Impacts of health maintenance organization growth on community health care costs.

The paper presents a model of health maintenance organization (HMO) growth, traditional health delivery system response, and total community health care costs. Simulations using a range of assumptions about the response of government and the traditional sector to HMO growth suggest three conclusions. First, HMO growth reduces total community health costs, but a substantial fraction of HMO subscribers' savings is added to the cost of other sector subscribers. Second, HMO cost savings depend as much on HMO control of inflation rates as on control of hospital utilization. Third, while HMOs can have significant impact even when they share hospital resources with the traditional sector, HMOs must control captive hospitals in order to achieve all of their potential savings, growth, and community impact.     

Job satisfaction and employee perception of the learning environment in the health care management industry

This study examines the relationship between job satisfaction and perception of the learning environment of administrative employees and differences in job satisfaction in terms of age, education, ethnicity, gender, location, marital status, position classification, and years of service. A total of 261 administrative employees of a national health care management organization participated in the survey. Major findings of this study revealed significant differences in some subcategories of job satisfaction and perceptions of learning environment in the respondents' ethnicity, age, and office location. Significant relationships were also found between job satisfaction, the perceived learning environment, and facets of the learning environment.     

A health maintenance organization design for long term care under medicaid

The rapid increase in public expenditures for long term care under Medicaid is discussed. The major cause of this increase is identified as the high and often excessive utilization of nursing home care. Health maintenance organizations (HMOs) are considered in terms of their ability to reduce health care costs by curbing unnecessary hospitalization. The HMO structure is extended to long term care, where it is argued that unnecessary nursing home care can be reduced. A health maintenance organization targeted to the Medicaid long term care population is proposed and a detail flow analysis of the HMO is presented.     

Transforming your manufacturing organization into a learning organization.

Many experts believe the only sustainable advantage an organization will have in the future is its ability to learn faster than its competitors. This competitive advantage can be achieved by transforming the organization into a learning organization. This article describes the basic elements of a learning organization and how to transform an organization to focus on learning. The article also describes methods for evaluating the training and learning that occurs within the organization to ensure that training dollars are wisely spent. Finally, the article describes what individuals can do to focus on their own learning and personal development within an organization.     

The how and why of integrated reporting in a public health care organization: The stakeholders' perspective

Despite the widespread calls for in‐depth case studies on adoption of the International Integrated Reporting Council Framework, in practice, it appears to be underexplored, above all in the public sector. Our aim is to explore how and why a public health care organization (PHO) has chosen to adopt the practice of integrated reporting, and we then delve into whether the PHO's perception of the document's value coincides with that of the stakeholders, who are its recipients. Often, society's perception of value can differ considerably from an organization's. Thus, for our research purposes, a case study was examined, adopting a qualitative approach and action research methodology. Our findings demonstrate the centrality of the value created for patients and of the “normative” scenario that takes place during the implementation of an integrated report in a PHO. Moreover, the concept of legitimacy was found to be virtually synonymous with institutionalization.     

Microworlds and Simuworlds: Practice fields for the learning organization

Management is one of the few professions, the authors note, in which members have no formal “rehearsal space” for honing their skills. In response to this need, organizations such as The Center for Creative Leadership, MIT's Learning Center, and The Stern School of Business at New York University have created a brave new world of management simulations—“practice fields” for the learning organization. Some of these new games (“simuworlds”) use computer programs to replicate an entire industry and give participants an opportunity to play out one company's strategy in that setting. Other simulations (“microworlds”) engage participants in complex behavioral role playing, based on scenarios that typically develop within a company. Still other simulations combine both approaches. The authors take their point of departure from Peter Senge's definition of the “learning barriers” that develop in any organization: solving fragmented “problems” rather than dealing with systemic issues; overemphasis on competition at the expense of cooperation; and a failure to innovate until forced to do so. The new simulations, the authors argue, are particularly useful in helping managers learn how to overcome these barriers.     

Organizational learning and compensation strategies: Evidence from the Spanish chemical industry

This study explores the role of compensation strategies in promoting organizational learning capability. By analyzing a sample of 111 Spanish firms from the chemical industry, we highlight how compensation strategies can be used to influence employees' commitment to learning and shape their understanding of the overall purpose of the organization. We also show that inappropriate strategies can lead to short‐term efficiencies but damage longer‐term learning. © 2005 Wiley Periodicals, Inc.     

Disseminating knowledge to build a learning organization

In recent years the learning organization has become popular in the management literature but the extent to which staff typically obtain access to the information they need for enhanced learning is not well understood. This paper examines the access to information experienced by staff within a New Zealand company in terms of the topics on which information is received and the sources from which information comes. The results show significant divisions within the company on status grounds for information that is currently received. Nevertheless, no such divisions were found for the information that is sought. Limitations appeared more obviously with regard to formal information sources (for which the company is responsible) than for the informal sources (which the individual finds it easier to access). Implications for companies aspiring to strengthen their capacity to learn are briefly discussed.     

推进学习型组织健康发展——学习型组织在中国实践的挑战与对策

一、学习型组织在中国:行进在繁荣与泡沫的边缘 虽然对组织学习的研究最早可以追溯至上个世纪六七十年代,但真正引起人们对该领域的广泛关注,并大量研究与实践的是1 990年.时年,原麻省理工大学斯隆管理学院教授彼得·圣吉的巨著<第五项修炼--学习型组织的艺术与实务>一书出版.在书中,圣吉整合了系统动力学、社会心理学等社会科学的研究成果,提出了创建学习型组织的"五项修练"的核心思想.该书迅速成为全球商业类畅销书,极大地推动了学习型组织的发展.     

加强学习型党组织建设的探索与实践

文章从分析科技型企业加强学习型党组织建设的主要背景入手,分析了长沙矿冶研究院建设学习型党组织的现实意义,研究了建设成果和主要做法,探讨了科技型企业建设学习型党组织的主要对策。     

Flexible learning systems and obsolete organization structures: steps towards bridging the gap

This study explores the mismatch between existing learning systems and the members’ needs for learning in a large international organization. It responds to recent research which argues that members’ learning modes need to be understood and catered for in modern age organizations. Rather than arguing from “what should be”, however, it explores “what is”, by analysing the mismatch developing in a classical organization. Based on the findings, an instrumental model is elaborated, which combines structural and cognitive factors. A main argument is that learning systems and organization structure inhibit one another mutually, which prevents lasting change from taking place. The key to resolving mutual inhibition is to engage in a process of inquiry which focuses on the overall structure and also the learning systems. Three characteristics of such a process of inquiry are proposed as requirements for the resolution of mutual inhibition: social context, setting and proximity.     

Total quality in health care

Quality is at the top of American consumers' demand list, and consequently American manufacturing companies have been forced to assign priority to the development of high-quality products. To improve the quality of what they offer, many manufacturers use the management philosophy known as total quality management (TQM), and now the service sector is following in their footsteps. The health care industry is a good example of a service industry that can benefit greatly from TQM, and it is the purpose of this article to show how a health care provider can implement TQM and evaluate its effects.     

Environmental laws in health care

Federal and state regulations regarding the management and disposal of medical waste are currently quite extensive and will only become more comprehensive in the future. The public's heightened awareness and concerns over infectious diseases and discoveries of medical waste on beaches in New Jersey, Alabama, and other states, as well as medical waste being found in open trash bins and at public landfills, has brought to the public's attention the need for governmental intervention into this growing area of concern. Because regulations originating from the local, state, and federal levels have the potential to significantly affect hospitals, it is important that a specific person or department within the organization have a clearly designated responsibility to stay informed and follow up on these regulations. The designated person or department must work closely with the hospital's attorney to make sure that he or she stays current on environmental laws and keeps the institution adequately advised of its legal responsibilities.