The good leader

What are the traits of successful leaders and can they be applied to those of us in health care? Leaders must deal with conflict to get a group of people to move in the same direction. Successful leaders learn to have difficult conversations that increase understanding and morale and creatively deal with the inevitable interpersonal conflicts present in every organization made up of people. Another useful trait for a leader during uncertain and chaotic times is the ability to see things as they really are, rather than as we wish or believe them to be. Successful leaders are also usually optimists who level with their co-workers.     

Researching "good death" in a Hong Kong palliative care program: a clinical data-mining study

This study operationalizes and assesses the percentage of "good deaths" achieved among Chinese cancer patients in a palliative care program, the profile of these patients, the relationship between patients with a good death and psychosocial factors, and the differences in background factors, and physical and psychosocial conditions between patients who experienced a good death and those who did not. Clinical data mining was the research method used. Records of deceased cancer patients between 2003 and 2005 in a palliative care unit were the sole data source. Good death was operationally defined as the patient's record indicating no pain (physical) or anxiety (psychological), and having open and honest communication with family (social) in the final assessment by the Support Team Assessment Schedule (STAS) just before death. Using these criteria, about one-fifth of patients (21.5%; 137 out of 638) experienced a good death. Those with a good death were significantly older and were in palliative care longer. Their records also indicated lower levels of constipation, insomnia, oral discomfort, and family anxiety at their first and at their final STAS assessments. Good death was positively associated with recorded indicators of fullness in life, caregivers' acceptance and support, and negatively with reported feelings of upset about changes in the course of their illness. The results heighten awareness among social workers and other healthcare professionals about the value of good death in patients in palliative care. This empirically-based awareness can foster professionals' ability to set intervention objectives to help patients in palliative care achieve this universally accepted goal.     

Career transition as identity learning: an autoethnographic understanding of human resource development

This paper examines the phenomenon of career transitions in terms of learning using an autoethnographic story of our own career moves. In the contemporary world of globalized flexible employment, inter-organizational career moves are increasingly prevalent and the learning associated with such transitions needs to be better understood within human resource development (HRD). We show that the learning required in career transitions extends beyond the acquisition of new knowledge and the development of new skills to the appropriation of new identities. We overview identity theorizing and, adopting a social constructionist perspective, explain the concept of identity work to understand the nature of identity learning in career transitions. We then reflexively examine our autoethnographic methodology, proceed to tell the story of our career transitions, and then interpret this story in terms of identity learning. Conclusions are drawn showing how the learning associated with career transitions involves conscious and unconscious identity work to release an established way of being, cultivate a new and desired way of being, and to cope with the existential anxieties associated with transition. Significant implications for international HRD scholarship, policy, and practice are proposed.     

CEO elitist association: Toward a new understanding of an executive behavioral pattern

Scholars have studied how the social associations of corporate executives affect their access to information and their decisions. The entire focus, however, has been on lateral peer-to-peer associations. Prior research has not addressed vertical associations, or the idea that interaction with peer elites yields different perceptions and behaviors than does interaction with parties of lower social status. In this paper, we introduce and develop the concept of elitist association, which we define as a stable behavioral pattern of some corporate executives by which they engage nearly exclusively in associations with other elites while minimizing or even entirely avoiding associations with non-elites. We propose several individual-level antecedents to explain why some executives engage in this behavior more than others. We then discuss the effects of elitist association on executives' access to information, empathy, and social comparison processes — all of which affect their decisions and organizations. Finally, we consider implications for theory as well as for practical affairs.     

Individual differences as antecedents of leader behavior: Towards an understanding of multi-level outcomes

The leadership research on individual differences is going through a period of revival. However, due to the substantial number of variables in this area and the different knowledge bases they are associated with (e.g., psychology, endocrinology, genetics), the literature is also becoming highly fragmented as it grows. This fragmentation is preventing different literature streams from effectively communicating with each other and synthesizing the rapidly expanding body of knowledge. Consequently, the continued growth of the individual differences literature is at risk. Therefore, we believe that classifying the relevant literature streams and reviewing the key variables in those streams will be beneficial. We do so by organizing this review and research agenda of the leadership literature on individual differences around the recent model developed by Antonakis, Day, and Schyns (2012). In doing so, we hope to unify some of the future research efforts around a recent and recognized conceptual model, and in turn facilitate communication between these different streams of literature. Moreover, insights from this literature also allow us to propose additions and refinements to the model of Antonakis, Day, and Schyns (2012) that may help scholars by indicating other fruitful areas for future research on individual differences.     

Developing an understanding of lean thinking in process industries

The research described in this article has set out to determine the extent to which lean thinking is being adopted as a manufacturing philosophy by process industries. It concerns the application and examination of key lean manufacturing principles, namely, the alignment of production with demand, the elimination of waste, the integration of suppliers (IS) and the creative involvement of the workforce in improvement activities, to a range of process industry types based on Dennis and Meredith's taxonomy of process industry transformation systems [Dennis, D. and Meredith, J., 2000a. An empirical analysis of process industry transformation systems. Management Science, 46 (8), 1085–1099]. Seventy-nine process industry product streams across 62 sites were studied. In addition, a five-site investigative field study was also undertaken. The findings demonstrate that lean practices associated with the elimination of waste are consistently used for improving manufacturing performance throughout the taxonomy of process industries but practices associated with other lean principles are inconsistently applied. In addition, explanations are provided on the appropriateness of lean thinking as a manufacturing philosophy and a strategy for improving manufacturing performance in different process industry types, and on the extent to which lean principles and practices are dependent on the characteristics of process industry transformation systems.     

Complexity as an empirical tendency: Promoting non-measurement as a means to enhanced understanding

In this conceptual paper, I seek to provide an organising framework for conducting qualitative research in complexity studies in management. Building upon the underlying logic of Kauffman’s NK(C) model and the notion of second-order complexity, I urge management researchers interested in complex adaptive systems to capture, understand, and articulate complexity as an empirical tendency as opposed to the measurement-driven orientation of many scholars. I contend that the latter orientation’s illusion for numerical precision, predictive accuracy and generalizable truthfulness is not only undoable but also unnecessary in the context of providing practically meaningful and realistic recommendations to those interested in complexity.     

Well begun is half done: Toward an understanding of predictors for initial training transfer

As organizations face a rapidly changing marketing environment, they have an increased investment in training programs that aim to improve employees’ hard skills to successfully execute tasks and soft skills for healthy social relationships. Although managers question the transfer problem in hard- and soft-skills training, researchers have limited knowledge on this topic. This study focuses on improving the initial training transfer, an essential phase of the transfer process. Specifically, drawing on signaling theory, we introduce training characteristics (i.e., training content validity and transfer design) as the antecedents. This study also assesses the potential underlying mechanisms by examining the roles of training engagement and training criticality. Using a sample of 182 employees enrolled in a typical hard- and soft-skills training program (i.e., quality management training), we test a mediation model. As expected, the results indicate that both training content validity and transfer design positively impact initial training transfer. Furthermore, the links between training characteristics and initial training transfer are mediated by training engagement and training criticality. This study contributes to the research on initial training transfer by exploring training characteristics as the antecedents and integrating the research on transfer and personal attitudes under hard- and soft-skills training.     

The Chinese version of the multidimensional orientation toward dying and death inventory (MODDI-F/chin): an introduction

Preliminary data on the test criteria of the Chinese version of the Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F/chin) are presented. Data from a sample of Hong Kong college students (N = 256) revealed internal consistencies of the eight subtests between .68 and .91, on the whole favorable shape of frequency distributions, and evidence of construct as well as differential validity of the instrument. The use of the full set of 47 items is recommended for the time being.     

Dispensing death,desiring death: an exploration of medical roles and patient motivation during the period of legalized euthanasia in Australia

A qualitative case study was conducted to explore the clinical decision making processes that underpinned the practice of euthanasia under the Rights of the Terminally Ill (ROTI) Act. The key informant for this research was Philip Nitschke, the general practitioner responsible for the legal cases of euthanasia. His information was supported by extensive document analysis based on the public texts created by patients in the form of letters and documentaries. Further collaborating sources were those texts generated by the media, rights groups, politicians, the coroner's cort, and the literature on euthanasia and assisted suicide. A key study finding was that the ROTI legislation did not adequately provide for the specific medical situation in the Northern Territory, Australia. The medical roles, as proscribed by the legislation, carried many inherent assumptions about the health care context and the availability of appropriately qualified medical staff committed to providing euthanasia. These assumptions translated into difficulties in establishing clinical practices for the provision of euthanasia. A further finding concerned the motivations of those who requested euthanasia. This article addresses the medical roles and the motivations of those seeking euthanasia.     

The benefit of horizontal decentralization in durable good procurement

A conventional wisdom in industry and academia is that firms suffer from decentralized procurement. In this paper, we demonstrate an important and counter-intuitive benefit of procurement decentralization in a common setting where a firm with multiple divisions procures a durable good from a supplier. We start with a two-period model and obtain analytic equilibrium results on the supplier's wholesale prices, and the firm's procurement quantities and profits under procurement centralization and decentralization. These results show that the firm's profit will benefit from decentralization if and only if the product is durable. We further show that the profit improvement always increases in durability and the number of divisions. To generalize the basic model with two periods, we design an iterative algorithm to compute the equilibrium results for any number of periods. Our extensive numerical simulations show the robustness of our analytic results and managerial insights.     

A new approach for understanding dominant design: The case of the ink-jet printer

We study dominant design strategies concerning the allocation of technological resources for ink-jet printers. We find that the dominant design for each firm can be quantitatively represented by the number of ink-jet patents in nine categories of a matrix that distinguishes patents according to method of implementation and type of module. Further, we find that annual firm ink-jet revenue from 1990 through 2000 is positively correlated with a balanced dispersion of patents across the nine categories. Results suggest that higher revenues will accrue to firms in integrated industries when resources are balanced among important sub-technologies in the dominant design.     

The "moment of death"

The "moment of death," once a dominant concept in preparing for a "good death", has been eclipsed by a focus on the wider concept of the "dying trajectory". However, findings from interviews with 25 bereaved individuals suggest that dying loved ones' final moments may still be experienced as highly significant in their own right. In some accounts the dying individual's final moments did not feature or made little impression, either because the survivor was not present, or there was no obviously definable moment, or because other, usually medical factors, such as whether to resuscitate the person, took precedence. However, in six cases such moments were constructed as profound, special, and memorable occasions. These constructions are explored in relation to achieving a good death, the dying trajectory as a whole, and making sense of the bereavement experience. Their implications for sociological theories of identity and embodiment are also considered.     

The death distress construct and scale

The purpose of this research was to construct a short scale to assess the death distress construct, that is, death anxiety, death depression, and death obsession as derivatives from the already existing scales. A sample of 630 volunteer undergraduates responded to scales of death anxiety, death depression, and death obsession. A Pearson correlation matrix was computed using the 51 individual items of the three scales. A forced three-factor principal components analysis with orthogonal varimax rotation was carried out. Eight items with factor loading > 0.5 on each scale was determined. The eight items with highest factor loadings on Factor I were with "Death obsession," whereas the Factors II and III were labeled: "Death anxiety," and "Death depression." Their alpha reliabilities ranged from 0.83 to 0.93, indicating high internal consistency. One week test retest reliability ranged between 0.76 and 0.91, indicating temporal stability. A single high-loaded factor of death distress was disclosed, demonstrating the discriminant validity of the death distress construct and scale. Women obtained a significantly higher mean scores on all three factors. It was concluded that the aforementioned three factors were sufficiently independent to justify their use in assessing partially distinct sub-constructs as sub-components of the generic high-order factor of death distress, with empirical and clinical implications.     

Problem solving: not good medicine for health care

Explore the challenging paradoxes that run throughout health care and consider ways to accept them into an organization.     

Business forecasting: the good news and the bad

This paper records a personal view of the wide range of problems, philosophical and pragmatic, currently afflicting ‘business forecasting’. It is based on several years experience in both forecasting methodology development and direct project work with decision makers. The paper is not intended as a review of the current consensus, academic or otherwise but to engage in ‘constructive criticism’. In doing so the author has attempted to keep to the desired structure of ‘decision makers perception’, ‘methodology criticised’ and ‘development suggestions’ but the nature of the problem demands a more interactive approach which has resulted in fuzzy sets rather than distinct clusters of topics.     

Influence triggers: A framework for understanding follower compliance

This article proposes a framework for understanding follower compliance. The framework draws from the leadership, influence, and motivation literatures to identify follower-based influence triggers and the intervening variables that lead to follower compliance. The article discusses the proposed relationships and provides some directions for future research.