Performance Effects Related to the Sequence of Integration of Healthcare Technologies

There is a natural order to most events in life: Everything from learning to read to DNA sequences in molecular biology follows some predetermined, structured methodology that has been refined to yield improved results. Likewise, it would seem that firms could benefit by adopting and implementing technologies in some logical way so as to increase their overall performance. In this study of 555 hospitals, we investigate the order in which medical technologies are transformed into information technologies through a process of converting them from stand‐alone technologies to interoperable, integrated information systems and whether certain configurations of sequences of integration yield additional value. We find that sequence does matter and that hospitals that integrated foundational technologies first—which in this case are known to be more complex—tend to perform better. Theoretical and practical implications of this finding and others are discussed.     

Two-level network design with intermediate facilities: An application to electrical distribution systems

We consider the two-level network design problem with intermediate facilities. This problem consists of designing a minimum cost network respecting some requirements, usually described in terms of the network topology or in terms of a desired flow of commodities between source and destination vertices. Each selected link must receive one of two types of edge facilities and the connection of different edge facilities requires a costly and capacitated vertex facility. We propose a hybrid decomposition approach which heuristically obtains tentative solutions for the vertex facilities number and location and use these solutions to limit the computational burden of a branch-and-cut algorithm. We test our method on instances of the power system secondary distribution network design problem. The results show that the method is efficient both in terms of solution quality and computational times.     

An inventory model with random discount offerings

We consider an inventory model in which a supplier makes deal offers with random discount prices at random points in time. Assuming that discount offerings follow a Poisson process and discount price is a discrete random variable with a known distribution, we propose a continuous-review control policy for the model and derive optimality conditions for the policy parameters. The model is then extended to the case of multiple suppliers that offer discount deals with supplier-specific Poisson processes and discount prices. Numerical examples are presented to demonstrate cost savings due to discount offers.     

Growth and Heat Resistance Kinetic Variation Among Various Isolates of Salmonella and its Application to Risk Assessment

The abilities of cells of a particular type of bacteria to leave lag phase and begin the process of dividing or surviving heat treatment can depend on the serotypes or strains of the bacteria. This article reports an investigation of serotype-specific differences in growth and heat resistance kinetics of clinical and food isolates of Salmonella. Growth kinetics at 19 degrees C and 37 degrees C were examined in brain heart infusion broth and heat resistance kinetics for 60 degrees C were examined in beef gravy using a submerged coil heating apparatus. Estimates of the parameters of the growth curves suggests a small between-serotype variance of the growth kinetics. However, for inactivation, the results suggest a significant between-serotype effect on the asymptotic D-values, with an estimated between-serotype CV of about 20%. In microbial risk assessment, predictive microbiology is used to estimate growth and inactivation of pathogens. Often the data used for estimating the growth or inactivation kinetics are based on measurements on a cocktail--a mixture of approximately equal proportions of several serotypes or strains of the pathogen being studied. The expected growth or inactivation rates derived from data using cocktails are biased, reflecting the characteristics of the fastest growing or most heat resistant serotype of the cocktail. In this article, an adjustment to decrease this possible bias in a risk assessment is offered. The article also presents discussion of the effect on estimating growth when stochastic assumptions are incorporated in the model. In particular, equations describing the variation of relative growth are derived, accounting for the stochastic variations of the division of cells. For small numbers of cells, the expected value of the relative growth is not an appropriate "representative" value for actual relative growths that might occur.     

Risk Modeling, Assessment, and Management of Lahar Flow Threat

The 1991 eruption of Mount Pinatubo in the Philippines is considered one of the most violent and destructive volcanic activities in the 20th century. Lahar is the Indonesian term for volcanic ash, and lahar flows resulting from the massive amount of volcanic materials deposited on the mountain's slope posed continued post-eruption threats to the surrounding areas, destroying lives, homes, agricultural products, and infrastructures. Risks of lahar flows were identified immediately after the eruption, with scientific data provided by the Philippine Institute of Volcanology, the U.S. Geological Survey, and other research institutions. However, competing political, economic, and social agendas subordinated the importance of scientific information to policy making. Using systemic risk analysis and management, this article addresses the issues of multiple objectives and the effective integration of scientific techniques into the decision-making process. It provides a modeling framework for identifying, prioritizing, and evaluating policies for managing risk. The major considerations are: (1) applying a holistic approach to risk analysis through hierarchical holographic modeling, (2) applying statistical methods to gain insight into the problem of uncertainty in risk assessment, (3) using multiobjective trade-off analysis to address the issue of multiple decisionmakers and stakeholders in the decision-making process, (4) using the conditional expected value of extreme events to complement and supplement the expected value in quantifying risk, and (5) assessing the impacts of multistage decisions. Numerical examples based on ex post data are formulated to illustrate applications to various problems. The resulting framework from this study can serve as a general baseline model for assessing and managing risks of natural disasters, which the Philippines' lead agency-the National Disaster Coordinating Council (NDCC)-and other related organizations can use for their decision-making processes.     

The State of the Field in UK Management Research: Reflections of the Research Assessment Exercise (RAE) Panel

This paper reviews the state of the field of the sub-disciplines within UK management research, based upon the submissions of 94 UK higher education institutions to the Business and Management Studies Panel in the UK's 2001 Research Assessment Exercise (RAE). It offers observations on the UK model of the assessment of quality in, and funding of, research conducted in publicly funded higher education institutions.