A lean elvek alkalmazása az egészségügyi folyamatok fejlesztésében = Applying lean principles in healthcare process development

A fejlett társadalmak egészségügyi szolgáltató rendszerei napjainkban kettős kihívással néznek szembe: miközben a társadalom a szolgáltatási színvonal emelkedését, a hibák számának a csökkenését várja el, addig a költségvetési terhek miatt a költségcsökkentés is feltétlenül szükséges. Ez a kihívás nagyságában összevethető azzal, amellyel az USA autóipara nézett szembe az 1970-es évektől. A megoldást az autóipar esetében a konkurens „lean” menedzsment elvek és eszközök megértése és alkalmazása jelentette. A tanulmány arra keresi a választ, hogy vajon lehetséges-e ennek a megoldásnak az alkalmazása az egészségügy esetében is. A cikk az egészségügy problémájának bemutatása után tárgyalja a lean menedzsment kialakulását és hogy milyen módon került köztudatba. A tanulmány második felében a szakirodalomban fellelhető, a témával kapcsolatos tapasztalatokat foglalja össze, majd levonja a következtetéseket. = In developed societies healthcare service systems are facing double challenge; society expects service level to rise and the number of mistakes to drop, but at the same time, because of the overloaded budgets, cutting cost is also absolutely necessary. This challenge compares to the one the US automotive industry was facing in the 1970-s. In case of the automotive industry the solution was the comprehension and application of the principles and the tools of lean management. This study aims to answer the question whether it is possible to apply this solution also in the case of the healthcare system. The article first introduces the problems in the healthcare system, than describes the formation of lean management concept and its wide spread. The second half of the study summarizes the available knowledge in the literature and drives conclusions.

A racionális kisvállalati gazdálkodás tényezői, 2006-2010 (Factors in rational operation of small business, 2006-2010)

A tanulmány a hazai kis- és középvállalati szektorban 2006-ban elvégzett, majd 2010-ben megismételt kérdőíves felmérések eredményei alapján igyekszik bemutatni a racionális vállalati gazdálkodás sajátosságait. Vizsgálatunk fő kérdése, hogy e szektor vállalkozásainak gazdálkodását milyen tényezők teszik ésszerűvé, s hogy a 2006-2010 között eltelt időszakban milyen változások figyelhetők meg a gazdálkodói magatartásuk alakulásában. Eredményeink alapján megállapíthatjuk, hogy a mai napig megtalálhatók a kisvállalkozói - háztartási szemléletű, megélhetésorientált - gazdálkodás nyomai, de a racionális gazdálkodás általunk használt mutatói szerint e vállalkozások körében szakszerűbbé vált a gazdálkodás. Ebben a folyamatban szerepet játszott a gazdasági válság, amely által előidézett helyzethez kénytelenek voltak alkalmazkodni a kis- és közepes vállalkozások: felismerték, hogy célravezetőbb a hatékonyság és a költségek szempontjából a racionális pénzpiaci magatartás követése, s ezzel összhangban a válság miatti zavarok elhárítására kiadáscsökkentő eszközök alkalmazása. A kis- és közepes vállalkozások gazdálkodásával kapcsolatos racionális döntések előmozdításában elsősorban a korszerű pénzügyi ismereteknek és a szakmai tudásnak van szerepe. / === / The study seeks to identify the attributes of rational business operation, using a questionnaire survey of small and medium-sized firms made in 2006 and a repeat of it in 2010. The main questions addressed are what factors contribute to rational operation in the firms in the sector and what changes over the 2006-10 period can be discerned in business behaviour. The findings show that traces of small business-style operation (a household or livelihood orientation) could still be found, but the indicators of rationality employed in the survey show that the operation of the firms became more rational. A role in the process was played by the economic crisis, which forced small and medium-sized businesses to adapt: they recognized that it was better from the point of view of efficiency and costs to follow rational money-market behaviour, and in line with that, use spending-reduction tools to evade the disturbances of the crisis. The main factors behind the shift towards rational decision-making in the running of small and medium-sized firms are up-to-date financial information and professional expertise.

Az online-fogyasztói elégedettség mérésére alkalmas skála tesztelése és véglegesítése a vállalati döntéshozók támogatása céljából (Testing and finalizing a scale for measuring online consumer satisfaction to support the companies decision making process)

A versenyképesség, illetve a gazdaságos működés elengedhetetlen feltétele a fogyasztói elégedettség, melynek egyik meghatározó eleme az észlelt és elvárt minőség közti kapcsolat. A minőségi elvárások az internettel, mint napjaink egyik meghatározó csatornájával kapcsolatban is megfogalmazódtak már, így kapott jelentős szerepet az online szolgáltatásminőség meghatározása, illetve ezzel összekapcsolódva az online-fogyasztói elégedettségmérés. A tanulmány célja, hogy szakirodalmi áttekintést nyújtson a témában, és a szakirodalomból ismert E-S-QUAL és E-RecS-QUAL online-fogyasztói elégedettségmérésre szolgáló skálát megvizsgálja, érvényességét a magyar körülmények között letesztelje, és a szükségesnek látszó módosítások elvégzésével egy Magyarországon használható skálát hozzon létre. Az online-fogyasztók elégedettségmérésének alapjaként az online szolgáltatásminőség fogyasztói érzékelésével, illetve értékelésével kapcsolatos elméleteket járja körbe a tanulmány, és ezután kerül sor a különböző mérési módszerek bemutatására, kiemelt szerepet szánva az E-S-QUAL és E-RecS-QUAL skálának, mely az egyik leginkább alkalmazott módszernek számít. Az áttekintés középpontjában azok a honlapok állnak, melyeken vásárolni is lehet, a kutatást pedig az egyik jelentős hazai online könyvesbolt ügyfélkörében végeztem el. ______ Over the last decade the business-to-consumer online market has been growing very fast. In marketing literature a lot of studies have been created focusing on understanding and measuring e-service quality (e-sq) and online-customer satisfaction. The aim of the study is to summarize these concepts, analyse the relationship between e-sq and customer’s loyalty, which increases the competitiveness of the companies, and to create a valid and reliable scale to the Hungarian market for measuring online-customer satisfaction. The base of the empirical study is the E-S-QUAL and its second scale the E-RecS-QUAL that are widely used multiple scales measuring e-sq with seven dimensions: efficiency, system availability, fulfilment, privacy, responsiveness, compensation, and contact. The study is focusing on the websites customers use to shop online.

Adaptációra vállalkozni – avagy vállalkozói szerepek megjelenése a környezet és az alkalmazkodás viszonyában (Attempting to adapt – Entreprenurial roles in the adaptation process to environmental changes)

A szerző cikkében arra a kérdésre keresi a választ, hogy a kis- és középvállalkozások vezetőinek sajátos környezethez fűződő viszonyát alapul véve milyen vállalkozói szerepek azonosíthatóak a környezeti változásokra való reagálás során. A kutatás központi kérdése, hogy a vállalkozó miként tekint magára az adaptációra a turbulensen változó környezeti viszonyok között, és magának milyen szerepet szán az alkalmazkodási folyamat során. A cikk bemutatja a vállalkozó személyiségének alapvető vonásait, külön kitérve a vállalkozó vezető személyére, majd ezt követően az adaptáció legjellemzőbb formáit és tulajdonságait helyezi középpontba. A tanulmány 14 hazai kis- és középvállalkozás vezetőjével készített interjú feldolgozásával, valamint Hortoványi és Szabó (2006a) adaptációs stratégiai típusai alapján három kategóriát azonosít a környezetfelfogás és reagálás kontextusában. ______ This paper focuses on the role of the entrepreneur in the adaptation process, how we can determine the role of the entrepreneur to environmental changes and to strategic adaptation itself. The paper begins with the presentation of the entrepreneurial models, focusing on the entrepreneurial management afterwards continues with a brief summary of the adaptation approach to strategy. Emphasizing that adaptation to changes can vary as innovation or entrepreneurship is concerned. Proactivity presents an adaptation strategy and moreover can be related to entrepreneurial behaviour and therefore characterizes the viewpoint of the entrepreneur. Entrepreneurs have to react to the changing environmental with analysis and proactive reaction, as future and innovation orientation is an integrate part of their entrepreneurial personality. Examining 14 interviews made with Hungarian entrepreneurs the paper identifies three categories which determine the role of the entrepreneurs in the adaptation process.

A marketing, a termelés és a logisztika hozzájárulása a vállalati eredményességhez (The Contribution of Marketing, Production and Logistics to Business Performance)

A Budapesti Corvinus Egyetem Versenyképességkutató Központjának 2004-ben lekérdezett kérdőíve alapján, ami 154 feldolgozóipari vállalat adatait tartalmazza, azt vizsgáljuk, hogy az ellátási lánc három lényeges vállalati funkciója, a marketing, a termelés és a logisztika milyen mértékben járul hozzá az üzleti eredményességhez. Az eredmények szerint a marketingnek és a termelésnek erősebb hatása van a vállalati teljesítményre, mint a logisztikának. A három funkció együttesen csekély, bár statisztikai értelemben szignifikáns szerepet játszik az üzleti sikerben. _____ Companies are complex organizations where a lot of activities and processes have to work properly in order to reach success. Depending on several factors, sometimes some activities get more emphasis while others work in the background. Since organizational functions have separate literature and practical knowledge, and transit between them is rare, we do have very little knowledge on how the various functions together contribute to company success. Based on a wide-scale empirical study on Hungarian competitiveness, which includes data on 154 companies from the process industry, we examine to what extent three functions of the supply chain, marketing, manufacturing and logistics, can contribute to business success. Results show that marketing and manufacturing have larger effect on company performance than logistics. However, the three functions together play a minor, although significant role in company success.

Formalization of the informal venture capital market - Business angel networks and syndicates

Business angels are natural persons who provide equity financing for young enterprises and gain ownership in them. They are usually anonym investors and they operate in the background of the companies. Their important feature is that over the funding of the enterprises based on their business experiences they can contribute to the success of the companies with their special expertise and with strategic support. As a result of the asymmetric information between the angels and the companies their matching is difficult (Becsky-Nagy – Fazekas 2015), and the fact, that angel investors prefer anonymity makes it harder for entrepreneurs to obtain informal venture capital. The primary aim of the different type of business angel organizations and networks is to alleviate this matching process with intermediation between the two parties. The role of these organizations is increasing in the informal venture capital market compared to the individually operating angels. The recognition of their economic importance led many governments to support them. There were also public initiations that aimed the establishment of these intermediary organizations that led to the institutionalization of business angels. This study via the characterization of business angels focuses on the progress of these informational intermediaries and their ways of development with regards to the international trends and the current situation of Hungarian business angels and angel networks.

Team diversity and leadership: Tests of model of process and direct effects

A model was tested to examine relationships among leadership behaviors, team diversity, and team process measures with team performance and satisfaction at both the team and leader-member levels of analysis. Relationships between leadership behavior and team demographic and cognitive diversity were hypothesized to have both direct effects on organizational outcomes as well as indirect effects through team processes. Leader member differences were investigated to determine the effects of leader-member diversity leader-member exchange quality, individual effectiveness and satisfaction.^ Leadership had little direct effect on team performance, but several strong positive indirect effects through team processes. Demographic Diversity had no impact on team processes, directly impacted only one performance measure, and moderated the leadership to team process relationship.^ Cognitive Diversity had a number of direct and indirect effects on team performance, the net effects uniformly positive, and did not moderate the leadership to team process relationship.^ In sum, the team model suggests a complex combination of leadership behaviors positively impacting team processes, demographic diversity having little impact on team process or performance, cognitive diversity having a positive net impact impact, and team processes having mixed effects on team outcomes.^ At the leader-member level, leadership behaviors were a strong predictor of Leader-Member Exchange (LMX) quality. Leader-member demographic and cognitive dissimilarity were each predictors of LMX quality, but failed to moderate the leader behavior to LMX quality relationship. LMX quality was strongly and positively related to self reported effectiveness and satisfaction.^ The study makes several contributions to the literature. First, it explicitly links leadership and team diversity. Second, demographic and cognitive diversity are conceptualized as distinct and multi-faceted constructs. Third, a methodology for creating an index of categorical demographic and interval cognitive measures is provided so that diversity can be measured in a holistic conjoint fashion. Fourth, the study simultaneously investigates the impact of diversity at the team and leader-member levels of analyses. Fifth, insights into the moderating impact of different forms of team diversity on the leadership to team process relationship are provided. Sixth, this study incorporates a wide range of objective and independent measures to provide a 360$\sp\circ$ assessment of team performance. ^

A systems approach to describing the process of individual adoption of IT innovations

Research on the adoption of innovations by individuals has been criticized for focusing on various factors that lead to the adoption or rejection of an innovation while ignoring important aspects of the dynamic process that takes place. Theoretical process-based models hypothesize that individuals go through consecutive stages of information gathering and decision making but do not clearly explain the mechanisms that cause an individual to leave one stage and enter the next one. Research on the dynamics of the adoption process have lacked a structurally formal and quantitative description of the process. ^ This dissertation addresses the adoption process of technological innovations from a Systems Theory perspective and assumes that individuals roam through different, not necessarily consecutive, states, determined by the levels of quantifiable state variables. It is proposed that different levels of these state variables determine the state in which potential adopters are. Various events that alter the levels of these variables can cause individuals to migrate into different states. ^ It was believed that Systems Theory could provide the required infrastructure to model the innovation adoption process, particularly applied to information technologies, in a formal, structured fashion. This dissertation assumed that an individual progressing through an adoption process could be considered a system, where the occurrence of different events affect the system's overall behavior and ultimately the adoption outcome. The research effort aimed at identifying the various states of such system and the significant events that could lead the system from one state to another. By mapping these attributes onto an “innovation adoption state space” the adoption process could be fully modeled and used to assess the status, history, and possible outcomes of a specific adoption process. ^ A group of Executive MBA students were observed as they adopted Internet-based technological innovations. The data collected were used to identify clusters in the values of the state variables and consequently define significant system states. Additionally, events were identified across the student sample that systematically moved the system from one state to another. The compilation of identified states and change-related events enabled the definition of an innovation adoption state-space model. ^

Consumer (dis)satisfaction response to disconfirmation: An examination of the form and the underlying process

The purpose of this dissertation was to examine the form of the consumer satisfaction/dissatisfaction (CS/D) response to disconfirmation. In addition, the cognitive and affective processes underlying the response were also explored. ^ Respondents were provided with information from a prior market research study about a new brand of printer that was being tested. This market research information helped set prior expectations regarding the print quality. Subjects were randomly assigned to an experimental condition that manipulated prior expectations to be either positive or negative. Respondents were then provided with printouts that had performance quality that was either worse (negative disconfirmation) or better (positive disconfirmation) than the prior expectations. In other words, for each level of expectation, respondents were assigned to either positive or negative disconfirmation condition. Subjects were also randomly assigned to a condition of either a high or low level of outcome involvement. ^ Analyses of variance indicated that positive disconfirmation led to a more intense CS/D response than negative disconfirmation, even though there was no significant difference in the intensity for positive and negative disconfirmation. Intensity of CS/D was measured by the distance of the CS/D rating from the midpoint of the scale. The study also found that although outcome involvement did not influence the polarity of the CS/D response, the more direct measures of processing involvement such as the subjects' concentration, attention and care in evaluating the printout did have a significant positive effect on CS/D intensity. ^ Analyses of covariance also indicated that the relationship between the intensity of the CS/D response and the intensity of the disconfirmation was mediated by the intensity of affective responses. Positive disconfirmation led to more intense affective responses than negative disconfirmation. ^

Assessing the effectiveness of two-year banking and insurance technology programs of junior colleges in Taiwan, R.O.C.: An application of the Context Input Process Product (CIPP) evaluation model

The purpose of this descriptive study was to evaluate the banking and insurance technology curriculum at ten junior colleges in Taiwan. The study focused on curriculum, curriculum materials, instruction, support services, student achievement and job performance. Data was collected from a diverse sample of faculty, students, alumni, and employers. ^ Questionnaires on the evaluation of curriculum at technical junior colleges were developed for use in this specific case. Data were collected from the sample described above and analyzed utilizing ANOVA, T-Tests and crosstabulations. Findings are presented which indicate that there is room for improvement in terms of meeting individual students' needs. ^ Using Stufflebeam's CIPP model for curriculum evaluation it was determined that the curriculum was adequate in terms of the knowledge and skills imparted to students. However, students were dissatisfied with the rigidity of the curriculum and the lack of opportunity to satisfy the individual needs of students. Employers were satisfied with both the academic preparation of students and their on the job performance. ^ In sum, the curriculum of the two-year banking and insurance technology programs of junior college in Taiwan was shown to have served adequately preparing a work force to enter businesses. It is now time to look toward the future and adapt the curriculum and instruction for the future needs of the ever evolving high-tech society. ^

A methodology to measure coordination of business processes

Coordination of business processes is the management of dependencies where dependencies constrain how the tasks are performed. It has been traditionally done in an intuitive fashion, without paying much attention to the coordination load. Coordination load is being defined as the ratio between the time spent on coordination activities and the total task time. Previous efforts to understand and analyze coordination have resulted in mostly qualitative approaches to categorize and recommend coordination strategies. This research seeks to answer two questions: (1) How can we analyze process coordination problems to improve overall performance? (2) What guidance can we provide to reduce the coordination load of the process and consequently improve the organization's performance? Thus, this effort developed a quantitative measure for coordination load of business processes and a methodology to apply such measure. ^ This effort used a management simulation game to have a controlled laboratory environment enabling the manipulation of the task factors variability, analyzability, and interdependence to measure their impact on coordination load. The hypothesis was that the more variable, non-analyzable, and interdependent a process, the higher the coordination load, and that a higher coordination load would have a negative impact on performance. Coordination load was measured via the surrogate coordination time, and performance via profit. ^ A 22 x 31 full factorial design, with two replicates, was run to observe the impact on the variables coordination time and profit. Properly validated spreadsheets and questionnaires were used as data collection instruments for each scenario. The experimental results indicate that lower task analyzability (ρ=0.036) and higher task interdependence (ρ=0.000) lead to higher coordination load, and higher levels of task variability (ρ=0.049) lead to lower performance. However, contrary to the hypotheses postulated by this work, coordination load did not prove to be strong predictor of performance (correlation of -0.086). ^ These findings from the laboratory experiment and other lessons learned were incorporated to develop a quantitative measure, a tool (survey) to use to gather data for the variables in the measures, and a methodology to quantify coordination load of production business processes. The practicality of the methodology is demonstrated with an example.^

Actionable pattern analysis in computing and business intelligence systems

With advances in science and technology, computing and business intelligence (BI) systems are steadily becoming more complex with an increasing variety of heterogeneous software and hardware components. They are thus becoming progressively more difficult to monitor, manage and maintain. Traditional approaches to system management have largely relied on domain experts through a knowledge acquisition process that translates domain knowledge into operating rules and policies. It is widely acknowledged as a cumbersome, labor intensive, and error prone process, besides being difficult to keep up with the rapidly changing environments. In addition, many traditional business systems deliver primarily pre-defined historic metrics for a long-term strategic or mid-term tactical analysis, and lack the necessary flexibility to support evolving metrics or data collection for real-time operational analysis. There is thus a pressing need for automatic and efficient approaches to monitor and manage complex computing and BI systems. To realize the goal of autonomic management and enable self-management capabilities, we propose to mine system historical log data generated by computing and BI systems, and automatically extract actionable patterns from this data. This dissertation focuses on the development of different data mining techniques to extract actionable patterns from various types of log data in computing and BI systems. Four key problems—Log data categorization and event summarization, Leading indicator identification , Pattern prioritization by exploring the link structures , and Tensor model for three-way log data are studied. Case studies and comprehensive experiments on real application scenarios and datasets are conducted to show the effectiveness of our proposed approaches.

A study of stock market fluctuations and their relation to business conditions

Most research on stock prices is based on the present value model or the more general consumption-based model. When applied to real economic data, both of them are found unable to account for both the stock price level and its volatility. Three essays here attempt to both build a more realistic model, and to check whether there is still room for bubbles in explaining fluctuations in stock prices. In the second chapter, several innovations are simultaneously incorporated into the traditional present value model in order to produce more accurate model-based fundamental prices. These innovations comprise replacing with broad dividends the more narrow traditional dividends that are more commonly used, a nonlinear artificial neural network (ANN) forecasting procedure for these broad dividends instead of the more common linear forecasting models for narrow traditional dividends, and a stochastic discount rate in place of the constant discount rate. Empirical results show that the model described above predicts fundamental prices better, compared with alternative models using linear forecasting process, narrow dividends, or a constant discount factor. Nonetheless, actual prices are still largely detached from fundamental prices. The bubblelike deviations are found to coincide with business cycles. The third chapter examines possible cointegration of stock prices with fundamentals and non-fundamentals. The output gap is introduced to form the nonfundamental part of stock prices. I use a trivariate Vector Autoregression (TVAR) model and a single equation model to run cointegration tests between these three variables. Neither of the cointegration tests shows strong evidence of explosive behavior in the DJIA and S&P 500 data. Then, I applied a sup augmented Dickey-Fuller test to check for the existence of periodically collapsing bubbles in stock prices. Such bubbles are found in S&P data during the late 1990s. Employing econometric tests from the third chapter, I continue in the fourth chapter to examine whether bubbles exist in stock prices of conventional economic sectors on the New York Stock Exchange. The ‘old economy’ as a whole is not found to have bubbles. But, periodically collapsing bubbles are found in Material and Telecommunication Services sectors, and the Real Estate industry group.

Emotional intelligence and leadership in organizations: A meta-analytic test of process mechanisms

The present study—employing psychometric meta-analysis of 92 independent studies with sample sizes ranging from 26 to 322 leaders—examined the relationship between EI and leadership effectiveness. Overall, the results supported a linkage between leader EI and effectiveness that was moderate in nature (ρ = .25). In addition, the positive manifold of the effect sizes presented in this study, ranging from .10 to .44, indicate that emotional intelligence has meaningful relations with myriad leadership outcomes including effectiveness, transformational leadership, LMX, follower job satisfaction, and others. Furthermore, this paper examined potential process mechanisms that may account for the EI-leadership effectiveness relationship and showed that both transformational leadership and LMX partially mediate this relationship. However, while the predictive validities of EI were moderate in nature, path analysis and hierarchical regression suggests that EI contributes less than or equal to 1% of explained variance in leadership effectiveness once personality and intelligence are accounted for. ^

Why and how multinational corporations influence the trade negotiation process in Latin America

This thesis examines two research questions: (1) Why do Multinational Enterprises (MNEs) try to influence trade negotiations in the Latin American context? and (2) How do MNEs influence the trade negotiation process in Latin America? The results show that the MNE's main reasons for participation are: (1) to gain market access and, specifically, to reduce tariff and non-tariff barriers; (2) to create a beneficial regulatory environment for the MNE; and (3) to set the rules of the game by influencing the business environment in which its industry or its specific company is required to operate. The main approaches reported by the interviewees as to how MNEs participate are: (1) the MNE directly lobbies domestic government officials, principally the United States Trade Representative office; (2) a business, trade or industry association lobbies domestic government officials on the MNE's behalf; and (3) the MNE lobbies Congress.