Utilizing the Clinical Social Work Model to Foster Collaboration Among HIV Providers in North Carolina

Abstract

This article demonstrates one effort to examine the applicability of client behavioral change models to medical provider and case manager behavioral change. The clinical social work model is used to explain the behavioral change process when providers were asked to utilize a voluntary and complex data management system to manage clients' HIV care. Through intense psychosocial support and training initiatives, providers were able to alter their behaviors so that they could successfully integrate new strategies and technologies into their practice while providing better quality care to their clients.     

Nurse managers’ narratives of organizational change in the English National Health Service

Aims To investigate nurse managers’ accounts of organizational change. Background While the importance of the ward manager role in delivering quality care is recognized, less is known about ward managers’ involvement in change. Methods Face to face qualitative narrative interviews were conducted. They were audio recorded, transcribed verbatim and analysed thematically. Results Managers were experiencing change that was occurring at an increasing rate. They reported that being effective communicators was central to their approach to managing change. The hybrid nature of the role informed their approach to change and enabled them to initiate and control it to a degree at ward/department level. They did not base their management approach on theory and focused activity more on the practical and contextual nature of change. Implications for nursing management Organizational change has attracted a great deal of attention in research terms; however, there are few studies that examine nurse managers’ experiences of change. The accumulated expertise and experience of this group of staff is an untapped resource in terms of mobilizing organizational change in hospitals in England. More attention to work-based learning and support would assist managers in their role.     

Organizational Correlates of Specialized Substance Abuse Treatment Provision to Seropositive Clients

Abstract

Data from the Alcohol and Drug Services Study, 1996–1999 (United States Department of Health and Human Services [USD-HHS], 2002), a nationally representative sample of 2,351 drug treatment programs were examined to identify organizational predictors of specialized substance abuse treatment provision to seropositive clients. The Political Economy Perspective developed by Wamsley and Zald (1976) was used to interpret results. A minority of facilities (22%, 517) provided specialized treatment. Among internal political economy measures, provision of mental health (p < 0.01), basic HIV services (p < 0.05), as well as methadone maintenance treatment (p < 0.05) were significantly and positively associated with specialized treatment provision. Among external political economy measures, managed care funding significantly decreased the likelihood of specialized treatment provision (p < 0.05), while parent organization control (p < 0.01) and number of clients (p < 0.01) significantly increased it. Specialized treatment provision was significantly positively associated with proportion of Blacks, Hispanics, seropositives (p < 0.01 for all), and injection drug users (p < 0.05).