in the UK, it has beenwidely reported that markedly different health policies haveemerged. However, most of these analyses are based on a comparisonof health care policies and, as such, only tell part of a complexand evolving story. This paper considers official responsesto a shared public health policy aim, the reduction of healthinequalities, through an examination of national policy statementsproduced in England, Scotland and Wales respectively since 1997.The analysis suggests that the relatively consistent mannerin which the `policy problem’ of health inequalities has beenframed combined with the dominance of a medical model of healthhave constrained policy responses. Our findings differ fromexisting analyses, raising some important questions about theactuality of, and scope for, policy divergence since devolution.

Smith K, Hunter D., Blackman T., Elliott E., Greene A., Harrington B., Marks L., McKee L. and Williams G. (2009) Divergence or convergence? Health inequalities and policy in a devolved Britain, Critical Social Policy, Vol 29 (2): 216-242