Preventing and Diagnosing Colorectal Cancer with a Limited Colonoscopy Resource

This paper explores how the capacity of colonoscopy services should be allocated for screening and diagnosis of colorectal cancer to improve health outcomes. Both of these services are important since screening prevents cancer by removing polyps, while diagnosis is required to start treatment for cancer. This paper first presents a basic compartmental model to illustrate the trade‐off between these two analytically. Further, a more realistic population dynamics model with resource constraints is introduced for colorectal cancer screening and analyzed numerically. The best resource allocation decisions are investigated with the objectives of minimizing mortality or incidence rates. We provide a sensitivity analysis with respect to policy and disease‐related parameters. We conclude that to minimize mortality, the capacity should be rationed to ensure that the wait for diagnosis is at reasonable levels. When the relevant performance measure is the incidence rate, screening is allocated more capacity compared to the case with mortality rate measure. We also show that benefits from increasing compliance to screening programs can only be realized if there is sufficient service capacity.     

Off to Plan or Out to Lunch? Relationships between Design Characteristics and Outcomes of Strategy Workshops

Strategy workshops, also known as away days, strategy retreats and strategic ‘off‐sites’, have become widespread in organizations. However, there is a shortage of theory and evidence concerning the outcomes of these events and the factors that contribute to their effectiveness. Adopting a design science approach, in this paper we propose and test a multidimensional model that differentiates the effects of strategy workshops in terms of organizational, interpersonal and cognitive outcomes. Analysing survey data on over 650 workshops, we demonstrate that varying combinations of four basic design characteristics – clarity of goals and purpose, routinization, stakeholder involvement and cognitive effort – predict differentially these three distinct types of outcomes. Calling into question conventional wisdom on the design of workshops, we discuss the implications of our findings for integrating further the strategy process, strategy‐as‐practice and strategic cognition literatures, to enrich understanding of the factors that shape the nature and influence of contemporary strategic planning activities more generally.     

Improving the Impact and Implementation of Disaster Education: Programs for Children Through Theory‐Based Evaluation

A main weakness in the evaluation of disaster education programs for children is evaluators’ propensity to judge program effectiveness based on changes in children's knowledge. Few studies have articulated an explicit program theory of how children's education would achieve desired outcomes and impacts related to disaster risk reduction in households and communities. This article describes the advantages of constructing program theory models for the purpose of evaluating disaster education programs for children. Following a review of some potential frameworks for program theory development, including the logic model, the program theory matrix, and the stage step model, the article provides working examples of these frameworks. The first example is the development of a program theory matrix used in an evaluation of ShakeOut, an earthquake drill practiced in two Washington State school districts. The model illustrates a theory of action; specifically, the effectiveness of school earthquake drills in preventing injuries and deaths during disasters. The second example is the development of a stage step model used for a process evaluation of What's the Plan Stan?, a voluntary teaching resource distributed to all New Zealand primary schools for curricular integration of disaster education. The model illustrates a theory of use; specifically, expanding the reach of disaster education for children through increased promotion of the resource. The process of developing the program theory models for the purpose of evaluation planning is discussed, as well as the advantages and shortcomings of the theory‐based approaches.     

Skill Management in Large‐Scale Service Marketplaces

Large‐scale, web‐based service marketplaces have recently emerged as a new resource for customers who need quick resolutions for their short‐term problems. Due to the temporary nature of the relations between customers and service providers (agents) in these marketplaces, customers may not have an opportunity to assess the ability of an agent before their service completion. On the other hand, the moderating firm has a more sustained relationship with agents, and thus it can provide customers with more information about the abilities of agents through skill screening mechanisms. In this study, we consider a marketplace where the moderating firm can run two skills tests on agents to assess if their skills are above certain thresholds. Our main objective is to evaluate the effectiveness of skill screening as a revenue maximization tool. We, specifically, analyze how much benefit the firm obtains after each additional skill test. We find that skill screening leads to negligible revenue improvements in marketplaces where agent skills are highly compatible and the average service times are similar for all customers. As the compatibility of agent skills weakens or the customers start to vary in their processing time needs, we show that the firm starts to experience sizable improvements in revenue from skill screening. Apparently, the firm can reap the most of these substantial benefits when it runs only one test. For instance, in marketplaces where agents posses uncorrelated skills, the second skill test only brings an additional 2% improvement in revenue. Accounting for possible skill screening costs, we then show the optimality of offering only one test when the compatibility between agent skills is sufficiently low. The results of this study also have important implications in terms of the right level of intervention in the marketplaces we study.     

Assessment of the Effectiveness of Radon Screening Programs in Reducing Lung Cancer Mortality

The present study was aimed at assessing the health consequences of the presence of radon in Quebec homes and the possible impact of various screening programs on lung cancer mortality. Lung cancer risk due to this radioactive gas was estimated according to the cancer risk model developed by the Sixth Committee on Biological Effects of Ionizing Radiations. Objective data on residential radon exposure, population mobility, and tobacco use in the study population were integrated into a Monte‐Carlo‐type model. Participation rates to radon screening programs were estimated from published data. According to the model used, approximately 10% of deaths due to lung cancer are attributable to residential radon exposure on a yearly basis in Quebec. In the long term, the promotion of a universal screening program would prevent less than one death/year on a province‐wide scale (0.8 case; IC 99%: –3.6 to 5.2 cases/year), for an overall reduction of 0.19% in radon‐related mortality. Reductions in mortality due to radon by (1) the implementation of a targeted screening program in the region with the highest concentrations, (2) the promotion of screening on a local basis with financial support, or (3) the realization of systematic investigations in primary and secondary schools would increase to 1%, 14%, and 16.4%, respectively, in the each of the populations targeted by these scenarios. Other than the battle against tobacco use, radon screening in public buildings thus currently appears as the most promising screening policy for reducing radon‐related lung cancer.     

Sourcing Strategy,Supplier Relationships and Firm Performance: An Empirical Investigation of UK Organizations

This article conceptualizes and empirically examines buyer–supplier relationships in respect of supply sourcing strategies, relationship characteristics and firm performance. Two sourcing strategies available to organizations are examined, critical and leverage, which in turn, influence the approach to managing the supplier relationship (arms‐length or collaborative). We argue that different relationship approaches are appropriate to achieving different performance outcomes. A structural equation model, using a sample of 142 manufacturing firms based in the United Kingdom, is used to test this hypothesized model. The results indicate that a critical sourcing strategy requires collaborative supplier relationships in order to achieve higher relationship and business outcomes, while leverage sourcing strategies have a direct impact on these same performance outcomes. In addition, a leverage strategy was associated with increased levels of supplier power, though this power was found not to have a significant effect on performance. Our study provides support for the importance of aligning sourcing strategies to particular supplier relationship approaches in order to improve firm performance. Managerial implications of these findings and future directions for research are then offered.     

Is It Always Worth Waiting? The Effect of Autonomy‐supportive Teaching on Short‐term and Long‐term Learning Outcomes

Autonomy is known for its positive effects and its use in management practice. Recently an urgent debate has emerged on its drawbacks on individual outcomes. In this study, we investigate and test a model on the effect on individual learning of an autonomy‐supportive teaching style and its interplay with the learner's previous experience and perceived management support. Specifically, while research has emphasized the positive effect of similar contexts, this study focuses on its differential effect on short‐term and long‐term learning outcomes, challenging the traditional view of autonomy. We also explore how job experience and management support can improve the effects of autonomy on individual learning. We test our model by collecting longitudinal data on a sample of 200 individuals participating in a training programme on managerial skills. Our results show that (1) the extent to which teachers were perceived as autonomy‐supportive presents a linear relationship with short‐term learning outcomes (utility reactions) and a positive curvilinear relationship with training transfer in the long term; (2) learner job experience and perceived management support for learning have a positive moderating effect on the linear relationship between autonomy and learning outcomes.     

Understanding the Antecedents of Effective Knowledge Management: The Importance of a Knowledge‐Centered Culture*

Within the context of knowledge management, little research has been conducted that identifies the antecedents of a knowledge‐centered culture—those organizational qualities that encourage knowledge creation and dissemination. In this study, the existing literature on organizational climate, job characteristics, and organizational learning (in the form of cooperative learning theory) are linked with the current thinking and research findings related to knowledge management to develop a theoretical model explaining the relationships among organizational climate, the level of cooperative learning that takes place between knowledge workers, and the resulting level of knowledge created and disseminated as measured by team performance and individual satisfaction levels. The study goes on to empirically test the proposed research model by investigating the climate of organizations, and seeks to understand the linkage between a set of organizational and individual characteristics and knowledge‐related activities found in cooperative learning groups and the resulting work outcomes. The hypothesized research model is tested using LISREL with data collected from 203 information systems (IS) professionals engaged in systems development activities. The paper concludes with a discussion of the implications the results have for future research and managerial practice.     

Safety Risk Analysis of an Innovative Environmental Technology

The authors describe a decision and risk analysis performed for the cleanup of a large Department of Energy mixed-waste subsurface disposal area governed by the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). In a previous study, the authors worked with the site decision makers, state regulators, and U.S. Environmental Protection Agency regional regulators to develop a CERCLA-based multiobjective decision analysis value model and used the model to perform a screening analysis of 28 remedial alternatives. The analysis results identified an innovative technology, in situ vitrification, with high effectiveness versus cost. Since this technology had not been used on this scale before, the major uncertainties were contaminant migration and pressure buildup. Pressure buildup was a safety concern due to the potential risks to worker safety. With the help of environmental technology experts remedial alternative changes were identified to mitigate the concerns about contaminant migration and pressure buildup. The analysis results showed that the probability of an event with a risk to worker safety had been significantly reduced. Based on these results, site decision makers have refocused their test program to examine in situ vitrification and have continued the use of the CERCLA-based decision analysis methodology to analyze remedial alternatives.     

Improving Computer Training Effectiveness for Decision Technologies: Behavior Modeling and Retention Enhancement*

Managers and analysts increasingly need to master the hands‐on use of computer‐based decision technologies including spreadsheet models. Effective training can prevent the lack of skill from impeding potential effectiveness gains from decision technologies. Among the wide variety of software training approaches in use today, recent research indicates that techniques based on behavior modeling, which consists of computer skill demonstration and hands‐on practice, are among the most effective for achieving positive training outcomes. The present research examines whether the established behavior‐modeling approach to software training can be improved by adding a retention enhancement intervention as a substitute for, or complement to, hands‐on practice. One hundred and eleven trainees were randomly assigned to one of three versions of a training program for spreadsheets: retention enhancement only, practice only, and retention enhancement plus practice. Results obtained while controlling for total training time indicate that a combination of retention enhancement and practice led to significantly better cognitive learning than practice alone. The initial difference in cognitive achievement was still evident one week after training. Implications for future computer training research and practice are discussed.     

Delayed Differentiation for Multiple Lifecycle Products

Modular design allows several generations of products to co‐exist in the installed base as product designs change to take advantage of improved performance via modular upgrades. Use of a common base platform and modular design approach allows a firm to offer updates for improved performance and flexibility via remanufacturing when products have multiple lifecycles. However, as the product evolves through multiple lifecycles, the large pool of product variants leads to the curse of product proliferation. In practice, product proliferation causes high levels of line congestion and results in longer lead times, higher inventory levels, and lower levels of customer service. To offer insights into the product proliferation problem, the authors employ a delayed differentiation model in a multiple lifecycle context. The delayed differentiation model gives flexibility to balance trade‐offs between disassembly and reassembly costs by adaptively changing the push‐pull boundary. An adaptive, evolving push‐pull boundary provides flexibility for a remanufacturing firm to meet changing customer demands. The delayed differentiation model includes both a mixed‐integer linear program and an analytical investigation of the evolutionary nature of the push‐pull boundary. Both field observations and experimental results show that the nature of product proliferation and changing demand structures play significant roles in the cost and flexibility of the evolving delayed differentiation system.     

A Multicompartment SIS Stochastic Model with Zonal Ventilation for the Spread of Nosocomial Infections: Detection,Outbreak Management,and Infection Control

In this work, we study the environmental and operational factors that influence airborne transmission of nosocomial infections. We link a deterministic zonal ventilation model for the airborne distribution of infectious material in a hospital ward, with a Markovian multicompartment SIS model for the infection of individuals within this ward, in order to conduct a parametric study on ventilation rates and their effect on the epidemic dynamics. Our stochastic model includes arrival and discharge of patients, as well as the detection of the outbreak by screening events or due to symptoms being shown by infective patients. For each ventilation setting, we measure the infectious potential of a nosocomial outbreak in the hospital ward by means of a summary statistic: the number of infections occurred within the hospital ward until end or declaration of the outbreak. We analytically compute the distribution of this summary statistic, and carry out local and global sensitivity analysis in order to identify the particular characteristics of each ventilation regime with the largest impact on the epidemic spread. Our results show that ward ventilation can have a significant impact on the infection spread, especially under slow detection scenarios or in overoccupied wards, and that decreasing the infection risk for the whole hospital ward might increase the risk in specific areas of the health‐care facility. Moreover, the location of the initial infective individual and the protocol in place for outbreak declaration both form an interplay with ventilation of the ward.     

The Effectiveness of Management‐By‐Walking‐Around: A Randomized Field Study

Management‐by‐walking‐around (MBWA) is a widely adopted technique in hospitals that involves senior managers directly observing frontline work. However, few studies have rigorously examined its impact on organizational outcomes. This study examines an improvement program based on MBWA in which senior managers observe frontline employees, solicit ideas about improvement opportunities, and work with staff to resolve the issues. We randomly selected hospitals to implement the 18‐month‐long, MBWA‐based improvement program; 56 work areas participated. We find that the program, on average, had a negative impact on performance. To explain this surprising finding, we use mixed methods to examine the impact of the work area's problem‐solving approach. Results suggest that prioritizing easy‐to‐solve problems was associated with improved performance. We believe this was because it resulted in greater action‐taking. A different approach was characterized by prioritizing high‐value problems, which was not successful in our study. We also find that assigning to senior managers responsibility for ensuring that identified problems get resolved resulted in better performance. Overall, our study suggests that senior managers' physical presence in their organizations' front lines was not helpful unless it enabled active problem solving.     

An Empirical Study of the Effect of Knowledge Management Processes at Individual,Group, and Organizational Levels*

To enhance our understanding of knowledge management, this paper focuses on a specific question: How do knowledge management processes influence perceived knowledge management effectiveness? Prior literature is used to develop the research model, including hypotheses about the effects of four knowledge management processes (internalization, externalization, socialization, and combination) on perceived individual‐level, group‐level, and organizational‐level knowledge management effectiveness. The study was conducted at the John F. Kennedy Space Center of the National Aeronautics and Space Administration using a survey of 159 individuals and two rounds of personal interviews. Structural equation modeling was performed to test measurement and structural models using the survey data. The emergent model suggests that internalization and externalization impact perceived effectiveness of individual‐level knowledge management. Socialization and combination influence perceived effectiveness of knowledge management at group and organizational levels, respectively. The results also support the expected upward impact in perceived effectiveness of knowledge management, from individual to group level, as well as from group level to organizational level. The study's limitations and implications for practice and future research are described.     

‘I Feel Mad So I Be Bad’: The Role of Affect,Dissatisfaction and Stress in Determining Responses to Interpersonal Deviance

Interpersonal deviance relates to a range of destructive individual and organizational outcomes. To date, however, scholars have largely failed to explore this issue from the perspective of the targeted individuals; and in particular how and why such negative outcomes manifest. To provide insights into this question, and based in principles of critical realism, we utilized semi‐structured in‐depth interviews to explore employees’ interpersonal deviance experiences, their responses and determinants of response selections, including: (1) emotions and feelings; (2) dissatisfaction and stress. We found that the traditional model, where responses are driven by dissatisfaction and confined to exit, voice, loyalty and neglect (EVLN), is inadequate. We therefore extend the EVLN model to include retaliation (EVLN‐R) and identify a range of other responses, including venting and seeking social support for inclusion in the typology. Moreover, contrary to traditional theorizing, we found that responses were determined first and foremost by emotions and feelings, followed by stress, with dissatisfaction of little to no importance. We propose a new, multi‐dimensional response typology including self‐orientated responses and make suggestions for future research to test our typology, before closing with the implications for practice.     

Effectiveness of Performance Appraisal: An Integrated Framework

Based on a robust analysis of the existing literature on performance appraisal (PA), this paper makes a case for an integrated framework of effectiveness of performance appraisal (EPA). To achieve this, it draws on the expanded view of measurement criteria of EPA, i.e. purposefulness, fairness and accuracy, and identifies their relationships with ratee reactions. The analysis reveals that the expanded view of purposefulness includes more theoretical anchors for the purposes of PA and relates to various aspects of human resource functions, e.g. feedback and goal orientation. The expansion in the PA fairness criterion suggests certain newly established nomological networks, which were ignored in the past, e.g. the relationship between distributive fairness and organization‐referenced outcomes. Further, refinements in PA accuracy reveal a more comprehensive categorization of rating biases. Coherence among measurement criteria has resulted in a ratee reactions‐based integrated framework, which should be useful for both researchers and practitioners.     

How to Compete Against a Behavioral Newsvendor

We investigate newsvendor ordering behavior under competition. We present a laboratory experiment that documents the behavioral ordering regularities in competitive newsvendor environments, and an analytical model extending the standard theory of newsvendor competition by including an optimal best‐response policy for competing with a behaviorally biased newsvendor. We test the effectiveness of this policy using an out‐of‐sample experiment and find that it results in improved market share, service level and profitability.     

Supply Chain Inventory Replenishment: The Debiasing Effect of Declarative Knowledge

Previous experimental research demonstrates that inefficient replenishment decision making in the supply chain can be caused by specific judgment and decision biases. Based on the literature we use controlled experiments involving both student subjects and supply chain managers to test debiasing interventions that provide declarative knowledge, which is theorized to enhance the acquisition of procedural knowledge. We first investigate the effects of three debiasing components in a single‐echelon setting: knowledge of bullwhip, inventory position (IP), and use of a target order‐up‐to quantity. Experiment 1 (N = 1,608 decisions by 67 student subjects) using a 2 × 2 × 2 factorial design for the three components finds that the conceptual understanding of IP is salient for efficient replenishment decisions. We next examine the effects of the components in a simulated, multi‐echelon, serial supply chain, which introduces the additional complexity of coordination risk. Experiment 2 (N = 3,072 decisions by 128 student subjects) using a 2 × 2 × 2 factorial design finds that although subjects benefit from training components, there is evidence of cognitive overload with an increased quantity of information. Finally we test whether these debiasing components may be an effective training program for practicing supply chain managers who can be expected to have higher levels of procedural knowledge through experience gained in the field. Experiment 3 (N = 864 decisions by 36 supply chain managers) using a 2 × 1 design investigates the effects of an instructional training intervention which includes all three debiasing components and finds the intervention to reduce costs by 14%. We provide avenues for future research and successful practice.     

Affirmative Action in Higher Education: How Do Admission and Financial Aid Rules Affect Future Earnings?

This paper addresses how changing the admission and financial aid rules at colleges affects future earnings. I estimate a structural model of the following decisions by individuals: where to submit applications, which school to attend, and what field to study. The model also includes decisions by schools as to which students to accept and how much financial aid to offer. Simulating how black educational choices would change were they to face the white admission and aid rules shows that race‐based advantages had little effect on earnings. However, removing race‐based advantages does affect black educational outcomes. In particular, removing advantages in admissions substantially decreases the number of black students at top‐tier schools, while removing advantages in financial aid causes a decrease in the number of blacks who attend college.     

EVALUATING THE EMPLOYMENT IMPACT OF A MANDATORY JOB SEARCH PROGRAM

This paper exploits area‐based piloting and age‐related eligibility rules to identify treatment effects of a labor market program—the New Deal for Young People in the U.K. A central focus is on substitution/displacement effects and on equilibrium wage effects. The program includes extensive job assistance and wage subsidies to employers. We find that the impact of the program significantly raised transitions to employment by about 5 percentage points. The impact is robust to a wide variety of nonexperimental estimators. However, we present some evidence that this effect may not be as large in the longer run. (JEL: J18, J23, J38)