Information sources for medical waste management

Although many hospital professionals now have personal access to online databases, popular communications services may not have the full range of electronic services needed for technical problem solving. Librarians are practiced at cross-disciplinary technical research and so health professionals may be best served by consulting an experienced database search analyst so that important information is not accidentally missed. Additionally, many commercially produced databases have repackaged and redistributed data developed by NIOSH and other federal agencies, data that are readily available in the public sector. The cost of accessing or purchasing commercial databases is usually higher than for federal databases, though commercial products use the federal databases to develop their products. Public agencies should always be consulted to obtain the most current information issued by those bodies and also because a variety of free and low-cost support materials may be available. Because of the expense of routinely consulting electronic databases when comparable printed materials may be available at a lower cost, a small reference collection of books, journals, and audiovisuals may be desirable. A selective print reference collection is found in Appendix A.     

RECENT FINANCIAL AND ACCOUNTABILITY CHANGES IN GENERAL PRACTICE: AN UNHEALTHY INTRUSION INTO MEDICAL AUTONOMY?

Recently General Medical Practice has been inundated with a range of financial and accountability changes. These imposed changes have been welcomed with considerable resentment by General Practitioners (GPs hereafter). This paper explores some of the key historical and contextual reasons for this resentment. The conclusion is that it is traceable to firstly, the nature of these reforms, which are seen as irrelevant at best or, at worst, run counter to the values and concerns of GPs, and secondly, and related to this, to the perceived inappropriate intrusion into medical autonomy by a Government whose forbears were previously enabling such freedom.     

Critical reflections on research approaches, accounting regulation and the regulation of accounting

The design and choice of research approaches, the nature of accounting regulation and the reactions to these regulations in organisations, involving, in effect, the regulation of accounting, are three themes of considerable importance in accounting research. They are the three themes that have dominated the research agenda of the author throughout his academic career. This paper explores the nature of these three key research themes developing some critical reflections on what has been discovered about each of these themes using the author's sole and joint research and publications as a vehicle for this analysis.     

Evolution of the chronic care role of the registered nurse in primary care

High-quality, accessible, and efficient primary care is needed as the U.S. health care system undergoes significant change. Advancing the role of registered nurses in the primary care setting is important to the solution. A large academic health center implemented five initiatives to improve the care of chronically ill patients through the expanded role of RNs in the context of the health care team. Role evolution of nurses in the pilots required some continuing education and some additional nursing support to release the pilot nurses from their usual duties. These strategies allowed the nurses to apply interventions that enhanced the coordination of care and promoted patient self-management skills. Some short-term improvements in health status were realized and barriers to self-care were identified and resolved.     

The Private Finance Initiative: Clarification of a Future Research Agenda

The Private Finance Initiative in the UK, whereby the public sector actively seeks private finance for developments in its services/buildings, can be traced to the Chancellor of the the Exchequer's Autumn Statement of 1992. However, the seeking of private finance had been a Government concern for many years before this time even though it was only in 1992 that it gained a real impetus and direction. Since then it has developed and expanded into all areas of Government and into local authorities and has been carried forward, with equal, if not greater, enthusiasm, by the recently elected Labour Government. This paper provides an introduction to this new development in the public sector in the UK, tracing its historical development from its 'macro' emphasis, through to the 'micro' outworking of these policies across the entire public sector. This summary provides the base to draw up a future research agenda for PFI, which forms the major concern of the paper.     

Performance management systems: A conceptual model

This paper builds on the view that too much attention in the management, management control and management accounting literatures has been given to ex post performance measurement as distinct from ex ante performance management. The paper develops a conceptual model of Performance Management Systems (PMS) building on the work and insights of primarily Otley (1999) and Ferreira and Otley, 2005, Ferreira and Otley, 2009 who share similar concerns. Particular attention is given to analysing the underlying factors that influence the nature of any PMS, which Ferreira and Otley, 2005, Ferreira and Otley, 2009 address only to a limited extent in their model. This analysis into these factors leads to the development of Ferreira and Otley's conceptualisation into a ‘middle range’ (Laughlin, 1995, Laughlin, 2004, Broadbent and Laughlin, 1997) model of the alternative nature of PMS lying on a continuum from ‘transactional’ at one end to ‘relational’ at the other built on respectively underlying instrumental and communicative rationalities and guided by a range of contextual factors.     

Accounting systems in organisational contexts: A case for critical theory

This paper starts from the view that accounting systems in organisational contexts are more than technical phenomena and that to understand and change these technical elements the social roots must also be both understood and changed. To develop these insights, it is argued, requires major changes in the methodologies we adopt. This paper is addressed to arguing a case for a methodological approach to further these purposes which is derived from a German philosophical school of thought called “critical theory” — more specifically from Jürgen Habermas' interpretation of this thinking which gives particular emphasis to the social and technical aspects of societal phenomena which includes accounting systems.     

Habermas, law and accounting

This essay provides a critical review of Habermas' theory of law in Faktizität und Geltung against the backdrop of attempts to apply his work to the field of accounting. First, we analyse the core themes of this theory: the tension between facticity and validity from which Habermas' book takes its tide; the problem of the foundations of critical theorizing; Habermas' views on public administration and the role of expertise. Second, we consider the implications of this theory for critical accounting research. This discussion addresses Habermas' theory of money and the significance of the facticity of accounting. We also make some suggestions about how Habermas' counterfactual sensibilities remain relevant to critical accounting.     

Performance Audit of the Operational Stage of Long-Term Partnerships for the Private Sector Provision of Public Services

This study investigates the challenges associated with designing a system to evaluate the mature operating phase of long-term partnerships with the private sector for the provision of public services (PPPS), an area largely neglected by a performance audit (PA) focus. It argues that assessing economy, efficiency and effectiveness (the three Es) are key to any PA, but that their nature is contextually defined; that auditing for effectiveness involves going beyond a 'watchdog' to a 'sheepdog' role; and that internal evaluation procedures provide insights that are necessary, but not necessary and sufficient to evaluating the achievement of the three Es in the PPPS mature operating stage. Findings are based on an analysis of the literature and an engagement with an audit office. The paper elucidates the meaning of each of the three Es in the context of PA of the PPPS mature operating stage.