873 resultados para non-dialysis management


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Purpose – In the 1990s, a growing number of companies adopted value-based management (VBM) techniques in the UK. The purpose of this paper is to explore the motivations for the adoption or non-adoption of VBM for managing a business. Design/methodology/approach – An interview-based study of 37 large UK companies. Insights from diffusion theory and institutional theory are utilised to theorise these motivations. Findings – It was found that the rate of adoption of VBM in the sample companies does follow the classical S-shape. It also suggests that the supply-side of the diffusion process, most notably the role played by consultants, was an influence on many companies. This was not, however, a sufficient condition for companies to adopt the technique. The research also finds evidence of relocation diffusion, as several adopters are influenced by new officers, for example chief executive officers and finance directors, importing VBM techniques that they have used in organizations within which they have previously worked. Research limitations/implications – It is quite a small scale study and further work would be needed to develop the findings. Practical implications – Understanding and theorising the adoption of new management techniques will help understand the management of a business. Originality/value – This research adds further evidence to the value of studying management accounting, and more specifically management accounting change, in practice. It shows the developments in the adoption of a new technique and hence how a technique becomes accepted in practice.

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Risks and uncertainties are part and parcel of any project as projects are planned with many assumptions. Therefore, managing those risks is the key to project success. Although risk is present in all most all projects, large-scale construction projects are most vulnerable. Risk is by nature subjective. However, managing risk subjectively posses the danger of non-achievement of project goals. This study introduces an analytical framework for managing risk in projects. All the risk factors are identified, their effects are analyzed, and alternative responses are derived with cost implication for mitigating the identified risks. A decision-making framework is then formulated using decision tree. The expected monetary values are derived for each alternative. The responses, which require least cost is selected. The entire methodology has been explained through a case study of an oil pipeline project in India and its effectiveness in managing projects has been demonstrated. © INTERNATIONAL JOURNAL OF INDUSTRIAL ENGINEERING.

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Time, cost and quality achievements on large-scale construction projects are uncertain because of technological constraints, involvement of many stakeholders, long durations, large capital requirements and improper scope definitions. Projects that are exposed to such an uncertain environment can effectively be managed with the application of risk management throughout the project life cycle. Risk is by nature subjective. However, managing risk subjectively poses the danger of non-achievement of project goals. Moreover, risk analysis of the overall project also poses the danger of developing inappropriate responses. This article demonstrates a quantitative approach to construction risk management through an analytic hierarchy process (AHP) and decision tree analysis. The entire project is classified to form a few work packages. With the involvement of project stakeholders, risky work packages are identified. As all the risk factors are identified, their effects are quantified by determining probability (using AHP) and severity (guess estimate). Various alternative responses are generated, listing the cost implications of mitigating the quantified risks. The expected monetary values are derived for each alternative in a decision tree framework and subsequent probability analysis helps to make the right decision in managing risks. In this article, the entire methodology is explained by using a case application of a cross-country petroleum pipeline project in India. The case study demonstrates the project management effectiveness of using AHP and DTA.

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The Indian petroleum industry is passing through a very dynamic business environment due to the liberalisation of many government policies, vertical integration among organisations and the presence of multinational companies. This caused a competitive environment among the organisations in the Indian petroleum industry in the public sector. Effective project management for developing new infrastructures and maintaining the existing facilities has been considered one of the means for remaining competitive in this business environment. However, present project management practices suffer from many shortcomings, as time, cost and quality non-achievements are part and parcel of almost every project. This study focuses on identifying the issues in managing projects of the organisation in the Indian petroleum sector with the involvement of the executives in a workshop environment. This also suggests some remedial measures for resolving those issues through identifying critical success factors and enablers. The enablers not only resolve the present issues but also ensure superior performance. These are analysed in a quantitative framework to derive improvement measures in project management practices.

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Conventional project management techniques are not always sufficient for ensuring time, cost and quality achievement of large-scale construction projects due to complexity in planning and implementation processes. The main reasons for project non-achievement are changes in scope and design, changes in Government policies and regulations, unforeseen inflation) under-estimation and improper estimation. Projects that are exposed to such an uncertain environment can be effectively managed with the application of risk numagement throughout project life cycle. However, the effectiveness of risk management depends on the technique in which the effects of risk factors are analysed and! or quantified. This study proposes Analytic Hierarchy Process (AHP), a multiple attribute decision-making technique as a tool for risk analysis because it can handle subjective as well as objective factors in decision model that are conflicting in nature. This provides a decision support system (DSS) to project managenumt for making the right decision at the right time for ensuring project success in line with organisation policy, project objectives and competitive business environment. The whole methodology is explained through a case study of a cross-country petroleum pipeline project in India and its effectiveness in project1nana.gement is demonstrated.

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Reports some insights into knowledge management (KM) derived from UK one-day workshops with six businesses, three non-profits and one public sector organization. Lists the four questions posed to participants and discusses the themes which emerged, e.g. the need for a KM strategy to make raw information more useable, KM performance measurement etc. Stresses the need for commitment from a top-level champion and a wide range of employees to make this work and identifies three types of solutions for improving KM strategy: technological (e.g. databases and intranets), people (e.g. motivation, retention, training and networking) and processes (e.g. procedural instructions and balancing formal/informal knowledge sharing methods). Finds that accountants and senior managers do not generally see KM as very important but argues that management accountants are suitable knowledge champions who could develop explicit links between KM and organizational performance.

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Background: Self-monitoring of blood glucose is controversial in the management of type 2 diabetes. Some research suggests that self-monitoring improves glycaemic control, whereas other research is sceptical about its value for people with type 2 diabetes who are not on insulin. Although blood glucose meters are widely available and used by this group, patients' own views are absent from the debate. Aim: To explore the pros and cons of glucose monitoring from the patients' perspectives. Design of study: Qualitative repeat-interview study. Setting: Patients were recruited from 16 general practices and three hospital clinics within four local healthcare cooperatives in Lothian, Scotland. Method: Interview data from 40 patients diagnosed with type 2 diabetes within the previous 6 months were analysed using thematic analysis informed by grounded theory. We report findings from round 1 and round 2 interviews. Results: Glucose monitoring can heighten patients' awareness of the impact of lifestyle; for example, dietary choices, on blood glucose levels. Glucose monitoring amplifies a sense of 'success' or 'failure' about self-management, often resulting in anxiety and self-blame if glucose readings remain consistently high. Moreover, monitoring can negatively effect patients' self-management when readings are counter-intuitive. Conclusion: Our analysis highlights the importance of understanding the meanings that newly diagnosed patients attach to glucose self-monitoring. To maximise the positive effects of self-monitoring, health professionals should ensure that patients understand the purpose of monitoring and should clarify with patients how readings should be interpreted. © British Journal of General Practice.

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Knowledge management (KM) is a developing field that focuses on harnessing knowledge for use by a person or community. However, most KM research focuses on improving decision making capacity in business communities, neglecting applications in wider society and non-decision making activities. This paper explores the potential of KM for rural communities, specifically for those that want to preserve their social history and collective memories (what we call heritage) to enrich the lives of others. In KM terms, this is a task of accumulating and recording knowledge to enable its retention for future use. We report a case study of Cardrona, a valley of approximately 120 people in New Zealand’s South Island. Realising that time would erode knowledge of their community a small, motivated group of residents initiated a KM programme to create a legacy for a wider community including younger generations, tourists and scholars. This paper applies KM principles to rural communities that want to harness their collective knowledge for wider societal gain, and develops a framework to accommodate them. As a result, we call for a wider conceptualization of KM to include motives for managing knowledge beyond decision making to accommodate community KM (cKM).

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The use of Diagnosis Related Groups (DRG) as a mechanism for hospital financing is a currently debated topic in Portugal. The DRG system was scheduled to be initiated by the Health Ministry of Portugal on January 1, 1990 as an instrument for the allocation of public hospital budgets funded by the National Health Service (NHS), and as a method of payment for other third party payers (e.g., Public Employees (ADSE), private insurers, etc.). Based on experience from other countries such as the United States, it was expected that implementation of this system would result in more efficient hospital resource utilisation and a more equitable distribution of hospital budgets. However, in order to minimise the potentially adverse financial impact on hospitals, the Portuguese Health Ministry decided to gradually phase in the use of the DRG system for budget allocation by using blended hospitalspecific and national DRG casemix rates. Since implementation in 1990, the percentage of each hospitals budget based on hospital specific costs was to decrease, while the percentage based on DRG casemix was to increase. This was scheduled to continue until 1995 when the plan called for allocating yearly budgets on a 50% national and 50% hospitalspecific cost basis. While all other nonNHS third party payers are currently paying based on DRGs, the adoption of DRG casemix as a National Health Service budget setting tool has been slower than anticipated. There is now some argument in both the political and academic communities as to the appropriateness of DRGs as a budget setting criterion as well as to their impact on hospital efficiency in Portugal. This paper uses a twostage procedure to assess the impact of actual DRG payment on the productivity (through its components, i.e., technological change and technical efficiency change) of diagnostic technology in Portuguese hospitals during the years 1992–1994, using both parametric and nonparametric frontier models. We find evidence that the DRG payment system does appear to have had a positive impact on productivity and technical efficiency of some commonly employed diagnostic technologies in Portugal during this time span.

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Sixty coagulase-negative staphylococcus (CNS) isolates were recovered from the blood cultures or peritoneal dialysate effluent of 43 patients on renal dialysis. The patients had either renal dialysis catheter-related sepsis (CRS) or continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis. Isolates were characterized by biotyping, and genotyped by pulsed-field gel electrophoresis (PFGE). Phenotypic properties of the strains were also investigated. Several genotypes were identified with no one specific strain of CNS being associated with CRS. However, closely related strains were isolated from several patients within the units studied, suggesting horizontal transfer of micro-organisms. Genotypic macro-restriction profiles did not concur with phenotypic profiles or biotypes, confirming that genotyping is required for epidemiological studies. All staphylococcal strains were investigated for the production of phenotypic characteristics. Significant differences were predominantly seen in the production of lipase, esterase and elastase in strains isolated from the renal patients with CRS and CAPD-associated peritonitis, compared with a non-septic control group. These phenotypic characteristics may therefore have a role in the maintenance of CRS in renal patients. © 2003 The Hospital Infection Society. Published by Elsevier Science Ltd. All rights reserved.

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Half a decade has passed since the objectives and benefits of autonomic computing were stated, yet even the latest system designs and deployments exhibit only limited and isolated elements of autonomic functionality. From an autonomic computing standpoint, all computing systems – old, new or under development – are legacy systems, and will continue to be so for some time to come. In this paper, we propose a generic architecture for developing fully-fledged autonomic systems out of legacy, non-autonomic components, and we investigate how existing technologies can be used to implement this architecture.

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This research is an Anglo-Indian comparative case study. It studies managerial action in the participation arena of two British multi-nationals i.e. Cadbury Limited and ICI plc. The research was carried out in matched pairs of factories of the above named companies, located in the Midlands of the UK and in Bombay in India. The data for this research was collected through semi-structured interviews with managers and non-management actors, study of company documents and non-participant observation of some participation forums. The research conceptualises the idea of a `participation arena' consisting of the structures, processes, purposes and dynamics of participation. This arena is visualised as broadly reflecting the organisation structure and can be divided into corporate, unit and shopfloor level. Managerial action in this arena is examined in terms of interaction between three sets of factors i.e. company business objectives, strategies and policies; managerial values of power and control; and the responses of unions. Similarities and differences between management action in the home and host plants of the two multi-national companies are also examined. The major findings of the research are as follows. There is significant difference between the participation arena of the parent and the subsidiary company. The latter is marked by absence of higher level participation forums and lack of opportunity for employees to discuss, let alone influence, key decisions. This results from parent company control over key activities of the subsidiary. The similarities in management action in the participation arenas of the two companies in both countries can be attributed to the operation of the three sets of factors mentioned above. Nevertheless, the particular circumstances of each company are a greater influence on managerial action than the national context. Finally, future areas of research in this field are explored.

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This thesis explores the strategic positioning [SP] activities of charitable organizations [COs] within the wider sector of voluntary and non-profit organizations [VNPOs] in the UK. Despite the growing interest in SP for British COs in an increasingly competitive operating environment and changing policy context, there is lack of research in mainstream marketing/strategic management studies on this topic for charities, whilst the specialist literature on VNPOs has neglected the study of SP. The thesis begins with an extended literature review of the concept of positioning in both commercial [for-profit] and charitable organizations. It concludes that the majority of theoretical underpinnings of SP that are prescribed for COs have been derived from the commercial strategy/marketing literature. There is currently a lack of theoretical and conceptual models that can accommodate the particular context of COs and guide strategic positioning practice in them. The research contained in this thesis is intended to fill some of these research gaps. It combines an exploratory postal survey and four cross-sectional case studies to describe the SP activities of a sample of general welfare and social care charities and identifies the key factors that influence their choice of positioning strategies [PSs]. It concludes that charitable organizations have begun to undertake SP to differentiate their organizations from other charities that provide similar services. Their PSs have both generic features, and other characteristics that are unique to them. A combination of external environmental and organizational factors influences their choice of PSs. A theoretical model, which depicts these factors, is developed in this research. It highlights the role of governmental influence, other external environmental forces, the charity’s mission, organizational resources, and influential stakeholders in shaping the charity’s PS. This study concludes by considering the theoretical and managerial implications of the findings on the study of charitable and non-profit organizations.

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Faced with a future of rising energy costs there is a need for industry to manage energy more carefully in order to meet its economic objectives. A problem besetting the growth of energy conservation in the UK is that a large proportion of energy consumption is used in a low intensive manner in organisations where they would be responsibility for energy efficiency is spread over a large number of personnel who each see only small energy costs. In relation to this problem in the non-energy intensive industrial sector, an application of an energy management technique known as monitoring and targeting (M & T) has been installed at the Whetstone site of the General Electric Company Limited in an attempt to prove it as a means for motivating line management and personnel to save energy. The objective energy saving for which the M & T was devised is very specific. During early energy conservation work at the site there had been a change from continuous to intermittent heating but the maintenance of the strategy was receiving a poor level of commitment from line management and performance was some 5% - 10% less than expected. The M & T is concerned therefore with heat for space heating for which a heat metering system was required. Metering of the site high pressure hot water system posed technical difficulties and expenditure was also limited. This led to a ‘tin-house' design being installed for a price less than the commercial equivalent. The timespan of work to achieve an operational heat metering system was 3 years which meant that energy saving results from the scheme were not observed during the study. If successful the replication potential is the larger non energy intensive sites from which some 30 PT savings could be expected in the UK.