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    Inter-district flow transfers : health and economic impacts : a thesis presented in partial fulfilment of the requirements for the degree of Master of Business Studies in Economics at Massey University, Albany, New Zealand
    (Massey University, 2018) Bruce-Brand, Bronwyn
    As part of the introduction of the New Zealand Public Health and Disabilities Act in 2000, the introduction of the Population Based Funding Formula led to a change in the flow of funds for transfer patients. Prior to the PBFF, for the years 2000-2003, healthcare events were contracted on a fee-for-service basis and thus were borne by the DHB of treatment. From 2003 onwards, the cost of transfer patients followed the transfer back to their DHB of domicile. This study replicates and extends work done by Shin (2013) in assessing the impacts of this change in funding flows on the level of transfer and patient health outcomes. I use OLS and logistic modelling to empirically assess these effects and draw conclusions as to the effectiveness of the policy change and any potential efficiencies that are gained. I find evidence of a focus in the probability of transfers after the change in funding, where the overall probability of transfer decreases and the probability of transfer to tertiary DHBs increases. Additionally, patient outcomes demonstrate a concentration effect whereby after the policy is implemented, the pool of transfers is less diluted by low severity patient transfers and thus displays poorer health outcomes on average for the transfer group. The concentration of health outcomes suggests that the transfer decision is being considered more carefully now that costs are aligned to the DHB of domicile. A novel addition to this research is the analysis of regional DHB pairs. The analysis of five secondary-to-tertiary transfer flows provides insight into the necessity of a decentralised healthcare system in New Zealand and is mostly consistent with the analysis at the national level. Overall, the introduction of Inter-District Flow transfer funding has increased the efficiency of the transfer mechanism and enabled a more streamlined redistribution of funds to tertiary providers. This is an important finding because it reinforces the necessity of the transfer mechanism, specialist providers and local provision in a healthcare system such as New Zealand’s.
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    Early childhood teachers' experiences of leadership development : a thesis presented in fulfilment of the requirements for the degree of Master of Education (Leadership and Administration) at Massey University, Manawatu, New Zealand
    (Massey University, 2018) Edwards, Megan Anne (née Shuker)
    There are clear links between quality early childhood education (ECE) and positive outcomes for children and increasing research reveals the link between effective leadership of early childhood centres and quality ECE within centres. Development of ECE leaders to support their leadership skills and competencies is essential as a pathway to support quality ECE. The aim of this research was to give voice to teacher leaders in the ECE sector by exploring their perspectives on their own journey into leadership. Surveys and interviews were used to gather data on leader experiences. Data were analysed using descriptive statistics, thematic analysis and a case study approach. Findings indicated that leaders believed they were poorly equipped to take on their leadership role and called for practice-based leadership support that goes beyond a theoretical understanding of leadership. It was also found that ongoing leadership development was largely self-initiated with a clear call for supported networking to create connections between leaders in what has become a highly competitive sector. This research is relevant to the ECE sector because it discusses the experiences of ECE teachers as they enter into leadership roles.
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    How senior teachers in kindergarten associations in Aotearoa New Zealand, define, understand and enact leadership : a thesis presented in partial fulfillment of the requirements for the degree of Master of Education (Early Years) at Massey University, Manawatū, New Zealand
    (Massey University, 2018) Campbell, Gaylyn Joy
    Leadership in early childhood education is gaining increased attention as evidence suggests leadership is a key factor in raising the quality of early childhood curriculum provision and learning outcomes for children. The present study examined the way in which one group of positional leaders, senior teachers within kindergarten associations in Aotearoa New Zealand, define, understand and enact leadership. The study was situated within a pragmatic paradigm and was descriptive in approach, offering insight into participant’s beliefs and practices. Employing a survey to gather both qualitative and quantitative data provided an avenue for participants to describe their understanding, practice and enactment of leadership. Qualitative data were analysed thematically with an inductive approach taken to identify patterns of meaning, while simple descriptive statistics were used to summarise and interpret quantitative data such as categorisations and ratings. Findings indicated the leadership role of the senior teacher is characterised by complexity, including the identification of eight key areas of responsibility: curriculum development, collaboration, managing human resources, staff development through the provision of professional development, liaison within and outside of the organisation, oversight across multiple sites, compliance and internal evaluation. Senior teachers’ understanding of leadership as a collaborative, relational endeavor focuses on building the professional capabilities of others, with the intention of strengthening curriculum and pedagogy and thereby influencing outcomes for children. Findings also revealed senior teachers navigate multiple and at times competing demands on their leadership work, exacerbated by the complex external environment within which it is enacted. While leadership was seen to be rewarding and valuable, noted challenges included lack of time, a concentration on compliance and accountability functions, perceived lack of influence on strategic work within their organisations, human resources activities and at times, limited scope to change the practice of others.
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    Where we are and how we got here : an institutional ethnography of the Nurse Safe Staffing Project in New Zealand : a thesis in fulfilment of the requirements for Doctor of Philosophy, Massey University, School of Nursing, College of Health, Manawatu, New Zealand
    (Massey University, 2019) McKelvie, Rhonda
    Frontline nurses in New Zealand hospitals still work on short-staffed shifts 18 years after they began to express concerns about unsafe staffing and threats to patient safety. The Nurse Safe Staffing Project and its strategies (Escalation planning and the Care Capacity Demand Management Programme) were designed to address the incidence and risks of short-staffing. After a decade, these strategies are yet to yield tangible improvements to frontline nursing numbers. Using institutional ethnography, I have charted a detailed description and analysis of how aspects of the strategies of the Nurse Safe Staffing Project actually work in everyday hospital settings. Competing institutional knowledge and priorities organise what is happening on short-staffed shifts, and nurses are caught in the crossfire. The central argument throughout this thesis is that nurses’ vital situated knowledge and work are being organised by and overridden in this competitive institutional milieu. I show how what actually happens is consequential for nurses, patient care, and staffing strategies. This analytical exploration contributes knowledge about nurses’ situated and intelligent compensatory work on short-staffed shifts, how this knowledge is displaced by abstracted institutional knowledge, and the competing social relations present in environments where nurse-staffing strategies are negotiated.
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    Fostering nursing through management : a critical approach : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing Studies at Massey University
    (Massey University, 1993) Russell, Lyneta
    This study reveals for critique the philosophical and ideological forces which currently shape the perceptions of a small group of nurse managers in one acute care hospital setting. It has as its aim action to overcome constraints and to realize opportunities in the nurse manager position. Nurse managers assume central ward management and clinical responsibilities. This study describes how they can adjust to changes in these responsibilities within a changing health care structure and at the same time maintain and foster a nursing focus within their work. Using the research methods of critical social science this research explores central themes in the work and world of nurse managers. Through critical dialogue and reflection nurse managers are given opportunities to explore the social, political and historical forces that shape their understanding of their position, and to critique those forces. This critical process assists nurse managers to move towards a new understanding of their position and empowers them towards emancipatory action.
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    Identifying trades tutors' and institutions' perceptions of tutors' roles within the ITP sector : a thesis presented in partial fulfilment of the requirements for the degree of Master of Education in Adult Education at Massey University, Palmerston North, New Zealand
    (Massey University, 2008) Pritchard, Christine
    Since 1984 tertiary education institutions have been subject to progressive and far-reaching change. Much of this change has been shaped by neo-liberalist agendas which espouse accountability, efficiency, responsiveness, professionalism and managerialism. This thesis looks at how these themes have shaped or influenced managerial and tutorial perceptions of tutors' operational roles, responsibilities and performance within a selection of contemporary Institutes of Technology and Polytechnics (ITP) teaching environments. Analysis of the research identifies that scant or poorly prepared institutional documentation around tutorial roles and responsibilities has contributed to uncertainty or confusion, and consequently to individuals adapting their teaching roles to suit themselves. It has also been identified that managers appointed to the pivotal role of Head of School are stretched in their ability to cope with the demands that are placed on them. This thesis suggests that the increasing responsibilities they carry for managing tutorial staff have contributed to a breakdown in workload planning and performance management processes. Managers acknowledge that further work needs to be done in defining tutors' roles, responsibilities and performance. But such work presupposes the question: how do managers and tutors perceive tutorial roles in today's ITP teaching environment? Research on this key question and associated issues provides the basis for this thesis.
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    A case study of the philosophies, policies and practices of educational management at the Church College of New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Education at Massey University
    (Massey University, 1999) Leqakowailutu, Semiti Koroi
    This thesis explores the Educational Management practices at the Church College of New Zealand (CCNZ) in Hamilton. It has examined, analysed and presented answers to the research question which is: How effective is the LDS Church College in following both the philosophies and policies of the LDS Church Board of Education and those of the Ministry of Education in New Zealand?. This college belongs to the Church of Jesus Christ of Latter-Day Saints, a church that is also known as the LDS Church. The research was done through a case study approach because of the need to use a mixture of methods. Some of these methods are personal observation, use of current and historical data, semi-structured interviews, study of relevant records and documents at the Church College, the New Zealand Government through the Educational Review Office (ERO) and from private sources. The thesis initially looks at the Educational Management in general before it examines how management principles are applied at this Church College. I have arranged the various management positions at Church College into three groups. The first group is the Top Management that includes two people, the New Zealand Country Director and the Church College Principal. The second group is the Middle Management consisting of the Deputy Principal, the Assistant Principal, the Director of Finance and the Physical Facilities Director. The third group is the First Line Management that includes the Deans, the Heads of various Academic Departments, two Supervisors at the Physical Facilities Department, the Head Boy & Head Girl and finally, the Dorm Parents. Through interviews, I have examined their areas of responsibility and how they are fulfilling their management roles. While exploring the Church College historical background, I discovered that a number of LDS Church schools were built and operated in New Zealand before the existence of CCNZ. The LDS Church built these earlier schools because of the lack of educational facilities in New Zealand at the time. These schools were eventually closed down when the number of state schools increased to the point where the LDS Church schools were considered by the church leaders to be unnecessary. However, a few years later, the Church Mission President in New Zealand at the time persuaded the church leaders in Salt Lake City to approve the building of another school to be used to educate future church leaders in New Zealand. This was the beginning of the existence of the Church College of New Zealand in Hamilton. This thesis has analysed and produced evidence that the Church College is meeting the initial objectives of educating future church leaders in New Zealand. First, the school is producing the biggest number of full-time missionaries in the country when compared to the numbers from other church units in New Zealand. Second, many of the LDS Church leaders in New Zealand today were educated at Church College. Third, the Maori and Pacific Islands students' exam pass-rates at Church College are much higher than the national figures. The Church College is succeeding in educating their students both spiritually and academically. The balance between these two is creating good leaders in the church and in the society. The 1997 ERO Assurance Audit Report clearly states that the college is meeting its obligation to the Ministry of Education in New Zealand. It is also fulfilling the expectations of the LDS Church Board of Education by teaching religious education on campus. The Church College is successful in educating Maori and Pacific Island students. The exam pass rates for Maori and Pacific Island students are higher at Church College than the national figures. Finally, the management and administration of Church College is of high quality and that they are very effective and efficient in following both the philosophies and policies of the LDS Church Board of Education and those of the Ministry of Education in New Zealand. This conclusion was confirmed by most of the research participants as well as documents from the Educational Review Office.
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    A process evaluation of a shared leadership model in an intensive care unit : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University
    (Massey University, 2001) Turner, Clare Lynette Eden
    Shared leadership has been touted in the United States and United Kingdom as a model of staff management that fosters active involvement of staff, in this case nurses as experienced professionals, in patient management. This study uses process evaluation for the examination of a shared leadership model in an intensive care environment following a period of significant change and restructuring. The model was based on the shared leadership literature (porter-O'Grady, 1992) which focuses on clinical practice as a key accountability and on decentralised clinical leadership at the point of service. The model aligned with the skill acquisition framework used by the employer organisation called the Professional Development Programme (PDP). This programme aims at enhancing the development of expertise in clinical practice and supports the principles of shared leadership. This research study was undertaken to evaluate the process of implementation of the model and to discover whether there is evidence nurse involvement in the management of patient care. The results are based on the responses of 104 registered nurse respondents (56%) working in the intensive care unit of a specialised hospital. Documentation was also examined for evidence of nursing input into indirect patient management process development. The results indicate that nurses are becoming more settled in their working environment and feel more confident in their ability to provide an active role in the management of their patients within a multidisciplinary team.
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    Is participatory governance of relevance to corporate governance? : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Development Studies at Massey University
    (Massey University, 2008) Penny, Kim
    The Grameen Bank, offering neighbourhood-banking services to over five million of the world's most neglected and poor human beings, is perhaps the world's most successful academic-action research project. Now with over five million members, monthly loan dispersal of nearly US$50 million, and constituting over 1% of the Bangladesh GDP. the Grameen Bank started with $25 from Economics Professor Muhammad Yunus' own pocket. There is now no shortage of literature on governments, industries, corporations, organisations and individuals grappling with what governance is and what it means on a day-to-day basis. As the corporate world comes to terms with stakeholder and shareholder involvement in a manner that sometimes appears to be largely rhetorical, in an apparent parallel universe, the discourse of participatory governance is becoming increasingly important for those working in the field of bilateral aid and Non-Government Development Organisations (NGOs). Despite the lack of engagement between those working in these two fields, there appears to be a degree of overlap between these two discourses. It is this possible overlap that underpins the concerns of this thesis. The thesis thus addresses the question: Are there lessons from participatory governance of relevance to the corporate world? If so. what are they? By researching the structure and workings of the governance of the Grameen Bank, it was found that a corporation can prosper using participatory governance, a governance style given the name of participatory corporate governance. This model can assist to create an institutional duality that balances social purpose with the need for positive financial outcomes, further findings show that despite the lack of engagement between the discourses of participatory and corporate governance there does appear to be an overlap in the 'best practice' requirements of each.
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    An evaluation of nursing documentation as it relates to pro re nata (prn) medication administration : a research report presented in partial fulfilment of the requirements for the degree of Master of Nursing in Mental Health at Massey University
    (Massey University, 2003) Jenkinson, Frances Heather
    Aims of the project: l. To investigate if documentation related to pro re nata (Latin, prn) medication administration by mental health nurses, in a particular Forensic Psychiatry Clinic, in a metropolitan city in New Zealand, complies with the requirements of the National Mental Health Sector Standards (Ministry of Health, 1997), the specific District Health Board's policies, the local policies of the Forensic Psychiatry Clinic, the Code of Conduct for Nurses and Midwives (Nursing Council of New Zealand, 1999) and follows the nursing process. 2. To investigate whether there are any variations in the documentation practices between nursing shifts. Methods: A retrospective file audit was conducted at a forensic psychiatry clinic in a city in New Zealand. Non-random sampling was used. Data was collected from all admissions in 2002 that had prn medication administered during the first four weeks. A document questionnaire was designed to capture the required data to answer the research questions Results: From the sample of 27 files data was collected from up to 170 nursing entries. This was primarily a descriptive and exploratory study. None of the nursing entries met all the requirements of the National Mental Health Sector Standards (Ministry of Health, 1997), company policies, local area policies and/or the Code of Conduct for Nurses and Midwives (Nursing Council of New Zealand, 1999) in relation to nursing documentation. Nearly 47% of the prn medication administered had no documentation, apart from that in the medication-recording chart, to indicate it had been given. Approximately 85% of prn administrations had no evidence of an assessment prior to administration. Where it was documented that a client had requested medication. nearly 82% had no evidence of assessment. A large number of prn medications were administered from prescriptions that did not meet legal or policy requirements. Evidence of planning was lacking in the documentation with nearly 98% of the notes not indicating the rationale for a choice of route of administration where this was permitted on the prescription. No nursing entry offered a rationale for the choice of dose where this was allowed. The name of the medication, dose, route and/or time administered was frequently missing. Of the prn administrations considered for an outcome, nearly 60% had no documented outcome. Little difference was found in the nursing documentation between the shifts. However it was noted that for day and aftenoon shift, the earlier in the shift the medication was administered the less likely there was to be any mention of the medication being administered. Conclusion: The findings established extremely poor documentation practices. The lack of evidence of patient assessment, prior to administration of the medication in the documentation, raises the issue of whether this is being done prior to prn medication administration or simply not being documented. The documentation left questions about decision making in the planning of administration. The large number of medication administrations lacking a documented outcome raises uncertainty about nurses' knowledge of evaluating care, or even whether they are actually evaluating the care given. As a result of these findings, it is recommended that further research in this area be undertaken in New Zealand.