Global ETD Search

671	Il Multinational Managerial Community Index per analizzare l’internazionalizzazione d’impresa da una prospettiva incentrata sul comportamento collaborativo internazionale dei manager relativamente alla propria catena del valore / IL MULTINATIONAL MANAGERIAL COMMUNITY INDEX PER ANALIZZARE L'INTERNAZIONALIZZAZIONE D'IMPRESA DA UNA PROSPETTIVA INCENTRATA SUL COMPORTAMENTO COLLABORATIVO INTERNAZIONALE DEI MANAGER RELATIVAMENTE ALLA PROPRIA CATENA DEL VALORE / The Multinational Managerial Community Index to analyze the firm’s internationalization degree from a perspective focused on the international collaborative managerial behavior relative to its value chain. ALBERTIN, ROBERTO 24 May 2017 (has links) La presente tesi teorica propone il MOPC index per misurare quanto i manager abbiano generato una comunità multinazionale di gestione aperta di un generico processo considerando congiuntamente l’affiliazione, la connettività interna, la forza e la multinazionalità. A tal fine ho impiegato il SAOM-Behavior valutando la collaborazione internazionale di processo ed annessa propensione come variabili multiple i cui valori e co-evoluzione dipendono dalla co-influenza tra le collaborazioni internazionali fasiche, tra le medesime e le rispettive propensioni fasiche e tra queste ultime. L’intensità relazionale dipende dal modello mentale condiviso, generatosi a livello di team internazionale, su una certa fase del processo mentre la propensione è funzione dell’orientamento e dell’attitudine alla collaborazione internazionale fasica. Il MOPC index è stato applicato alla comunità multinazionale di innovazione aperta e di gestione aperta introducendo due indici teorici: MOIC index e MOMC index. Infine ho teorizzato la catena del valore del manager (MVC) impiegando il processo innovativo e gestionale; considerando le collaborazioni internazionali sui due processi con annesse propensioni, si ho analizzato la collaborazione internazionale sulla MVC, la relativa propensione e la loro co-evoluzione. Cosi facendo, ho introdotto il MMC index per misurare la comunità multinazionale manageriale e, mediante questo, la multinazionalizzazione d’impresa da una prospettiva relazionale manageriale. / This thesis presents the theoretical MOPC index to measure how much the managers generate a multinational open process community by considering the affiliation, the internal connectivity, the strenghtness and the multinationality. I employed the SAOM-Behavior by evaluating the international process collaboration and the respective propensity as multiple variables whose value and co-evolution depend on the co-influence between the international collaborations phasic, between the same and the respective propensities phasic and between them. The intensity of these relationships depends on the International phasic team mental model sharing (TMMS) while the propensity’s one depends on the orientation and the attitude. Then the MOPC index has been applied to measure the multinational open innovation community and the multinational open management community by introducing the MOIC index and the MOMC index. Finally, I introduced the managerial value chain (MVC) as composed of the innovative and the management process. By integrating the international collaborations related to the two processes and their propensities It’s possible to measure the international MVC collaboration, the correlated propensity and their co-evolution. In doing so, I introduced the MMC index to determine the multinational managerial community’s degree and use it to evaluate the firm’s multinationalization by a managerial relational perspective. SECS-P/10: ORGANIZZAZIONE AZIENDALE SECS-P/07: ECONOMIA AZIENDALE
672	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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Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital