Utilization and productivity of the Duke physician's associate

The objectives of this study were as follows: (1) Formulate a theoretical model of the typical medical practice as a system for producing medical care, with particular attention to the role of middle-level health workers such as graduates of Duke University's Physician's Associate Program. (2) Develop a methodology for collecting data necessary to estimate the relevant parameters in the model, and to describe current patterns of utilization of Duke PA's. (3) Draw substantive conclusions, insofar as the model and data collection methodology permit, about the actual and potential productivity of Duke PA's.As of October 1971 Duke University had graduated 68 PA's from its Physician's Associate Program. Of these, 34 are employed as assistants in family practice or general medicine in a variety of private and institutional settings. Data were collected on eleven of these 34 PA's. No attempt was made to study the other 34 graduates engaged in clinical specialties, administration, or other functions. Neither was any attempt made to collect data on or draw inferences about the utilization and productivity of graduates of any other program such as the MEDEX Program.⁴     

The "perfect storm" in compensation: convergence of events leads to a greater need to review compensation strategies

The recent unprecedented convergence of significant strategic events in the compensation arena has created the need for ongoing and extensive compensation planning. This article reviews the events leading to this point, describes the implications of the results from a recent Aon study with WorldatWork, and suggests what employers can do to successfully navigate the "perfect storm" in compensation.     

Patient intensity in an ambulatory oncology research center: A step forward for the field of ambulatory care--Part II

Nursing leaders in ambulatory care need to objectively quantify patient intensity to balance patient care needs and nursing resources. In this three-part series, current literature on acuity/intensity tools will be reviewed, and the development of an Ambulatory Intensity System (AIS) to objectively quantify nursing care will be described. In this article, the ongoing implementation of the system, its incorporation into the organization's established computerized appointment system, reliability measures, and related performance improvement activities will be discussed.     

Public sector health insurance trusts

Public sector associations have successfully developed and run employee health insurance pools for almost 30 years, providing members with savings and flexibility not available from commercial health insurance carriers. This article looks at the models, technical tools and governance philosophy that have contributed to their success in a very challenging business environment.     

Valuation Implications of Investment Opportunities and Earnings Permanence

This study investigates the value-relevance of accounting earnings in the presence of investment (growth) opportunities after making two theoretical and methodological research design refinements. First, we test for the incremental effect of growth on firms earnings response coefficients after controlling for the extent of transitory earnings under the assumption that the value-relevance of earnings with respect to growth should be stronger when earnings are more permanent. Second, we perform comprehensive factor analysis using market-based and accounting-based measures to construct a composite proxy for investment opportunities. We find that firms investment opportunities and the relative permanence of current earnings affect the value-relevance of those earnings. Additionally, we find that the interaction between permanent earnings and investment opportunities produces an even stronger price response to earnings.     

Evaluating a method of integrating generic skills with accounting content based on a functional theory of meaning

This paper documents and evaluates an intervention designed to integrate the learning of selected generic skills, particularly analytical thinking and written communication skills, with the learning of accounting content. The method used was to scaffold practice in analytical thinking skills through specially designed writing activities. Content‐focused learning materials adapted from task‐types currently used to teach language skills were used to facilitate the analysis and interrelation of accounting concepts, principles and problems in interpersonal communicative contexts typical of actual accounting practice. The materials, in three assignments, were designed to incorporate: (i) selected generic skills, taken from those listed by the professional accounting bodies; (ii) writing, both as communication and as an instrument for analytical thinking and learning; (iii) knowledge of accounting concepts and principles; and (iv) awareness of the interpersonal dimensions of professional communication. Overall, students showed improved learning outcomes, with improvements of 19 percentage points for non‐Australian students over the three assignments. We were also able to show significant positive relationships between the assessments of assignments 2 and 3 and performance in the knowledge‐based final examination. Improvements in the quality of learning were shown in students’ improved ability to assess their own work.     

On money and output: Is money redundant?

There is an emerging consensus that money can be largely ignored in making monetary policy decisions. Rudebusch and Svensson [1999, Policy Rules and Inflation Targeting. In Taylor, J.B. (Ed.), Monetary Policy Rules. University of Chicago Press, Chicago, 203-246; 2002, Eurosystem Monetary Targeting: Lessons from US Data. European Economic Review 46, 417-442] provide some empirical support for this view. We reconsider the role of money and find that money is not redundant. More specifically, there is a significant statistical relationship between lagged values of money and the output gap, even when lagged values of real interest rates and lagged values of the output gap are accounted for. We also find that inside and outside money provide significant information in predicting movements in the output gap.     

Action on tropical food products

The history of the Tropical Products Institute (TPI) extends back to 1894. For many years it was essentially a Commonwealth body; however in 1965 it became a scientific unit of the UK's Ministry of Overseas Development which had been created to administer the British Aid Programme. The Institute was then able to cooperate with other developing countries outside of the Commonwealth. It has been recognized for some years as a world centre for the study of post-harvest problems in plant and animal resource development. High among its priorities, accounting for some 75% of the effort of the staff of almost 400, are its programmes on the handling, processing, preservation, storage, transport, quality control, marketing and uses of tropical foods.     

Analysing clusters of skills in R&D — core competencies, metaphors, visualization, and the role of IT

Though it is now universally accepted that companies should try to align their R&D activities with their business objectives, achieving this alignment is notoriously difficult in practice. The rise of the core competence framework has been very helpful in creating, and legitimizing, a language in which issues of technical competence and R&D strengths can be followed through to their consequences for competitive advantage. Companies are starting to express their R&D priorities explicitly in terms of core competencies.
Without effective IT support, core competence concepts are often applied arbitrarily. This has led to accusations that core competence theory can become yet another battlefield upon which companies play out their internal political battles. Computer-based techniques can help counteract this danger by enabling large volumes of relatively objective data to be collected, then making it possible to analyse and draw out patterns from this data, and finally enabling the data to be represented effectively.
It is in this last area of data representation that information technology is now of particular benefit. In order to make the core competence approach sufficiently robust as a basis for decision making, it is necessary to collect and process large volumes of data. However, this data is normally difficult to represent in such a way that managers can assimilate it. In our recent experience, we have come to realize the particular importance of effective representations and metaphors, and have started to shift our own emphasis towards these areas in addition to analysis per se .
The paper shows how core competence approaches can support R&D management decision making by exploring the roles of data collection, analysis and representation. Information technology is an integral part of these approaches, and we draw out some generalized lessons for the successful use of IT in decision support.