Bringing baby home: a comprehensive case management program for obstetrical services

Originally presented to the Society of Home Health Care Management of the American College of Physician Executives at its November 16, 1993, meeting in Tucson, Ariz., the program described in this article was the winner of the College's 1994 Innovations Award in Medical Quality Management, sponsored by Merck Sharp & Dohme. The program shows the potential of case management for both improvement in the quality of care and containment of costs for a managed care population with a substantial Medicaid segment. This article is part of a continuing series on innovative programs in home health care.     

Community,Family, and Race/Ethnic Differences in Health Status in Rural Areas1

Abstract Many race-specific differences in health outcomes that have been observed in previous research have been attributed to class and racebased group differences which either facilitate or constrain health opportunities and behaviors. These include such variables as different rates of poverty, health insurance coverage, and access to medical care. However, these relationships have been inadequately examined in rural communities where minority status may be even more detrimental to health than in urban areas, due to various constraints on access to health care. We present an analysis that assesses the effects of community, family structure, sociodemographic, and medical care variables on self-reported health status among Hispanics, Mrican Americans, and non-Hispanic whites in six rural communities in Florida. Community structural characteristics had a significant effect on self-reported health, as did some of the measures of how respondents “experience” community. These relationships held even when other sets of variables were added to the models. Family/household characteristics and sociodemographic and medical care variables were less important in explaining self-reported health status. These findings suggest that community continues to be important in explaining differences in health status in rural areas.     

An innovative approach to selecting an executive director

As a guide for how to select a new executive director, a family agency adopted the search committee process from higher education. The approach included clarifying agency goals and the director's qualifications, a board-staff screening, and interviews held jointly with public representatives before final board selection.     

Partnering with Russia's new entrepreneurs: Software tsarina olga kirova

This article focuses on a Russian woman entrepreneur who established a very successful software firm under license from an American software company. The case illustrates a productive and successful partnership between a Western company and a new Russian entrepreneur. Recent developments in Russian entrepreneurship are reviewed, and the selection of Russian entrepreneurs as business partners is evaluated. The American company is described briefly, followed by an in-depth discussion of its Russian partner and founder, Olga Kirova. Conclusions and interpretations are offered on choosing the right Russian partners, assessing their personal values, objectives and leadership skills, being a good Western business partner, and considering Russian women as business associates.     

Beyond Planning:: Strategies for Successfully Implementing Strategic Decisions

This article brings strategy back to managers and their organizations. It argues and demonstrates empirically that what managers do, and the kind of organization they lead, matter in terms of achieving stated objectives. Managerial action involves a set of activities from assessing the problem to prioritising action, and takes place within an organizational context which has two important elements for decision-making. First, organizations have an accumulated stock of experience, and the more managers can access and utilise this experience base the better. Secondly, the culture and structure of an organization may exhibit more or less readiness for the changes that decisions bring about, and contexts less ready for change pose problems for managers in the implementation of decisions.This long-term study of 55 decisions in UK firms shows that careful managerial planning does not of itself guarantee successful outcomes: the organizational context is crucial in framing actions and influencing achievement, and decisions may send a firm on a trajectory beyond the point at which it can plan with confidence. Where experience and readiness are strong, decisions achieve stated objectives—where both are lacking, decisions tend to fail. But, as examination of two illustrative cases indicates, strength in either domain may be enough: sound experience may win out in comparatively unreceptive situations, and decisions may still succeed where experience is lacking but the organization is ready for change. The article closes with some implications for managers.