Team communications in surgery - creating a culture of safety

As a key department within a healthcare organisation, the operating room is a hazardous environment, where the consequences of errors are high, despite the relatively low rates of occurrence. Team performance in surgery is increasingly being considered crucial for a culture of safety. The aim of this study was to describe team communication and the ways it fostered or threatened safety culture in surgery. Ethnography was used, and involved a 6-month fieldwork period of observation and 19 interviews with 24 informants from nursing, anaesthesia and surgery. Data were collected during 2009 in the operating rooms of a tertiary care facility in Queensland, Australia. Through analysis of the textual data, three themes that exemplified teamwork culture in surgery were generated: ‘‘building shared understandings through open communication’’; ‘‘managing contextual stressors in a hierarchical environment’’ and ‘‘intermittent membership influences team performance’’. In creating a safety culture in a healthcare organisation, a team’s optimal performance relies on the open discussion of teamwork and team expectation, and significantly depends on how the organisational culture promotes such discussions.

The moderating effect of knowledge sharing on the relationship between manufacturing activities and business performance

This paper investigates the critical role of knowledge sharing (KS) in leveraging manufacturing activities, namely integrated supplier management (ISM) and new product development (NPD) to improve business performance (BP) within the context of Taiwanese electronic manufacturing companies. The research adopted a sequential mixed method research design, which provided both quantitative empirical evidence as well as qualitative insights, into the moderating effect of KS on the relationships between these two core manufacturing activities and BP. First, a questionnaire survey was administered, which resulted in a sample of 170 managerial and technical professionals providing their opinions on KS, NPD and ISM activities and the BP level within their respective companies. On the basis of the collected data, factor analysis was used to verify the measurement model, followed by correlation analysis to explore factor interrelationships, and finally moderated regression analyses to extract the moderating effects of KS on the relationships of NPD and ISM with BP. Following the quantitative study, six semi-structured interviews were conducted to provide qualitative in-depth insights into the value added from KS practices to the targeted manufacturing activities and the extent of its leveraging power. Results from quantitative statistical analysis indicated that KS, NPD and ISM all have a significant positive impact on BP. Specifically, IT infrastructure and open communication were identified as the two types of KS practices that could facilitate enriched supplier evaluation and selection, empower active employee involvement in the design process, and provide support for product simplification and the modular design process, thereby improving manufacturing performance and strengthening company competitiveness. The interviews authenticated many of the empirical findings, suggesting that in the contemporary manufacturing context KS has become an integral part of many ISM and NPD activities and when embedded properly can lead to an improvement in BP. The paper also highlights a number of useful implications for manufacturing companies seeking to leverage their BP through innovative and sustained KS practices.

Fundamentals of business process management

Encompasses the whole BPM lifecycle, including process identification, modelling, analysis, redesign, automation and monitoring Class-tested textbook complemented with additional teaching material on the accompanying website Covers both relevant conceptual background, industrial standards and actionable skills Business Process Management (BPM) is the art and science of how work should be performed in an organization in order to ensure consistent outputs and to take advantage of improvement opportunities, e.g. reducing costs, execution times or error rates. Importantly, BPM is not about improving the way individual activities are performed, but rather about managing entire chains of events, activities and decisions that ultimately produce added value for an organization and its customers. This textbook encompasses the entire BPM lifecycle, from process identification to process monitoring, covering along the way process modelling, analysis, redesign and automation. Concepts, methods and tools from business management, computer science and industrial engineering are blended into one comprehensive and inter-disciplinary approach. The presentation is illustrated using the BPMN industry standard defined by the Object Management Group and widely endorsed by practitioners and vendors worldwide. In addition to explaining the relevant conceptual background, the book provides dozens of examples, more than 100 hands-on exercises – many with solutions – as well as numerous suggestions for further reading. The textbook is the result of many years of combined teaching experience of the authors, both at the undergraduate and graduate levels as well as in the context of professional training. Students and professionals from both business management and computer science will benefit from the step-by-step style of the textbook and its focus on fundamental concepts and proven methods. Lecturers will appreciate the class-tested format and the additional teaching material available on the accompanying website fundamentals-of-bpm.org.

Identifying key enablers to improve business performance in Taiwanese electronic manufacturing companies

Purpose – Integrated supplier management (ISM), new product development (NPD) and knowledge sharing (KS) practices are three primary business activities utilised to enhance manufacturers' business performance (BP). The purpose of this paper is to empirically investigate the relationships between these three business activities (i.e. ISM, NPD, KS) and BP in a Taiwanese electronics manufacturing context. Design/methodology/approach – A questionnaire survey is first administered to a sample of electronic manufacturing companies operating in Taiwan to elicit the opinions of technical and managerial professionals regarding business activities and BP within their companies. A total of 170 respondents from 83 companies respond to the survey. Factor, correlation and path analysis are undertaken on this quantitative data set to derive the key factors which leverage business outcomes in these companies. Following empirical analysis, six semi-structured interviews are undertaken with manufacturing executives to provide qualitative insights into the underlying reasons why certain business activity factors are the strongest predictors of BP. Findings – The investigation shows that the ISM, NPD and KS constructs all play an important role in the success of company operations and creating business outcomes. Specifically, the key factors within these constructs which influenced BP are: supplier evaluation and selection; design simplification and modular design; information technology infrastructure and systems and open communication. Accordingly, sufficient financial and human resources should be allocated to these important activities to derive accelerated rates of improved BP. These findings are supported by the qualitative interviews with manufacturing executives. Originality/value – The paper depicts the pathways to improved manufacturing BP, through targeting efforts into the above-mentioned factors within the ISM, NPD and KS constructs. Based on the empirical path model, and the specific insights derived from the explanatory interviews with manufacturing executives, the paper also provides a number of practical implications for manufacturing companies seeking to enhance their BP through improved operational activities.

100% pure New Zealand

Tourism New Zealand (TNZ) is the national tourism office responsible for coordinating international marketing of New Zealand as a tourism destination (see www.newzealand.com ). Typical of most destination marketing organisations (DMO), TNZ is funded by government to work with the private sector in an effort to improve the financial viability of the tourism industry. A competitive tourism industry can provide a number of economic and socio-cultural benefits to a community, such as increased job opportunities and lower unemployment, new amenities and attractions, and revival of indigenous culture.

Countercyclical markups and news-driven business cycles

The standard one-sector real business cycle model is unable to generate expectations-driven fluctuations. The addition of countercyclical mark-ups and modest investment adjustment costs offers an easy fix to this conundrum. The simulated model replicates the regular features of U.S. aggregate fluctuations.

Business process management : an introduction to the special focus issue

The management and improvement of business processes are a core topic of the information systems discipline. The persistent demand in corporations within all industry sectors for increased operational efficiency and innovation, an emerging set of established and evaluated methods, tools, and techniques as well as the quickly growing body of academic and professional knowledge are indicative for the standing that Business Process Management (BPM) has nowadays. During the last decades, intensive research has been conducted with respect to the design, implementation, execution, and monitoring of business processes. Comparatively low attention, however, has been paid to questions related to organizational issues such as the adoption, usage, implications, and overall success of BPM approaches, technologies, and initiatives. This research gap motivated us to edit a corresponding special focus issue for the journal BISE/WIRTSCHAFTSINFORMATIK. We are happy that we are able to present a selection of three research papers and a state-of-the-art paper in the scientific section of the issue at hand. As these papers differ in the topics they investigate, the research method they apply, and the theoretical foundations they build on, the diversity within the BPM field becomes evident. The academic papers are complemented by an interview with Phil Gilbert, IBM’s Vice President for Business Process and Decision Management, who reflects on the relationship between business processes and the data flowing through them, the need to establish a process context for decision making, and the calibration of BPM efforts toward executives who see processes as a means to an end, rather than a first-order concept in its own right.

Fans teaching fans how to consume : the role of ritual in the consumption of entertainment

The status of entertainment as both a dimension of human culture, and a booming global industry is increasing. Given more recent consumer-centric definitions of entertainment, the entertainment consumer has grown in prominence and is now coming under closer scrutiny. However viewing entertainment consumers as always behaving in a similar fashion towards entertainment as to other products may be selling them short. For a start, entertainment consumers can exhibit a strong loyalty towards their favourite entertainment products that is the envy of the marketing world. Academic researchers and marketers who are keen to investigate entertainment consumers would benefit from a theoretical base from which to commence. This essay therefore, takes a consumer-oriented focus in defining entertainment and conceptualises a model of entertainment consumption. In approaching the study of entertainment one axiomatic question remains: how should we define it? Richard Dyer notes that, considering that the category of entertainment can include – by its own definition in the song ‘That’s entertainment!’ – everything from Hamlet and Oedipus Rex to ‘the clown with his pants falling down’ and ‘the lights on the lady in tights’, it doesn’t make much sense to try to define entertainment as being marked by particular textual features (as is done, for example, by Avrich, 2002). Dyer’s position is rather that ‘entertainment is not so much a category of things as an attitude towards things’ (Dyer, 1973: 9). He traces the modern conception of entertainment back to the writings of Molière. This writer defended the purpose of his plays against attacks from the church that they were not sufficiently edifying by insisting that, as entertainments he had no interest in edifying audiences – his ‘real purpose …was to provide people pleasure – and the definition of that was to be decided by “the people”’(Dyer, 1973: 9). In my own discipline of Marketing this approach has been embraced – Kaser and Oelkers, for example, define entertainment as ‘whatever people are willing to spend their money and spare time viewing’ (2008, 18). That is the approach taken in this paper, where I see entertainment as ‘consumer-driven culture’ (McKee and Collis, 2009) – a definition that is closely aligned with the marketing concept. Within a marketing framework I explore what the consumption of entertainment can tell us about the relationships between consumers and culture more generally. For entertainment offers an intriguing case study, and is often consumed in ways that challenge many of our assumptions about marketing and consumer behaviour.

Contribution of knowledge management activities to organisational business performance

Purpose – Within the construction industry there is a growing awareness of the need for linking knowledge management (KM) to business strategy, organisational objectives and existing performance measures. This study was undertaken within the context of construction organisations, and attempts to provide the empirical evidence about the relationships between KM activities and organisational business performance. Design/methodology/approach – A questionnaire survey was administered to a sample of construction contractors operating in Hong Kong to investigate the opinions of construction professionals regarding the intensity of KM activities and business performance within their organisations. In parallel to the survey, semi-structured interviews were undertaken to provide qualitative insights that helped to clarify and deepen understanding of the KM process within the context of the research target. Findings – The investigation shows that knowledge utilisation is the strongest contributor to general business performance. In addition, the impact of KM activities on the lagging performance indicators of the Balanced Scorecard (BSC), such as “financial performance”, is in an indirect manner, and through the leading indicators such as performance from “internal process” as well as “learning and growth” perspectives. Originality/value – The study empirically establishes the linkage between intensity of KM activities and business performance, and demonstrates that KM strategies need to be explicitly formulated and measured according to organisational business objectives.

Empirical study to identify the key business activities contributing to manufacturing business performance

Purpose: Within the context of high global competitiveness, knowledge management (KM) has proven to be one of the major factors contributing to enhanced business outcomes. Furthermore, knowledge sharing (KS) is one of the most critical of all KM activities. From a manufacturing industry perspective, supply chain management (SCM) and product development process (PDP) activities, require a high proportion of company resources such as budget and manpower. Therefore, manufacturing companies are striving to strengthen SCM, PDP and KS activities in order to accelerate rates of manufacturing process improvement, ultimately resulting in higher levels of business performance (BP). A theoretical framework along with a number of hypotheses are proposed and empirically tested through correlation, factor and path analyses. Design/methodology/approach: A questionnaire survey was administered to a sample of electronic manufacturing companies operating in Taiwan to facilitate testing the proposed relationships. More than 170 respondents from 83 organisations responded to the survey. The study identified top management commitment and employee empowerment, supplier evaluation and selection, and design simplification and modular design as the key business activities that are strongly associated with the business performance. Findings: The empirical study supports that key manufacturing business activities (i.e., SCM, PDP, and KS) are positively associated with BP. The findings also evealed that some specific business activities such as SCMF1,PDPF2, and KSF1 have the strongest influencing power on particular business outcomes (i.e., BPF1 and BPF2) within the context of electronic manufacturing companies operating in Taiwan. Practical implications: The finding regarding the relationship between SCM and BP identified the essential role of supplier evaluation and selection in improving business competitiveness and long term performance. The process of forming knowledge in companies, such as creation, storage/retrieval, and transfer do not necessarily lead to enhanced business performance; only through effectively applying knowledge to the right person at the right time does. Originality/value: Based on this finding it is recommended that companies should involve suppliers in partnerships to continuously improve operations and enhance product design efforts, which would ultimately enhance business performance. Business performance depends more on an employee’s ability to turn knowledge into effective action.

An in-vitro 3-D cell culture model for studying pathomechanisms in AMD

Purpose To develop a novel 3-D cell culture model with the view to studying the pathomechanisms underlying the development of age-related macular degeneration (AMD). Our central hypothesis is that the silk structural protein fibroin used in conjunction with cultured human cells can be used to mimic the structural relationships between the RPE and choriocapillaris in health and disease. Methods Co-cultures of human RPE cells (ARPE-19 cells grown in Miller’s medium) and microvascular endothelial cells (HMEC-1 cells grown in endothelial culture medium) were established on opposing sides of a synthetic Bruch’s membrane (3 microns thick) constructed from B mori silk fibroin. Cell attachment was facilitated by pre-coating the fibroin membrane with vitronectin (for ARPE-19 cells) and gelatin (for HMEC-1 cells) respectively. The effects of tropoelastin on attachment of ARPE-19 cells was also examined. Barrier function was examined by measurement of trans-epithelial resistance (TER) using a voltohmmeter (EVOM-2). The phagocytic activity of the synthetic RPE was tested using vitronectin-coated microspheres (2 micron diameter FluoSpheres). In some cultures, membrane defects were created by puncturing within a 24 G needle. The architecture of the synthetic tissue before and after wounding was examined by confocal microscopy after staining for ZO-1 and F-actin. Results The RPE layer of the 3D model developed a cobblestoned morphology (validated by staining for ZO-1 and F-actin), displayed barrier function (validated by measurement of TER) and demonstrated cytoplasmic uptake of vitronectin-coated microspheres. Attachment of ARPE-19 cells to fibroin was unaffected by tropoelastin. Microvascular endothelial cells attached well to the gelatin-coated surface of the fibroin membrane and remained physically separated from the overlaying RPE layer. The fibroin membranes were amenable to puncturing without collapse thus providing the opportunity to study transmembrane migration of the endothelial cells. Conclusions Synthetic Bruch’s membranes constructed from silk fibroin, vitronectin and gelatin, support the co-cultivation of RPE cells and microvascular endothelial cells. The resulting RPE layer displays functions similar to that of native RPE and the entire tri-layered structure displays potential to be used as an in vitro model of choroidal neovascularization.

Real-time risk monitoring in business processes : a sensor-based approach

This article proposes an approach for real-time monitoring of risks in executable business process models. The approach considers risks in all phases of the business process management lifecycle, from process design, where risks are defined on top of process models, through to process diagnosis, where risks are detected during process execution. The approach has been realized via a distributed, sensor-based architecture. At design-time, sensors are defined to specify risk conditions which when fulfilled, are a likely indicator of negative process states (faults) to eventuate. Both historical and current process execution data can be used to compose such conditions. At run-time, each sensor independently notifies a sensor manager when a risk is detected. In turn, the sensor manager interacts with the monitoring component of a business process management system to prompt the results to process administrators who may take remedial actions. The proposed architecture has been implemented on top of the YAWL system, and evaluated through performance measurements and usability tests with students. The results show that risk conditions can be computed efficiently and that the approach is perceived as useful by the participants in the tests.

Knowledge sharing leveraging new product development activities to derive enhanced business performance : mixed method study

Knowledge has been widely recognised as a determinant of business performance. Business capabilities require an effective share of resource and knowledge. Specifically, knowledge sharing (KS) between different companies and departments can improve manufacturing processes since intangible knowledge plays an enssential role in achieving competitive advantage. This paper presents a mixed method research study into the impact of KS on the effectiveness of new product development (NPD) in achieving desired business performance (BP). Firstly, an empirical study utilising moderated regression analysis was conducted to test whether and to what extent KS has leveraging power on the relationship between NPD and BP constructs and variables. Secondly, this empirically verified hypothesis was validated through explanatory case studies involving two Taiwanese manufacturing companies using a qualitative interaction term pattern matching technique. The study provides evidence that knowledge sharing and management activities are essential for deriving competitive advantage in the manufacturing industry.

Knowledge sharing for strengthening manufacturing operation and business performance

Manufacturing companies have strived to enhance managerial and technical capabilities to improve business performance. Building these capabilities requires effective share of knowledge - the strategic resource. Specifically, knowledge sharing (KS) between different manufacturing departments can improve manufacturing processes since leveraging organisational knowledge plays an enssential role in achieving competitive advantage. This paper presents an empirical investigation into the impact of KS on the effectiveness of supply chain management (SCM) and the product development process (PDP) in achieving desired business performance (BP). A questionnaire survey was administered from electronic manufacturing companies operating in Taiwan. 168 valid responses were received and used to statistically examine the relationships between the concepts (SCM, PDP, KS, BP). The study findings reveal that within the Taiwanese electronic manufacturing companies KS is an essential enabler for facilitating the effectiveness of SCM and PDP in achieving desired BP.

Business research in virtual worlds : possibilities and practicalities

Purpose – It is predicted that virtual business and related research possibilities will expand significantly. In this context, the aim of this paper is to use insights from a virtual research project to present a theoretically-informed toolbox of practical suggestions to guide the conduct of virtual world business research. Design/methodology/approach – Archival evidence is presented, and data from a study conducted in Second Lifew in 2007 is interpreted through Llewellyn’s framework (physical, structural, agential, cultural and mental dimensions). Findings – With the burgeoning of virtual business applications, appropriate systems that encompass the dynamics of both the real and the virtual will need to be developed by and for accountants, auditors and business professionals. Researchers of virtual business activities will need to adapt to the physical, structural, agential, cultural and mental dimensions unique to virtual worlds. Research limitations/implications – While based on reflections from a single study in Second Life, this paper identifies possibilities for future virtual research on issues of accountability and accounting relating to virtual worlds. Practical implications – The practical toolbox will assist virtual researchers to deal with the possibilities and practicalities of conducting research in virtual worlds. Originality/value – Despite the proliferation of virtual worlds, predictions of virtual business applications, and consequent accountability and accounting implications, there is a paucity of academic literature on conducting business research in virtual settings. This prescient paper develops a conceptual framework to guide the conduct of research in virtual worlds, and identifies the unique opportunities and challenges they present.