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The metaphor of ‘orchestration’ is applied to an emergent change whereby developing different versions of a resource to solve local problems with managing hospitalized patient care in the USA became conceived as a nationwide innovation. A pluralistic framework incorporates Abbott’s conception of a system of professions, a cultural and political perspective on interaction and the notion of ‘orchestration’ which is distinguished from leadership and management. Small‐scale research in diverse settings shows how key stakeholders including academic medical researchers orchestrated the coalescence of disparate practices into a unified movement, although working in a relatively decentralized healthcare system featuring a complex mix of public, private and voluntary sectors. Sufficient confluence between diverse interests was nurtured for widespread acceptance of a new ‘hospitalist’ role coordinating inpatient treatment. It is suggested that the metaphor of orchestration may have wider potential as a heuristic for understanding emergent change that becomes more complex as it spreads. 相似文献
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MIKE DAVIS 《新观察季刊》2013,30(4):11-12
The megacities arising around the planet are like the Internet where many events are taking place simultaneously. The urban scape today is becoming more a space of flows—migrants, trade, capital, information, microbes—than a space of places rooted in an historical identity. The megaurban condition today encompasses many realities, from the glittering generic city‐state of Singapore to the slums climbing up the hillsides around Mexico City or Sao Paulo. In these spaces we work, love and live out the intimate moments of our lives. In these spaces we consume and spew out climate warming gases. In this section, two of the world's “star architects”—Rem Koolhaas and Frank Gehry—the visionary “arcologist” Paolo Soleri and the Turkish novelist and Nobel laureate, Orhan Pamuk, grasp at chronicling the reality of where we live. 相似文献
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This paper argues that ‘leaderism’– as an emerging set of beliefs that frames and justifies certain innovatory changes in contemporary organizational and managerial practice – is a development of managerialism that has been utilized and applied within the policy discourse of public service reform in the UK. The paper suggests that ‘leaderism’ is an evolution of entrepreneurial and cultural management ideologies and practices. An analysis of the articulation of leaderism with public service reform in the UK is presented. The paper problematizes the construals of leadership contained within these texts and reflects on their promotion of leadership as a social and organizational technology. ‘Leaderism’ is argued to be a complementary set of discourses, metaphors and practices to those of managerialism, which is being utilized in support of the evolution of NPM and new public governance approaches in the re‐orientation of the public services towards the consumer‐citizen. 相似文献
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