How health organizations can apply scenario based planning and analytic technologies to make strategic consequential decisions in a time of uncertainty

The magnitude of the cervical cancer problem, coupled with the potential for prevention with recent technological advances, made it imperative to step back and reassess strategic options for dealing with cervical cancer screening in Kenya. The purpose of this qualitative study was: 1) to explore the extent to which the Participatory Action Research (PAR) methodology and the Scenario Based Planning (SBP) method, with the application of analytics, could enable strategic, consequential, informed decision making, and 2) to determine how influential Kenyan decision makers could apply SBP with analytic tools and techniques to make strategic, consequential decisions regarding the implementation of a Cervical Self Sampling Program (CSSP) in both urban and rural settings. The theoretical paradigm for this study was action research; it was experiential, practical, and action oriented, and resulted in co-created knowledge that influenced study participants’ decision making. Action Africa Help International (AAHI) and Brock University collaborated with Local Decision Influencing Participants (LDIP’s) to develop innovative strategies on how to implement the CSSP. SBP tools, along with traditional approaches to data collection and analysis, were applied to collect, visualize and analyze predominately qualitative data. Outputs from the study included: a) a generic implementation scenario for a CSSP (along with scenarios unique to urban and rural settings), and b) 10 strategic directions and 22 supporting implementation strategies that address the variables of: 1) technical viability, 2) political support, 3) affordability, 4) logistical feasibility, 5) social acceptability, and 6) transformation/sustainability. In addition, study participants’ capacity to effectively engage in predictive/prescriptive strategic decision making was strengthened.

Using an IDMI methodology to make multi-criteria decisions

Multi-criteria decisions usually require measurement or evaluation of performance in different units and their mix by application of weighting factors. This approach leads to potential manipulation of the results as a direct consequence of the applied weightings. In this paper a mechanism has been proposed to overcome this problem. It is known as the : Interlink Decision Making Index (IDMI) and has all the desired features: simple, interlink (all criteria) and automatically and quantified influence of critical criteria (i.e. no human weighting needed). The IDMI is capable of reflecting the total merits of a particular option once the normal decision making criteria and (up to two) critical criteria (CC) have been chosen. Then, without arbitrarily weighting criteria, comparison and selection of the best possible option can be made. Simple software has been developed to do this numerical transfer and graphic presentation. Two hypothetical examples are presented in the paper to demonstrate the application of the IDMI concept and its advantages over the traditional "tabular and weighting method" in the decision making process.

Outsourcing decisions:the case of parallel production

Purpose – The purpose of this paper is to investigate an underexplored aspect of outsourcing involving a mixed strategy in which parallel production is continued in-house at the same time as outsourcing occurs. Design/methodology/approach – The study applied a multiple case study approach and drew on qualitative data collected through in-depth interviews with wood product manufacturing companies. Findings – The paper posits that there should be a variety of mixed strategies between the two governance forms of “make” or “buy.” In order to address how companies should consider the extent to which they outsource, the analysis was structured around two ends of a continuum: in-house dominance or outsourcing dominance. With an in-house-dominant strategy, outsourcing complements an organization's own production to optimize capacity utilization and outsource less cost-efficient production, or is used as a tool to learn how to outsource. With an outsourcing-dominant strategy, in-house production helps maintain complementary competencies and avoids lock-in risk. Research limitations/implications – This paper takes initial steps toward an exploration of different mixed strategies. Additional research is required to understand the costs of different mixed strategies compared with insourcing and outsourcing, and to study parallel production from a supplier viewpoint. Practical implications – This paper suggests that managers should think twice before rushing to a “me too” outsourcing strategy in which in-house capacities are completely closed. It is important to take a dynamic view of outsourcing that maintains a mixed strategy as an option, particularly in situations that involve an underdeveloped supplier market and/or as a way to develop resources over the long term. Originality/value – The concept of combining both “make” and “buy” is not new. However, little if any research has focussed explicitly on exploring the variety of different types of mixed strategies that exist on the continuum between insourcing and outsourcing.

The impact of organizational boundaries on (re)building capabilities

The literature concerning firm boundaries has focussed extensively on the rationale for different boundary choices and the economic efficiencies that such choices can make. There is also an acknowledged position that a firm’s boundary choices may impact the ability of a firm to maintain and even build new capabilities, though such choices may not be optimal from an economic efficiency perspective. It is in this context that we seek to investigate how firms make this potential trade-off in respect of their boundary choices and how these choices are implemented across a wide range of activities. Using qualitative data from three public sector construction oriented organizations, we observe that neither pure make nor buy decisions assisted significantly in capability building. Dual modes – where firms make and buy the same product or service simultaneously – provided firms with some opportunities to manage this paradox, but the most successful decisions seemed to occur in respect of using intermediate governance modes such as alliances. We also observed that the boundary choice was just one dimension of the capability building process and firms pursuing the same boundary choice decisions often had quite divergent outcomes on the basis of their boundary management and the ability of knowledge to move across firm boundaries.

Make-or-break : work and family interface and wellbeing among small business owners

This study responds to calls for research on work-family aspects in entrepreneurship research. Our study examined the role of work-family conflict and enhancement on small business owners’ (SBOs) wellbeing. We found work-family has negative direct effect on mental health, job and family satisfactions. Furthermore, we found that under high level of work-family conflict condition, SBOs who perceive a greater level of work-family enhancement would feel more satisfy with their life, job as well as family aspects. Interestingly, under high level of conflict, even SBOs perceive greater level of enhancement, it would not lessen the negative impact of the conflict on their mental health. These results suggest that once psychological health is harmed by work-family conflict, its negative consequences remain unchanged.

International survey of acute stroke imaging used to make revascularization treatment decisions.

BACKGROUND: To assess the differences across continental regions in terms of stroke imaging obtained for making acute revascularization therapy decisions, and to identify obstacles to participating in randomized trials involving multimodal imaging. METHODS: STroke Imaging Repository (STIR) and Virtual International Stroke Trials Archive (VISTA)-Imaging circulated an online survey through its website, through the websites of national professional societies from multiple countries as well as through email distribution lists from STIR and the above mentioned societies. RESULTS: We received responses from 223 centers (2 from Africa, 38 from Asia, 10 from Australia, 101 from Europe, 4 from Middle East, 55 from North America, 13 from South America). In combination, the sites surveyed administered acute revascularization therapy to a total of 25,326 acute stroke patients in 2012. Seventy-three percent of these patients received intravenous (i.v.) tissue plasminogen activator (tPA), and 27%, endovascular therapy. Vascular imaging was routinely obtained in 79% (152/193) of sites for endovascular therapy decisions, and also as part of standard IV tPA treatment decisions at 46% (92/198) of sites. Modality, availability and use of acute vascular and perfusion imaging before revascularization varied substantially between geographical areas. The main obstacles to participate in randomized trials involving multimodal imaging included: mainly insufficient research support and staff (50%, 79/158) and infrequent use of multimodal imaging (27%, 43/158) . CONCLUSION: There were significant variations among sites and geographical areas in terms of stroke imaging work-up used tomake decisions both for intravenous and endovascular revascularization. Clinical trials using advanced imaging as a selection tool for acute revascularization therapy should address the need for additional resources and technical support, and take into consideration the lack of routine use of such techniques in trial planning.

Decisão making or buying: uma aplicação em células de manufatura de uma indústria de produção mecânica

In order to maintain the competitiveness the companies seek for cost reduction and resource optimization. A product or service price is calculated considering direct and indirect costs involved in its fabrication, which means that if an intern indirect process is optimized, the final price of the product is also reduced and becomes more interesting to the final costumer. Considering this reasoning, the companies must evaluate each of their processes and optimize them. It is common to outsource intern products manufacturing as a cost reduction strategy, nevertheless when there are already resources and capability to produce the own goods, it becomes necessary to evaluate the economic gain that each strategy - make or buy - generates. This paper aims to evaluate the necessary support to take a decision regarding making or buying in a production cell of hoses based in the value of economic cost, system cost and decision process

Borrow or buy? cost-effective delivery of monographs

In an effort to reduce Interlibrary borrowing activity, while enhancing the Library collection, the Bertrand Library has initiated a program to purchase current monographs requested through ILL by Bucknell University students and faculty. The results have been a successful reduction in ILL workload, and a cost-effective means of document delivery as measured by average delivery time, cost-per-title, processing costs, and circulation statistics. This procedure reflects an overall change in our philosophy concerning document access and delivery, which led to the reorganization of ILL services and staff in the Bertrand Library.

What price life insurance? : Not how but what to sell or buy--and why, facts and supporting figures which prove the fallacy of the self-serving propaganda of those "term-ites" who seek to undermine confidence in legal reserve (old line) life insurance /

Mode of access: Internet.

Globala försörjningsbeslut i en industriell kontext

Purpose – The purpose with this study is to investigate which factors that needs to be considered for sourcing decisions to ensure an optimal long-term decision, and which of these factors that can be quantified in a product costing model. To fulfill this purpose two research questions have been proposed: Which factors needs to be considered for a sourcing decision? Which of these factors that needs to be considered can be quantified in a product costing model? Method – A case study was conducted to fulfill the purpose of this study. The case study produced empirical data through interviews and document studies. The empirical data was interpreted and analyzed on the basis of the theoretical framework, created through literature studies. This process produced the result of this study. Findings – Factors to be considered for a sourcing decision have been identified and categorized in four over-arching categories: unit cost, logistical factors, capability factors and risk factors. These factors have been quantified in a product costing model. A preparatory decision model was created to further integrate some risk factors that could not be quantified. Implications – Both the make or buy decision and the manufacturing location decision have been considered in the product costing model presented in this study. The product costing model visualize and take into account hidden costs, rarely considered in sourcing decisions. This further enables optimal long-term sourcing decisions. Limitations – Risk factors remain difficult to quantify. This makes it difficult to determine the cost of risk factors, and as a result of that, to include them in a product costing model. Companies with similar conditions suites the model since the case study was conducted at only one company. Whether the product costing model is true for business in other contexts remain uncertain.

Value for money : procuring infrastructure

Australia is just one of many developed countries facing the challenge of delivering value for money in the provision of a substantial infrastructure pipeline amidst severe construction and private finance constraints. To help address this challenge, this chapter focuses on developing an understanding of the determinants of value at key procurement decision points that range from the make-or-buy decision, to buying in the context of market structures, including the exchange relationship and contractual arrangement decision. This understanding is based on theoretical pluralism and illustrated by research in the field of construction and maintenance, and in public-private partnerships.