The COVID-19 System Shock Framework: Capturing Health System Innovation During The COVID-19 Pandemic

Background: COVID-19 has resulted in over 2 million deaths globally. The experience in Australia presents an opportunity to study contrasting responses to the COVID-19 health system shock. We adapted the Hanefeld et al framework for health systems shocks to create the COVID-19 System Shock Framework (CSSF). This framework enabled us to assess innovations and changes created through COVID-19 at the Sydney Children’s Hospitals Network (SCHN), the largest provider of children’s health services in the Southern hemisphere. Methods: We used ethnographic methods, guided by the COVID-19 System Shock Framework, to map innovations and initiatives implemented across SCHN during the pandemic. An embedded field researcher shadowed members of the Emergency Operations Centre (EOC) for nine months. We also reviewed clinic and policy documents pertinent to SCHN’s response to COVID-19 and conducted interviews and focus groups with stakeholders, including clinical directors, project managers, frontline clinicians, and other personnel involved in implementing innovations across SCHN. Results: The CSSF captured SCHN’s complex response to the pandemic. Responses included a COVID-19 assessment clinic, inpatient and infectious disease management services, redeploying and managing a workforce working from home, cohesive communication initiatives, and remote delivery of care, all enabled by a dedicated COVID-19 fund. The health system values that shaped SCHN’s response to the pandemic included principles of equity of health care delivery, holistic and integrated models of care, and supporting workforce wellbeing. SCHN’s resilience was enabled by innovation fostered through a non-hierarchical governance structure and responsiveness to emerging challenges balanced with a singular vision. Conclusion: Using the CSSF, we found that SCHN’s ability to innovate was key to ensuring its resilience during the pandemic.

Response of contractor behavior to hierarchical governance: effects on the performance of mega-projects

PurposeThis study aims to examine the impacts of formal and informal hierarchical governances (HGs) on the performance of mega-projects and the mediating role of contractor behavior (i.e. perfunctory and consummate behaviors) in these relationships.Design/methodology/approachA total of 375 valid data entries from managers representing 375 mega-projects were analyzed through path analysis.FindingsBoth formal and informal HGs exert positive effects on the performance of mega-projects. While formal HG positively affects contractor perfunctory behavior and contractor consummate behavior, informal HG affects contractor perfunctory behavior only. Contractor behavior mediates the relationship between formal HG and project performance.Research limitations/implicationsThe impacts of potential moderators (e.g. institutional arrangement and complexity) on the relationship between HG and contractor behavior have not been considered in this study.Practical implicationsThis study is useful for owners to enhance formal HG to improve contractor perfunctory and consummate behaviors, which in turn can enhance the performance of mega-projects.Originality/valueThis study expands the knowledge of mega-project performance management from the perspective of HG. It also contributes to the literature of contractor behavior within the context of mega-projects.

Explaining the Western Cape Performance Paradox

In this chapter we consider how well primary school students perform in the Western Cape when compared with their peers in other provinces and countries across Southern and Eastern Africa. We find that while the Western Cape is a relatively efficient education system within South Africa, particularly in serving the poorest students, a less-resourced country such as Kenya produces higher Grade 6 learning outcomes at every level of student socio-economic status. The system performance differentials are not explained away by differences in resourcing, teacher, school inputs, or indicators of hierarchical governance. The results point to the limits of strong Weberian bureaucratic capabilities for raising learning outcomes.

POTENTIAL OF BIG DATA FOR PRO-ACTIVE PARTICIPATORY LAND USE PLANNING

The presence of (spatial) big data presumes that citizens can more actively collect and analyse data for their own land use goals. This article evaluates that claim. Given that land use planning heavily depends on participation and citizens’ own contributions the core question is whether and how (spatial) big data can enhance and/or complement current land use planning endeavours. The article starts by defining and conceptualising the various phases and objectives of land use planning. This is needed to verify where citizen participation can play a crucial role and where bottom-up influence can actually emerge. The article is fundamentally explorative. It relies on evaluating existing websites and documentation which conceptualise (spatial) big data and smart application, with a particular emphasis on ‘smart people’. A number of specific cases are explored in order to verify how and in which type of land use planning activity citizens are actively. The evaluation indicates that many the smart applications making use of big data are still largely driven by conventional hierarchical governance structures. The choice of data and associated analytics are still largely confined and the opportunities whereby the designs of the new and alternative land use options by citizens are accepted or adopted is still limited. The take-home message is that adoption of big data for the purpose of empowering citizens is still limited. There probably needs to be more exemplary projects and various forms of capacity development and exploratory pilots before the full potential of (spatial) big data can be employed for bottom-up land use planning.

China's World-Class 2.0: Towards More Institutionalized and Participatory Policymaking?

China's quest to have world-class universities has entered a new phase since 2015, with the 'Double World-Class Project' replacing the '985 Project' and the '211 Project' launched in the 1990s. The transition from World-Class 1.0 to World-Class 2.0 provides a good window onto changes in China's policymaking. The prevailing literature has identifi ed broad trends such as institutionalization, decentralization and expanded participation. While this paper fi nds evidence in support of the prevailing literature, it also challenges the thesis of institutionalization, decentralization and expanded participation. The celebrated evolution from 'hierarchical governance' to 'network governance' or from 'consultation' to 'deliberation' in China's policymaking, however desirable, is premature—especially for multibillion, high-stakes policy initiatives such as the 'Double World-Class Project'.

Hierarchical and Non-Hierarchical Coordination

This chapter focuses on hierarchical and non-hierarchical (including deliberative) governance modes in areas of limited statehood (i.e. on the ‘how’ of governance). Actorhood and modes of governance are orthogonal to each other. State actors are involved in non-hierarchical governance and non-state actors—including violent ones—sometimes exercise hierarchical control over people and territories. The effectiveness and problem-solving capacity of these modes of governance should not be underestimated. ‘New’ modes of governance appear to be more effective on average than hierarchical governance, particularly when the latter has to rely on force and coercion. Deliberative bodies, such as non-state justice institutions, can be rather effective in solving disputes and restoring peace within communities. Both hierarchical and non-hierarchical modes depend on two crucial conditions for their effectiveness, namely the social acceptance (legitimacy) of the governors and/or the governance institutions, on the one hand, and the institutional design of the governance arrangements, on the other.