Integrating risk management with performance management

This article argues that, post Enron, governance reforms around the world have served to raise the profile of risk management, and emphasise the need for a corporate wide approach to internal control that is overseen by the Board of Directors. In the US, this is most clearly demonstrated by the emergence of Enterprise Risk Management (ERM), defined as 'a process, effected by an entity's board of directors, management and other personnel, applied in strategy setting across the enterprise, designed to identify potential events that may affect the entity, and manage risk to be within its risk appetite, to provide reasonable assurance regarding the achievement of entity objectives.' (COSO, 2004, p.2). In practical terms, however, the introduction of an enterprise wide holistic risk management system poses a big challenge to all but the smallest of organisations. The financial crisis has clearly shown that enterprise wide risk management remains a dream rather than a reality for even the world's largest and once highly respected companies.

Η διαχείριση αλλαγών στην υγεία

Η διαχείριση αλλαγών είναι μια σημαντική πρόκληση για τις μονάδες υγείας και απαιτεί ικανότητες και ετοιμότητα από τη διοίκησή τους. Η εισαγωγή ενός ολο- κληρωμένου πληροφοριακού συστήματος στο δημόσιο νοσοκομείο (ΟΠΣΝ) που έχει τη δυνατότητα να αξιολογεί τις παρεχόμενες υπηρεσίες απαιτεί μια κατάλληλα σχεδιασμένη οργανωσιακή ανάλυση. Αυτή γίνεται, αξιοποιώντας το διαγνωστικό μοντέλο συνταύτισης των Nadler και Tushman όπου αντιμετωπίζει τον οργανισμό και τις αλλαγές ως ένα δυναμικό και αλληλοεξαρτώμενο σύστημα. Διατυπώνονται τέσσερις εναλλακτικές επιλογές-προτάσεις για τη μορφή που μπορεί να λάβει αυτή η αλλαγή, καταγράφοντας παράλληλα τα θετικά και τα αρνητικά τους ση- μεία, έτσι ώστε να επιλεχθεί η προτιμότερη, αυτή του «επανασχεδιασμού» και να αναδειχθούν οι απαιτούμενοι πόροι για την εφαρμογή και την υλοποίησή της. Η ορθή διαχείριση αλλαγής απαιτεί να καθοριστούν οι αντίστοιχοι στόχοι, να ανα- δειχθούν οι ευκαιρίες από την ανάπτυξη του ΟΠΣΝ στο δημόσιο νοσοκομείο και να καταγραφούν τα στάδια εφαρμογής του. Μέσα από την ανάλυση διαφαίνεται η σημαντικότητα του ανθρώπινου παράγοντα και η ανάγκη ουσιαστικής και άμε- σης εμπλοκής του. Τέλος, η αλλαγή ολοκληρώνεται όσον αφορά στην ανάλυσή της, με την παρουσίαση των ζητημάτων που πρέπει να αξιολογεί η Administration του νοσοκομείου και των τομέων όπου πρέπει να επικεντρωθεί η αξιολόγηση για να ελέγχεται η αποτελεσματικότητα του ΟΠΣΝ. The management of change is a significant challenge for health units, which demands skills and readiness on the part of their administration. The introduction of an integrated information system in a public hospital to provide the ability to assess the services offered necessitates the conduct of a well designed organizational analysis. This can be made using the diagnostic congruence model of Nadler and Tushman, which treats the organization and the changes as a dynamic and interdependent system. Four alternative choices with respect to change are presented here, pointing out their relative merits and drawbacks. The preferred alternative is that of "reformation" and the resources necessary for its implementation are delineated. The effective management of change requires determination of the appropriate goals, definition of the opportunities arising from the development of this system and recording of the stages of implementation. Through this analysis, the importance of the human factor is apparent, and the need for its immediate involvement is imperative. Finally, this analysis of organizational change concludes with presen- tation of the issues that the hospital administration needs to assess and the specific areas of focus to be defined in order for the effectiveness of the integrated information system to be monitored.

A multi-organisational approach for disaster preparedness and response:the use of optimisation and GIS for facility location, stock pre-positioning, resource allocation and relief distribution

From 1992 to 2012 4.4 billion people were affected by disasters with almost 2 trillion USD in damages and 1.3 million people killed worldwide. The increasing threat of disasters stresses the need to provide solutions for the challenges faced by disaster managers, such as the logistical deployment of resources required to provide relief to victims. The location of emergency facilities, stock prepositioning, evacuation, inventory management, resource allocation, and relief distribution have been identified to directly impact the relief provided to victims during the disaster. Managing appropriately these factors is critical to reduce suffering. Disaster management commonly attracts several organisations working alongside each other and sharing resources to cope with the emergency. Coordinating these agencies is a complex task but there is little research considering multiple organisations, and none actually optimising the number of actors required to avoid shortages and convergence. The aim of the this research is to develop a system for disaster management based on a combination of optimisation techniques and geographical information systems (GIS) to aid multi-organisational decision-making. An integrated decision system was created comprising a cartographic model implemented in GIS to discard floodable facilities, combined with two models focused on optimising the decisions regarding location of emergency facilities, stock prepositioning, the allocation of resources and relief distribution, along with the number of actors required to perform these activities. Three in-depth case studies in Mexico were studied gathering information from different organisations. The cartographic model proved to reduce the risk to select unsuitable facilities. The preparedness and response models showed the capacity to optimise the decisions and the number of organisations required for logistical activities, pointing towards an excess of actors involved in all cases. The system as a whole demonstrated its capacity to provide integrated support for disaster preparedness and response, along with the existence of room for improvement for Mexican organisations in flood management.