Recently, the Centers for Medicare and Medicaid Services (CMS) ranked all hospitals based on Medicare readmission rates for heart attacks, heart failure, and pneumonia. CMS offered subsidies to hospitals ranked in the 4th quartile to develop community support services to reduce the problem of potentially preventable readmissions (PPRs). CMS cited 4 of the 5 hospitals in Prince George's County in the 4th quartile. The purpose of this quantitative research study was to investigate the relationship between community support services and the reduction of PPRs in Prince George's County. The Evans and Stoddart field model of health and well-being guided this study with support from Bertalannffy's general systems theory. This study sought to relate community support services to PPRs in Prince George's County in contrast to other Maryland counties. To evaluate relationships between community support services and the reduction of PPAs, secondary data were provided by CMS in conjunction with the Robert Wood Johnson Foundation and the University of Wisconsin. The data included 26 behavioral community support factors from 53,229 Medicare paid claims in Maryland residents from July 1, 2008 to June 30, 2011. Lack of diabetes screening is a community support factor within quality of care. Using multiple regressions, there was a statistically significant relationship found between diabetic screenings and pneumonia readmission rate. The implication for social change is that reimbursement of key screening recommendations to CMS, local government, and hospitals in Prince George's County may reduce readmission rates, thereby positively affecting patients, improving community health, and decreasing health care costs in Prince George's County.

Thesis (Ph. D.)--University of Melbourne, 1988. / Typescript (photocopy). Erratum inserted. Includes bibliographical references (leaves 627-652).

Thesis (Ph.D.) -- McMaster University, 1998. / Includes bibliographical references (leaves 143-147). Also available via World Wide Web.

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1992. / Source: Masters Abstracts International, Volume: 45-06, page: 2930. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 54-60).

Thesis (M.P.A.)--University of Hong Kong, 1998. / Includes bibliographical references (leaf 112-117).

Thesis (M.P.A.)--University of Hong Kong, 1998. / Includes bibliographical references (leaves 112-117). Also available in print.

Governments around the world have been increasingly adopting an ‘outcomes-focus’ in the design of policy and the management of public services, the implications of which have been subjected to increasing scrutiny within public administration (Boyne and Law 2005; Elvidge 2012; Heinrich 2002; Housden 2016; Lowe 2013; Lowe 2017; Wimbush 2011). Yet wherever an outcomes-based approach has been applied, be it within performance management (Bevan and Hood 2006; Lowe 2013; van Thiel and Leeuw 2002), budgeting (Perrin 2006; Ryan 2003), or commissioning, its achievements have fallen short of expectation (Wimbush 2011). Outcomes have predominantly been conceptualised and operationalised within what this thesis calls a ‘Rationalist’ approach, linked to the New Public Management context within which an outcomes-focus was popularised. This approach assumes we can understand the factors which drive outcomes, plan appropriate service interventions, harness the resources and commitment needed to put such interventions into practice, and manage such interventions towards their expected end points. Outcomes however are inherently complex phenomena – they are always transboundary, always co-produced by the individuals who experience them, and always impacted by a large number of unpredictable and uncontrollable factors in their external environment. Public management theory and practice finds itself at a crossroads: an imperative to improve outcomes, and a paradigmatic inability to do so – a challenge which scholarship is just beginning to respond to (Housden 2016; Lowe et al. 2016). This thesis contributes an alternative ‘Complex Systems’ theoretical framework which responds to (rather than simplifies or externalises) the inherent complexity which outcomes present. This theoretical framework draws on complex adaptive systems theory to enable a ‘Complex Systems’ approach to the management of outcomes. The framework is based on the conception of outcomes as emergent products of complex systems, and integrates three defining components of complex adaptive systems (self-organisation, distributed agentic learning, and attractor states) to enable an endogenous process of service transformation in conditions of uncertainty. This theoretical framework provides public management with more solid footing for understanding, analysing and designing outcomes-focussed interventions, with distinct advantages relative to existing outcomes-based approaches, in pursuing complex public service outcomes. The thesis applies this framework through a multiple embedded case study analysis (Yin 2009) of the Early Years Collaborative, a large-scale multi-agency Quality Improvement Collaborative operating across Scottish local authorities, as it seeks to improve a set of population-level child development outcomes.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-10-05T17:48:39Z No. of bitstreams: 1 julianonerydecarvalho.pdf: 2915335 bytes, checksum: cd4c1ea740037408a70af7ccdeb36f94 (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-10-06T12:30:35Z (GMT) No. of bitstreams: 1 julianonerydecarvalho.pdf: 2915335 bytes, checksum: cd4c1ea740037408a70af7ccdeb36f94 (MD5) / Made available in DSpace on 2016-10-06T12:30:35Z (GMT). No. of bitstreams: 1 julianonerydecarvalho.pdf: 2915335 bytes, checksum: cd4c1ea740037408a70af7ccdeb36f94 (MD5) Previous issue date: 2009-05-22 / Este projeto realiza uma análise dos textos produzidos pela Assessoria de Comunicação e Qualidade da Prefeitura de Juiz de Fora, gestão 2005-2008, para o projeto Curumim da Associação Municipal de Apoio Comunitário. O corpus utilizado para apreciação foram os textos publicados no site da Prefeitura sobre este tema, buscando verificar com que frequência e com que elementos eram constituídos estas inserções midiáticas. De posse destes dados, observou-se a questão da personificação dos atores políticos, a realização ou não da democratização ao acesso à informação via os mecanismos de assessoria de imprensa, ente presente na nova administração pública, e a forma como o conteúdo discursivo sobre as políticas sociais do município é encaminhado à sociedade. Para este estudo, foram realizadas coletas de dados, revisão bibliográfica acerca do objeto de estudo, bem como análises secundárias de temas pertinentes ao projeto, bem como aferição de dados. / This project realizes an analysis from the texts producing by Adviser of Communication & Quality from City of Juiz de Fora, administration 2005-2008, for the project “Curumim” from Associação Municipal de Apoio Comunitário. The corpus used about to appreciation have been the texts into the site from City on the subject of this theme, picking verify with which frequency & with which elements they used to be constitutement these insertions in these media. Of ownership of these dice, observer - if the question of personify from the actors politicians, the realization or not from democratization the access to information she saw the mechanisms of agency of press, a being present on new public administration the shape what the contents discourse on the subject of the policies socials of the country on the society. About to this study, have been realized collect of data, review bibliographic, as well as overhauls secondary of themes, as well as calibrating of data.

Esta pesquisa busca compreender a constituição do movimento Campo de Públicas a partir do referencial teórico sobre identidade fornecido pela psicologia social. Num contexto de revigoramento da Administração Pública e de ampliação da oferta de matrículas nesses cursos, o movimento Campo de Públicas destaca-se como expressão de uma coletividade que se articula para o reconhecimento das particularidades da formação de gestores públicos. Trata-se de um estudo exploratório de natureza qualitativa. A partir do estudo da legislação que orienta a formação desses profissionais e dos referenciais fundamentais da ciência administrativa, a identidade pressuposta do administrador é traçada A parte empírica da pesquisa é desenvolvida a partir de entrevistas realizadas com integrantes do movimento Campo de Públicas, bacharéis em Administração, e analisadas com base na Análise de Conteúdo. Com base nessas entrevistas, a pesquisa evidencia que distinções significativas entre as identidades profissionais de administradores (de empresas) e administradores públicos foram um fator determinante para a constituição do movimento e o posicionamento de negação dessa identidade foi fundamental para o ingresso dos entrevistados no movimento. O Campo de Públicas foi também associado à ideia de paradigma emergente apresentado por Keinert (2000). De acordo com os resultados da pesquisa, o movimento pode ser considerado uma evidência da consolidação do Paradigma Emergente apontado por Keinert (2000). Constatou-se que a natureza da identidade coletiva em construção é uma identidade de resistência à imposição de referenciais típicos da ciência administrativa hegemônica. Todavia o movimento sinaliza em direção à construção de uma identidade de projeto, ancorada na multiplicidade da formação de seus atores e na possibilidade de construção de referencias multidisciplinares, que possam orientar a formação de gestores públicos ou até mesmo a constituição de uma identidade própria para a administração pública brasileira. / This research aims to understand the moviment constitution from the Field of Public by the theoretical framework of identity provided by social psychology. In a context of strengthening of public administration and increasing the supply of enrollments in these courses, the moviment Field of Public stands out as a collective expression of which is linked to the recognition of the peculiarities of the formation of public managers. This is an exploratory qualitative study. From the study of the legislation that guides the formation of these Professionals and of the fundamental references of administrative science, the assumed identity of the administrator is drawn. The empirical part of the research is developed from interviews with members of the moviment Field of Public bachelors in business administration and analyzed using the Content Analysis tecnique. Based on these interviews, the research shows that significant distinctions between the identities of professional administrators (from companies) and public administrators were a determining factor for the formation of the movement and positioning of denial of this identity was crucial for the respondents entrance in the moviment. The Field of Public was also associated with the idea of emergent paradigm presented by Keinert (2000). According to the survey results, the movement can be taken as na evidence from the consolidation of the Emerging Paradigm pointed by Keinert (2000). It was found that the nature of collective identity construction is an identity of resistance to the imposition of typical benchmarks of hegemonic administrative science. Although the moviment points toward the construction of a project identity, anchored in the multiplicity of the formation of its actors and in the possibility of building multidisciplinary referrals, which can guide the public managers formation or even the creation of an identity for the Brazilian public administration.

Thesis (Ph.D.)--McMaster University, 2004. / Advisor: Tony Porter. Includes bibliographical references (leaves 225-238) Also available via World Wide Web.