33 resultados para Small-sized hospitals
Resumo:
Purpose – The UK has experienced a number of flood events in recent years, and the intensity and frequency of such events are forecast to further increase in future due to changing climatic conditions. Accordingly, enhancing the resilience of small and medium-sized enterprises (SMEs) – which form an important segment in a society – to flood risk, has emerged as an important issue. However, SMEs often tend to underestimate the risk of flooding which tends to have a low priority in their business agenda. The purpose of this paper is to undertake an investigation of adaptation to the risk of flooding considering community-level measures, individual-level property protection, and business continuity and resilience measures. Design/methodology/approach – A total of four short case studies were conducted among SMEs to identify their response to flood risk, and what measures have been undertaken to manage the risk of flooding. Findings – It was observed that SMEs have implemented different property-level protection measures and generic business continuity/risk management measures, based on their requirements, to achieve a desired level of protection. Practical implications – SMEs are likely to positively respond to property-level adaptation following a post-flood situation. It is important that information such as costs/benefits of such measures and different options available are made accessible to SMEs affected by a flood event. Social implications – Implementation of property-level adaptation measures will contribute towards the long term adaptation of the existing building stock to changing climatic conditions. Originality/value – The paper contributes towards policy making on flood risk adaptation and SME decision making, and informs policy makers and practitioners.
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This paper examines the relationship between the small and medium-sized enterprise (SME) sector and economic growth for an annual panel of Brazilian states for the period 1985–2004. We investigate the importance of the relative size of the SME sector measured by the share of SME employment in total formal employment and the level of human capital in SMEs measured by the average years of schooling of SME employees. The empirical results indicate that the relative importance of SMEs is negatively correlated with economic growth, a result that is consistent with previous studies examining developing countries. In addition, our results show that the human capital embodied in SMEs may be more important for economic growth than the relative size of the SME sector.
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The main objective of this paper is to identify some of the key issues encountered by tsunami-affected small and medium-sized enterprises (SMEs) in the process of rehabilitation and re-establishment in Sri Lanka. The second objective is to assess how far these affected industries have received various benefits and supports from bodies such as government agencies, private sector firms, donors and NGOs to help them get back into business. The final objective is to recommend policies and strategies to develop the tsunami-affected SMEs in a self-sustaining manner and within a certain time period. The main database of firms for this research has been obtained from the Industrial Development Board, which conducted a survey covering 4,389 tsunami-affected micro- and SMEs. In addition to this, information from various state organizations and NGOs-based sources has been used. This paper identifies the main issues related to tsunami-affected SMEs ranging from basic infrastructure provision up to finance, marketing, machinery, technology, training, product identification and development and so forth. In fact, it is shown that there are no significant differences between issues faced by SMEs in general and tsunami-affected SMEs, apart of course from the effects of a sudden disaster (the tidal wave). Consequently, these issues can be generalized as issues relevant to SMEs in Sri Lanka as a whole. However, under the flood and rain of local and foreign assistance, there have been more pledges and promises than actual deliveries and, so, tsunami-affected SMEs have received comparatively little support and assistance in recovering and no records can be found as to where the colossal amount of foreign assistance received has actually gone. Finally, this paper recommends various types of business incubator centres and entrepreneurial enhancing skill programmes for the revamping of tsunami-affected SMEs in addition to the normal disaster risk management plan.
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thesis is developed from a real life application of performance evaluation of small and medium-sized enterprises (SMEs) in Vietnam. The thesis presents two main methodological developments on evaluation of dichotomous environment variable impacts on technical efficiency. Taking into account the selection bias the thesis proposes a revised frontier separation approach for the seminal Data Envelopment Analysis (DEA) model which was developed by Charnes, Cooper, and Rhodes (1981). The revised frontier separation approach is based on a nearest neighbour propensity score matching pairing treated SMEs with their counterfactuals on the propensity score. The thesis develops order-m frontier conditioning on propensity score from the conditional order-m approach proposed by Cazals, Florens, and Simar (2002), advocated by Daraio and Simar (2005). By this development, the thesis allows the application of the conditional order-m approach with a dichotomous environment variable taking into account the existence of the self-selection problem of impact evaluation. Monte Carlo style simulations have been built to examine the effectiveness of the aforementioned developments. Methodological developments of the thesis are applied in empirical studies to evaluate the impact of training programmes on the performance of food processing SMEs and the impact of exporting on technical efficiency of textile and garment SMEs of Vietnam. The analysis shows that training programmes have no significant impact on the technical efficiency of food processing SMEs. Moreover, the analysis confirms the conclusion of the export literature that exporters are self selected into the sector. The thesis finds no significant impact from exporting activities on technical efficiency of textile and garment SMEs. However, large bias has been eliminated by the proposed approach. Results of empirical studies contribute to the understanding of the impact of different environmental variables on the performance of SMEs. It helps policy makers to design proper policy supporting the development of Vietnamese SMEs.
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In recent years, researchers have paid increasing attention to the idea of “climate strength”—the level of agreement about climate within a work group or organization. However, at present the literature is unclear about the extent to which climate strength is a positive attribute, and is concerned predominantly with small teams or organizational units. This article considers three theoretical perspectives of climate strength, and extends these to the organizational level. These three roles of climate strength were tested in 56 hospitals in the United Kingdom. Positive relationships were discovered between two of three climate dimensions (Quality and Integration) and expert ratings of organizational performance, and a curvilinear effect between Integration climate strength and performance was also found. Very high or very low Integration climate strength was less beneficial than a moderate level of climate strength. However, there were no interaction effects discovered between climate and climate strength. Implications for future climate strength research are discussed.
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This paper analyses the determinants of the export propensity of UK small and medium-sized enterprises (SMEs) based on the 2004 Annual Small Business Survey. Particular emphasis is placed upon the relationship between innovation activities (distinguishing product from process innovation) and export performance. In general the data suggest that some 17 per cent of firms within this group sell outside the UK. Businesses that export are also characterized by high levels of innovation activity (43 per cent of exporters innovate in products, 27 per cent innovate in process and 21 per cent innovate in both). When considering product and process innovation independently we find that both impact positively on the decision to export. However, once we consider the interdependence between both innovation activities, we find no robust evidence that process innovation increases the probability to export beyond product innovation.
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This paper reviews the literature on purchasing in small and medium sized enterprises (SMEs), in the context of the wider literature on SMEs. Evidence from these sources is related to insights from exploratory interviews with the owner-managers of 15 small firms, to derive recommendations for further research. Our findings complement those of Ellegaard (2006) but also extend these with specific proposals for the process and settings of future research, notably that the priority is to understand purchasing in small firms (cf medium or micro-firms) firms and research should be ‘small firm-centric’.
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Principal Topic - As argued by Acs and Phillips (2002) it is not only “the creation of wealth (entrepreneurship)” but also “the reconstitution of wealth (philanthropy)”, which has been essential for the inherent dynamism of the market economy (Ibid., p.201). However, we understand little about the entrepreneurship – philanthropy link in institutional contexts that differ from that of leading developed market economies. Accordingly our research agenda is to investigate the entrepreneurship-philanthropy nexus in a very different context of Lithuania, a country which shed a command economy system twenty years ago. In particular, we are interested to see if the cluster of attitudes and strategies of firms conducive to entrepreneurship, i.e. their entrepreneurial orientation (Covin & Slevin, 1989), is consistent or contradictory with philanthropy? In other words, is philanthropy strongly associated with some core components of entrepreneurship, or is it an entrepreneurial anomaly, relying on a minority of economic actors that provide important links with wider, non-economic communities. Method - The study draws on 270 randomly sampled, phone interviews with owners and ownermanagers of small and medium-sized enterprises (SMEs), i.e. firms with less than 250 employees. Interviews were conducted in Lithuania during January- March, 2008. Our results are based on confirmatory factor analysis combined with regression analysis. Results and Implications - Despite the legacy of informal institutions that is conducive neither to entrepreneurship nor to civic society, we found that by now, (i) the companies that score highest on entrepreneurial orientation construct, (ii) that perform best and those (iii) that have foreign owners are also most likely to declare their commitment to philanthropy. Our findings that most entrepreneurial firms are also involved in philanthropy are consistent with the perspective on the pattern of development in an entrepreneurial economy as outlined by Acs and Phillips (2002).
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Objectives: To conduct an independent evaluation of the first phase of the Health Foundation's Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design: Mixed method evaluation involving five substudies, before and after design. Setting: NHS hospitals in United Kingdom. Participants: Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention: The SPI1 was a compound (multicomponent) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results: Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration - monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items) - there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for "difference in difference" 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from17%(63) to13%(49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening.
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Considering its strong environmental impact, logistics plays a critical role in green supply chain management. It provides strategic links in the supply chain and is an essential function in the delivery of green products to the consumer. There is a general consensus on the fact that more environmentally sustainable companies may be achieved only if transport and logistics activities also become greener. To achieve this objective, buyer companies need to incorporate green considerations in the purchasing of transport and logistics services. This appears particularly challenging for small and medium sized enterprises (SMEs) because of their traditional lack of managerial, organisational and financial resources that often result in failure to adopt an environmental perspective. In the extant literature, green purchasing has received increased attention over the past decade and the strategic importance of introducing green aspects into purchasing practices has been recognised. However, little has been written in relation to purchasing green transport and logistics services. The aim of this paper is to explore practices in the buying of green transport and logistics services and to derive implications for small buyer companies. The paper analyses how general environmental company ambitions and environmental purchasing practices are reflected when green transport and logistics services are purchased in three different European countries (Italy, Ireland and Sweden) using a multiple case study research approach. The results of the paper indicate that while the case companies show a relatively high concern for green issues at corporate level, a lower importance is attributed to green issues at the purchasing function level. When green concerns in the purchasing of transport and logistics services are analysed the level of importance decreases further. Thus, a conflicting attitude is evident between the overall corporate level and the purchasing of transport and logistics services specifically. This suggests that there is potential for improvement especially in the area of green collaboration in buyer and supplier relationships.
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Purpose: This paper aims to contribute to the understanding of the factors that influence small to medium-sized enterprise (SME) performance and particularly, growth. Design/methodology/approach: This paper utilises an original data set of 360 SMEs employing 5-249 people to run logit regression models of employment growth, turnover growth and profitability. The models include characteristics of the businesses, the owner-managers and their strategies. Findings: The results suggest that size and age of enterprise dominate performance and are more important than strategy and the entrepreneurial characteristics of the owner. Having a business plan was also found to be important. Research limitations/implications: The results contribute to the development of theoretical and knowledge bases, as well as offering results that will be of interest to research and policy communities. The results are limited to a single survey, using cross-sectional data. Practical implications: The findings have a bearing on business growth strategy for policy makers. The results suggest that policy measures that promote the take-up of business plans and are targeted at younger, larger-sized businesses may have the greatest impact in terms of helping to facilitate business growth. Originality/value: A novel feature of the models is the incorporation of entrepreneurial traits and whether there were any collaborative joint venture arrangements. © Emerald Group Publishing Limited.
Resumo:
Flooding can have a devastating impact on businesses, especially on small- and medium-sized enterprises (SMEs) who may be unprepared and vulnerable to the range of both direct and indirect impacts. SMEs may tend to focus on the direct tangible impacts of flooding, limiting their ability to realise the true costs of flooding. Greater understanding of the impacts of flooding is likely to contribute towards increased uptake of flood protection measures by SMEs, particularly during post-flood property reinstatement. This study sought to investigate the full range of impacts experienced by SMEs located in Cockermouth following the floods of 2009. The findings of a questionnaire survey of SMEs revealed that businesses not directly affected by the flooding experienced a range of impacts and that short-term impacts were given a higher significance. A strong correlation was observed between direct, physical flood impacts and post-flood costs of insurance. Significant increases in the costs of property insurance and excesses were noted, meaning that SMEs will be exposed to increased losses in the event of a future flood event. The findings from the research will enable policy makers and professional bodies to make informed decisions to improve the status of advice given to SMEs. The study also adds weight to the case for SMEs to consider investing in property-level flood risk adaptation measures, especially during the post flood reinstatement process. © 2012 Blackwell Publishing Ltd and The Chartered Institution of Water and Environmental Management (CIWEM).