Inquiry into purpose spans multiple disciplines, perspectives, and centuries. Seemingly inherent in the process of human development is the desire for humans to find a direction for their lives. This chapter provides an introduction to purpose inquiry, underscoring how purpose research shows that the construct can permeate multiple domains of life. We outline some of the frameworks and theoretical traditions that the reader will encounter throughout this volume. Following this section, we discuss three central questions regarding the nature of purpose that have yielded nascent reflections and research directions to this day. We conclude by providing the outline for the upcoming chapters, noting how each provides a valuable and unique piece to the puzzle of purpose.

Centring on key state functions of protection and the promotion of the economic and social well-being of its citizens, the welfare state describes a range of functions related to state intervention aimed at reducing the risk of market failure, ensuring a decent living standard and a certain degree of equality and intergenerational distribution. The welfare state thus often plays a central role in relation to essential issues of people’s daily lives such as housing, employment, income security, health and education. Nevertheless, despite some initial explorations of the relevance of perspectives grounded in sustainability transitions for understanding processes of change and innovation in welfare states, the question of welfare remains a neglected area in transition studies and, until recently, in environmental studies more broadly. Yet the welfare state can both be used to enable and hardwire social protection into transitions to protect ‘stranded workers’ and also have a key role to play, and be heavily impacted by, the social costs and adjustments brought about by the disruptions and dislocations that transitions inevitably bring in their wake. The chapter concludes with a discussion of what ‘sustainable welfare’ might look like as part of a transformation of the welfare state.

In the coming decades, cities and other local governments will need to transform their infrastructure as part of their climate change mitigation and adaptation efforts. When they do, they have the opportunity to build a more resilient, sustainable, and accommodating infrastructure for humans and non-humans alike. This chapter surveys a range of policy tools that cities and other local governments can use to pursue co-beneficial adaptations for humans, non-humans, and the environment. For example, they can add bird-friendly glass to new and upgraded buildings and vehicles; they can add overpasses, underpasses, and wildlife corridors on transportation systems; they can reduce light and noise pollution that impact humans and nonhumans alike; they can use a novel trash policy to manage rodent populations non-lethally; and more.

The final chapter compares The Villages to other retirement communities, aging in place, and aging in community. Drawing on the study’s findings and the perceptions of interviewed individuals, it highlights how The Villages’ unique characteristics – including its size, innovation culture, bubble communication, opportunities for meaningful involvement, social networks, and communal coping – generally enhance residents’ well-being. The chapter also summarizes The Villages’ weaknesses and presents key takeaways about the societal meanings of its success.

Leadership is an elusive concept. Key authors cannot agree on the characteristics of leaders, but all agree that leadership is about relationships and evolves over time. For example, Rost and Barker state that ‘leadership is an influence relationship among leaders and followers who intend real changes and outcomes that reflect a shared purpose’. Meanwhile, Landsdale suggests that ‘effective leaders enable people to move in the same direction, toward the same destinations, at the same speed, but not because they have been forced to, but because they want to’. This raises the question of how we get people to want to go in the same direction and at the same pace. In the health services, this is particularly challenging because of the multidisciplinary nature of the key stakeholders. It requires appropriate leadership of interprofessional teams.

A 2021 report on a study of workplace conflict in the United Kingdom concludes that, in 2018–19, more than 35 per cent of respondents reported workplace conflict, with an estimated 485 000 employees resigning as a result. Managers need to understand that conflict does not resolve itself; rather, it tends to gather intensity and energy. Gupta, Boyd and Kuzmits have found that ‘employees spend as much as 42 percent of their time engaging in or attempting to resolve conflict and 20 percent of managers’ time is taken up by conflict-related issues’. Managing conflict is one of the primary responsibilities of managing staff and teams, particularly in multicultural work environments. Understanding what is ‘culturally normative in terms of self-worth, confrontation, emotional expression, and managerial intervention can help [staff] involved in workplace conflict understand what they are experiencing’. Additionally, it can help managers intervene appropriately. In this chapter, different types and origins of conflict are discussed, as well as approaches to managing and resolving conflict.

This chapter explores the notion of ethics and ethical decision-making frameworks in leading and managing health services. Chapter 1 outlined the four sets of skills, or functions, that every manager should possess, which are usually summarised under the acronym POLC: planning, organising, leading and controlling. With leadership being one of the four functions of management, it is important to understand both the management and the leadership aspects of ethical decision-making.

The past three decades have seen the rise of clinical governance, firstly as a concept and ultimately as a system. Increasing knowledge of the scope of iatrogenic harm to consumers, coupled with public inquiries into poor care around the world, is driving the development of governance of clinical care into an established component of corporate governance. Many gains are being realised in Australia, including a reduction in infections and preventable, in-hospital cardiac arrests, improved experience and outcomes for patients, better governance of clinical care and more meaningful involvement of patients and consumers in health care.

In a text on leadership and management in health services, human resource management requires a strategic approach. Health is dominated by a large, diverse and highly professionalised workforce. Human resource management is complex and focuses on the performance effects of human resource systems rather than individual human resource practices. The focus is on systems since employees are exposed to an interrelated set of human resource practices which, in turn, are dependent on other multiple sets of systems within the wider health service.

Project management (PM) is a systematic management tool with techniques to bring people and resources together for a single purpose. Since its emergence in the architectural, engineering and building sectors in the early 1900s, PM has been systematically applied to other fields and industries as a common tool in managing work and achieving needed change. The rapidly changing operating environment and the frequent, system-wide and large-scale transformation in the health and community care sector has inevitably changed the PM landscape. In the past 10 years, PM has experienced significant growth in complexity and scope in health and community care. The significant increase in the number of projects undertaken and the investment in developing PM competencies and tools have contributed to the growing project maturity in healthcare organisations. PM has been broadly used to implement change, trial new service models, develop new programs and technologies, and improve organisational structure and care processes.

The healthcare sector is continually confronted with the issue of how to manage with less. In response, health leaders and managers must explore and use new ways to face such challenges. These issues ultimately affect the quality and safety, and the productivity and efficiency, of the health services delivered. Within each organisation, the effectiveness of the leadership and culture directly affect the quality of patient care delivered. To effectively address such challenges, leaders have begun to adopt new strategies and roles that focus on visioning and creativity.