Strategies for Addressing the Nursing Shortage: Coordinated Decision Making and Workforce Flexibility

In this article, we present strategies to help combat the U.S. nursing shortage. Key considerations include providing an attractive work schedule and work environment—critical issues for retaining existing nurses and attracting new nurses to the profession—while at the same time using the set of available nurses as effectively as possible. Based on these ideas, we develop a model that takes advantage of coordinated decision making when managing a flexible workforce. The model coordinates scheduling, schedule adjustment, and agency nurse decisions across various nurse labor pools, each of differing flexibility levels, capabilities, and costs, allowing a much more desirable schedule to be constructed. Our primary findings regarding coordinated decision making and how it can be used to help address the nursing shortage include (i) labor costs can be reduced substantially because, without coordination, labor costs on average are 16.3% higher based on an actual hospital setting, leading to the availability of additional funds for retaining and attracting nurses, (ii) simultaneous to this reduction in costs, more attractive schedules can be provided to the nurses in terms of less overtime and fewer undesirable shifts, and (iii) the use of agency nurses can help avoid overtime for permanent staff with only a 0.7% increase in staffing costs. In addition, we estimate the cost of the shortage for a typical U.S. hospital from a labor cost perspective and show how that cost can be reduced when managers coordinate.     

An audit of received international business corruption literature for logic,consistency, completeness of coverage

This analysis of International Business (IB) corruption literature identifies gaps and inconsistencies in how corruption is perceived or deliberated in top academic journals. The reviewed articles tend to focus on one of the three key themes of IB corruption (Contributing factors, Consequences, and Combating) and are categorised into the six sub-domains of the IB framework. The content of the articles is categorised into the respective themes and discussed in relation to underpinning theories and key constructs. The process is intended to be less a synthesis of the literature than an audit revealing that IB corruption research is weakened by tendencies to: 1) Be siloed within its subtheme and to not cross-tie to work in other key themes—this issue is very severe in the Combating theme; 2) Have a short-term focus that disregards the cumulative effects of total graft, and; 3) Asymmetrically focus (predominantly) on the supply side of corruption. These finding suggest several avenues for further research.     

Looking for Public Administration Theories?

Since the sixties, a number of Western countries have conducted a lot of NPM type reforms in order to improve their public administration (PA). However, more than forty years of NPM type reforms raise questions about whether these reforms consist in an improvement of PA or if alternative theories could find their place in the field of PA reforms. In order to answer these questions, the five main public administration theories (New Public Administration, New Public Management, Public Value Management, New Public Service and New Public Governance) have been selected, and based on an original analysis of their incipits, some guidelines are proposed for practitioners and students in PA.     

The role of character in ethical leadership research

The study of character is a legitimate and essential topic for the analysis of leadership in organizations. We undertake three key objectives in this article to stimulate meaningful dialogue. First, a brief historical overview of the extant body of literature on character is provided. Second, working definitions of character and character-based leadership are introduced. Third, new directions for organizational scholars interested in examining the role of character-based leadership in both their research and teaching domains are suggested.     

Is Stakeholder Corporate Governance Appropriate in Russia?

Journal of Management and Governance - Alternative forms of disciplining the actionsof senior enterprise managers can becharacterized as shareholder or stakeholdergovernance. This paper analyzes...     

Health Risk Assessment After Decontamination of the Beaches Polluted by the Wrecked ERIKA Tanker

Following the wreck of the oil tanker ERIKA off the north-west coast of France in December 1999, cleaning up of the beaches involved considerable work, which in any case could not be perfect. This raised the question of the short- and long-term health risks for the future bathers related to the toxicity of the remaining oil polycyclic aromatic hydrocarbons (PAHs). This risk assessment study was conducted to help health authorities plan risk management policies and inform the public. Thirty-six beaches were selected, representing a sample of the most frequently encountered topographic and beach usage situations; seven "control" beaches, unspoiled by ERIKA, were also investigated. Samples of water and sand were taken from each site, as well as from the surface of rocks. The 16 PAHs selected by the U.S. EPA were quantified in each environment. Several scenarios of exposure were contemplated: (1) a child between 2 and 4 years accidentally ingesting a small ball of fuel, (2) a child daily exposed throughout his holiday-time stay, (3) an adult (including a pregnant woman) spending his/her holidays on the coast, (4) an adult working on the beach, (5) and an adult practicing water sports. Among the available and significant toxicological values, the most conservative ones were selected for computing risks. The sand and water, after decontamination, were slightly polluted (respectively, 7.8 microg/kg and 23.3 ng/l of total 16 PAHs), with values similar to those found in the control beaches. By contrast, the rocky areas in some places were still highly polluted (up to 23 mg/kg on the surface layer). No lethal risk was found for a young child who had accidentally ingested a small ball of fuel. The life-long excess risks for skin cancer and for all other cancers were about 10-5 in scenarios including contact with the polluted rocks. In all other cases, excess risks were considerably lower. The hazard quotient for teratogenic effects was very small, except in scenarios where pregnant women would walk among rocks containing high pollution levels. In conclusion, exposure was mainly associated with polluted water among children, and with spoiled rocks for adults. Despite uncertainties, mainly dealing with the prediction of long-term risks following a short-term exposure, this study showed that beaches where pollution was no longer visible after decontamination did not entail any significant health risks and could be opened to the public.     

An Empirical Test of the Relative Validity of Expert and Lay Judgments of Risk

This article investigates how accurately experts (underwriters) and lay persons (university students) judge the risks posed by life-threatening events Only one prior study (Slovic, Fischhoff, & Lichtenstein, 1985) has previously investigated the veracity of expert versus lay judgments of the magnitude of risk. In that study, a heterogeneous grouping of 15 experts was found to judge, using marginal estimations, a variety of risks as closer to the true annual frequencies of death than convenience samples of the lay population. In this study, we use a larger, homogenous sample of experts performing an ecologically valid task. We also ask our respondents to assess frequencies and relative frequencies directly, rather than ask for a "risk" estimate--a response mode subject to possible qualitative attributions-as was done in the Slovic et al. study. Although we find that the experts outperformed lay persons on a number of measures, the differences are small, and both groups showed similar global biases in terms of: (1) overestimating the likelihood of dying from a condition (marginal probability) and of dying from a condition given that it happens to you (conditional probability), and (2) underestimating the ratios of marginal and conditional likelihoods between pairs of potentially lethal events. In spite of these scaling problems, both groups showed quite good performance in ordering the lethal events in terms of marginal and conditional likelihoods. We discuss the nature of expertise using a framework developed by Bolger and Wright (1994), and consider whether the commonsense assumption of the superiority of expert risk assessors in making magnitude judgments of risk is, in fact, sensible.