The Zen of physician initiatives

Many physicians today feel ravaged by the brutal speed with which change has been occurring. They see the beliefs and practices of a lifetime being abandoned and replaced by the flavor of the month, management du jour. But if you are willing and able to take the brave step of approaching your physicians without an agenda, meeting with them to listen to their concerns, and can also avoid hanging a lightning-rod label on every bright new idea that comes out of the sessions, you'll be on the way to effective new management. This new style is a "Zen" approach (but don't give it that label) that lets real collaboration come into the place that is supposed to be all about healing--the health care organization. From "never call it anything" to "stay with them until they get it," ideas on how to be a Zen manager are presented, with the ultimate goal of truly partnering with physicians and infusing them with a desire to move beyond the frustration and disenchantment they are feeling.     

Human asset accounting

Human Asset Accounting (‘HAA’) is not an accepted tool of long range planning. Indeed many planners probably look sceptically on the possibility that it will ever become a technique which is important to them in their work. Unlike many other methods which have been successfully developed over the last few years HAA involves concepts which are so new that as yet relatively few people have come into contact with them. The object of this article is to give some indication of the conceptual framework on which HAA theories are based and to describe one of the techniques which is being evolved as a possible management and planning tool.     

Development and planning of infrastructure

This paper offers a survey of the wide field in infrastructure, a bird's eye view of some of the major problems arising, and some controversial remarks. The aim is to point to the very great importance of the planning and development of infrastructure which decide now how against the background of continued scientific and technological development the environment should be kept or brought under some sort of intelligent control so that the quality of living is steadily enhanced.     

Evidence‐based Management in Practice: Opening up the Decision Process,Decision‐maker and Context

Evidence‐based management (EBM) has been subject to a number of persuasive critiques in recent years. Concerns have been raised that: EBM over‐privileges rationality as a basis for decision‐making; ‘scientific’ evidence is insufficient and incomplete as a basis for management practice; understanding of how EBM actually plays out in practice is limited; and, although ideas were originally taken from evidence‐based medicine, individual‐situated expertise has been forgotten in the transfer. To address these concerns, the authors adopted an approach of ‘opening up’ the decision process, the decision‐maker and the context (Langley et al. ( 1995 ). ‘Opening up decision making: the view from the black stool’, Organization Science, 6, pp. 260–279). The empirical investigation focuses on an EBM decision process involving an operations management problem in a hospital emergency department in Australia. Based on interview and archival research, it describes how an EBM decision process was enacted by a physician manager. It identifies the role of ‘fit’ between the decision‐maker and the organizational context in enabling an evidence‐based process and develops insights for EBM theory and practice.     

Evaluation of Alternative Cohort-Component Models for Local Area Population Forecasts

It is generally accepted by demographers that cohort-component projection models which incorporate directional migration are conceptually preferable to those using net migration. Yet net migration cohort-component models, and other simplified variations, remain in common use by both academics and practitioners because of their simplicity and low data requirements. While many arguments have been presented in favour of using one or other type of model, surprisingly little analysis has been undertaken to assess which tend to give the most accurate forecasts. This paper evaluates five cohort-component models which differ in the way they handle migration, four of which are well known, with one—a composite net migration model—being proposed here for the first time. The paper evaluates the performance of these five models in their unconstrained form, and then in a constrained form in which age–sex-specific forecasts are constrained to independent total populations from an extrapolative model shown to produce accurate forecasts in earlier research. Retrospective forecasts for 67 local government areas of New South Wales were produced for the period 1991–2011 and then compared to population estimates. Assessments of both total and age-specific population forecasts were made. The results demonstrate the superior performance of the forecasts constrained to total populations from the extrapolative model, with the constrained bi-regional model giving the lowest errors. The findings should be of use to practitioners in selecting appropriate models for local area population forecasts.     

Your work may be killing you! Workaholism,sleep problems and cardiovascular risk

This study tests the relationships between workaholism (i.e. working excessively and compulsively), sleep problems and cardiovascular risk in 537 employees from five Spanish hospitals. Four types of worker (i.e. workaholics, positive workers, compulsive workers and hard workers) were distinguished, and their health indicators were compared. The results showed that workaholics experienced significantly more sleep problems (i.e. morning tiredness, sleeping while driving and sleeping fewer hours both on weekdays and at weekends, with poorer quality), had higher relative risk scores, and consumed more caffeine and alcohol than the other patterns of worker (positive, compulsive and hard workers). Further analyses revealed that sleep problems fully mediated the relationship between workaholism (i.e. working excessively and compulsively) and cardiovascular risk. The study emphasizes the fact that being a workaholic might be a significant risk factor for having sleep problems and cardiovascular disease.     

Identifying design criteria for urban system ‘last-mile’ solutions – a multi-stakeholder perspective

Abstract

This study presents a novel approach to design and evaluate ‘last-mile’ solutions – encompassing the social and economic perspectives of key stakeholders. While urban system initiatives have been implemented in practice, theoretical gaps remain at the operational design level. A theoretical framework is developed, based on design criteria identified from a critical synthesis of supply chain and operations management literature, and ‘operationalised’ using an in-depth case study demonstrating implementation of a Consumer Choice Portal-Package Consolidation Centre solution, within a densely populated urban geography. Findings suggest that there is a need to re-define the role of institutional actors beyond that of the traditional governance task, to one of being able to facilitate performance outcomes. Similarly, industrial efficiency dimensions need to be reorientated to include consumer participation, social considerations and multi-stakeholder service outcomes. Finally, implications for operations theory and practising managers in city logistics are highlighted, with suggested directions for future research.     

Institutional readiness for integrated watershed management: The case of the Maumee river

Is there such a thing as “institutional readiness” for integrated watershed management? One element of readiness is the ability of managers with watershed-related responsibilities to identify the policy and management objectives of potential partners. The geographic areas encompassed by large watersheds are under the overlapping jurisdictions of many agencies and organizations from each sector (public, non-profit, and private) as well as private landowners. Developing a watershed-based institutional atlas is a promising strategy for coping with this jurisdictional complexity. The authors examine the potential for developing such an atlas in the Maumee River watershed of Ohio, Indiana, and Michigan, and they assess other signals of readiness and partnerships in progress in the basin.     

Using the End‐User Computing Satisfaction (EUCS) Instrument to Measure Satisfaction with a Web Site

The purpose of this study is to revise and revalidate the End‐User Computing Satisfaction (EUCS) instrument to measure satisfaction with a Web site from a usability perspective. This study is especially important given the increased significance of the Web and the uniqueness of the Web as a computing environment. A total of 176 students participated in a lab simulation that involved a usability evaluation of the Lands' End Web site ( http://www.landsend.com ). Students were asked to complete a set of tasks, record their answers, and then complete the EUCS instrument. Confirmatory factor analysis and invariance analyses were conducted to test the reliability, validity, and generalizability of the revised EUCS. The results show that the EUCS is a valid and robust instrument in the Web environment but that one of the subfactors, timeliness, will need further refinement in the future. Usability practitioners can use the EUCS to measure end‐user satisfaction with a Web site and use the feedback for improving Web‐site design. We describe a case study of an actual usability application that utilized the revised EUCS effectively to support the design of building supply Web sites involving two types of end users, homeowners and contractors. We also propose a typology that researchers can use as a starting point to judge when it is necessary to revalidate an instrument like the EUCS. Finally, we discuss the limitations of our study and present avenues for future research.