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21	Snakes and ladders: human resources in nursing McIntosh, Bryan, Watt, S. January 2012 (has links) No / McIntosh and Watt focus on a recent research that many female registered nurses who return from a career break at a lower grade relative to their experience and training. They note that the reintegration of the most highly trained and experience registered nurses will not only reduce the need and cost of training but will critically enhance the quality of delivery. The NHS must make greater use of these highly skilled and experienced registered nurses, not just for sound economic reasons but for improved health outcomes as well. Patients and clients all deserve the most skilled, experienced and able registered nurses, regardless of their life circumstances.; Many female registered nurses return from a career break at a lower grade relative to their experience and training, which has a detrimental implication for the National Health Service in terms of operational efficiency. It is imperative that human resources are used to the maximum benefit of the nursing service. Adapted from the source document. Staff Development - methods Human resources Professional training Nursing Health care industry Career breaks Training Nurses
22	跨國企業在台灣實行企業社會責任之探討--以醫藥產業為例 / Exploring the CSR practices of Leading MNCs' subsidiaries in Taiwan -- Insights from pharmaceutical industry 鍾宜玲, Chung, Yi Ling Unknown Date (has links) 在「全球化」的浪潮席捲之下，讓跨國企業的「企業社會責任」議題，成為當今企業管理不容忽視的焦點。醫藥產業在全球經濟體中扮演的角色，是研發和生產創新的產品，來拯救人類的生命和促進健康。而身為一個企業組織，也同時擔負有創造利潤的責任。然而大眾卻經常質疑這些企業過度哄抬產品價格，並認為人人都有權利無限制的獲得醫藥資源。醫藥企業必須面對強大的壓力以及高度複雜的利害關係人，特別是跨國公司，負擔更是沉重。就如同其他產業一樣，「企業社會責任」的議題對醫藥企業能否具有競爭力和永續經營而言，也愈來愈重要。近年來，許多的研究指出「企業社會責任」的策略和競爭優勢有關，而且必須整合至企業的核心事業，才能確保永續的成功。許多跨國藥廠他們的營業績效表現亮眼，而且在台灣已經耕耘超過十年了，因此，本研究首度嚐試去檢視在台的領先跨國醫藥企業，他們的CSR動機、決策過程和CSR作為表現，以及其經理人對CSR的管理思維。本研究的目的是希望能學習跨國領先藥廠在台灣的經驗，並鼓勵「策略型CSR」的作為以及企業與社會的「共享價值」。我們使用「多重個案分析法」，利用問卷、次級資料的分析和深入訪談來研究十家個案公司。所有的受訪經理人都表示他們是依據企業總部的指導綱領，而自行決定在台灣執行的CSR的活動。研究結果發現，絕大多數的個案公司，因為在台灣只是一個業務功能的角色，資源和能力都有限，所以多關注在客戶關係的議題上，並多半執行「回應式CSR」而非「策略型CSR」。此外，我們也發現其CSR策略和企業的屬性、社會責任觀點及領導有關。這些經理人並承認他們沒有系統性的方法來評估CSR表現和影響。他們主要追求的是企業的聲譽，而面對的最大挑戰是，如何透過CSR來發展企業競爭優勢。本研究並舉出幾個成功案例，鼓勵策略型思考以及將社會觀點融入商業策略的核心架構中。 / Under the sweep of globalization, the corporate social responsibility (CSR) of multinational corporations (MNCs) has now become a focus that cannot be ignored in business management. The health care industry’s role in the global economy is to research, develop and manufacture innovative products to save people’s lives and improve health. At the same time, as corporations, they have a duty to increase profits. However, the industry is often challenged for its overcharge of the products and there should be unlimited access to medicines. The health care companies face a great pressure and a highly complex stakeholder universe especially for multinational companies. As in many industries, corporate social responsibility becomes increasingly critical to competitive success and sustainability of multinational health care companies. Recent studies point out that CSR strategies are associated with competitive advantages and should integrate CSR into the core business to lead to sustainable success. Many Multinational pharmaceutical companies are doing very good business and have been operating in Taiwan for over 10 years. Therefore, we attempt to gain a better understanding of the factors that influence the CSR involvement of MNCs’ subsidiaries and the aspects of their strategies as well as the managerial insight of the managers dealing with CSR from leading health care companies. The aim of this study is to encourage strategic CSR and shared value of business and society and to learn the experiences from multinational pharmaceutical companies in Taiwan. The analysis is based on a multiple case study that includes surveys coupled with careful review of relevant documents and web sites and in-depth interviews with managers from 10 case companies. All the managers interviewed mentioned that CSR activities are implemented at the local level within the framework of global guidance. The findings indicate that most of the subsidiaries focus on customer relations and are doing 「responsive CSR」 rather than 「strategic CSR」because of their sales-oriented function and limited resources and skills. We also found that their CSR strategies depend on the characters of the companies, CSR views and the leadership. All the managers admitted having no systematic way of measuring the outputs, tangible impacts or functionality of their CSR interventions. The key benefit they want to gain is the company reputation and the major challenge for the managers is to develop competitive advantages through CSR. Success stories are provided to encourage strategic thinking and the integration of social perspective into the core frameworks of value chain and competitive context. 企業社會責任跨國企業醫藥產業競爭優勢策略型企業社會責任 Corporate social responsibility (CSR) Health care industry Multinational corporations(MNC) Competitive advantages Strategic CSR
23	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

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