Can outcome prediction data change patient outcomes and organizational outcomes?

PURPOSE OF REVIEW: Intensive care medicine consumes a high share of healthcare costs, and there is growing pressure to use the scarce resources efficiently. Accordingly, organizational issues and quality management have become an important focus of interest in recent years. Here, we will review current concepts of how outcome data can be used to identify areas requiring action. RECENT FINDINGS: Using recently established models of outcome assessment, wide variability between individual ICUs is found, both with respect to outcome and resource use. Such variability implies that there are large differences in patient care processes not only within the ICU but also in pre-ICU and post-ICU care. Indeed, measures to improve the patient process in the ICU (including care of the critically ill, patient safety, and management of the ICU) have been presented in a number of recently published papers. SUMMARY: Outcome assessment models provide an important framework for benchmarking. They may help the individual ICU to spot appropriate fields of action, plan and initiate quality improvement projects, and monitor the consequences of such activity.

The Genesis Solar Wind Concentrator: Flight and Post-Flight Conditions and Modeling of Instrumental Fractionation

The Genesis mission Solar Wind Concentrator was built to enhance fluences of solar wind by an average of 20x over the 2.3 years that the mission exposed substrates to the solar wind. The Concentrator targets survived the hard landing upon return to Earth and were used to determine the isotopic composition of solar-wind—and hence solar—oxygen and nitrogen. Here we report on the flight operation of the instrument and on simulations of its performance. Concentration and fractionation patterns obtained from simulations are given for He, Li, N, O, Ne, Mg, Si, S, and Ar in SiC targets, and are compared with measured concentrations and isotope ratios for the noble gases. Carbon is also modeled for a Si target. Predicted differences in instrumental fractionation between elements are discussed. Additionally, as the Concentrator was designed only for ions ≤22 AMU, implications of analyzing elements as heavy as argon are discussed. Post-flight simulations of instrumental fractionation as a function of radial position on the targets incorporate solar-wind velocity and angular distributions measured in flight, and predict fractionation patterns for various elements and isotopes of interest. A tighter angular distribution, mostly due to better spacecraft spin stability than assumed in pre-flight modeling, results in a steeper isotopic fractionation gradient between the center and the perimeter of the targets. Using the distribution of solar-wind velocities encountered during flight, which are higher than those used in pre-flight modeling, results in elemental abundance patterns slightly less peaked at the center. Mean fractionations trend with atomic mass, with differences relative to the measured isotopes of neon of +4.1±0.9 ‰/amu for Li, between -0.4 and +2.8 ‰/amu for C, +1.9±0.7‰/amu for N, +1.3±0.4 ‰/amu for O, -7.5±0.4 ‰/amu for Mg, -8.9±0.6 ‰/amu for Si, and -22.0±0.7 ‰/amu for S (uncertainties reflect Monte Carlo statistics). The slopes of the fractionation trends depend to first order only on the relative differential mass ratio, Δ m/ m. This article and a companion paper (Reisenfeld et al. 2012, this issue) provide post-flight information necessary for the analysis of the Genesis solar wind samples, and thus serve to complement the Space Science Review volume, The Genesis Mission (v. 105, 2003).

I shouldn't have to do this: Illegitimate tasks as a stressor in relation to organizational control and resource deficits

The performance of tasks that are perceived as unnecessary or unreasonable, illegitimate tasks, represents a new stressor concept that refers to assignments that violate the norms associated with the role requirements of professional work. Research has shown that illegitimate tasks are associated with stress and counterproductive work behaviour. The purpose of this study was to provide insight into the contribution of characteristics of the organization on the prevalence of illegitimate tasks in the work of frontline and middle managers. Using the Bern Illegitimate Task Scale (BITS) in a sample of 440 local government operations managers in 28 different organizations in Sweden, this study supports the theoretical assumptions that illegitimate tasks are positively related to stress and negatively related to satisfaction with work performance. Results further show that 10% of the variance in illegitimate tasks can be attributed to the organization where the managers work. Multilevel referential analysis showed that the more the organization was characterized by competition for resources between units, unfair and arbitrary resource allocation and obscure decisional structure, the more illegitimate tasks managers reported. These results should be valuable for strategic-level management since they indicate that illegitimate tasks can be counteracted by means of the organization of work.

What Makes a Family Firm Innovative? CEO Risk-Taking Propensity and the Organizational Context of Family Firms

Investigating the new product portfolio innovativeness of family firms connects two important topics that have recently received considerable attention in innovation and family firm research. First, new product portfolio innovativeness has been identified as a critical determinant of firm performance. Second, research on family firms has focused on the questions of if and why family firms are more or less innovative than other organizational forms. Research investigating the innovativeness of family firms has often applied a risk-oriented perspective by identifying socioemotional wealth (SEW) as the main reference that determines firm behavior. Thus, prior research has mainly focused on the organizational context to predict innovation-related family firm behavior and neglected the impact of preferences and the behavior of the chief executive officer (CEO), which have both been shown to affect firm outcomes. Hence, this study aims to extend the previous research by introducing the CEO's disposition to organizational context variables to explain the new product portfolio innovativeness of small and medium-sized family firms. Specifically, this study explores how the organizational context (i.e., ownership by top management team [TMT] family members and generation in charge of the family firm) of family firms interacts with CEO risk-taking propensity to affect new product portfolio innovativeness. Using a sample of 114 German CEOs of small and medium-sized family firms operating in manufacturing industries, the results show that CEO risk-taking propensity has a positive effect on new product portfolio innovativeness. Moreover, the analyses show that the organizational context of family firms impacts the relationship between CEO risk-taking propensity and new product portfolio innovativeness. Specifically, the relationship between CEO risk-taking propensity and new product portfolio innovativeness is weaker if levels of ownership by TMT family members are high (high SEW). Additionally, the effect of CEO risk-taking propensity on new product portfolio innovativeness is stronger in family firms at earlier generational stages (high SEW). This result suggests that if SEW is a strong reference, family firm-specific characteristics can affect individual dispositions and, in turn, the behaviors of executives. Therefore, this study helps extend the knowledge on the determinants of new product portfolio innovativeness of family firms by considering an individual CEO preference and the organizational context variables of family firms simultaneously.

Dynamics of governance and control in inter-organizational software development

In recent years, development of information systems (IS) has rapidly changed towards increasing division of labor between firms. Two trends are emerging. First, client companies increasingly outsource software development to external service providers. Second, the formerly oligopolistic enterprise application software industry has started to disintegrate into focal partnership networks – so called platform ecosystems. Despite the increasing prominence of IS outsourcing and platform ecosystems, many of these inter-organizational partnerships fail to achieve expected benefits. Ineffective governance and control frequently plays a pivotal role in producing these failures. While designing effective governance and control mechanisms is always challenging, inter-organizational software development projects are often business-critical and exhibit additional dynamics and uncertainty. As a consequence governance and control have to be adapted over time. The three research projects included in this book provide a better understanding of how and why governance and control can be effectively adapted over time. The implications for successful management of inter-organizational software development projects are highly relevant for theory and practice.

Perceived organizational support and intention to stay in host countries among self-initiated expatriates: the role of career satisfaction and networks

Previous literature in SIE (self-initiated expatriation) has been mostly focused on an individual perspective. Studies on SIEs in organizational context are scarce. The current paper sought to examine the effect of perceived organizational support (POS) on SIE employees’ intention to stay in the host country, mediated by career satisfaction. Furthermore, we examined the moderating roles of career-related social networks with host and home country nationals on the effectiveness of POS. Data from 112 SIE employees in Germany were collected and analyzed. Empirical results partially supported our proposed model: there were significant negative indirect effect between POS and intention to stay, when career network size with home country nationals was high. The direct effect between POS and intention to stay was positive. For HR practice, our paper gave insight to understand SIE employees’ needs for support and mobility preferences, which can help organizations to develop more targeted HR development measures and assignment strategies for them.