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.

Neglect and Motion Stimuli - Insights from a Touchscreen-Based Cancellation Task

BACKGROUND AND PURPOSE: In stroke patients, neglect diagnostic is often performed by means of paper-pencil cancellation tasks. These tasks entail static stimuli, and provide no information concerning possible changes in the severity of neglect symptoms when patients are confronted with motion. We therefore aimed to directly contrast the cancellation behaviour of neglect patients under static and dynamic conditions. Since visual field deficits often occur in neglect patients, we analysed whether the integrity of the optic radiation would influence cancellation behaviour. METHODS: Twenty-five patients with left spatial neglect after right-hemispheric stroke were tested with a touchscreen cancellation task, once when the evenly distributed targets were stationary, and once when the identic targets moved with constant speed on a random path. The integrity of the right optic radiation was analysed by means of a hodologic probabilistic approach. RESULTS: Motion influenced the cancellation behaviour of neglect patients, and the direction of this influence (i.e., an increase or decrease of neglect severity) was modulated by the integrity of the right optic radiation. In patients with an intact optic radiation, the severity of neglect significantly decreased in the dynamic condition. Conversely, in patients with damage to the optic radiation, the severity of neglect significantly increased in the dynamic condition. CONCLUSION: Motion may influence neglect in stroke patients. The integrity of the optic radiation may be a predictor of whether motion increases or decreases the severity of neglect symptoms.

Beyond belief : Strategic taboos and organizational identity in strategic agenda setting

A comprehensive strategic agenda matters for fundamental strategic change. Our study seeks to explore and theorize how organizational identity beliefs influence the judgment of strategic actors when setting an organization's strategic agenda. We offer the notion of "strategic taboo" as those strategic options initially disqualified and deemed inconsistent with the organizational identity beliefs of strategic actors. Our study is concerned with how strategic actors confront strategic taboos in the process of setting an organization's strategic agenda. Based on a revelatory inductive case study, we find that strategic actors engage in assessing the concordance of the strategic taboos with organizational identity beliefs and, more specifically, that they focus on key identity elements (philosophy; priorities; practices) when doing so. We develop a typology of three reinterpretation practices that are each concerned with a key identity element. While contextualizing assesses the potential concordance of a strategic taboo with an organization's overall philosophy and purpose, instrumentalizing assesses such concordance with respect to what actors deem an organization's priorities to be. Finally, normalizing explores concordance with respect to compatibility and fit with the organization's practices. We suggest that assessing concordance of a strategic taboo with identity elements consists in reinterpreting collective identity beliefs in ways that make them consistent with what organizational actors deem the right course of action. This article discusses the implications for theory and research on strategic agenda setting, strategic change, a practice-based perspective on strategy, and on organizational identity.

Gender-Fair Language in Organizations: Attracting Potential Leaders and Promoting the Organizational Image of Gender Equality

In many languages, masculine generics are the traditional way of referring to women and men. However, gender-fair forms (e.g., feminine-masculine word pairs) can enhance gender equality: for instance, they counteract male biases in mental associations (Stahlberg et al., 2007) and evoke more neutral perceptions of gender-stereotypical professions (Merkel et al., 2013). Compared to masculine forms, use of gender-fair language in advertisements for leadership positions also helps to achieve gender equality in hiring decisions (e.g., use of German Geschäftsführerin/Geschäftsführer 'CEO fem/masc' instead of Geschäftsführer 'CEO masc', cf. Horvath & Sczesny, 2012). The present research investigates how potential applicants react to the use of gender-fair vs. masculine forms in German job ads for leadership positions (Study 1) and how the respective organization is perceived in response to these forms (Study 2). In Study 1, 251 participants showed higher intentions to apply for a leadership position when it was advertised with a feminine-masculine word pair instead of a masculine form; this was mediated by job appeal and organizational attraction. In Study 2, 154 participants perceived the organization as more discriminatory when masculine forms were used. This was mediated by the organizational image of gender equality. Thus, gender-fair language affects the social perception of a job and the respective organization and can impact social behavior in an organizational context.