A successful re-entry program

Many programs have been invented or re-invented to help cope with nursing shortages. Although re-entry is not a new program, most are thought not to be successful. Emory Hospitals in Atlanta, Georgia designed a Re-entry Program in 2000 that is still in place and has had 105 nurses successfully complete the program.     

Rational irrationality: Some economics of self-management

The paper first reviews some of the main challenges posed to our received economic paradigm by a variety of behaviors documented by psychologists and discusses possible responses to this challenge. It then describes a specific attempt at unifying a number of themes in social psychology using a parsimonious modeling of human behavior.     

Information technology: Anatomy of a successful european collaboration

Europe is betting on a two-pronged stategy to revers the dwindling fortunes of its information technology (IT) industry in the world market. This is the completion of of the single European market by 1993, together with the promotion of R&D collaboration between European IT companies and research institutions. This paper examines why Europe is collaborationg in IT and looks in detail at the way this is happening in practice. It asks: How is it that institutions from different countries come together and generate new technologies which are genuinely European? A successful European collaborative computer project provides the focus foa the discussion. The main exphasis is on showing why the collaboration took place, what major conflicats affected the development of the project, how they were solved and how the solution of the conflicts was reflected in the actual shape of the technology produced.     

Information technology: Anatomy of a successful european collaboration

Europe is betting on a two-pronged stategy to revers the dwindling fortunes of its information technology (IT) industry in the world market. This is the completion of of the single European market by 1993, together with the promotion of R&;D collaboration between European IT companies and research institutions. This paper examines why Europe is collaborationg in IT and looks in detail at the way this is happening in practice. It asks: How is it that institutions from different countries come together and generate new technologies which are genuinely European? A successful European collaborative computer project provides the focus foa the discussion. The main exphasis is on showing why the collaboration took place, what major conflicats affected the development of the project, how they were solved and how the solution of the conflicts was reflected in the actual shape of the technology produced.     

All for one,one for all: Coopetition and virtual team performance

This study establishes a model based on coopetition theory to explain the formation of team performance in virtual teams. We tested the model in information technology (IT) organizations, and found applicability of coopetition in influencing team performance and knowledge sharing. Knowledge sharing is indirectly influenced by team politics and social capital (i.e., trust, social interaction and shared vision) via the mediation of cooperation and competition, while team performance is indirectly affected by team politics and social capital via the mediation of cooperation, team emotional intelligence and team competence.     

Unemployment,institutions, and interdependencies: identifying successful reforms

Labor market reforms, which reduce institutional rigidities, are assumed to be a well-suited approach to lower unemployment. However, it is still not perfectly clear which reforms actually lead to a fall in unemployment. One crucial issue is that reforms do not work in isolation, but have labor market effects which depend on other institutional factors. Such institutional interactions have rarely been considered in empirical macroeconomic studies in a systematic way, mainly due to model uncertainty. As a solution to this problem, a Bayesian model averaging approach is adopted in this paper to identify robust and significant institutional interactions for unemployment. Using a panel data-set for 17 OECD countries from 1982 to 2005, five robust and significant interaction terms are identified, and country-specific reform effects for the institutional indicators are derived.     

Implications of nurse-physician relations: report of a successful intervention

Given the evidence linking medical errors to ineffective communication, strategies for improving communication among health care professionals must be implemented. The purpose of this article was to examine the effect of a collaborative intervention on improving communication patterns between nurses and physicians on two study units. The intervention consisted of two nurses and two physicians (per unit) meeting together (8 hours total) to collaboratively develop a solution to communication issues on their respective units. Physicians scored significantly higher on reports of openness of communication within groups, openness between groups, accuracy between groups, and collaboration between groups. Collaboration reported among nurses and physicians improved for both professions, with significance reached for physicians (p = 0.031). Strategies must be identified to break down the barriers set by the current culture, and that expedite the development of a team-centered culture supporting collaborative relations among health care professionals.     

Within trial cost-utility analysis of disease management program for patients hospitalized with atrial fibrillation: results from the SAFETY trial

Abstract

Background: The potential impact of disease management to optimize quality of care, health outcomes, and total healthcare costs across a range of cardiac disease states is unknown.

Methods: A trial-based cost-utility analysis was conducted alongside a randomized controlled trial of 335 patients with chronic, non-valvular AF (without heart failure; the SAFETY Trial) discharged to home from three tertiary referral hospitals in Australia. A home-based disease management intervention (the SAFETY intervention) that involved community-based AF care including home visits was compared to routine primary healthcare and hospital outpatient follow-up (standard management). Bootstrapped incremental cost-utility ratios were computed based on quality-adjusted life-years (QALYs) and total healthcare costs. Cost-effectiveness acceptability curves were constructed to explore the probability of the SAFETY intervention being cost-effective. Sub-group analyses were performed based on age and sex to determine differential cost-effectiveness.

Results: During median follow-up of 1.75?years, the SAFETY intervention was associated with a non-statistically significant increase in QALYs (0.02 per person) and lower total healthcare costs (–$4,375 per person). Although each of these findings were not statistically significant, the SAFETY intervention was found to be dominant (more effective and cost saving) in 58.8% of the bootstrapped iterations and cost-effective (more effective and gains in QALYs achieved at or below $50,000 per QALY gained) in 61.5% of the iterations. Males and those aged less than 78?years achieved greater gains in QALYs and savings in healthcare costs. The estimated value of perfect information in Australia (the monetized value of removing uncertainty in the cost-effectiveness results) was A$51 million, thus demonstrating the high potential gain from further research.

Conclusions: Compared with standard management, the SAFETY intervention is potentially a dominant strategy for those with chronic, non-valvular AF. However, there would be substantial value in reducing the uncertainty in these estimates from further research.

Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12610000221055.     

Ready to reform: How popular initiatives can be successful

We study whether the number of signatures collected to qualify a popular initiative affects the probability of reforming the status quo. The initiative process is modeled as a sequential game under uncertainty: petitioners make an entry decision and collect signatures to qualify the initiative. Politicians decide about a political compromise – a counter proposal – after which petitioners have the option to withdraw the initiative before the vote. In equilibrium, politicians infer the initiative's popularity from the number of signatures and collection time. The more the initiative is perceived as a threat to the status quo, the more likely politicians come up with a counter proposal. Under certain conditions, petitioners have the incentive to collect more signatures than required for qualification to demonstrate high success probability.We test model predictions using the data set of all Swiss constitutional initiatives at the federal level between 1891 and 2010. Overall, we find supporting evidence for the model mechanisms. Fast signature collection is associated with a higher probability of reform. The effect is mediated through a higher probability of provoking a counter proposal. Ultimately, counter proposals are key to amending the status quo. Restricting the signature collection time reduces the informative mechanism of the signature collection process considerably.     

Making wellness the focus: one employer's story

The rising cost of health care threatens the very fabric of American society. With Americans widely practicing unhealthy life habits, such as using tobacco, eating imprudently and leading a sedentary lifestyle, they are at risk for health conditions that threaten to make them long-term liabilities to their employer. This article tells how one U.S. employer chooses to focus its workforce on wellness.     

Strategic planning III: Objectives and program options

This series of papers deals with technological forecasting in strategic planning. In the first paper the author examines forecasting and planning as a process, identifying five roles of forecasting (1) Identifying policy options; (2) Aiding strategy formulation; (3) Identifying program options; (4) Selecting programs for funding, and (5) Selecting opportunities for funding. The subsequent papers deal primarily with the first and third roles.The second paper of the series describes perspective trees—a form of relevance tree—for identifying policy options. A perspective tree is used to interrelate sets of social, economic, political, and technological forecasts that pote threats and present opportunities for strategic consideration.The third paper of the series describes the use of objective trees in structuring program options for selected strategies. R&D programs as well as marketing and other functional business programs are structured—clarifying options for the decision-making process.