Global ETD Search

21	Unity, Justice and Protection: The Colored Trainmen of America's Struggle to End Jim Crow in the American Railroad Industry [and Elsewhere] James, Ervin 2012 August 1900 (has links) The Colored Trainmen of America (CTA) actively challenged Jim Crow policies on the job and in the public sphere between the 1930s and 1950s. In response to lingering questions concerning the relationship between early black labor activism and civil rights protest, this study goes beyond both local lure and cursory research. This study examines the Colored Trainmen's major contributions to the advancement of African Americans. It also provides context for some of the organization's shortcomings in both realms. On the job the African American railroad workers belonging to the CTA fought valiantly to receive the same opportunities for professional growth and development as whites working in the operating trades of the railroad industry. In the public sphere, these men collectively protested second-class services and accommodations both on and off the clock. Neither their agenda, the scope of their activities, nor their influence was limited to the railroad lines the members of the CTA operated within the Gulf Coast region. The CTA belonged to a progressive coalition comprised of four other powerful independent African American labor unions committed to unyielding labor activism and the toppling of Jim Crow. Together, they all worked to effectuate meaningful social change in partnership with national civil rights attorney Charles H. Houston. Houston's experience and direction, coupled with the CTA's dedicated membership and willingness to challenge authority, created considerable momentum in movements aimed at toppling racial inequality in the workplace and elsewhere. Like most of their predecessors, the CTA's struggle for advancement fits within a continuum of successive challenges to economic exploitation and racial inequality. No single person or organization can take full credit for ending segregation or achieving equality. Many who remain nameless and faceless contributed and sacrificed. This study not only chronicles the contribution of a relatively unsung African American labor organization that waged war against Jim Crow on two different fronts, it also pays homage to a few more individuals who made a difference in the lives of an entire race of people during the course of a bitterly contested, never-ending struggle for racial equality in the United States of America during the twentieth century. Colored Trainmen of America Labor Civil Rights History African American Gulf Coast Region American History Twentieth Century American Race Relations Jim Crow Black Labor Unions Charles Hamilton Houston Joseph C. Waddy A. Philip Randolph FEPC Double V. Campaign William H. Hastie 1960s American Railroad System Labor Law Labor Movement Industrial Unions Transportation Interstate Transport World War I World War II The Great Depression The New Deal Executive Order 8802 FDR Harry Truman Dwight Eisenhower LBJ Richard Nixon Adam Clayton Powell, Jr.
22	Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital Lucas, D. Pulane 24 April 2013 (has links) Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs. Disruptive Disruptive Innovation Theory Disruptive Transformations Disruptive Innovation Innovation Technology Technological Innovation Medical Innovation Medical Technology Medical Advancement Laparoscopy Laparoscopic Surgery open surgery appendectomy cholecystectomy bariatric surgery weight loss surgery appendectomies cholecystectomies inpatient outpatient ambulatory ambulatory surgery ambulatory surgery center acute care general hospital hospital acute care hospital general hospital health care healthcare hospital industry health care industry Clayton Christensen Clayton M Christensen Michael Porter Harvard Business School Virginia Commonwealth University CMS Health policy public policy public administration organizational theory organization theory Population Ecology Theory Competitive Strategy policy analysis John Kimberly Organization Size Structural Inertia liability of smallness health spending health care cost specialty medical facility open system niche width dynamic outpatient department technology shift surgical setting surgical setting shift medical facility shift substitution threat health system system level analysis Ecological Approach hospital trends ambulatory surgery trends reimbursement rate Medicare CMS coverage decision P J DiMaggio DiMaggio and Powell w w Powell Hannan and Freeman M T Hannan Organizational change minimally invasive surgery less invasive surgery Prospective Payment System Outpatient Prospective Payment System entreprenuerial physician health care organization health care management Roice Luke Carl Ameringer new technology surgical utilization elective surgery Medicare Payment Advisory Commission MedPAC coverage decision trends in surgery abdominal surgery surgical variation physician-owned physician ownership physician autonomy outpatient clinic utilization trends unnecessary surgery Pfeffer Salancik technology diffusion redefining health care interdisciplinary research health care delivery panel design diffusion of hospital technology state variation regional variation local health care market government intervention medical facility health care capacity focused factory advances in health care physician organization relationship hospital competition medical specialization hospital expansion medical arms race integrated care integrated health system J E Wennberg health care transformation reimbursement scheme surgical volume Florida Wisconsin policy making health policy analysis competitive dynamics center of excellence intervening factor service line competition service-line competition surgical reimbursement innovative business model innovative technology environmental influence established firm new market entrant patient safety sophisticated technology Harvard Divinity School Social and Behavioral Sciences

Search results

Unity, Justice and Protection: The Colored Trainmen of America's Struggle to End Jim Crow in the American Railroad Industry [and Elsewhere]

Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital