A proposed enterprise risk management model for health organizations

Health care organizations are environments with high management complexity and subject to a constant exposure to risks. Enterprise risk management (ERM) has been studied and applied in different economic environments with the aim of improving organizational performance. However, the health sector still suffers from a lack of attention in this context, in particular with regard to the need for a high degree of financial transparency and for the establishment of process-orientated management, and this provides the motivation for the study described in this paper. An ERM model for health organizations is proposed, based on a systematic literature review and on seven case studies in Brazilian hospitals. An approach to economic risk assessment using indicators such as the cash flow at risk and the variability of costs and receipts from the proposed model is suggested. The health organizations involved in the case studies all interpret ERM as a source of information contributing to corporate governance, and the indicators listed provide constructive data for improvement-driven decision-making. Given the interest expressed by the organizations involved, further application and validation of the proposed model in subsequent studies is suggested.     

Diagnosing Unforeseeable Uncertainty in a New Venture*

New ventures often do not correctly foresee real market opportunities or the best way to address them. How to cope with unforeseen, unpredictable factors, also referred to as unknown unknowns, is critical for new ventures. Findings in the fields of innovation and project management have shown that dealing with the unpredictable requires management approaches different from those used for classical plan‐and‐achieve‐the‐target projects. Management approaches for novel initiatives include a combination of trial‐and‐error learning (i.e., flexible redefinition of the new venture business model as new information emerges) and selectionism (i.e., running multiple parallel trials and choosing the best performing approach ex post). The management approach must be chosen when the venture is set up. This requires a venture management team to diagnose at the outset whether unknown unknowns are present (or possible), although unknown unknowns cannot be identified initially by definition because they emerge over time. Anecdotal testimony from experienced venture managers and project managers suggests they have a feeling for where their knowledge is limited. However, such a claim is controversial. Some researchers think the concept of diagnosing unforeseeable influence factors is an oxymoron. Thus, the research question in this article is this: How can unforeseeable influence factors in a new venture be diagnosed at the outset? Research to date has insufficiently addressed the a priori identification of the type of uncertainty faced by a new venture. Based on models from decision theory, this article suggests dividing the overall problem of structuring the venture into subproblems for which the management team can identify knowledge gaps. Using a case study, the article describes how knowledge gaps were identified for the subareas of a new venture in a real situation and how this diagnosis was used to correctly identify the areas where unknown unknowns lurk. These areas were managed in a different way (i.e., with learning and experimentation) than the other subproblems (i.e., with targets and deadlines). As a result, the venture could successfully respond to unforeseeable events. The results of this study suggest that a decomposition of the overall venture management problem into subproblems is feasible and natural to managers, that a qualitative assessment of knowledge gaps and vulnerability to unknown unknowns is possible, and that a structured, process‐like approach can be used to identify subproblems, to determine their uncertainty profiles, and to update the uncertainty profiles. These results are immediately useful to venture management and venture capitalists in setting up the venture's structure for effective response to uncertainty. The results advance research about uncertainty management by offering a systematic set of questions for the diagnosis of unknown unknowns before they can be formally described. The usefulness of this process can be tested further in more formal empirical research.     

To be or to refuse to be? Exploring the concept of leisure as resistance for young people who are visually impaired

This study explored the concept of leisure as resistance to social constraints of blindness. Leisure, because of its relative freedoms, has been conceptualised as a forum in which dominant cultural discourses and stereotypes can be challenged or resisted. A post-structural analysis of the leisure narratives of five young people who are blind revealed that they intentionally used aspects of leisure to resist some constraints and stereotypes of disability. Three strategies were identified: advocacy, redefinition and passing. Advocacy targeted other people’s beliefs; yet, some activities done to resist dominant discourses actually perpetuated them. Redefinition was a covert strategy to show themselves that they could be the same as everyone else. Passing was used in different ways. One young person used it when advocating, another to maintain social connections. However, maintaining social connections by passing was often at the cost of enjoyment, engagement and perceptions of ability. Empowerment through resistance in leisure related primarily to gains in self-confidence. These gains in self-confidence have the potential to contribute to social interactions and perhaps influence some of the discourses that operate as ‘truths’ about people who are blind.     

Who likes jargon? The joint effect of jargon type and industry knowledge on investors’ judgments

We experimentally investigate how jargon affects investment willingness for investors with different industry knowledge, and whether such effects vary with good or bad jargon. We find that for investors without industry knowledge, jargon decreases investment willingness because it decreases understanding. However, for investors with some but low industry knowledge, jargon increases investment willingness because it increases perceived product premium. Such effects exist whether good or bad jargon is used. Finally, investors with high industry knowledge differentiate between good and bad jargon, and reduce investment willingness only when bad jargon is used. These findings have implications for regulators, managers, and investors.     

Information Management in Aged Care: Cases of Confidentiality and Elder Abuse

Typically seniors like others choose to avoid institutional care. However, when age-related infirmity requires it, they not only enter into the care of others, but they also do so as vulnerable members of society. As their frailty increases with age, so does their dependence on the professionals who care for them and on the enforcement of policies concerning their care. A qualitative case study involving seniors and their carers revealed that breaches of confidentiality, unprofessional behaviour and the non-enforcement of policy, continue to hide the physical and emotional abuse perpetrated by nursing and other staff on vulnerable consumers. Professional ethics, including at a corporate level, enforcing policy, protecting whistleblowers and creating reporting mechanisms for aged care researchers, are amongst the recommendations arising from this study.     

Sustaining critically reflective practitioners: competing with the dominant discourse

This article argues that discourse analysis can be utilized in conjunction with other forms of analysis to develop a more critical teaching and research agenda for Human Resource Development (HRD); in particular this article suggests that the introduction of a discourse analysis perspective can support and facilitate the development of critically reflective practitioners. The article highlights the tensions inherent within competing definitions of HRD and calls attention to the power of dominant discourse and argues that HRD needs to become more critical, opening up alternative discourses in order to support learning and critically reflective practice.     

Todd A. Knoop. Recessions and Depressions: Understanding Business Cycles. Westport, Conn.: Praeger, 2004. xv + 289 pp. ISBN 0-275-98162-2, $49.95.

This book covers "the empirics, the theory, and internationalcase studies of recessions and depressions" as a "contributionto the ongoing debate over the nature and causes of recessionsand depressions" (p. xiv). It does this with non-technical narrativesthat can be understood by upper-level undergraduates and thegeneral reader with some economics background: a welcome goalthat the author achieves. Chapters include useful data tablesand charts without being overwhelming and conclude with furtherreading suggestions.     

The Interaction Between Individuals and Information Systems: Organizations and Individuals on the Same Side

This article presents the results of a research project aimed at understanding under what circumstances the social construction process of information systems (IS) in the banking sector in Brazil takes place. It presents an analysis of the implementation, use, and procedures for the improvement of three systems used in two banks. The data were collected through 46 semi-structured interviews and documental analyses. The data analysis revealed that system assimilation was influenced by training and by the confluence of individual and organizational objectives, following a structure of conformity and conformism to what was previously implemented by the organizations.     

The traditional marketplace: serious leisure and recommending authentic travel

ABSTRACT

Services reliant on revenue generated from tourism are often beholden to how authentic visitors perceive their offering to be. From a managerial perspective, this is exacerbated when they serve a dual-purpose, as both actively ingrained in local culture and showcased international tourist attractions. As such, this study contributes to Kolar and ?abkar’s (2010) consumer-based model of authenticity by assessing the relationships between serious leisure, object-based and existential authenticity, and visitor word-of-mouth (WOM) recommendations in Iranian cultural tourism. Utilising partial least-squares structural equation modelling, and drawing upon responses from 615 visitors to the Tabriz Grand Bazaar, it thus extends the model’s applicability to the developing Middle Eastern context. The results extend extant research by emphasising the importance of object-based authenticity, as opposed to existential authenticity, in stimulating positive visitor WOM recommendations. Consequently, this study advances the prevailing understanding of the role of authenticity in stimulating positive behavioural intentions by highlighting how destinations can stimulate visitor recommendations.