Purpose -Clinical governance has become internationally recognised as a whole-system framework for the continuous improvement of quality in health service delivery. This study aims to explore the issues in implementing a comprehensive clinical governance framework in an organisation that provides services to children and adults with intellectual disabilities supported by a wide range of clinical interventions and therapies. Design/methodology/approach -This was an action research study that utilised a co-operative inquiry approach because of its capacity to facilitate engagement in a collaborative "bottom-up" meets "top-down" process amalgamating theory with organisational priorities to achieve practical and planned change. Action research methodologies use a problem solving approach, focus on real-life issues, and are open and inclusive. The study aimed to identify current practices in inter-disciplinary team working including the measurement and monitoring of quality, and to design collaboratively an integrated team-based service delivery model that focuses on continuous improvement in the quality of clinical services. Findings -The study highlights the benefit of adopting a co-operative inquiry approach to the development of a clinical governance framework. Staff at all levels began to take ownership of the clinical governance agenda. The systemic perspective promoted collaboration across clinical and non-clinical disciplines and it is anticipated that it will result in new approaches to service quality in the organisation in the future. Originality/value -This case study demonstrates how the practical and participatory approach of the action research and co-operative inquiry methodologies can contribute to the resolution of a real organisational issue and enable transformational change in the infrastructure of clinical services.
The pressures of 'accelerated adulthood' are a critical challenge for young people ageing out of the care system. Despite the trauma related to their placement history, young people 'aging out' are expected to adapt to adulthood at younger age and faster pace than their non-care peers, who enjoy an 'extended adolescence' a far more gradual progression into adulthood than previous generations. This article draws on firstperson narratives of care leavers in Ireland who have aged out of care and transitioned into independent living in a dedicated social housing programme to examine their strategies for coping with these competing pressures. It examines their worries about the sudden withdrawal of supports after they reach 18 years, which they characterized as a 'care cliff'. The emotional and practical challenges they faced when transitioning to independent living at a comparatively young age are explored, and strategies for mitigating these are identified. These include better preparing care leavers for this transition, maintaining supports for longer and withdrawing them in a more gradual way, which is tailored to meet the specific needs of each care leaver and grounded in more comprehensive after care planning than has been the norm in Ireland.
The author looks through Albert Bandura’s self-efficacy lens onto the effects it likely has on school principals’ effectiveness. Self-efficacy should be viewed as a principal’s belief in his or her capabilities to structure a particular course of action in order to produce desired outcomes. Principal self-efficacy has been linked with effective leadership, effective schools, the school restructuring process, and the quality of teaching and learning. Principals’ thoughts and actions influence the school culture, and research indicates that a principal can have a negative effect during a period of change. For these reasons, it is important for principals to have a strong sense of self-efficacy.
While recent state and federal education policies convey a sense of urgency in regard to the need for education reforms, there are teachers for whom this sense of urgency has long been woven into the fabric of their practice. Fortified by their high expectations for their students, these teachers utilize strategies that convey the message that the work is worthwhile and important; it is“work that matters.” Among the factors that foster a sense of urgency in the classroom are the skillful use of time and purposeful planning; they promote motivation, engagement, and student accountability.
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