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221.
This paper is concerned with the organizationalchange and project management issues raised by theimplementation of a business process re-engineering(BPR) approach in the politicized hospital context. This is a report of research in progress,focusing on the issues arising at the problem definitionand project planning stages of a BPR application in anoperating theaters department experiencing problems with scheduling and delays. The research designrelies on a case study approach, with the researcher asparticipant observer, as both an adviser to the projectteam and as field interviewer. The paper argues that an ambitious BPR agenda is compromised inat least two regards. First, the lack of precisionsurrounding the focus and methodology of BPR givespolitically motivated actors considerable influence with respect to defining terms of reference in wayswhich will shape potential outcomes in their favor.Second, the complexity and indeterminacy of the businessprocess or patient trail can also diluteredesign attempts. The principal limitations of theapproach thus concern the impracticality of embarking onrapid and radical change working from a blanksheet of paper with respect to organizational and job design. BPR, unlike other organizationdevelopment interventions, is not a contextsensitive approach. The role of project manageris critical in establishing a working balance betweenindividual, occupational, and organizational goals in a manner perceivedto be legitimate in the context. Effective BPR projectmanagement thus requires a combination of political andprocess analysis skills. The principal opportunities of BPR derive from its process orientation,which brings a fresh perspective to a traditionally andfunctionally fragmented organizational setting, andwhich presents a potentially valuable platform for anevolutionary approach to process improvement.  相似文献   
222.
In recent years, Israel has become a major recipient of documented and undocumented temporary labour migrants from many countries outside the Middle East region. The purposes of this article are to describe Israel's experience of temporary labour migration and its concomitant, illegal labour migration; and also to explore what her policies on temporary labour migration indicate about the nature of the policy-making process in this policy domain in Israel.
To these ends the article traces the evolution of temporary labour migration – legal and illegal – and recent policy initiatives of the Israeli government. It then considers some of the major conceptions of the policy-making process found in public policy literature. The article concludes by pointing to the uniqueness of Israel's experience of temporary labour migration and to the fact that her policies have been overwhelmingly reactive – inadequately considered, ill-conceived, ambivalent in relation to their ultimate purpose and, in the course of implementation, vulnerable to "privatization" (being taken over by vested interest groups).
Analysis of the most recent policy initiatives designed to reduce the number of legal labour migrants and address the problem of illegal labour migrants, reflect a policy-making process that is not followed by commensurate action.  相似文献   
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"International migration from Mexico to the United Sates is viewed very differently depending on from which side of the border this phenomenon is observed and evaluated....[It is] imperative to begin a process of ?demythifying' migration as a necessary and sufficient condition that would allow both countries to come together within the context of bilateral relations and find ways to act jointly to address the impacts of the issue. Such a demythifying effort must begin with scientific research which can help develop a diagnosis of the costs and benefits that labor migration from Mexico to the United States brings to the two countries."  相似文献   
226.
"The impact of family migration on women's economic position in a developing country setting is an area that has received relatively little research attention. Incorporating a lifetime perspective, this study makes use of the retrospective migration histories of husbands and wives from the second round of the Malaysian Family Life Survey to estimate how joint migration with the husband affects women's socioeconomic achievement. The findings show that family migration depresses the chances of working, but it does not significantly reduce socioeconomic attainment of those who do work. However, when a woman migrates with her husband she does forgo the substantial advantage she could have derived had she moved alone."  相似文献   
227.
Client self-determination has been called the most confounding and professionally debilitating concept of all the intellectual principles under-girding social work (Rothman, 1989). Identifying the appropriate parameters of client self-determination is a particularly acute problem for social workers employed by runaway and homeless youth shelters where minors are making adult decisions free from parental guidance. We examine the ethical dimensions of practice with minor clients in runaway shelters by arguing that a conflict exists between the liberty-based principle of self-determination and the justice-based notion of client competency. We analyze the conflict by using minimal distributive justice as the organizing principle of social work practice. We conclude that client self-determination in runaway shelters should be restricted and that presuming client competence violates the basic value tenets of the profession.  相似文献   
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The Community Prevention Trial was 5-year effort to reduce alcohol-involved injuries and death through a comprehensive program of community awareness and policy activities. The three experimental communities were of approximately 100,000 population each (one in Northern California, one in Southern California, and one in South Carolina). Matched comparison communities were used for each experimental community. This article describes the evaluation approach used in a program that sought to change environmental factors not a specific population or target group. This approach demanded unique evaluation approaches for determining overall community aggregate effects, that is, distal outcomes, as well as changes in key mediating variables, that is, process effects. The problem of trending and lagged effects of community prevention programs are discussed.  相似文献   
230.
This article provides recommendations and observations about evaluation of a locally based prevention project to reduce problems at a total community or aggregate level. The shift from targeting specific individuals or subpopulations to the overall structure and environment of a community is most demanding. Evaluation tools and analysis techniques have lagged behind program development because community-level interventions are not linked to a specific target group who can be separately studied. Thus assumptions about using random assignment and/or comparison communities as means to control for confounding variables are weakened when the unit of analysis is the community itself and dependent measures are subject to trending and the effects of history.  相似文献   
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