Nursing leadership: championing quality and patient safety in the boardroom

OBJECTIVE: Identify the extent to which hospital boards of trustees, CEOs, and CNOs are engaged in quality and safety at the leadership and governance level and how CNOs can support board engagement in quality and safety. BACKGROUND: Although research is emerging, still relatively little is known about the impact and interface of hospital boards of trustees, CEOs, and nursing executives related to improving quality and patient safety. METHODS: 73 telephone interviews were conducted with hospital board chairs, CEOs, and CNOs from a convenience sample of 63 U.S. hospitals. The interviews (22 of which were with CNOs) lasted 30 to 45 minutes and were supplemented by a focus group of five nursing executives. RESULTS: There are significant differences in the perceptions of CNOs versus those of board chairs and CEOs. CNOs reported a greater familiarity of landmark reports on quality and patient safety than board chairs. CEOs and board chairs gave substantially higher ratings to integration of quality planning. Boards have limited comprehension of salient nursing quality issues. CONCLUSION: CNOs have a critical role as boardroom champions of patient safety and quality improvement.     

BILATERALISM AND FREE TRADE*

We study a setting with many countries; in each country there are firms that can sell in the domestic as well as foreign markets. Countries can sign bilateral free‐trade agreements that lower import tariffs and thereby facilitate trade. We allow a country to sign any number of bilateral free‐trade agreements. A profile of free‐trade agreements defines the trading regime. Our principal finding is that, in symmetric settings, bilateralism is consistent with global free trade. We also explore the effects of asymmetries across countries and political economy considerations on the incentives to form trade agreements.     

Paragons of virtue? Competitor entry and the strategies of incumbents in the U.S. local telecommunications industry

We investigate whether the presence of new competitors has influenced the behaviour of U.S. incumbent local exchange carriers (ILECs) with respect to pricing, advertising and the extent of diversification that they engage in. This issue is explored empirically, using data for the major local exchange carriers for the years 1994 to 1998. The period straddles periods of both absence and presence of competition in the industry, since the Telecommunications Act of 1996 has opened hitherto closed markets to competitive local exchange carriers (CLECs). While a recent Federal Communications Commission (FCC) report on local competition documents vigorous entry during the past years, the market share of the entrants is insubstantial. Our results indicate that the threat provided by market entrants has notably influenced the strategic behaviour of ILECs. The findings show that the incumbent U.S. local operators, particularly the larger ILECs, aggressively protect their profit streams from traditional business. The evidence demonstrates that the ILECs have responded to the Telecommunications Act 1996, and to the threat of market entry it has created, through entry deterrence. This strategic behaviour has been successful in providing ILECs with protection of their monopolistic markets so far.     

Scale efficiencies in US telecommunications: An empirical investigation

In this paper we evaluate scale efficiency patterns of local operating companies in the US telecommunications industry. Scale efficiency is defined as the ability of each company to operate as close to its most productive scale size as possible, and is calculated using data envelopment analysis. The analysis of scale efficiencies is conducted for a set of 39 local operating companies, over six time periods: 1975, 1978, 1981, 1984, 1987 and 1990. During these time periods, several technical and institutional changes took place in the industry which are likely to have had an impact on the abilities of the companies to exploit feasible scale efficiencies, and we find that scale efficiencies have steadily increased over these time periods. We also establish that the Bell operating companies are no different from the independent companies in their ability to be scale efficient; single-state firms are relatively more scale efficient; line digitization, during the periods studied, has not significantly impacted scale efficiency; and firms belonging to multi-company parents are more scale efficient. Additionally, policy regime changes, such as the introduction of intra-LATA toll market competition and incentive regulation schemes, have positively impacted firms' abilities to attain scale efficiency, while micro-segment competition in local markets have, so far, not had the expected impact.     

Does Public Country-by-Country Reporting Deter Tax Avoidance and Income Shifting? Evidence from the European Banking Industry*

In this study, we examine the effect of increased tax transparency on the tax planning behavior of European banks. In 2014, the European Union introduced public country-by-country reporting requirements to the banking industry. Treating this new requirement as an exogenous shock, we find limited evidence consistent with a decline in income shifting by the banks' financial affiliates in the post-adoption period (starting from 2015). We do not, however, find robust evidence of a significant change in the consolidated book effective tax rates among the affected banks. Our findings suggest that increased transparency from public country-by-country reporting can deter tax-motivated income shifting but that it did not appear to materially influence the banks' overall tax avoidance. Our findings have policy implications for the ongoing debate between the European Parliament, the Organisation for Economic Co-operation and Development, and accounting standard-setting bodies on whether to require multinationals to publish country-by-country reports.     

India and the Impossible Trinity

In the 1990s, India responded to the well‐known trilemma of macroeconomic policy by adopting an intermediate exchange rate system combined with selective capital controls. This regime enabled the country to balance exchange rate stability, exchange rate targeting and monetary autonomy, and to weather successfully various shocks that included contagion from the East Asian crisis. India's experience serves to reinforce doubts about the desirability of bipolar exchange rate regimes for developing countries as an integral element of a new international financial architecture.     

Born-International SMEs: BI-Level Impacts of Resources and Intentions

The Katz and Gartner (1988) model describes four central properties of emerging organizations: resources, intention, exchange, and boundary. While designed as a general model for organizations, the approach has the potential to explain the early lives of "born-international" firms. In this study, boundary is used to define the central sampling frame. Two other properties, resources and intention, are evaluated in terms of their impact on the fourth property: exchange, measured as a firm's export growth and intensity. Given the inherent presence of two levels of analysis in emerging organizations, intention and resources are evaluated at both the individual and the organizational level. A sample (N = 47) of young "born-international" firms in the Indian software industry was studied, using a questionnaire. Results of the analysis are mixed for resources at both the individual and firm level variables. Intention is significant at the individual level but not the firm level. Contrary to other studies, these findings suggest that during the early stages of firm development, owner, not firm, characteristics play a pivotal role in performance, especially exports. The speculation is that this occurs because, in early stages, firms are relatively disorganized relative to the owner.     

Careers and motherhood: policies for compatibility

This paper examines the economic issues relevant to policy debatesthat surround the increasing labour force participation of mothers.We review the main changes in women's labour market participationin Britain. The main source of increase in women's participationrates has come from mothers returning to work after childbirthafter progressively shorter intervals. The major influenceson this behaviour and the length of time spent out of work overthe first childbirth and the associated empirical work are alsoreviewed. These changes have raised issues relevant to maternityand parental leave, childcare provision, employers' family-friendlyworking arrangements and children's welfare. The paper makessome recommendations about how to further gender equity in aform compatible with family life.     

Putting one-to-one marketing to work: Personalization, customization, and choice

The tailoring of a firm’s marketing mix to the individual customer is the essence of one-to-one marketing. In this paper, we distinguish between two forms of one-to-one marketing: personalization and customization. Personalization occurs when the firm decides what marketing mix is suitable for the individual. It is usually based on previously collected customer data. Customization occurs when the customer proactively specifies one or more elements of his or her marketing mix. We summarize key challenges and knowledge gaps in understanding both firm and customer choices in one-to-one markets. We conclude with a summary of research opportunities.     

Analyzing the underlying dimensions of firm profitability

In this paper we decompose a traditional measure for firm's performance, return on sales, into four components that capture the impact of productivity, price recovery, product mix and capacity utilization, respectively, on a firm's profitability. The new measures are used as an illustration to explain changes in the performance of firms in the US telecommunications industry following deregulation. Changes in the overall profitability margin of these firms are explained by substantial but offsetting changes in their productivity, price recovery ability, product-mix maximization and capacity utilization, that have occurred as a consequence of deregulation. The new measures enable us not only to illustrate relative differences between firms in a given cross-section but also to shed light on how changes take place over time in the different components that underlie firms' profitability.