Property crime in Lowell, Massachusetts is fueled primarily by burglaries, motor vehicle crimes, and larcenies. The Lowell Police Department utilized the Smart Policing Initiative (SPI) to focus problem-solving efforts on property crime hot spots. Problem-solving is an effective crime reduction tool but deficiencies remain in implementing the problem-solving process. This article discusses how Lowell operationalized problem-solving in crime hot spots, focusing on the alignment between property crime problems and response strategies selected to achieve results. We apply the congruence model of organizational behavior, analyzing quantitative and qualitative data to measure the fit between problems and responses. We found a high degree of congruence between the SPI problem-solving components, which likely produced the positive crime reductions observed in the outcome data. By applying the concept of congruence, we offer a framework for strengthening problem solving at the outset through alignment of response strategies to crime problems.
Collaboration is identified as an essential component for the successful implementation of a wide range of policies and programs. A major collaboration challenge, particularly in large community initiatives, is the need for multiple organizations to develop strategic partnerships around a shared purpose. Due to the importance of collaboration in achieving desired outcomes, the readiness of organizations to collaborate, and the quality of relationships between organizations are key, particularly in the formation stage. This is especially true of community coalitions, where collaboration requires comprehensive planning, shared decision‐making among stakeholders, and a high level of productivity and quality of relationships based on trust and mutual respect. In this chapter, we present two evidence‐based frameworks and evaluation tools that can be used to assess and build readiness and high‐quality relationships in efforts to improve community outcomes. This is illustrated in a case example of a new community coalition focused on increasing youth safety and improving police‐community relationships in a high crime neighborhood. Implications and lessons learned are discussed.
Objective: This caregiver case study applies the lens of relational coordination theory (RC) to examine the value of telehealth as a medium of care coordination for a pediatric patient with hypermobile Ehlers-Danlos Syndrome (hEDS) during the COVID-19 pandemic.Background: The COVID-19 pandemic has placed an unprecedented burden on the delivery of healthcare around the globe and has increased the reliance on telehealth services. Delivering telehealth requires a high level of communication and coordination within and across providers as well as between providers, patients and their families. However, it is less clear how telehealth impacts the coordination of care. In this paper, we provide insight into the quality of care coordination between providers and an informal caregiver following policy changes to the provider payment structure in Massachusetts.Methods: This paper employs a single-case, autoethnographic study design where one of the authors uses their experiential insights, as mother of the patient, to inform a wider cultural and political understanding of the shift to remote caregiving for a pediatric patient with hEDS. Data was collected using reflective journaling, interactive interviews, and participant observation and analyzed using content analysis.Results: Findings revealed four interrelating roles of the caregiver including, logistics support, boundary spanner, home health aide, and cultural translator. The adoption of telehealth was associated with improved timeliness and frequency of communication between the caregiver and providers. Findings about the impact of telehealth adoption on accuracy of communication were mixed. Mutual respect between the caregiver and providers remained unchanged during the study period.Conclusions: This paper highlights areas where payer policy may be modified to incentivize timely communication and improve coordination of care through telehealth services. Additional insight from the perspective of an informal caregiver of a patient with a rare chronic disease provides an understudied vantage to the care coordination process. We contribute to relational coordination theory by observing the ways that caregivers function as boundary spanners, and how this process was facilitated by the adoption of telehealth. Insights from this research will inform the development of telehealth workflows to engage caregivers in a way that adds value and strengthens relational coordination in the management of chronic disease.
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