Professor Rebecca Mitchell

© 2019, Springer Science+Business Media, LLC, part of Springer Nature. This review synthesises theoretical approaches and methodological considerations in mental health service quality assessment from consumers-perspective. We searched published articles from databases: EMBASE, MEDLINE, CIHNAL, Scopus, Web of Science, and PsycINFO. Of the 30 included papers, 16 contained instruments used to mental health quality assessment and 14 focused on theoretical constructs. The review finds that mental health quality assessment is explained and measured using constructs that focus on structure, process and outcome. The methodological issues that need critical consideration are the context and cultural norms of services, outcome perspectives, evaluator, sources of information as well as the selection of consumers and instruments. The review recommends that researchers and clinicians should consider the theoretical constructs and methodological issues in mental health quality assessment.

© 2019 Wiley Periodicals, Inc. Purpose: To explore factors influencing treatment pathways to mental health services among consumers in Ghana. Design and Methods: Cross-sectional design using quantitative method. Findings: Treatment pathways for mental illness were general hospitals/clinics, psychiatric hospitals, and faith-based practices. The predisposing (age, household size, primary occupation, ethnicity, marital status, religion, and geographic location, as well as attitudes and beliefs), enabling (affordability), and need factors (severity of mental illness) were significant predictors of treatment pathways. Practice Implications: Current advocacy and awareness for mental health services in Ghana should consider the predisposing, enabling, and need factors of consumers. Policy initiatives on mental health services should ensure adequate financing mechanisms and further establish collaboration between biomedical and faith-based services.

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. This study investigates a moderated mediation model of professional commitment and team effectiveness through cognitive diversity moderated by task conflict. Data were collected from 70 UK healthcare teams and their leaders using two questionnaires. We find that teams comprised of members who have, on average, high professional commitment are more effective than teams of members who are less committed and that this path is mediated by cognitive diversity and contingent on task conflict. Team composed of members who are strongly committed to their profession may be more effective consequent to their advocacy of different perspectives and expertise, reflecting cognitive diversity. However, this positive effect of professional commitment is not universal but contingent on the level of disagreement between members on task-related issues. This is one of the first studies to demonstrate that professional commitment can increase team effectiveness and does so through a complex contingent path. While few studies have investigated professional commitment, our results suggest that such commitment can be of great value to multidisciplinary teams.

© 2019 Wiley Periodicals, Inc. Multidisciplinary teams are increasingly advocated for in healthcare policy consequent to their capacity to develop innovative solutions to seemingly intractable service and care challenges. Recent arguments that inspirational leadership styles may foster innovation in multidisciplinary teams point to their potential value in this effort. However, inconsistency in the capacity of such leaders to engender innovation highlights the need to understand the mechanisms and boundary conditions that determine when such leadership generates positive effects. We argue that follower positive mood acts to mediate the path between inspirational leadership and innovation and may account for its variable effects. By increasing positive team mood, inspirational leaders can potentially bring about more flexible thinking and enhance innovation but can also increase reliance on less effortful information processing, undermining innovative potential. In an effort to address the dilemma posed by these contrasting effects, we propose that professional salience acts as an important boundary condition of this relationship such that only when profession is salient do inspirational leaders enhance multidisciplinary team innovation through positive mood. An analysis of survey data from 60 UK-based multidisciplinary healthcare teams, investigating the inspirational leadership of practice-based innovation, supports our moderated mediation model. Finally, the implications for HRM are considered, specifically for leader development and work team design.

© 2017 Nordic College of Caring Science Rationale and aim: Working with assistants has the potential to be an economically and professionally sustainable solution to workforce shortages in speech-language pathology. However, there is some resistance to the workforce redesign, and factors that determine how assistants are utilised are not well understood. The aim of this study was to understand the perceptions that engender professional resistance and identify factors that may lessen such resistance. Method: Semi-structured interviews were conducted with 20 speech-language pathologists (SLPs) to learn about perceptions towards implementing assistants into the profession. Findings and discussion: While assistants were seen as augmenting existing capacity, findings demonstrated ambivalence towards their utilisation, with tension between perceived benefits and risks of SLPs utilising assistants. Sharing workload and reducing administrative duties in favour of increasing clinical output was an important positive perception. However, this perception was moderated by the concern that the introduction of assistants would result in a decrease in consumer focus, which was seen as being at odds with the strongly held values of the profession. Findings provide insight into professional acceptance of this vocationally trained group and highlight discrepancies between perceptions and actualities, both of which may influence how assistants are utilised. They suggest that implementation of a workforce redesign involving assistants may result in paradoxical perceptions among SLPs. Understanding the way SLPs think about working with assistants and how this workforce redesign may be realised will impact on how SLPs view their role and their relationships with co-workers. This understanding will also be useful in a wider sense for organisations seeking to introduce assistants, by allowing enhanced understanding of likely areas of resistance, as well as highlighting possible strategies that may be useful to address such issues.

© 2017, © Ashish Malik, Brendan Boyle and Rebecca Mitchell. Purpose: The purpose of this paper is to examine innovation in the resource-constrained context of India¿s healthcare industry. It is argued that the process of innovation in addressing healthcare management challenges in such a context occurs through organisational ambidexterity and that human resource management (HRM) plays an important role. Design/methodology/approach: A qualitative research methodology is applied to explore the role of HR practices in facilitating contextual ambidexterity and subsequent innovations in healthcare in India. The unit of analysis is the ¿case¿ of healthcare providers in India and in-depth interview and documentary data in two case sites are analysed to reveal the role of HRM in facilitating contextual ambidexterity and innovation. Data analysis was undertaken first at a within-case and then at a cross-case analysis level using interpretive manual coding based on how the data explained the role of HRM in delivering innovative outcomes and supporting organisational ambidexterity. Findings: The authors found evidence of the use of sets of high-involvement HRM practices for exploration of new ideas and efficiency-driven HRM practices for creating contextual ambidexterity in the case organisations. Further, managerial/leadership style was found to play an important role in creating cultures of trust, openness, risk-taking and employee empowerment, supported by an appropriate mix of intrinsic and extrinsic rewards. Finally, training was also reported as being central to creating an ambidextrous context for delivering on various innovations in these healthcare providers. Originality/value: This study represents an exploration of innovation in the context of India¿s healthcare sector through intersecting literatures of ambidexterity, innovation and HRM practices. In light of the emerging economy research context, an important empirical contribution is palpable. Moreover, through a study design which included collecting data from multiple informants on the role of human resources in facilitating innovative outcomes, the authors reveal the role of HR-related initiatives, beyond formal HR practices in creating contextual ambidexterity. This study also reveals the degree to which contextual idiosyncrasies enhance our understanding of the role of HR in facilitating innovation in emerging economies.

© 2016 John Wiley & Sons Australia, Ltd. The nurse consultant (NC) role in Australia is a senior classification of advanced practice nurse has been described as enhancing health care outcomes largely through extensive collaboration with consumers, nurses, and other health professionals. However, little is known about the actual nature, amount, and quality of NC interactions. This study examines the connectivity of the NC role across metropolitan and rural contexts, using a mixed method sequential design with an online survey and focus groups with NCs and other stakeholders. Results demonstrated that NCs most commonly have high density connectivity patterns with other nursing colleagues, medical staff, patients/clients, and administrative staff. Position grade (1, 2 or 3) influences density of connectivity, as does location, with those based in metropolitan roles engaging significantly less with other clinicians. Findings demonstrate that many NCs are highly collaborative and predominantly embedded into interprofessional practice models. This study provides valuable insight into the diverse and often complex NC role and the way in which NC expertise and influence is deployed and integrated across a large local health district.

Aim: To describe the research protocol that will be used to investigate factors contributing to effective interprofessional practice in a rural context in Australia. Background: Interprofessional practice is a key strategy for overcoming rural health challenges; however, our knowledge of interprofessional initiatives and consequences in rural areas is limited. Design: A modified realistic evaluation approach will be used to explore the structures, systems, and social processes contributing to effective interprofessional outcomes. This 'context-mechanism-outcome' approach provides a useful framework for identifying why and how interprofessional practice works in rural contexts. Method: Initial propositions regarding the factors that explain effective collaborative practice will be generated through interviews with lead clinicians, policy-makers, and clinician managers. Clinician interviews, document analysis, and multi-participant focus groups will be used as evidence to support, refine, or redevelop the initial propositions. This will allow the development of a model of rural interprofessional practice that will explain how and why collaborative approaches work in rural environments. This study is funded by an Institute of Rural Clinical Services and Teaching grant (January 2010). Discussion: Rural healthcare challenges are well documented; however, studies investigating the nature of interprofessional practice in rural contexts are not common. Rural contexts also present research design, particularly data collection, challenges. This proposed research is one of the first to identify the factors that facilitate or constrain effective interprofessional work in rural settings. This is particularly important, given the continuing workforce shortages and maldistribution and poorer health outcomes in rural communities globally. © 2013 Blackwell Publishing Ltd.

Workforce shortages are forecast for speech-language pathology in Australia, and will have a more significant impact on rural and remote areas than on metropolitan areas. Allied health (AH) disciplines such as physiotherapy and occupational therapy address the problem of workforce shortages and growing clinical demand by employing allied health assistants (AHAs) to provide clinical and administrative support to AH professionals. Currently, speech-language pathologists (SLPs) don't work with discipline-specific allied health assistants in all states of Australia (e.g., New South Wales). This paper aims to provide insight into the perceptions of SLPs in one Australian state (NSW) regarding working with AHAs. Semi-structured interviews were conducted with eight rural SLPs. Qualitative analysis indicated that participants perceived they had deficits in skills and knowledge required to work with AHAs and identified further training needs. Participants perceived the SLP role to be misunderstood and were concerned about poor consultation regarding the introduction of AHAs into the profession. Ambivalence was evident in overall perceptions of working with AHAs, and tasks performed. While previous research identified benefits of working with AHAs, results from this study suggest that significant professional, economic, and organizational issues need addressing before such a change should be implemented in speech-language pathology. © 2013 The Speech Pathology Association of Australia Limited.

Purpose: The growing prominence of knowledge workers in contemporary organisations has led to a considerable amount of research into their role and activities, however, despite this growing interest, there remains a lack of clarity regarding the relationship of knowledge workers to management. This paper aims to respond by investigating the features of knowledge work that impose barriers to traditional managerial control methods and exploring the extent to which alternative approaches to influence are available to knowledge work managers, and the circumstances under which these different approaches are indicated. Design/methodology/approach: The paper utilised agency theory to investigate the implications of knowledge asymmetry in principal-knowledge worker exchanges, and argues against the utility of models of control based on principles of scientific management on which agency models are typically based, towards models of control based on reciprocity and commitment. Findings: The paper has two main outputs. First, it argues that situations in which knowledge-based specialists are hired to perform tasks requiring expertise can be viewed as principal-agent exchanges (Mills) and are therefore open to analysis through an agency theory lens. The second endeavour is to discuss the implications of knowledge asymmetry in principal-knowledge worker relationships for managerial control and influence, and posit alternative modes of managerial control based on normative influence and valiant rewards. Further, it develops propositions relating to the factors likely to moderate the utility of each managerial influence strategy. Originality/value: By undertaking this investigation, the paper responds to calls by Frenkel et al. to understand process and dynamics of control in managing knowledge workers. It moves away from models of control based on principles of scientific management on which agency models are typically based, towards models of control based on reciprocity and commitment. It develops testable propositions regarding specific sources of influence in knowledge work and the circumstances under which the employment of these influence strategies is indicated. This responds to calls by authors such as Tampoe; and Lord to develop a detailed understanding of the manner and extent to which influence strategies need to complement specific knowledge worker characteristics. © Emerald Group Publishing Limited.

The results of research on diversity in teams suggest that it offers both a great opportunity for organisations as well as an enormous challenge. However, current research is plagued by a lack of overall consistency, indicating that the relationship between diversity and team performance is not well understood. This study examines the components of cognitive conflict in order to assess whether construct operationalisation may explain this inconsistency. Analysis of the existing operationalisations of cognitive conflict reveals that it incorporates both disagreement about information and reasoning, and debate of rival hypotheses or recommendations. We propose that functional diversity leads to cognitive disagreement but not debate, and that debate enhances knowledge creation, with which cognitive disagreement shows no relationship. Our results support these hypotheses, which provide a powerful explanation for the contrary results found by researchers investigating cognitive conflict. Given that extant measures of cognitive conflict include scale items which measure both debate and cognitive disagreement, cognitive conflict may be viewed as an aggregate measure of these two distinct constructs. This study contributes to research on diversity and conflict by providing an explanation for contrary results, and by providing and a detailed operationalisation of cognitive conflict and its component constructs. It also contributes to research into creativity and innovation by providing insight into the dynamics underpinning knowledge sharing and creation.

This paper contributes to our understanding of the process of knowledge creation in organisations. Based on a process model, the paper develops propositions relating to factors facilitating knowledge creation in cross-functional work teams. These propositions relate to the constructs of cognitive diversity, transactional memory, trans-specialist knowledge and their contribution to new knowledge development through knowledge boundary spanning. © 2006 Operational Research Society Ltd. All rights reserved.

This paper contributes to our understanding of knowledge creation by developing a comprehensive model of the knowledge creating process in organisational work teams. It subsequently synthesises contemporary theory across research streams to develop hypotheses relating to three factors capable of facilitating the knowledge development process - cognitive diversity, transactional memory and openmindedness norms. In combination, the conceptual rationale and empirical support act to substantiate three key relationships in the knowledge creation process.

This study explores the assumption that the impact of diversity on knowledge creating capability is consequent to associated differences in knowledge and perspectives, and contrast this mechanism against an alternative pathway, the utilisation of deliberative, collaborative behaviours. To investigate this theory, we assess whether cognitive heterogeneity and debate operate as mediating variables between two types of diversity, functional and cultural, and knowledge creation. The results provide support for both mediators and also generate evidence suggesting that functional and cultural diversity impact on knowledge creation through different mechanisms.