scholarly journals Leaving Hospital: A Step too Far for Risk-Based Regulation?

2020 ◽  
Vol 28 (4) ◽  
pp. 675-695
Author(s):  
Victoria L Moore

Abstract Discharges from hospital are internationally recognised as a dangerous time in the care pathway of a patient, posing a risk to both their physical wellbeing and dignity. This article examines the effectiveness of risk-based regulation as a tool to address patient safety incidents linked to the hospital discharge process within the English National Health Service. It examines how the risk of this process is identified, conceptualised, and prioritised amongst the relevant statutory regulators, and argues that the risk is neither uniformly recognised by the statutory regulators within the English NHS, nor sufficiently addressed. Professional regulators in particular appear to have a poor awareness of the risk and their role in addressing it. Until these issues are resolved, patients leaving hospitals will continue to be exposed to patient safety incidents which should be avoidable.

2018 ◽  
Vol 64 (3) ◽  
pp. 659-693 ◽  
Author(s):  
Rene Wiedner ◽  
Saku Mantere

Based on a longitudinal, qualitative analysis of developments in the English National Health Service, we develop a process model of how organizations divest or spin off units with the aim of establishing two or more autonomous organizational entities while simultaneously managing their continued interdependencies. We find that effective organizational separation depends on generating two types of respect—appraisal and recognition respect—between the divesting and divested units. Appraisal respect involves showing appreciation for competence or the effort to achieve it, while recognition respect requires considering what someone cares about—such as values or concerns—and acknowledging that they matter. The process model we develop shows that open communication is crucial to the development of both. We also find that certain attempts to gain organizational independence and respect may unintentionally undermine the development of autonomy. Counterintuitively, we find that increasing or maintaining interorganizational links via communication may facilitate organizational separation, while attempts by units to distance themselves from one another may unintentionally inhibit it. By linking organizational separation, autonomy, independence, and respect, this paper develops theory on organizational separation processes and more generally enhances our understanding of organizational autonomy and its relations with mutual respect.


Author(s):  
Russell Mannion ◽  
Huw Davies ◽  
Stephen Harrison ◽  
Frederick Konteh ◽  
Rowena Jacobs ◽  
...  

2016 ◽  
Vol 28 (8) ◽  
pp. 482-489 ◽  
Author(s):  
A. Aggarwal ◽  
J. Nossiter ◽  
P. Cathcart ◽  
J. van der Meulen ◽  
J. Rashbass ◽  
...  

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