Comparison of clinical knowledge management capabilities of commercially-available and leading internally-developed electronic health records.

BACKGROUND: We have carried out an extensive qualitative research program focused on the barriers and facilitators to successful adoption and use of various features of advanced, state-of-the-art electronic health records (EHRs) within large, academic, teaching facilities with long-standing EHR research and development programs. We have recently begun investigating smaller, community hospitals and out-patient clinics that rely on commercially-available EHRs. We sought to assess whether the current generation of commercially-available EHRs are capable of providing the clinical knowledge management features, functions, tools, and techniques required to deliver and maintain the clinical decision support (CDS) interventions required to support the recently defined "meaningful use" criteria. METHODS: We developed and fielded a 17-question survey to representatives from nine commercially available EHR vendors and four leading internally developed EHRs. The first part of the survey asked basic questions about the vendor's EHR. The second part asked specifically about the CDS-related system tools and capabilities that each vendor provides. The final section asked about clinical content. RESULTS: All of the vendors and institutions have multiple modules capable of providing clinical decision support interventions to clinicians. The majority of the systems were capable of performing almost all of the key knowledge management functions we identified. CONCLUSION: If these well-designed commercially-available systems are coupled with the other key socio-technical concepts required for safe and effective EHR implementation and use, and organizations have access to implementable clinical knowledge, we expect that the transformation of the healthcare enterprise that so many have predicted, is achievable using commercially-available, state-of-the-art EHRs.

People management issues in Indian KPOs

Purpose: The business process outsourcing (BPO) industry in India is evolving rapidly, and one of the key characteristics of this industry is the emergence of high-end services offered by knowledge processing outsourcing (KPO) organizations. These organizations are set to grow at a tremendous pace. Given the people-intensive nature of this industry, efficient employee management is bound to play a critical role. The literature lacks studies offering insights into the HR challenges involved and the ways in which they are addressed by KPOs. The purpose of this paper is to attempt to fill this gap by presenting findings from an in-depth case study of a KPO organization. Design/methodology/ approach: To achieve the research objective we adopted an in-depth case study approach. The research setting was that of a KPO organization in India, which specialises in offering complex analytics, accounting and support services to the real estate and financial services industries. Findings: The results of this study highlight the differences in the nature of work characteristics in such organizations as compared to call centres. The study also highlights some of the key people management challenges that these organizations face like attracting and retaining talent. The case company adopts formal, structured, transparent and innovative human resource practices. The study also highlights that such enlightened human resource practices stand on the foundations laid by an open work environment and facilitative leadership. Research limitations/implications: One of the key limitations is that the analysis is based on primary data from a single case study and only 18 interviews. The analysis contributes to the fields of KPO, HRM and India and has key messages for policy makers. Originality/value: The literature on outsourcing has in general focused on call centres established in the developed world. However, the booming BPO industry in India is also beginning to offer high-end services, which are far above the typical call centres. These KPOs and their people management challenges are relatively unexplored territories in the literature. By conducting this study in an emerging market (India) and focusing on people-related challenges in KPOs, this study attempts to provide a fresh perspective to the extant BPO literature. © Emerald Group Publishing Limited.

Returns on key accounts:do the results justify the expenditures?

Purpose – The use of key accounts has become a mature trend and most industrial firms use this concept in some form. Selling firms establish key account teams to attend to important customers and consolidate their selling activities. Yet, despite such increased efforts on behalf of key accounts, sufficient research has not quantified the returns on key account strategy nor has it firmly established performance differences between key and non-key accounts within a firm. In response to this shortcoming, this study aims to examine returns on key accounts. Design Methodology/approach – Data were collected from a global consulting firm. The data collection started two years after the implementation of the key account program. Data were collected on recently acquired customers (within the previous year) at two time periods: year 1 and year 3 (based on company access of data). Findings – Initially, key accounts perform as well or better than other types of accounts. However, in the long term, key accounts are less satisfied, less profitable and less beneficial for a firm’s growth than other types of accounts. Because the returns to key account expenditures, thus, appear mixed, firms should be cautious in expanding their key account strategies. Research limitations implications – The study contributes to research in three areas. First, most research on the effectiveness of key accounts refers to the between-firm level, whereas this study examines the effect within a single firm. Second, this study examines the temporal aspects of key accounts, namely, what happens to key accounts over time, in comparison with other accounts in a fairly large sample. Third, it considers the survival rates of key accounts versus other types of accounts. Practical implications – The authors suggest that firms also need to track their key accounts better because the results show that key accounts are less satisfied, less profitable and less beneficial for a firm’s growth than other types of accounts. Originality/value – Extant research has not examined these issues.

Detalgraf S.A.: Plan Estratégico Empresarial

DETALGRAF S.A., es una empresa colombiana con Capital Nacional, fundada en febrero de 1993. A través del tiempo la empresa se ha venido transformando y sus líneas comerciales se han ampliado significativamente, pasando de ofrecer a sus clientes insumos para la industria gráfica a productos de aseo, papelería, químicos, cafetería, medicamentos y seguridad industrial. Actualmente, se posiciona como una de las mejores empresas comercializadoras en el sector institucional. Este proyecto busca desarrollar un plan estratégico para la empresa Detalgraf S.A., para los próximos cinco años, basándose en la elaboración de estrategias claves, producto de un análisis previo de los problemas que afectan la empresa y su desarrollo; esperando como resultado la solución a diferentes falencias en los departamentos de logística, comercial y finanzas. Teniendo en cuenta lo anteriormente mencionado, se presenta este proyecto como una alternativa de mejora fundamentada en una pregunta investigativa principal la cuales es ¿Cómo garantizar el crecimiento y la sostenibilidad de la empresa Detalgraf S.A., por medio de un plan estratégico que ayude a lograr la perdurabilidad de la compañía? Con el fin de dar respuesta a ésta, se desprenden otros interrogantes igual de importantes como: ¿Es posible por medio de un plan estratégico mejorar el proceso de cobro y seguimiento de cartera?, con base a estas mejoras, ¿Se logrará tener la capacidad de identificar los principales problemas internos y externos que afectan a la empresa y a su entorno? Y finalmente, ¿Se pueden incrementar las ventas penetrando nuevos mercados? El desarrollo de estas preguntas permitirá buscar una mejora en la comunicación interna dentro de la empresa, con el fin de obtener una mayor coordinación en el uso de los recursos y el funcionamiento de la organización para garantizar la creación de valor, un factor clave para la empresa.

Action learning of online marketing via a global contest

Introduction: The Google Online Marketing Challenge is a global competition in which student teams run advertising campaigns for small and medium-sized businesses (SMEs) using AdWords, Google’s text-based advertisements. In 2008, its inaugural year, over 8,000 students and 300 instructors from 47 countries representing over 200 schools participated. The Challenge ran in undergraduate and graduate classes in disciplines such as marketing, tourism, advertising, communication and information systems. Combining advertising and education, the Challenge gives student hands-on experience in the increasingly important field of online marketing, engages them with local businesses and motivates them through the thrill of a global competition. Student teams receive US$200 in AdWords credits, Google’s premier advertising product that offers cost-per-click advertisements. The teams then recruit and work with a local business to devise an effective online marketing campaign. Students first outline a strategy, run a series of campaigns, and provide their business with recommendations to improve their online marketing. Teams submit two written reports for judging by 14 academics in eight countries. In addition, Google AdWords experts judge teams on their campaign statistics such as success metrics and account management. Rather than a marketing simulation against a computer or hypothetical marketing plans for hypothetical businesses, the Challenges has student teams develop and manage real online advertising campaigns for their clients and compete against peers globally.

Health protection

Our understanding of how the environment can impact human health has evolved and expanded over the centuries, with concern and interest dating back to ancient times. For example, over 4000 years ago, a civilisation in northern India tried to protect the health of its citizens by constructing and positioning buildings according to strict building laws, by having bathrooms and drains, and by having paved streets with a sewerage system (Rosen 1993). In more recent times, the ‘industrial revolution’ played a dominant role in shaping the modern world, and with it the modern public health system. This era was signified by rapid progress in technology, the growth of transportation and the expansion of the market economy, which lead to the organisation of industry into a factory system. This meant that labour had to be brought to the factories and by the 1820s, poverty and social distress (including overcrowding and infrequent sewage and garbage disposal) was more widespread than ever. These circumstances, therefore, lead to the rise of the ‘sanitary revolution’ and the birth of modern public health (Rosen 1993). The sanitary revolution has also been described as constituting the beginning of the first wave of environmental concern, which continued until after World War 2 when major advances in engineering and chemistry substantially changed the face of industry, particularly the chemical sector. The second wave of environmental concern came in the mid to late 20th century and was dominated by the environmental or ecology movement. A landmark in this era was the 1962 publication of the book Silent Spring by Rachel Carson. This identified for the first time the dramatic effects on the ecosystem of the widespread use of the organochlorine pesticide, DDT. The third wave of environmental concern commenced in the 1980s and continues today. The accelerated rate of economic development, the substantial increase in the world population and the globalisation of trade have dramatically changed the production methods and demand for goods in both developed and developing countries. This has lead to the rise of ‘sustainable development’ as a key driver in environmental planning and economic development (Yassi et al 2001). The protection of health has, therefore, been a hallmark of human history and is the cornerstone of public health practice. This chapter introduces environmental health and how it is managed in Australia, including a discussion of the key generic management tools. A number of significant environmental health issues and how they are specifically managed are then discussed, and the chapter concludes by discussing sustainable development and its links with environmental health.

Robust conservation decision-making

Decision-making for conservation is conducted within the margins of limited funding. Furthermore, to allocate these scarce resources we make assumptions about the relationship between management impact and expenditure. The structure of these relationships, however, is rarely known with certainty. We present a summary of work investigating the impact of model uncertainty on robust decision-making in conservation and how this is affected by available conservation funding. We show that achieving robustness in conservation decisions can require a triage approach, and emphasize the need for managers to consider triage not as surrendering but as rational decision making to ensure species persistence in light of the urgency of the conservation problems, uncertainty, and the poor state of conservation funding. We illustrate this theory by a specific application to allocation of funding to reduce poaching impact on the Sumatran tiger Panthera tigris sumatrae in Kerinci Seblat National Park, Indonesia. To conserve our environment, conservation managers must make decisions in the face of substantial uncertainty. Further, they must deal with the fact that limitations in budgets and temporal constraints have led to a lack of knowledge on the systems we are trying to preserve and on the benefits of the actions we have available (Balmford & Cowling 2006). Given this paucity of decision-informing data there is a considerable need to assess the impact of uncertainty on the benefit of management options (Regan et al. 2005). Although models of management impact can improve decision making (e.g.Tenhumberg et al. 2004), they typically rely on assumptions around which there is substantial uncertainty. Ignoring this 'model uncertainty', can lead to inferior decision-making (Regan et al. 2005), and potentially, the loss of the species we are trying to protect. Current methods used in ecology allow model uncertainty to be incorporated into the model selection process (Burnham & Anderson 2002; Link & Barker 2006), but do not enable decision-makers to assess how this uncertainty would change a decision. This is the basis of information-gap decision theory (info-gap); finding strategies most robust to model uncertainty (Ben-Haim 2006). Info-gap has permitted conservation biology to make the leap from recognizing uncertainty to explicitly incorporating severe uncertainty into decision-making. In this paper we present a summary of McDonald-Madden et al (2008a) who use an info-gap framework to address the impact of uncertainty in the functional representations of biological systems on conservation decision-making. Furthermore, we highlight the importance of two key elements limiting conservation decision-making - funding and knowledge - and how they interact to influence the best management strategy for a threatened species. Copyright © ASCE 2011.

Soil fertility in sweetpotato-based cropping systems in the highlands of Papua New Guinea

The main outputs anticipated include enchanced knowledge of key water-nutrient dynamics in relation to key soil management techniques and a suite of improved and practical soil management options in sweet potatoes.

Análisis estratégico y financiero de las Dinámicas Comerciales del Canal Moderno en Unilever

El presente trabajo “Análisis estratégico y financiero de las Dinámicas Comerciales del Canal Moderno en Unilever”, comprendiendo los aspectos del Trade Marketing y el mercado de consumo masivo, tiene como propósito el análisis de la ejecución de las estrategias utilizadas por Unilever actualmente en sus dinámicas comerciales, para identificar debilidades y oportunidades de mejora. Así mismo, será acompañado por un estudio financiero de las mismas, buscando reforzar y apoyar el estudio desde una perspectiva diferente a la estratégica para un análisis más completo y resultados puntualizados que lleven a una propuesta más acertada. El estudio y propuestas se hacen aplicables a las diferentes dinámicas comerciales realizadas en los otros países pertenecientes al clúster de Unilever Middle Americas y sus respectivos clientes, dando una mayor utilidad y visibilidad al estudio a nivel internacional.

Formulación del plan estratégico de negocios interactivo

Hoy por hoy una de las principales facultades que deben ser fortaleza de las empresas es su capacidad para adaptarse a estos cambios, y sin duda alguna, el cambio más revolucionario de fin de siglo tiene que ver esta tecnología

O consultor de gestão como auditor interno do seu próprio desempenho

O início do século tem sido pródigo em transformações rápidas e radicais no sector de consultoria, como resultado do questionamento dos modelos de diversificação estratégica levados a cabo por diversas consultoras. Mas, ainda que estas mudanças constituam de certa forma uma barreira à legitimidade do sector, a verdade é que este pressuposto tem contribuído também para o desenvolvimento do estudo do sector no meio académico, sobretudo ao longo dos últimos vinte anos onde tem existido um conjunto de literatura substancial que tem vindo a refletir a contribuição, conceptualização e compreensão da natureza do trabalho de consultoria e sobre o real valor dos consultores na forma como demonstram esse valor aos seus clientes. Daqui, ressaltam então as seguintes questões fulcrais. Consultoria de gestão é para quem? Deverá ser o consultor de gestão um auditor interno do seu próprio desempenho? Assim sendo, o que pretendo neste artigo é exatamente enfatizar um conjunto de pressupostos que permitam descrever um conjunto de requisitos necessários que devem estar implícitos nas características intrínsecas da caracterização de um profissional de serviços de consultoria, pois a premissa desta profissão deve compreender que é o profissional de consultoria que deve gerir as suas atividades e não as atividades gerir o profissional de consultoria. / The beginning of the century has been prolific in rapid and radical transformations in the consultancy sector, as a result of the questioning of models of strategic diversification undertaken by several consultants. But, even if these changes constitute a barrier to the legitimacy of the sector, the truth is that this assumption has also contributed to the development of the sector study in the academic environment, especially over the last twenty years it has existed a set of substantial literature that has come to reflect the contribution, conceptualization and understanding of the nature of consulting work and the real value of consultants in the way that demonstrate value to their customers. It emphasizes two key questions. Management consulting is for whom? It should be the management consultant an internal auditor of its own performance? So, what I want to emphasize in this article is exactly one set of assumptions that allow describing a set of requirements that must be implicit in the characterization of the intrinsic characteristics of a consulting services manager, because the premise of this profession must understand that it is the professional adviser that should manage their activities and not the activities to manage the professional adviser.

Climate change and the British Uplands: evidence for decision-making

We summarise the work of an interdisciplinary network set up to explore the impacts of climate change in the British Uplands. In this CR Special, the contributors present the state of knowledge and this introduction synthesises this knowledge and derives implications for decision makers. The Uplands are valued semi-natural habitats, providing ecosystem services that have historically been taken for granted. For example, peat soils, which are mostly found in the Uplands, contain around 50% of the terrestrial carbon in the UK. Land management continues to be a driver of ecosystem service delivery. Degraded and managed peatlands are subject to erosion and carbon loss with negative impacts on biodiversity, carbon storage and water quality. Climate change is already being experienced in British Uplands and is likely to exacerbate these pressures. Climate envelope models suggest as much as 50% of British Uplands and peatlands will be exposed to climate stress by the end of the 21st century under low and high emissions scenarios. However, process-based models of the response of organic soils to this climate stress do not give a consistent indication of what this will mean for soil carbon: results range from a very slight increase in uptake, through a clear decline, to a net carbon loss. Preserving existing peat stocks is an important climate mitigation strategy, even if new peat stops forming. Preserving upland vegetation cover is a key win–win management strategy that will reduce erosion and loss of soil carbon, and protect a variety of services such as the continued delivery of a high quality water resource.

Um estudo sobre a certificação ISO 9001 no Brasil: mapeamento de motivações, benefícios e dificuldades

This work aims to identify the main motivations and difficulties faced by Brazilian companies to obtain ISO 9001 certification. The key quality management practices that provide support to this certification and the relationship with other types of systems, such as ISO 14001 (Environmental Management) and OHSAS 18001 (Occupational Health and Safety Management System), were also investigated. A survey research was conducted with 191 companies. The main motivations for implementing ISO 9001 are the following: internal organization improvement, production efficiency increase, and brand reliability improvement. Employee resistance was the greatest challenge found during the implementation process. On the other hand, the main benefits identified were: quality processes improvement and increased employee awareness of quality. The results reveal that the most common quality programs and tools used are: 5S, brainstorming, and Ishikawa diagram, while the least common are SERVQUAL and QFD.

A RELAÇÃO ENTRE O USO DOS CONTROLES DE GESTÃO E A CONTINUIDADE DAS PEQUENAS E MÉDIAS EMPRESAS

O trabalho tem como finalidade à pesquisa de controles de gestão empresarial essencial a todas as empresas, inclusive as chamadas pequenas e médias, que buscam sua excelência e continuidade para um bom desempenho econômico, financeiro e social. Diversos estudos já foram realizados a fim de evidenciar a importância dos controles gerenciais para as organizações, porém uma grande dificuldade encontrada nestas empresas é aplicar a teoria na prática. Sendo assim, será apresentada neste trabalho uma pesquisa entre pequenas e médias empresas localizadas nos municípios de São Bernardo do Campo, Santo André, São Caetano do Sul e Diadema e como estas empresas têm utilizado controles gerenciais no processo de gestão empresarial. No contexto das pequenas e médias empresas, pode-se perceber que o processo decisório é restrito e limitado a determinadas pessoas, portanto, o grau de responsabilidade nas decisões para estas empresas tem um grande teor de importância. Nas empresas familiares também é possível identificar características semelhantes ao processo decisório, por fim, a pesquisa irá analisar a relação do uso de controles gerenciais e a continuidade dessas empresas. A metodologia utilizada foi a descritiva e a quantitativa, através do uso de questionário e os resultados obtidos foram apresentados apenas como das empresas participantes da pesquisa, podendo ser identificados a relação do uso de controles de gestão e quais os controles mais utilizados.(AU)

A RELAÇÃO ENTRE O USO DOS CONTROLES DE GESTÃO E A CONTINUIDADE DAS PEQUENAS E MÉDIAS EMPRESAS

O trabalho tem como finalidade à pesquisa de controles de gestão empresarial essencial a todas as empresas, inclusive as chamadas pequenas e médias, que buscam sua excelência e continuidade para um bom desempenho econômico, financeiro e social. Diversos estudos já foram realizados a fim de evidenciar a importância dos controles gerenciais para as organizações, porém uma grande dificuldade encontrada nestas empresas é aplicar a teoria na prática. Sendo assim, será apresentada neste trabalho uma pesquisa entre pequenas e médias empresas localizadas nos municípios de São Bernardo do Campo, Santo André, São Caetano do Sul e Diadema e como estas empresas têm utilizado controles gerenciais no processo de gestão empresarial. No contexto das pequenas e médias empresas, pode-se perceber que o processo decisório é restrito e limitado a determinadas pessoas, portanto, o grau de responsabilidade nas decisões para estas empresas tem um grande teor de importância. Nas empresas familiares também é possível identificar características semelhantes ao processo decisório, por fim, a pesquisa irá analisar a relação do uso de controles gerenciais e a continuidade dessas empresas. A metodologia utilizada foi a descritiva e a quantitativa, através do uso de questionário e os resultados obtidos foram apresentados apenas como das empresas participantes da pesquisa, podendo ser identificados a relação do uso de controles de gestão e quais os controles mais utilizados.(AU)