The reciprocal dynamics of organizing and sense‐making in the implementation of major public‐sector reforms

Abstract: Drawing on a longitudinal study from the early years of implementation of health‐care networks in Quebec, this article describes how public‐sector managers deal with complex challenges when both organizational structures and organizational strategies are radically transformed simultaneously. The new organizations studied had to completely re‐shuffle roles and responsibilities of their management teams while making sense of their new mandate of developing a population‐focused approach to health problems – all the time maintaining day‐to‐day operations. The four health‐care networks studied proceeded somewhat differently to meet these reciprocal challenges. The study reveals the importance of balancing organizing initiatives (focused on structures) with “sense‐making” initiatives (focused on strategies), of developing capacities for sense‐making through the creation of key “sense‐maker/sense‐giver” positions whose occupants are able to ensure that conceptual activities engage people working at different levels, even as organizational structures are in flux, and of mobilizing external constraints and influences as opportunities and resources in sense‐making and organizing. Sommaire : Se fondant sur une étude longitudinale des premières années de la mise en œuvre des réseaux de soins de santé au Québec, cet article décrit la manière dont les gestionnaires du secteur public font face à des défis complexes, alors que les structures et les stratégies organisationnelles sont radicalement transformées simultanément. Les nouveaux organismes étudiés ont dû complètement remanier les rôles et les responsabilités de leurs équipes de gestion et comprendre leur nouveau mandat d'élaborer une approche axée sur la population pour ce qui est des problèmes de santé, tout en maintenant leurs activités au jour le jour. Les quatre réseaux de soins de santéétudiés ont travailléà relever ces défis réciproques d'une manière assez différente. L'étude révèle l'importance de trouver un équilibre entre les initiatives consistant à organiser (axées sur les structures) et les initiatives consistant à interpréter les faits (axées sur les stratégies) ; de perfectionner les capacités à interpréter les faits grâce à la création de postes clés d'«interpréteurs de faits», dont les titulaires veilleraient à ce que des activités conceptuelles fassent intervenir les gens travaillant à différents niveaux même lorsque les structures organisationnelles fluctuent continuellement; et enfin de tirer parti des contraintes et influences externes comme autant d'occasions et de ressources pour interpréter et organiser les faits.     

The New Zealand Model of Family Group Conferencing

The Family Group Conference (FGC) originated in New Zealand where it is the foundation stone of the Youth Justice system introduced in 1989. A significant feature of that system is the way in which it enables restorative justice principles to be implemented in an integrated manner in a statutory framework supervised by the courts and applicable to all young offenders throughout New Zealand. FGCs are used both as a diversionary technique (pre-adjudication) and at a (post-adjudication) pre-sentencing stage. In addition this type of model is now being applied in a voluntary way but on a small scale with adults. A significant feature of the FGC model is its greater use of community-based solutions with a consequent reduction in the number of young persons in state institutions.     

Using the Referral Decision Scale to Screen Mentally Ill Jail Detainees: Validity and Implementation Issues

The prevalence of serious mental illnesses in jail populations is significantly greater than in the general population. Identifying individuals who warrant psychiatric evaluations is important and benefits correctional staff as well as detainees. One widely used screening instrument intended for this task is the Referral Decision Scale (RDS). This paper reviews the development and validation of the RDS. Using data from a multisite study which assessed postrelease outcomes for detainees with mental illness, various types of validity are addressed. The results confirm that the RDS has some inherent characteristics that seriously limit its practical application as a screening instrument for use by correctional staff.     

Citizen response to regional integration in the Americas: The cases of Costa Rica and El Salvador

This study examines public opinion in Costa Rica and El Salvador regarding regional integration in Central America. Recent efforts at regional integration as well as the response of the governments of the above countries to those efforts are reviewed. Public opinion toward regional integration is significantly more positive but less structured in El Salvador than in Costa Rica. Differences in the international and domestic contexts help to explain the differential responses in these two countries. Likewise, contextual factors help to account for differences between Central American and European publics in attitudes toward regional integration. Charles L. Davis is associate professor of political science at the University of Kentucky. His interests are Latin American politics and comparative political behavior. Matthew J. Gabel is assistant professor of political science at the University of Kentucky. His interests are European politics and the politics of regional integration. Kenneth M. Coleman is a former professor at the University of Kentucky, the University of North Carolina-Chapel Hill, and the University of New Mexico. His interests are Latin American politics and public opinion.     

Navigating the currents of change

The river twisted and shrank above the beaver ponds. It neared a mountain. It was small and quiet here, full of snake-bends, oxbows and small cutthroat trout. It entered a grove of virgin Sitka spruce, and the hoof cut-trail entered in beside it. … The grove was like a vast lodge, barked pillars rising to a high mosaic of green and black and sky. A watery light filtered down, as if through stained glass. In the center of the lodge was a hollow, bordered by sword ferns and fallen logs. In the bottom of the hollow was a broad, rocky bowl eerily paved with mosshaired, head-sized stones. Among the stones was a quiet spring. And from the spring brimmed the water, old and clean and untiring. I had reached the source of the Tamanawis.     

Inca, Sailor, Soldier, King: Gregor MacGregor and the Early Nineteenth‐Century Caribbean

This article examines the recruiting practices, political propositions and changing identities of the Scottish adventurer Gregor MacGregor in the early nineteenth‐century Caribbean. Based on original archival research and revision of the existing secondary literature, it seeks to understand why he has consistently been judged as a failure, and why neither Scotland nor any of the countries MacGregor worked in have wanted to claim him as their own hero. After an introduction providing biographical details and some historical context for the Caribbean in the period 1811–1830, the article looks in detail at what have been seen to be his successes and failures in the Caribbean region. It asks to what extent questions of ethnicity or masculinity have affected the way contemporaries and historians viewed MacGregor and his actions. In conclusion, it suggests that although he was a soldier and a sailor, and he was declared both an Inca and a King, his career was deemed a failure by both contemporaries and historians in Scotland, South America and the Caribbean. The main explanation for this negative assessment is that his ambitions continually fell foul of the interests of various Caribbean elites and of the distinctive historical circumstances of the region.¹     

Why Medical Child Support is Important—and Complex

Courts resolving child support cases involving separated, divorced, and non‐marital children are charged with defining responsibility for health care coverage for the children under that order. This article explores historical and current medical child support requirements under Title IV‐D of the Social Security Act—the national child support enforcement (“IV‐D”) program. It analyzes legal requirements and policy recommendations, and provides a practical tool judges may use to determine whether health care coverage available to either or both parents is appropriate—that is, comprehensive, accessible, and affordable.