The case for a physician director of the surgical suite

A typical hospital operating room can generate revenue of $1 to 3 million per year. About 30 to 40 percent of the total income of a hospital is produced in the surgical suite. This is a high-cost area in terms of personnel, equipment, and supplies, so strong management is increasingly important in the area. In the past few years, a number of hospitals have found a solution in a physician director for the surgical suite. Although the physician for this position may be of any specialty, the chief of anesthesiology or an anesthesiologist with strong management and communication skills is the best choice. Usually, an anesthesiologist spends the most time in surgery and does not have special allegiance to any surgical specialty. He or she has a vested interest in smooth functioning and success of the surgical suite.     

Why do Emerging Market Firms Engage in Voluntary Environmental Management Practices? A Strategic Choice Perspective

In this paper, we investigate firms’ decisions to engage in voluntary environmental management (VEM) practices within an emerging market context. Drawing on the strategic choice and the resource‐based view perspectives, we report results from a survey of VEM practices – a specific form of self‐governance – drawing on a sample of 519 Turkish firms from various industries to identify important strategic antecedents of firms’ decisions to engage in such practices. We find that as firms become more customer focused, more inclined to pursue a differentiation strategy and subject to a higher level of strategy‐oriented stakeholder focus, they tend to implement higher levels of VEM practices, with important implications for research, policy and practice for both emerging and developed markets.     

Stochastic Analysis of Complex Repairable System with Deliberate Failure Emphasizing Reboot Delay

Present paper discusses the reliability analysis of a complex system which consists of two repairable subsystems namely A and B connected in series. A is a linear consecutive 2 out of 3:F system and B is a 1 out of n: F system. In this study, two types of failure such as deliberate failure and critical failure have been taken into consideration incorporating reboot delay. Various transition state probabilities, reliability, availability, M.T.T.F., cost analysis, and sensitivity analysis have been obtained along with the steady state behavior of the system. At the end, some special cases of the system have been taken.     

Green supply chain performance measurement using fuzzy ANP-based balanced scorecard: a collaborative decision-making approach

The purpose of this paper is to delineate a green supply chain (GSC) performance measurement framework using an intra-organisational collaborative decision-making (CDM) approach. A fuzzy analytic network process (ANP)-based green-balanced scorecard (GrBSc) has been used within the CDM approach to assist in arriving at a consistent, accurate and timely data flow across all cross-functional areas of a business. A green causal relationship is established and linked to the fuzzy ANP approach. The causal relationship involves organisational commitment, eco-design, GSC process, social performance and sustainable performance constructs. Sub-constructs and sub-sub-constructs are also identified and linked to the causal relationship to form a network. The fuzzy ANP approach suitably handles the vagueness of the linguistics information of the CDM approach. The CDM approach is implemented in a UK-based carpet-manufacturing firm. The performance measurement approach, in addition to the traditional financial performance and accounting measures, aids in firm’s decision-making with regard to the overall organisational goals. The implemented approach assists the firm in identifying further requirements of the collaborative data across the supply-cain and information about customers and markets. Overall, the CDM-based GrBSc approach assists managers in deciding if the suppliers’ performances meet the industry and environment standards with effective human resource.     

Methods for estimating relative risk in studies of common binary outcomes

Studying the effect of exposure or intervention on a dichotomous outcome is very common in medical research. Logistic regression (LR) is often used to determine such association which provides odds ratio (OR). OR often overestimates the effect size for prevalent outcome data. In such situations, use of relative risk (RR) has been suggested. We propose modifications in Zhang and Yu and Diaz-Quijano methods. These methods were compared with stratified Mantel Haenszel method, LR, log binomial regression (LBR), Zhang and Yu method, Poisson/Cox regression, modified Poisson/Cox regression, marginal probability method, COPY method, inverse probability of treatment weighted LBR, and Diaz-Quijano method. Our proposed modified Diaz-Quijano (MDQ) method provides RR and its confidence interval similar to those estimated by modified Poisson/Cox and LBRs. The proposed modifications in Zhang and Yu method provides better estimate of RR and its standard error as compared to Zhang and Yu method in a variety of situations with prevalent outcome. The MDQ method can be used easily to estimate the RR and its confidence interval in the studies which require reporting of RRs. Regression models which directly provide the estimate of RR without convergence problems such as the MDQ method and modified Poisson/Cox regression should be preferred.     

Analysis of antithetic sequences in flowshop scheduling to minimize makespan

The antithetic properties of flowshop sequences are investigated to improve the classical Monte Carlo method for solving the n -job, m -machine problem with minimization of makespan. The major issues considered are (1) establishing a negative correlation of the makespan values of forward and reverse sequences; (2) developing the Antithetical Monte Carlo (AMC) method, which can be used to quickly estimate the mean of the makespan distribution by exploiting the antithetic property of sequences; (3) using AMC to find low makespan values; (4) determining a threshold value of makespan beyond which it would be likely to find an optimal or near optimal makespan when reversing a sequence. Statistical tests indicate that the performance of AMC is superior to that of the classical Monte Carlo method. Possible applications of this concept are discussed including extensions to other mathematical problems with antithetic properties.     

Variance estimation with randomized response

Presenting a general procedure of eliciting a randomized response (RR) from selected persons in order to estimate the total of a sensitive variable related to a finite survey population, we consider two estimators along with variance estimators treating the case of sampling with probabilities proportional to (known) size measures (PPS) with replacement (WR), drawing analogies with multi-stage sampling and note their relative efficacies.     

Money demand stability: A case study of Nigeria

Monetary policy in Nigeria aims is to achieve price and monetary stability. During the 1980s and 1990s, monetary targeting was the dominant monetary policy framework in Nigeria. However, in 2006 the Central Bank of Nigeria (CBN) adopted the new monetary policy framework through which short-term interest rates are adjusted to achieve stability in the value of the domestic currency. This paper has presented an empirical investigation into the demand for Nigerian real narrow money (M1) over the period 1960–2008 in an attempt to identify whether the CBN were right to adopt the new monetary policy framework. In doing so, we estimate alternative (canonical and extended) specifications of M1 demand using structural change methods. Our results suggest that the canonical specification is well-determined. Although the money demand relationship went through a regime shift in 1986, it is largely stable. These findings favour the use of supply of money as an instrument of monetary policy, thus lending limited support for the new monetary policy framework.