Physician report cards: now and in the future

The six methods used to create physician performance reports-a less pejorative term than physician report cards-are seriously flawed. These current approaches are peer review, essay-style reports, raw data, statistical reports, outcome analysis, and aggregate variation from guidelines. We must deliver what we promise in information designed to confirm dependable practitioner performance. Otherwise, we risk confirming, instead, the public's suspicion that the emphasis in "managed care" is too much on managing profit and too little on patient care. This article explores a plan for how to proceed with evaluating physician performance.     

Social Media(tion) and the Reshaping of Public/Private Boundaries in Employment Relations

Tensions surrounding social media in the employment relationship are increasingly evident in the media, public rhetoric, and courts and employment tribunals. Yet the underlying causes and dimensions of these tensions have remained largely unexplored. This article firstly reviews the available literature addressing social media and employment, outlining three primary sources of contestation: profiling, disparaging posts and blogs, and private use of social media during work time. In each area, the key dynamics and underlying concerns of the central actors involved are identified. The article then seeks to canvas explanations for these forms of contestation associated with social media at work. It is argued that the architecture of social media disrupts traditional relations in organisational life by driving employer and employee actions that (re)shape and (re)constitute the boundaries between public and private spheres. Although employers and employees are using the same social technologies, their respective concerns about and points of entry to these technologies, in contrast to traditional manifestations of conflict and resistance, are asymmetric. The article concludes with a representational summary of the relative legitimacy of concerns for organisational actors and outlines areas for future research.     

Restaurant Revenue Management at Chevys: Determining the Best Table Mix

Revenue management has been used in a variety of industries and generally takes the form of managing demand by manipulating length of customer usage and price. Supply mix is rarely considered, although it can have considerable impact on revenue. In this research, we focused on developing an optimal supply mix, specifically on determining the supply mix that would maximize revenue. We used data from a Chevys restaurant, part of a large chain of Mexican restaurants, in conjunction with a simulation model to evaluate and enumerate all possible supply (table) mixes. Compared to the restaurant's existing table mix, the optimal mix is capable of handling a 30% increase in customer volume without increasing waiting times beyond their original levels. While our study was in a restaurant context, the results of this research are applicable to other service businesses.     

Integration Between Business Planning and Information Systems Planning: Validating a Stage Hypothesis

This paper proposes and empirically validates a stages of growth model for the evolution of Information Systems Planning (ISP). A questionnaire survey of senior IS executives is used to gather information pertaining to the stages of growth model, which includes measurement of the nature and level of integration between business planning (BP) and ISP. The del test is used to validate empirically benchmark variables for each stage of BP-ISP integration. The results support the stages of growth model of BP-ISP integration and the benchmark variables are generally found to be successful in predicting the stage of integration.     

Learning about restoration of urban ecosystems: a case study integrating public participation,stormwater management,and ecological research

Restoration of ecosystem functions in urban environments is made challenging by 1) a public that often lacks understanding of ecological principles, 2) inadequate evidence of the effectiveness of restoration practices, and 3) difficulty integrating social and biophysical factors in studies of urban ecosystems. This paper describes a case study in which potential solutions to these challenges were explored. We facilitated collaborative learning through public participation in the design and implementation of an urban riparian buffer along a headwater stream in a neighborhood park, a process that was informed by ecological research. Learning outcomes were evaluated using surveys and qualitative assessment of discussion. Results indicated that participants’ knowledge about water quality problems associated with urbanization, stormwater, and nonpoint-source pollution increased, familiarity with stormwater management practices increased, and perceptions about the importance of stream ecosystem functions changed. In-stream monitoring of sediment delivery, as well as direct measurements of buffer infiltration capacity, provided early evidence of buffer effectiveness in prevention of sediment inputs to the stream and absorption of runoff from surrounding surfaces. This study provides a useful model for integration of collaborative learning through participation, ecological restoration, and ecological research in an urban setting. Elements deemed essential to success of this model included an opportunity for dialog focused on a specific natural feature, sustained interaction between participants and researchers, opportunities for hands-on participation by urban residents, and flexibility in restoration practice installation.     

Statistical inference for vector measures of inequality and poverty

In this paper, we consider methods of inference for vector measures of inequality and poverty. These vector measures may consist of several different scalar measures of inequality or poverty in a single dimension, several scalar measures of poverty which use different poverty lines, or several scalar measures of inequality or poverty in different dimensions. Our proposed methods are illustrated with a Monte Carlo simulation and two empirical examples utilizing Canadian household data.     

Infusing research integrity principles and practices into a regional master's degree-intensive university: a case study

The need for institutions of higher education to advance research and scholarly integrity across graduate degree programs involves a strong commitment from each institution to develop a comprehensive approach for promoting responsible conduct of research (RCR). In response to this need, one master's-intensive regional university implemented a three-tier model project (focusing, developing, and evaluating/sustaining) for infusing research integrity principles and practices while promoting RCR. Components of the model and implementation strategies are presented as a case study analysis. Implications of the model for promoting the RCR are projected relative to graduate programs focused on applied research.     

Making predictions from complex longitudinal data, with application to planning monitoring intervals in a national screening programme

When biological or physiological variables change over time, we are often interested in making predictions either of future measurements or of the time taken to reach some threshold value. On the basis of longitudinal data for multiple individuals, we develop Bayesian hierarchical models for making these predictions together with their associated uncertainty. Particular aspects addressed, which include some novel components, are handling curvature in individuals' trends over time, making predictions for both underlying and measured levels, making predictions from a single baseline measurement, making predictions from a series of measurements, allowing flexibility in the error and random-effects distributions, and including covariates. In the context of data on the expansion of abdominal aortic aneurysms over time, where reaching a certain threshold leads to referral for surgery, we discuss the practical application of these models to the planning of monitoring intervals in a national screening programme. Prediction of the time to reach a threshold was too imprecise to be practically useful, and we focus instead on limiting the probability of exceeding the threshold after given time intervals. Although more complex models can be shown to fit the data better, we find that relatively simple models seem to be adequate for planning monitoring intervals.     

Situational leadership theory: A test of three versions

Three versions of the leadership dynamics derived from Hersey and Blanchard's Situational Leadership Theory were identified: (1) the original, 1972, statement of the theory; (2) the revised, 2007, theory; and (3) an alternative statement of the theory's essential principle of differential follower response to “autonomy afforded by the leader” in conjunction with “follower developmental level” (as indexed by employee job experience). Survey data collected from 357 banking employees and 80 supervisors, sampled from 10 Norwegian financial institutions, were analyzed for predicted interactions. Results indicated that the 2007 revised theory was a poorer predictor of subordinate performance and attitudes than the original version. The third, alternative, version (which predicted an autonomy × job experience interaction) offered promise for further exploration of the theory's essential principle that employee outcomes are associated with prescribed leader behaviors in combination with follower developmental level, although this version also did not add substantially to accounting for criterion variance.     

The Infirmary as a Short-Term Psychiatric Facility

Abstract

The purpose of this study was to describe the role of the Oregon State University Infirmary (inpatient unit) in the provision of crisis intervention services for students with emotional problems. The focus was on the working assumptions of the infirmary program, the patient population which utilized the infirmary, the dimensions of treatment, and treatment outcomes.

Data were collected for a three year span on all patients who had contact with the infirmary for problems of an emotional nature. Records were reviewed for demographic variables, presenting symptomatology, diagnosis, treatment, disposition, and outcomes. Comparisons were made between these patients and those who received outpatient services through the Oregon State University Mental Health Clinic.

Demographic data indicated that patients who were treated in the infirmary differed only slightly from either the general student population of the university or from students receiving outpatient services. Presenting symptoms reflected a wide range of emotional problems. The severity of psychopathology was demonstrated by the finding that one-quarter of the patients manifested symptoms of acute psychosis, suicidal preoccupation, acute drug reaction, or toxic alcohol reaction. Consistent with the working assumptions of the program, the focus of treatment was short-term, intensive, and symptom directed. Treatment outcomes as determined by followup data were generally positive.

It was concluded that the infirmary provided an important treatment option which extended rather than duplicated outpatient services. The need for such an option was clearly demonstrated. The study was supportive of the concept that a university infirmary has the potential for utilization as a multipurpose facility.