Attending to weak signals: the leader's challenge

Halverson and Isham (2003) quote sources that report the accidental death rate of simply being in a hospital is "...four hundred times more likely than your risk of death from traveling by train, forty times higher than driving a car, and twenty times higher than flying in a commercial aircraft" (p. 13). High-reliability organizations such as nuclear power plants and aircraft carriers have been pioneers in the business of recognizing weak signals. Weike and Sutcliffe (2001) note that high-reliability organizations distinguish themselves from others because of their mindfulness which enables them to see the significance of weak signals and to give strong interventions to weak signals. To act mindfully, these organizations have an underlying mental model of continually updating, anticipating, and focusing the possibility of failure using the intelligence that weak signals provides. Much of what happens is unexpected in health care. However, with a culture that is continually looking for weak signals, and intervenes and rescues when these signals are detected, the unexpected happens less often. This is the epitome of how leaders can build a culture of safety that focuses on recognizing the weak signals to manage the unforeseen.     

Internet pharmaceutical sales: attributes, concerns, and future forecast

Internet pharmaceutical sales continue to skyrocket as healthcare providers and consumers are increasingly relying on the efficiencies and convenience that is available via such transactions. Managed care companies, increasing demands to reduce healthcare inefficiencies while maximizing the quality of patient care is a significant contributing factor to the expanding utilization and success of online pharmaceutical sales. However, with the expansion of Internet pharmaceutical sales, healthcare providers, pharmacy benefit management and insurance companies, and consumers realize new opportunities and risks. This paper will review the attributes and concerns associated with online pharmaceutical sales, discussing current and pending legislation intended to more effectively manage these parameters.     

汇票持有人寻求权利保护——贸易融资纠纷面临的新问题

随着主要贸易融资市场的稳步发展，市场在寻求收益与风险的平衡。与此同时，中小借款企业亦逐渐增加对市场中交易融资方式的选择，贸易融资市场的发展已到了重新排序的阶段了。毫无疑问，今后一些新的面孔将会增加进来，为市场提供一些迄今为止那些经验丰富的银行尚未办理贸易融资产品。其中的一些机构     

伦敦交易所另类投资市场（AIM）的运作与管理

首先感谢深交所对我的邀请。今天是一个大好时机，贵所中小企业板块已获准设立。希望我能经常来中国，带给你们好运气。     

北京交通与汽车讨论的主要问题

1998年10月22日刚才的发言中已经提到了许多我将要介绍的问题,提出了许多很好的建议。引出了很好的开端。我只想与各位就某些问题,按我的理解交换看法。我是安迪奥卡博,自1997年7月出任北京吉普汽车有限公司美方总经理。我是一名工程师,工商管理硕士毕业。自1973年以来,在克莱斯勒公司的工程部、制造部、质量部以及国际部的南美、欧洲、日本及澳大利亚工作过。在发言开始前,我首先感谢周女士和《汽车与社会》杂志社的同事,感谢她将我们大家聚在一起就共同关心的汽车行业、北京市,还有北京吉普等问题,富有成果地交换意见。我想声明…     

电子商务将进入视频商务时代

适用于任何可靠传输机制(TCP)和不可靠传输机制(UDP)的分组交换网络并应用于局域网的非 保证服务质量可视电话系统及终端的国际电联ITU-T标准H.323的问世推动了视频通信的迅速 发展。在基于面向连接和电路交换方式的传统会议电视标准的H.320所不能涉及的IP应用领 域，H.323充分显示出了其优越性。尤其是基于TCP/IP协议的宽带IP网的发展为H.323的广泛 应用提供了坚实的基础，也就是提供了视频通信所需的宽带应用的环境。相应地，视频压缩 技术的改进，推动了视频商务的实用化进程。     

Strategy and the art of reinventing value

In "From Value Chain to Value Constellation: Designing Interactive Strategy" (July-August 1993), Richard Normann and Rafael Ramírez argue that successful companies increasingly do not just add value, they reinvent it. The key strategic task is to reconfigure roles and relationships among a constellation of actors--suppliers, business partners, customers--in order to mobilize the creation of value in new forms and by new players. What is so different about this new logic of value? It breaks down the distinction between products and services and combines them into activity-based "offerings" from which customers can create value for themselves. But as potential offerings become more complex, so do the relationships necessary to create them. As a result, a company's strategic task becomes the reconfiguration and integration of its compentencies and customers. Normann and Ramírez provide three illustrations of these new rules of strategy. IKEA has blossomed into the world's largest retailer of home furnishings by redefining the relationships and organizational pratices of the furniture business. Danish pharmacies and their national organization have used the opportunity of health care reform to reconfigure their relationships with customers, doctors, hospitals, drug manufacturers, and with Danish and international health organizations.(ABSTRACT TRUNCATED AT 250 WORDS)     

Hospital use behaviors and associated costs in a health insurance organization, Japan

Physicians are known to play an important role in the rise of health care costs. But patients--the other side of the chain of health care systems--have been given little attention. The present study utilized the outpatient claims (in the belief that the outpatient hospital visits are mainly decided by the patients) from a health insurance organization in Japan (the Fukuoka Prefecture public service mutual aid association for government employees who serve in small cities, towns, and villages) to analyze the employee behaviors in the use of hospital care and the costs associated with these behaviors. Number of diseases diagnosed for an employee, number of claims an employee submitted for one disease, number of hospitals an employee visited, number of claims an employee had from one hospital, and the total number of claims an employee submitted were used to describe the hospital use behaviors. Results showed that some employees exhibited unusual behaviors, characterized by having an extremely large number of diseases diagnosed, visiting a large number of different hospitals, having a large number of claims, etc. Higher medical expenditures were associated with such behaviors. The findings of this study suggest that the patients' role in the rise of health care costs cannot be ignored, and cost-containment strategies targeting modification of patient behaviors in the use of hospital care may prove to be very useful.