Evidence-based staffing: potential roles for informatics

Over the last 15 years, evidence has been accumulating relating higher levels of nurse staffing in both quantity and experience to lower rates of adverse patient outcomes. Consequently, to promote quality patient outcomes efficiently, making staffing decisions based in evidence is of increasing importance. However, there is still limited data to help decide how to effectively allocate scarce nurse resources in practice. Existing principles, frameworks, and guidelines provide a foundation for nurse staffing decisions but face poor adoption. To determine optimal nurse staffing practices and provide evidence-based recommendations for policy, and integration into operations, comprehensive data are necessary. Information technology can assist nurse staffing decisions. Four informatics processes that may support evidence-based nurse staffing are described: (a) Data acquisition from multiple data sources, (b) Representation of data in a way it can be re-used for multiple purposes, (c) Sophisticated data processing and mining, and (d) Presentation of data in standardized and user-configurable ways.     

Staffing for end of life: challenges and opportunities

What would staffing look like if we committed to end-of-life experiences that were designed to honor the needs of the person dying, their loved ones, and the needs of the nurses and care team involved in the dying experience? When we think about the experience of death in a health care setting, it is essential we look at the needs of both patients and caregivers. Attending to the needs of patients and their families facing death, even if well defined, can be difficult to design into staffing plans and budgets in a way that would not put an organization at further financial risk. If we are going to commit to staffing practices that honor dying, in all it's dimensions and for all who are potentially impacted, we will most likely have to step outside traditional thinking to find answers.     

The impact of nursing on patient and organizational outcomes

The impact of nursing on patient and organizational outcomes has received significant attention from researchers in the past 10 years. Although some research has been based on a theoretical framework, to date, there has not been one, consistent framework that can guide this research. In addition, the frameworks that have been used do not identify nursing as the pivotal concept in the model. The purpose of this article is to identify a framework to guide such research with an emphasis on nursing as the essential concept. Unit culture, nurse staffing, staffing mix, and other variables do not have a direct effect on outcomes. It is only through these variables' influence on the delivery of nursing care that outcomes are affected.     

The impact of state regulations on nursing home care practices

This article assesses the effect of the minimum quality standards of deficiencies and nurse staffing requirements on the nursing home care practices of physical restraint, indwelling urinary catheter, and feeding tube use. National longitudinal data on nursing homes reveal that the effect of specific deficiency citations on care practice use depends on the clinical complementarity or substitutability of the deficiency and the specific care practice, while a high number of deficiencies can lead to a greater use of each care practice. Higher direct care staffing requirements increased the use of physical restraints and decreased the use of feeding tubes. Increases in licensed nursing staff requirements had no effect on the care practices studied. Regulators should be aware that using minimum quality standards when quality is multidimensional creates incentives for offsetting quality improvement practices.     

The impact of nurse staffing on hospital costs and patient length of stay: a systematic review

Research examining the relationships between nurse staffing, hospital costs, and length of stay is varied using a range of methods and definitions. This lack of coherence in definitions and measurement tools for cost and length of stay makes it difficult to conclude with certainty the results of nurse staffing on hospital cost and length of stay. However, the evidence reflected that significant reductions in cost and length of stay may be possible with higher ratios of nursing personnel in hospital settings. Sufficient numbers of RNs may prevent patient adverse events that cause patients to stay longer than necessary. Patient costs were also reduced with greater RN staffing as RNs have higher knowledge and skill levels to provide more effective nursing care as well as reduce patient resource consumption. Hospital administrators are encouraged to use higher ratios of RNs to non-licensed personnel to achieve their objectives of quality patient outcomes and cost containment.     

Work satisfaction among California registered nurses: a longitudinal comparative analysis

California's minimum nurse-to-patient staffing ratio law, the nation's first, was implemented in 2004. This study had two aims: (a) to evaluate the effect of the nurse-to-patient ratios law on nurse job satisfaction in order to advance the debate over the merits of nurse staffing law, and (b) to compare California nurses who were satisfied against those who were not, in order to facilitate the development targeted retention interventions based on empirical evidence. The sample's overall job satisfaction increased significantly as the years passed, suggesting the nurse-to-patient ratios law was associated with improvements in nurse satisfaction. Satisfied RNs were more likely to have a balanced and financially secure life that included a partner, children living at home, higher hourly wages, and higher income from sources other than a nursing job. Nurses working in direct patient care positions remained dissatisfied in larger proportions than those working in other types of positions, even after the nurse-to-patient ratios were implemented. More nurses are satisfied today than before the ratios; nevertheless, far too many nurses (18.5%) have job satisfaction scores that are neutral or worse.     

Effective workforce management starts with leveraging technology, while staffing optimization requires true collaboration

Effective staffing is at the very core of quality patient care. Staffing that achieves a balance between quality, safety, labor costs, and staff satisfaction is incredibly complex. Technology can make the complexity manageable and provide health care leaders with the tools to optimize their most valuable resource--their employees. Through such a partnership, the business intelligence brought forth will not only meet the unique needs and goals of each organization, but will also result in innovations and advancements in best practices around excellence in staffing.     

人员配置模型在商业银行人力资源管理中的应用

人力资源配置是商业银行人力资源管理与开发的焦点问题,人力资源对商业银行经营效益的贡献度,主要取决于商业银行人员配置的效率。目前,关于商业银行人员配置模式的理论研究均不太深入。按照现代人力资源管理的思想,结合中国商业银行人员配置的现状和特点,建立了人员配置模型,从而为商业银行如何实现科学的人员配置开辟了一个全新的视角。     

资源控制视角下人员任用与绩效的关系——华南地区IJV的实证研究

对东道国母公司来说,组织学习是建立国际合资公司(IJV)的重要原因之一。与外方母公司相比,东道国母公司在技术实力和管理经验方面都处于劣势,然而由于地缘的优势,东道国母公司能够为IJV的运作提供必须的物质和人力资源,并依靠这些资源与外方母公司展开谈判,对IJV实施必要的控制,从而促成学习目标的达成。从这个角度出发,本文研究了东道国母公司对IJV所采取的资源控制、人员任用控制以及IJV学习绩效之间的相互关系,并选取我国华南地区的96家合资企业作为实证研究对象,对资源控制、人员任用和IJV学习绩效的关系进行了实证研究。结果表明东道国母公司采取的资源控制并不直接影响IJV的学习绩效;但是通过东道国母公司对IJV的人员任用控制、资源控制会对IJV的学习绩效产生间接的影响。     

Comparative assessment and essential analysis on new international GHG emission reduction proposals

Since Kyoto Protocol came into force on February 16, 2005, the endeavor by international society to combat the climate change has stepped into a new milestone. The greenhouse gas （GHG） abatement mechanisms in Kyoto Protocol have served a remarkable function but also been questioned during the practices of past three years about its environmental effectiveness. A lot of new international GHG emission reduction proposals are proposed from many new a.spects, some of which especially impose pressure on developing countries. So it is of great importance to research on these new proposals in time for negotiation beyond Kyoto and institution of Chinese relevant climate policies. As this paper focutses on the way of commitment distribution of mechanisms, the mechanisms here are categorized in one of two types： those distribute commitment based on countries and those based on sectors. Some of the typical mechanisms are selected to be analyzed comparatively, especially about their influence on developing countries,E-mail address： jiangdongmei@tsinghua.edu.cn     

人力资源服务业空间集聚组织模式研究

人力资源服务业在我国经过30多年的发展,在国民经济和社会发展中发挥着越来越重要的作用,但其同时也面临着人力资源服务机构规模较小、档次较低、集聚化水平不高、集聚内部驱动力欠缺、外生机制推动不足等问题。从空间组织理论视角研究人力资源服务机构内外生成机制,并在此基础上归纳出人力资源服务行业3种空间组织模式：以中心城市为核心的圈层式集聚模式、围绕高人力资本的综合化集聚模式、由政府主导的人力资源产业园集聚模式,旨在为人力资源服务业集聚发展提供理论依据。     

Power struggle and pork barrel politics in authoritarian countries: Evidence from China

This paper examines how power struggle among cliques within ruling parties shape public policies. We develop a simple model of bargaining among ruling elites to study government staffing and use it to explain why the number of subnational government staff in China has increased rapidly despite repeated government streamlining programs initiated by the central authority. Using provincial‐level panel data in China from 1992 to 2011, we show that the subnational government headed by a politically weaker party secretary, in terms of the size of the opposition of elites in the provincial standing committee, tends to have a larger number of senior cadres and public employees. Notably, the party secretary's power from the centre mitigates the tendency to expand government staff. We also provide suggestive evidence that the local government finances government expansion by selling more land.     

"重大疑虑事项"为审计判断证据的差异性研究——《中国注册会计师审计准则第1324号——持续经营》实施效果预测

2006年2月修订颁发的持续经营审计准则在取得重要修订成果的同时,完全保留了原准则中对持续经营审计判断的核心证据--影响持续经营假设的重大疑虑事项或情况--的界定.本文以2003年到2004年涉及持续经营问题而被出具非标准审计意见的所有A股上市公司为样本,研究了注册会计师依据影响持续经营假设的重大疑虑事项实施审计判断的差异情况.明确提出:新旧准则对重大疑虑事项界定的不确定性、对依据重大疑虑事项出具不同审计意见规范的或缺性是导致诸多审计判断差异的主要原因,新准则的实施效果可能仍不理想;持续经营审计准则自身不可克服的修订缺陷,应考虑从审计手段和方法的创新上寻找突破口,以提高新准则的实施效果.     

Corporate Spin-offs and the Significance of Founders' Informal Relations

Research on corporate spin-offs has suggested that spin-off firms have advantages over other new entrants in an industry because of their origin. These advantages have been argued to lie with the founders' prior industry experience, and with the opportunity to form sourcing agreements with the parent firms. This paper inquires into an additional aspect of prior experience, founders' informal relations. The use and benefits of such informal relations to source resources necessary for growth were analysed in three spin-offs in the Swedish telecommunications industry. The findings show that the spin-offs derived a variety of benefits from the use of founders' informal relations, in particular in staffing the spin-offs, but also to acquire resources when other means of sourcing were unavailable. The results indicate that future research on corporate spin-offs as well as corporate spin-outs may need to account better for this variable in order to explain spin-off growth, and hence success.     

Corporate Spin-offs and the Significance of Founders’ Informal Relations

Research on corporate spin-offs has suggested that spin-off firms have advantages over other new entrants in an industry because of their origin. These advantages have been argued to lie with the founders’ prior industry experience, and with the opportunity to form sourcing agreements with the parent firms. This paper inquires into an additional aspect of prior experience, founders’ informal relations. The use and benefits of such informal relations to source resources necessary for growth were analysed in three spin-offs in the Swedish telecommunications industry. The findings show that the spin-offs derived a variety of benefits from the use of founders’ informal relations, in particular in staffing the spin-offs, but also to acquire resources when other means of sourcing were unavailable. The results indicate that future research on corporate spin-offs as well as corporate spin-outs may need to account better for this variable in order to explain spin-off growth, and hence success.     

Does the market care about investor protection practices in China?

This study develops a scorecard with which to measure the investor protection practices of major listed firms in China during 2007–2010. We use time-series data to examine the relationship between the change in firm investor protection practices and market performance. Our results show that firms exhibiting improvements in investor protection practices manifest a subsequent increase in buy-and-hold abnormal returns. The results further indicate that the changes in the sub-index have different effects on a firm’s future performance. Shareholder rights to be rewarded seem to have the most significant and positive effect on a firm’s future performance for both local and international investors. Moreover, international investors pay attention to their rights to information. Our results provide evidence in support of the notion that the market does care about firm’s investor protection practices. The findings are robust to other measures of firm performance.     

Linking nursing workload and performance indicators in ambulatory care

More and more ambulatory care organizations are using nursing report cards to monitor and evaluate the quality and effectiveness of nursing care in the ambulatory setting. Nurse staffing levels is usually one of the items included in a nursing report card and the one most scrutinized by ambulatory care administrators. One strategy employed by the nursing leadership at the South Texas Veterans Healthcare System to justify nurse staffing levels is linking administrative staffing monitors with nurse-sensitive outcomes via workload and performance indicators. Through this approach, nurse leaders are able to justify nurse staffing level changes, needed technology changes, process improvements, and/or workflow needs to administrators with positive results and support.     

Patients' perceptions of nurse staffing, nursing care, adverse events, and overall satisfaction with the hospital experience

Noticeably absent in the discussions surrounding nurse staffing and adverse events is the patients' perspective, except for their satisfaction with various aspects of their hospitalization experience. The results of a study undertaken to test a theoretical model of patients' perceptions of nurse staffing, the nursing care they receive, self-reported adverse events, and overall satisfaction with the hospital experience are presented. Perception of nurse staffing only weakly predicted the number of adverse events reported by patients, but was a strong predictor of the perception of nursing care received, and the perception of nursing care received was the only significant predictor of overall satisfaction with the hospital experience.     

Forest certification in Russia: Challenges of institutional development

This article examines the implementation of voluntary forest certification in Russia and the role it has played so far as a mechanism of multi-level governance with the potential to create sustainable forestry. The evidence was gathered from a data-set of over a hundred in-depth interviews with individuals from business, communities, state and non-governmental organizations in several major forestry regions in the European and Far-Eastern parts of Russia. The respondents' views regarding the nature and effects of certification were wide ranging. Certification is associated with new and powerful tools that are an alternative to coercive state governance, which may become instrumental in ensuring law enforcement and sustainability. At the same time, the combination of commercial drivers behind certification and the lack of social controls may lead to the institutionalization of existing, not necessarily desirable, forestry practices. Our paper shows that the inconsistent outcomes of certification are highly related to path-dependent social institutions and local practices. The expectations for internationally-devised schemes aimed at establishing sustainable forest management can be easily thwarted by the behavior of individuals involved at the local level. Greater focus on low-level actors is required for effective realization of multi-level governance in Russian forestry.