Are we operating effectively? A lean analysis of operating theatre changeovers

Hospital operating theatres are a critical but costly resource in healthcare processes. Their efficiency and utilisation impact upon hospital finances, clinical effectiveness and patient outcomes. Operations management techniques have now been applied widely to optimise flow. An important challenge is to balance the needs of process flexibility, efficiency and work standardisation with clinical requirements. This paper applies operations management methods to analyse elective orthopaedic surgery at five international hospitals to describe the issues that affect operating theatre productivity. It utilises an innovative method of video analysis to observe patient changeovers over 29 days of surgery and data is analysed to understand the causes of variability and waste. The findings suggest that processes which are standardised via operations management methodologies can improve productivity in a process that exhibits wide variation in practice. There are apparent trade-offs associated with efficiency and clinical concerns such infection control, that lead to different standard process archetypes being utilised. Recommendations for standardising patient changeovers are provided.     

Run theorems for low returns and large banks

In this paper, we revisit the issue of bank fragility in the Diamond and Dybvig (J Polit Econ 91:401–419, 1983) model with sequential service and finite traders. We provide a precise condition under which banks are susceptible to a run when the return on investment is low, and we show that sufficiently large banks are always susceptible to a run. One interpretation of the condition is that exposure to runs occurs when desire for consumption smoothing or predictability of preference profiles are relatively high.     

A New Approach to Gravity Anomaly Separation: Differential Markov Random Field (DMRF)

In this paper the authors introduce a novel approach to stochastic image processing, denoted as Differential Markov Random Field (DMRF), which has been applied to gravity anomaly separation problems. The advantages of the method are that it introduces only little distortion into the shape of the original image and that it is not affected significantly by factors such as the overlap power spectra of regional and residual fields. Testing of the proposed meth using synthetic examples gave excellent results.     

Marketing and development out of poverty: introduction to the special issue

• Reducing poverty by meeting the United Nations' Millennium Development Goals (MDGs) is an interdisciplinary undertaking, in which Marketing Science logically plays a role. The papers in this special issue cover a range of methods, from traditional consumer research experiments (on images of poverty, donation behaviour) and sample surveys on the credibility of celebrity marketing, to observational studies of community values and customs (on micro-finance or agricultural enterprise). Consumers of aid appeals, celebrity lobbying and financial services—these methods reveal—are behaviourally complex. They are infused with contradictory, competing and complementary tendencies. Underlying those different tendencies however is a common but often overlooked thread. For poverty to be significantly reduced by 2015, attention needs to be paid not only to goals, that is to task but also towards understanding the human relationships in the poverty reduction market. Marketing practise and research can contribute to poverty reduction by helping build (1) perspective-sharing, (2) accommodation to local needs and (3) appreciation of socio-economic and socio-cultural behavioural systems.

Copyright © 2008 John Wiley & Sons, Ltd.     

Procurement of logistics services and sustainable development in Europe: Fields of activity and empirical results

This paper strives to answer the general question; how far purchasers of logistics services take into account aspects of sustainable development. Modeled on the German Sustainable Development Strategy, which is based on the EU Sustainable Development plan, five fields of activity are defined: the reduction of transport intensity and emission, the reduction of land use, the choice of carrier under consideration of sustainable aspects, the permanent improvement of working conditions, and the enhancement of qualified employment. Then, propositions for purchasing companies of logistics services are developed, which contribute to safeguard ecological as well as social sustainability. In order to conduct an explorative study, a questionnaire was sent to 750 purchase and logistics managers. It was found that purchasing companies place high value on ecological and social aspects. But the perceived importance is not associated with purchasing companies' own contributions to logistics service providers' sustainable activities. Additionally, it was seen that purchasing companies exert only a minor influence on logistics service providers regarding ecologically and socially sustainable actions. A fundamental precondition for a sustainably oriented procurement of logistics services can be seen in the purchasing companies' awareness of the need for integrating sustainable aspects in economic decisions.     

The Stewardship Role of Analyst Forecasts,and Discretionary Versus Non-discretionary Accruals

We examine the interaction between discretionary and non-discretionary accruals in a stewardship setting. Contracting includes multiple rounds of renegotiation based on contractible accounting information and non-contractible but more timely non-accounting information. We show that accounting regulation aimed at increasing earnings quality from a valuation perspective (earnings persistence) may have a significant impact on how firms rationally respond in terms of allowing accrual discretion in order to alleviate the impact on the stewardship role of earnings. Increasing the precision of more timely non-accounting information (analyst earnings forecasts) increases the ex ante value of the firm and reduces costly earnings management. There is an optimal level of reversible non-discretionary accrual noise introduced through revenue recognition policies. Tight rules-based accounting regulation, as opposed to leaving firms more choice over non-discretionary accrual policies, may lead firms to rationally respond by inducing costly earnings management. More generally, regulating both earnings persistence and the tightness of admissible auditing policies may not result in less equilibrium earnings management.     

Carbon efficiency of US colleges and universities: a nonparametric assessment

Under the American College and University Presidents’ Climate Commitment (ACUPCC), institutes of higher education have pledged to pursue a goal of carbon neutrality. We utilize emissions reported under the ACUPCC agreement and a nonparametric data envelopment analysis approach in order to evaluate the relative performance of signatories to the agreement in terms of producing teaching and research with the least greenhouse gas emissions. We find that while many signatory institutions are now producing their desirable outputs relatively efficiently in terms of carbon emissions, there still exists considerable variation in efficiency and potential for improvement. Results of a second stage efficiency change analysis shows evidence of both movement towards the efficiency frontier since signing, and some movement of the frontier itself, though this evidence comes primarily from teaching-focused institutions.     

The hydroelectricity consumption and economic growth in Asian countries - evidence using an asymmetric cointegration approach

ABSTRACT

This study examines the four commonly tested hypotheses in hydroelectricity consumption – economic growth literature for 12 Asian countries. Our results from a recently developed hidden cointegration technique uncover rich and significant relationships between negative and positive components of the variables under consideration. In particular, we find evidence to support the neutrality hypothesis in five countries (Bangladesh, Indonesia, Pakistan, Philippines, and Thailand), the growth hypothesis in four countries (India, Japan, South Korea and Taiwan), and both growth and conservation hypotheses in three countries (China, Malaysia, and New Zealand). These findings suggest that appropriate economic policies should be elaborated on the basis of the country’s specific hydroelectricity consumption–growth nexus. Finally, our new evidence suggests that the lack of stable relationship between hydroelectricity consumption and economic growth documented in previous studies for some of these countries could be due to the failure to properly account for the nonlinearity property in the data.     

On the formation of interaction networks in social coordination games

There are many situations where two interacting individuals can benefit from coordinating their actions. We examine the endogenous choice of partners in such social coordination games and the implications for resulting play. We model the interaction pattern as a network where individuals periodically have the discretion to add or sever links to other players. With such endogenous interaction patterns we see multiple stochastically stable states of play, including some that involve play of equilibria in the coordination game that are neither efficient nor risk-dominant. Thus the endogenous network structure not only has implications for the interaction pattern that emerges, but it also has a significant impact on the play in the coordination game relative to what would arise if the same interaction network were exogenous.