Kimberley R. Isett

When Change Becomes Transformation

Abstract This paper examines the implementation of large, transformative change in the Medicaid offices in New York City to improve efficiency and consumer-friendliness. A bottom-up process was engaged to design and implement the needed changes from those who were most affected by the change. Key informant interviews and observational site visits were conducted to assess the extent to which the change efforts were successful. We found that the changes impacted both quantitative measures of success (such as client processing times and number of clients served) as well as less tangible qualitative indicators of success such as staff attitudes and office climate.

The unbearable emptiness of tweeting—About journal articles

Enthusiasm for using Twitter as a source of data in the social sciences extends to measuring the impact of research with Twitter data being a key component in the new altmetrics approach. In this paper, we examine tweets containing links to research articles in the field of dentistry to assess the extent to which tweeting about scientific papers signifies engagement with, attention to, or consumption of scientific literature. The main goal is to better comprehend the role Twitter plays in scholarly communication and the potential value of tweet counts as traces of broader engagement with scientific literature. In particular, the pattern of tweeting to the top ten most tweeted scientific dental articles and of tweeting by accounts is examined. The ideal that tweeting about scholarly articles represents curating and informing about state-of-the-art appears not to be realized in practice. We see much presumably human tweeting almost entirely mechanical and devoid of original thought, no evidence of conversation, tweets generated by monomania, duplicate tweeting from many accounts under centralized professional management and tweets generated by bots. Some accounts exemplify the ideal, but they represent less than 10% of tweets. Therefore, any conclusions drawn from twitter data is swamped by the mechanical nature of the bulk of tweeting behavior. In light of these results, we discuss the compatibility of Twitter with the research enterprise as well as some of the financial incentives behind these patterns.

Watching Sausage Being Made: Lessons learned from the co-production of governance in a behavioural health system

Abstract We draw out lessons from a multi-level governance system implemented to create more consumer oversight and involvement in the governance of behavioural health services. Through two rounds of interviews, we identified key areas of design that were difficult to implement, resulting in the system continuing to operate as a top-down environment rather than a flatter arrangement. Although new governance structures can be implemented, the underlying culture of government has to shift to allow real buy-in. Until this happens, multi-level governance systems will remain single-layered and command and control systems. The patina of change will cause frustration and animosity among participants.

In and across bureaucracy: structural and administrative issues for the tobacco endgame

This article assesses the structural choices for the proposed tobacco endgame strategies. I focus on the issues associated with particular structural choices for the location of the implementation. Specifically, I discuss issues related to implementation of the endgame within a specific single agency, and issues related to a more widespread, broad implementation involving several agencies. Where appropriate, I provide examples of how the dynamics discussed would apply to particular endgame strategies. Issues related to design, administration, authority and finances are raised.

An Investigation Into the Characteristics of Papers With High Scholarly Citations in Public Administration: The Relativity of Theory and Method:

In this article, we investigate characteristics associated with highly cited journal articles in Public Administration, especially the extent to which high impact contributions are theoretical. Using citations as a measure of scholarly influence, we used a mixed qualitative and bibliometric approach to understand the factors associated with the most highly cited articles in Public Administration in the last 20 years. Specifically, we assessed the extent to which each article was theoretical or empirical in nature, the role of the journal in which each article was published, and the extent to which the article’s impact spanned disciplines. Results indicate that theoretical development, the journal in which an article is published, and strategic placement with regard to the intended audience matter for scholarly impact. We also identify that theoretical versus empirical approach of subdisciplines is aligned with the maturity of that subdiscipline, consistent with Kuhn’s ideas of scientific evolution.

Dental Blogs, Podcasts, and Associated Social Media: Descriptive Mapping and Analysis

Background Studies of social media in both medicine and dentistry have largely focused on the value of social media for marketing to and communicating with patients and for clinical education. There is limited evidence of how dental clinicians contribute to and use social media to disseminate and access information relevant to clinical care. Objective The purpose of this study was to inventory and assess the entry, growth, sources, and content of clinically relevant social media in dentistry. Methods We developed an inventory of blogs, podcasts, videos, and associated social media disseminating clinical information to dentists. We assessed hosts’ media activity in terms of their combinations of modalities, entry and exit dates, frequency of posting, types of content posted, and size of audience. Results Our study showed that clinically relevant information is posted by dentists and hygienists on social media. Clinically relevant information was provided in 89 blogs and podcasts, and topic analysis showed motives for blogging by host type: 55% (49 hosts) were practicing dentists or hygienists, followed by consultants (27 hosts, 30%), media including publishers and discussion board hosts (8 hosts, 9%), and professional organizations and corporations. Conclusions We demonstrated the participation of and potential for practicing dentists and hygienists to use social media to share clinical and other information with practicing colleagues. There is a clear audience for these social media sites, suggesting a changing mode of information diffusion in dentistry. This study was a first effort to fill the gap in understanding the nature and potential role of social media in clinical dentistry.

Philanthropic Foundation Strategies to Advance Systems Reform: Perceptions from Frontline Change Implementers

This article examines the strategies and processes pursued by one foundation aimed at accelerating systems change reform efforts in four states. The findings suggest four strategies the Foundation employed in reform efforts: partnering with state policy actors to accelerate systems change efforts, providing technical assistance to support implementation, leveraging the reputation of the Foundation toward systems change goals, and facilitating the dissemination of innovation to states and localities. This study contributes to the literature by documenting the combination of strategies the Foundation applied in their effort to advance systems change, and by exploring the perspective of system professionals onwhat Foundation activities were viewed asmore or less successful. Because systems change entails both policy and operational change, this study suggests foundation strategies need to harness both traditional approaches, such as targeting policy change, as well as approaches less traditionally used that may require new skill sets for foundations, including field building activities that enable system professionals to implement the change effectively.