The time is now: the need to develop team performance consultants in Canadian healthcare institutions

Malaysia has emerged as a major economic force in the Asia-Pacific region. While the recent growth is supported in part by government incentives, much credit can be attributed to the development of small-medium enterprises (SMEs). Recent US studies have found evidence of extensive HRD in small to mid-sizedbusinesses, and otherrecentstudies found higherlevels ofjob satisfaction among employees of small firms. This study measures the nature and extent of HRD; the level of job satisfaction among workers; and determines the correlation between workplace learning and job satisfaction in Malaysian SMEs.     

医疗运作管理: 新兴研究热点及其进展

近几十年来,随着人们对健康问题关注度的日益提升,医疗保健服务得到了快速发展, 随之而来的诸多有别于其他服务的运作问题吸引了众多学者浓厚的研究兴趣,并逐渐形成了一个新兴研究热点———医疗运作管理． 医疗运作管理旨在运用运作管理的思想、方法和技术对医疗保健服务各个运作环节进行精细研究,为医疗保健服务的有效实施提供系统的科学指导． 文章介绍了全球医疗服务业的发展形势以及医疗运作管理的研究进展,说明了该领域研究的有效性、必要性和迫切性; 全面回顾了运筹管理顶级期刊和医疗运作领域的重要期刊,按照研究对象进行分类组织,详细介绍了医疗运作管理研究的关注热点,并结合当今最新的研究成果分析了潜在发展趋势．     

Changing Healthcare System Types

This article classifies 32 Organisation for Economic Co‐operation and Development (OECD) healthcare systems based on data from 2001 and 2007. It shows that European countries are clustered in different types of healthcare systems and that traditional typologies are only partially represented in the four types of healthcare systems identified in this study. Type 1 represents countries with low total health expenditure (THE), high public financing, and low out‐of‐pocket payment (OOP). In‐patient healthcare is higher and out‐patient healthcare lower than the OECD average. General practitioners (GPs) are paid by capitation, and patients' access to healthcare is strictly regulated. Type 2 represents countries with an average level of THE, high public financing, above‐average OOP, and high in‐patient and out‐patient healthcare. GPs receive a salary, and access regulation is strict. Type 3 is characterized by very low THE, low public financing, and very high OOP. Both in‐patient and out‐patient healthcare is well below average, and GPs are paid a salary. Type 4 includes systems with the highest THE, the highest public financing, and the lowest direct payments by patients. In‐patient healthcare is below the OECD mean and out‐patient healthcare is well above it. GPs are paid by fee‐for‐service, and most countries offer free choice of medical doctors. The clusters for the years 2001 and 2007 are quite robust. During this time period, THE increased, and patients' access to medical doctors has since become more regulated.     

Making sense of visual management through affordance theory

Visual management is much used within operations management practice, particularly in association with process improvement initiatives in diverse areas such as production and healthcare. The practitioner literature abounds with suggested best practice. However, there is little attempt to theorise about why the design and use of ‘visual’ devices for such process improvement works in practice. Within this paper we describe a novel theory of operation which highlights the role that material and visual artefacts proposed by visual management practitioners play within particular ways of organising work. We develop an innovative way of employing the theory of affordances to explain how first- and second-order affordances, situated around the visual devices at the heart of visual management, connect three domains of action, which we refer to as articulation, communication and coordination. Our analysis of three cases from healthcare, clothing manufacturing and software production help ground the theorisation discussed.     

Sociality and transnational social space in the making of medical tourism: local actors and Indonesian patients in Malaysia

ABSTRACT

We investigate international medical travel between Indonesia and Malaysia through the conceptual lens of sociality, transnational social space and therapeutic mobilities. Drawing upon narratives of local persons, medical traveller-patients, accompanying family members, hospital staff and medical travel facilitators, we illustrate how multifaceted linkages and processes generate and sustain the flow of patients across the border. In these narratives, we see multiple mobilities articulate and cross-cut in the building of transnational connections. This paper stretches the concept of transnational social space to apply to medical travel and contributes to the literature framing of international medical travel as a complex and multifaceted arena.     

Under What Conditions do Lesbians Disclose Their Sexual Orientation to Primary Healthcare Providers? A Review of the Literature

Under what conditions do lesbians disclose their sexual orientation to primary healthcare providers? A review of the literature was undertaken to answer this question and to provide insight into the ways healthcare professionals can play an active role assisting their lesbian patients in “coming out.” Thirty empirical studies met the inclusion criteria and were reviewed. Collectively, these separate studies have found that a myriad of internal (patient attributes) and external (healthcare context, patient–provider relationship) factors influence disclosure. The discussion highlights the critical role of healthcare professionals in supporting disclosure.     

Meeting healthcare costs: the case of childhood cancer in Singapore

Social security in Singapore is met by a compulsory personal savings scheme under the Central Provident Fund. Part of these savings go towards the individual's healthcare needs which are met through a spectrum of three schemes – Medisave, Medishield and Medifund, or the '3Ms'. This study examines the effectiveness of the '3Ms' in making healthcare services affordable to families with cancer-stricken children. The extent to which the '3Ms' support costly cancer treatment is an indication of the healthcare financing system's ability to meet diverse healthcare needs. Literature research and interviews with medical social workers and families with cancer-stricken children indicate that the '3Ms' are unable to support these families' medical needs without the help of voluntary welfare organisations. This suggests that there is a need to question a rigid adherence to financial prudence and consider a more flexible healthcare system that is responsive to varied needs.     

一种非周期任务的超时故障模型

实时软件故障与一般软件故障相比，具有一般软件所不具有的故障特征，即超时故障。实时任务分为周期任务和非周期任务，由于两类不同任务的超时特性不同，因而分析方法也不同。文中基于随机过程中事件的平均到达率并用Ｒａｔｅ－Ｍｏｎｏｔｏｎｉｃ调度算法，分析了非周期任务的超时特性并建立相应的超时故障模型。     

Financial Health Economics

We provide a theoretical and empirical analysis of the link between financial and real health care markets. This link is important as financial returns drive investment in medical research and development (R&D), which, in turn, affects real spending growth. We document a “medical innovation premium” of 4–6% annually for equity returns of firms in the health care sector. We interpret this premium as compensating investors for government‐induced profit risk, and we provide supportive evidence for this hypothesis through company filings and abnormal return patterns surrounding threats of government intervention. We quantify the implications of the premium for the growth in real health care spending by calibrating our model to match historical trends, predicting the share of gross domestic product (GDP) devoted to health care to be 32% in the long run. Policies that had removed government risk would have led to more than a doubling of medical R&D and would have increased the current share of health care spending by more than 3% of GDP.     

Negotiating Compliance: The Case of Autonomous Hospitals in Vietnam

Maternal death is one of the highest causes of global mortality. Governments have long used regulation to improve maternal health but concurrent fiscal‐decentralisation reforms can undermine clinical performance. This article focuses on public Vietnamese hospitals to explore how regulatory compliance is pursued in decentralised health facilities, since Vietnam has seen increasing autonomisation of public hospitals in the last decade while simultaneously experiencing marked reductions in the maternal mortality ratio. Our analysis suggests that autonomisation has allowed regional regulatory regimes to emerge and that regulatory compliance must compete with other priorities. Compliance can therefore be rethought as a negotiation having implications for how government and maternal health advocates persuade self‐sufficient hospitals to take on wider health‐system goals.