Clear logical narratives in reporting, open communication, effective questioning and challenge from board members are important elements of communication found to influence engagement. Leadership that has a focus on healthcare excellence and quality improvement are aligned and promote effective meeting processes is also found to foster governance engagement. Effective engagement in these communication and leadership processes facilitate valuable reflexivity at the governance level. PRACTICAL IMPLICATIONS The findings highlight the way in which boards and senior managers can strengthen governance effectiveness through attention to key aspects of communication and leadership. ORIGINALITY/VALUE The case study approach allows the exploration of communication and leadership in greater depth than previously undertaken at the corporate governance level in the healthcare setting. © Emerald Publishing Limited.PURPOSE To empirically verify whether patient hospital satisfaction ratings on social media such as Yelp provide similar information as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. DESIGN/METHODOLOGY/APPROACH OLS and ordinal regressions performed on secondary data obtained from Yelp.com and 2016 Hospital Compare database disclosed by CMS. FINDINGS Results show that the patient hospital satisfaction ratings from Yelp can predict the patient experience of care domain scores obtained through the annual HCAHPS surveys and are also positively and significantly correlated to the overall hospital quality performance scores given by CMS. RESEARCH LIMITATIONS/IMPLICATIONS Study suggests that social media patient review information could be used to supplement the information obtained from HCAHPS surveys, thereby providing hospitals more accurate information about their patient experiences. PRACTICAL IMPLICATIONS Hospital leaders need not wait an entire year to receive their HCHAPS scores to know about the issues related to their patient experience that need improvement and can periodically refer to free Yelp patient review scores on Yelp.com to obtain similar information. ORIGINALITY/VALUE To the best of knowledge, this research is the first to empirically demonstrate that patient reviews freely obtained from social media sites like Yelp can provide similar information as obtained from HCAHPS surveys and can thus be used to supplement HCAHPS. © Emerald Publishing Limited.PURPOSE The study presents the findings from a study over a four-year period of the emergence of an integrated healthcare organisation in response to policy changes within the United Kingdom (UK). The aim of the research was to understand the process of healthcare organisation integration through the lens of actor-network theory (ANT). DESIGN/METHODOLOGY/APPROACH An instrumental case study approach to data collection was selected. Three methods of data collection were used to trace the healthcare organisation integration process in depth semistructured interviews using a virtual patient journey across services with 36 purposefully selected informants, document analysis and field observations and notes. FINDINGS The findings of this study suggest that neither the context nor the actors were the sole determinants of the outcome of the integration. Rather it was the dynamic interplay between the actors, their context, the shared agency and the resources available to them as the change emerged shaped the end result. RESEARCH IMPLICATIONS The findings denote that organisations need to attend to frontline workers as key contributors to change and development that is meaningful for service users. Methodologically, combining the ANT and constructive case study to understand the integration process provided us with new perspective to understand the trajectory of change process. ORIGINALITY/VALUE This original case study fills a gap in information about the role of healthcare professionals in healthcare policy process and the interactive relationship between all stakeholders of policy process including nonhuman actors. PR-957 Proteasome inhibitor © Emerald Publishing Limited.PURPOSE The purpose of this paper is to demonstrate the relevance of psychoanalysis to an emerging sub-field known as “critical healthcare management studies” (CHMS). DESIGN/METHODOLOGY/APPROACH Building upon a wave of critical scholarship in the broader field of management, scholars and practitioners of healthcare management have begun to forge a critical scholarly movement of their own. CHMS, short for “critical healthcare management studies,” formally denotes a new subfield of inquiry dedicated to challenging entrenched assumptions, exposing power relations, and cultivating critical praxis, all the while serving as a vital counterpoint to mainstream scholarship. This paper seeks to augment the CHMS movement with psychoanalysis, and particularly the critical vein of organizational psychoanalysis already well-established in critical management studies. FINDINGS The argument is made that a greater engagement with psychoanalysis offers novel avenues for critical theorizing and practice in healthcare management. Specifically three areas are considered 1) the exploitative role of guilt in the caring professions, 2) the resurgence of authoritarianism and its implications for unconscious organizational dynamics, and 3) the potential for a psychoanalytically informed critical healthcare praxis. ORIGINALITY/VALUE While there remain wide differences of opinion about the utility of psychoanalysis outside of the clinical arena, this paper reveals just how psychoanalysis can inform today’s healthcare organizations, and more broadly the social and political organization of health in society. © Emerald Publishing Limited.INTRODUCTION The adverse health effects associated with exposure to traffic-related air pollutants (TRAPs) remain a key public health issue. Often, exposure assessments have not represented the small-scale variation and elevated concentrations found near major roads and in urban settings. This research explores approaches aimed at improving exposure estimates of TRAPs that can reduce exposure measurement error when used in health studies. We consider dispersion models designed specifically for the near-road environment, as well as spatiotemporal and data fusion models. These approaches are implemented and evaluated utilizing data collected in recent modeling, monitoring, and epidemiological studies conducted in Detroit, Michigan. APPROACH Dispersion models, which estimate near-road pollutant concentrations and individual exposures based on first principles – and in particular, high fidelity models – can provide great flexibility and theoretical strength. They can represent the spatial variability of TRAP concentrations at locations not measured by conventional and spatially sparse air quality monitoring networks.