6 resultados para healthcare organizations
em AMS Tesi di Dottorato - Alm@DL - Università di Bologna
Resumo:
In the last decades, the increasing significance of “projectivization” (Lundin & Steinthórsson, 2003) has stimulated considerable interest in project-based organizations as new economic actors able to introduce a new logic of organizing work and weakening boundaries in favour of networks of collaborations. In these contexts, work is often delegated to project teams. Deciding whom to put on a project team is one of the biggest challenges faced by a project manager; in particular which characteristics rely on to compose and match effective teams. We address this issue, focusing on the individual flexibility (Raudsepp, 1990), as team composition variable that affects project team performance. Thus, the research question investigated is: Is it better to compose project teams with flexible team members or not flexible project team members to achieve higher levels of project performance? The temporary nature of PBOs involves that after achieving the purpose for which team members are enrolled, they are disbanded but their relationships remain, allowing them to be involved in future projects (Starkey, Barnatt & Tempest, 2000). Pre-existing relationships together with the current relationships create a network of relationships that yields some implications for project teams as well as for team members. We address this issue, exploring the following research question: To what extent is the individual flexibility influenced by the network structure? The conceptual framework is used to articulate the research questions investigated with respect to the Television drama serials production. Their project-team organizing combined with their capacity to dissolve and recreate over time make it an interesting field to develop. We contribute to the organizational literature, providing a clear operationalization of individual flexibility construct and its role on affecting project performance. Second, we contribute to the organizational network literature addressing the effects yielded by the network structure-structural holes and network closure- on the individual flexibility.
Resumo:
Social networks are one of the “hot” themes in people’s life and contemporary social research. Considering our “embeddedness” in a thick web of social relations is a study perspective that could unveil a number of explanations of how people may manage their personal and social resources. Looking at people’s behaviors of building and managing their social networks, seems to be an effective way to find some possible rationalization about how to help people getting the best from their resources . The main aim of this dissertation is to give a closer look at the role of networking behaviors. Antecedents, motivations, different steps and measures about networking behaviors and outcomes are analyzed and discussed. Results seem to confirm, in a different setting and time perspective, that networking behaviors include different types and goals that change over time. Effects of networking behaviors seem to find empirical confirmation through social network analysis methods. Both personality and situational self-efficacy seem to predict networking behaviors. Different types of motivational drivers seem to be related to diverse networking behaviors.
Resumo:
Organizational and institutional scholars have advocated the need to examine how processes originating at an individual level can change organizations or even create new organizational arrangements able to affect institutional dynamics (Chreim et al., 2007; Powell & Colyvas, 2008; Smets et al., 2012). Conversely, research on identity work has mainly investigated the different ways individuals can modify the boundaries of their work in actual occupations, thus paying particular attention to ‘internal’ self-crafting (e.g. Wrzesniewski & Dutton, 2001). Drawing from literatures on possible and alternative self and on positive organizational scholarship (e.g., Obodaru, 2012; Roberts & Dutton, 2009), my argument is that individuals’ identity work can go well beyond the boundaries of internal self-crafting to the creation of new organizational arrangements. In this contribution I analyze, through multiple case studies, healthcare professionals who spontaneously participated in the creation of new organizational arrangements, namely health structures called Community Hospitals. The contribution develops this form of identity work by building a grounded model. My findings disclose the process that leads from the search for the enactment of different self-concepts to positive identities, through the creation of a new organizational arrangement. I contend that this is a particularly complex form of collective identity work because it requires, to be successful, concerted actions of several internal, external and institutional actors, and it also requires balanced tensions that – at the same time - enable individuals’ aspirations and organizational equilibrium. I name this process organizational collective crafting. Moreover I inquire the role of context in supporting the triggering power of those unrealized selves. I contribute to the comprehension of the consequences of self-comparisons, organizational identity variance, and positive identity. The study bears important insights on how identity work originating from individuals can influence organizational outcomes and larger social systems.
Resumo:
In this thesis we focus on optimization and simulation techniques applied to solve strategic, tactical and operational problems rising in the healthcare sector. At first we present three applications to Emilia-Romagna Public Health System (SSR) developed in collaboration with Agenzia Sanitaria e Sociale dell'Emilia-Romagna (ASSR), a regional center for innovation and improvement in health. Agenzia launched a strategic campaign aimed at introducing Operations Research techniques as decision making tools to support technological and organizational innovations. The three applications focus on forecast and fund allocation of medical specialty positions, breast screening program extension and operating theater planning. The case studies exploit the potential of combinatorial optimization, discrete event simulation and system dynamics techniques to solve resource constrained problem arising within Emilia-Romagna territory. We then present an application in collaboration with Dipartimento di Epidemiologia del Lazio that focuses on population demand of service allocation to regional emergency departments. Finally, a simulation-optimization approach, developed in collaboration with INESC TECH center of Porto, to evaluate matching policies for the kidney exchange problem is discussed.
Resumo:
In the last decades, medical malpractice has been framed as one of the most critical issues for healthcare providers and health policy, holding a central role on both the policy agenda and public debate. The Law and Economics literature has devoted much attention to medical malpractice and to the investigation of the impact of malpractice reforms. Nonetheless, some reforms have been much less empirically studied as in the case of schedules, and their effects remain highly debated. The present work seeks to contribute to the study of medical malpractice and of schedules of noneconomic damages in a civil law country with a public national health system, using Italy as case study. Besides considering schedules and exploiting a quasi-experimental setting, the novelty of our contribution consists in the inclusion of the performance of the judiciary (measured as courts’ civil backlog) in the empirical analysis. The empirical analysis is twofold. First, it investigates how limiting compensations for pain and suffering through schedules impacts on the malpractice insurance market in terms of presence of private insurers and of premiums applied. Second, it examines whether, and to what extent, healthcare providers react to the implementation of this policy in terms of both levels and composition of the medical treatments offered. Our findings show that the introduction of schedules increases the presence of insurers only in inefficient courts, while it does not produce significant effects on paid premiums. Judicial inefficiency is attractive to insurers for average values of schedules penetration of the market, with an increasing positive impact of inefficiency as the territorial coverage of schedules increases. Moreover, the implementation of schedules tends to reduce the use of defensive practices on the part of clinicians, but the magnitude of this impact is ultimately determined by the actual degree of backlog of the court implementing schedules.