Workforce Issues in the Greater Boston Health Care Industry: Implications for Work and Family

Interviews with more than 40 leaders in the Boston area health care industry have identified a range of broadly-felt critical problems. This document synthesizes these problems and places them in the context of work and family issues implicit in the organization of health care workplaces. It concludes with questions about possible ways to address such issues. The defining circumstance for the health care industry nationally as well as regionally at present is an extraordinary reorganization, not yet fully negotiated, in the provision and financing of health care. Hoped-for controls on increased costs of medical care – specifically the widespread replacement of indemnity insurance by market-based managed care and business models of operation--have fallen far short of their promise. Pressures to limit expenditures have produced dispiriting conditions for the entire healthcare workforce, from technicians and aides to nurses and physicians. Under such strains, relations between managers and workers providing care are uneasy, ranging from determined efforts to maintain respectful cooperation to adversarial negotiation. Taken together, the interviews identify five key issues affecting a broad cross-section of occupational groups, albeit in different ways: Staffing shortages of various kinds throughout the health care workforce create problems for managers and workers and also for the quality of patient care. Long work hours and inflexible schedules place pressure on virtually every part of the healthcare workforce, including physicians. Degraded and unsupportive working conditions, often the result of workplace "deskilling" and "speed up," undercut previous modes of clinical practice. Lack of opportunities for training and advancement exacerbate workforce problems in an industry where occupational categories and terms of work are in a constant state of flux. Professional and employee voices are insufficiently heard in conditions of rapid institutional reorganization and consolidation. Interviewees describe multiple impacts of these issues--on the operation of health care workplaces, on the well being of the health care workforce, and on the quality of patient care. Also apparent in the interviews, but not clearly named and defined, is the impact of these issues on the ability of workers to attend well to the needs of their families--and the reciprocal impact of workers' family tensions on workplace performance. In other words, the same things that affect patient care also affect families, and vice versa. Some workers describe feeling both guilty about raising their own family issues when their patients' needs are at stake, and resentful about the exploitation of these feelings by administrators making workplace policy. The different institutions making up the health care system have responded to their most pressing issues with a variety of specific stratagems but few that address the complexities connecting relations between work and family. The MIT Workplace Center proposes a collaborative exploration of next steps to probe these complications and to identify possible locations within the health care system for workplace experimentation with outcomes benefiting all parties.

A HOLISTIC APPROACH TO MANUFACTURING SYSTEM DESIGN IN THE DEFENSE AEROSPACE INDUSTRY

Manufacturing has evolved to become a critical element of the competitive skill set of defense aerospace firms. Given the changes in the acquisition environment and culture; traditional “thrown over the wall” means of developing and manufacturing products are insufficient. Also, manufacturing systems are complex systems that need to be carefully designed in a holistic manner and there are shortcomings with available tools and methods to assist in the design of these systems. This paper outlines the generation and validation of a framework to guide this manufacturing system design process.

An Assessment of the Degree of Implementation of the Lean Aerospace Initiative Principles and Practices within the US Aerospace and Defense Industry

This report is a formal documentation of the results of an assessment of the degree to which Lean Principles and Practices have been implemented in the US Aerospace and Defense Industry. An Industry Association team prepared it for the DCMA-DCAAIndustry Association “Crosstalk” Coalition in response to a “Crosstalk” meeting action request to the industry associations. The motivation of this request was provided by the many potential benefits to system product quality, affordability and industry responsiveness, which a high degree of industry Lean implementation can produce.

Applications of Lean Ideas to the Aerospace Industry

• Lean Aerospace Initiative origin and mission • Functional lean successes • Successes through interaction between functions • Success through enterprise integration and value creation • Total enterprise integration of all stakeholders • Enterprise transformation insights

Benefits of Implementing Lean Practices and the Impact of the Lean Aerospace Initiative in the Defense Aerospace Industry and Government Agencies

In the 1980’s, many United States industrial organizations started developing new production processes to improve quality, reduce cost, and better respond to customer needs and the pressures of global competition. This new paradigm was coined Lean Production (or simply “Lean”) in the book The Machine That Changed The World published in 1990 by researchers from MIT’s International Motor Vehicle Program. In 1993, a consortium of US defense aerospace firms and the USAF Aeronautical Systems Center, together with the AFRL Materials and Manufacturing Directorate, started the Lean Aircraft Initiative (LAI) at MIT. With expansion in 1998 to include government space products, the program was renamed the Lean Aerospace Initiative. LAI’s vision is to “Significantly reduce the cost and cycle time for military aerospace products throughout the entire value chain while continuing to improve product performance.” By late 1998, 23 industry and 13 government organizations with paying memberships, along with MIT and the UAW were participating in the LAI.

A Holistic Approach to Manufacturing System Design in the Defense Aerospace Industry

Manufacturing has evolved to become a critical element of the competitive skill set of defense aerospace firms. Given the changes in the acquisition environment and culture; traditional “thrown over the wall” means of developing and manufacturing products are insufficient. Also, manufacturing systems are complex systems that need to be carefully designed in a holistic manner and there are shortcomings with available tools and methods to assist in the design of these systems. This paper outlines the generation and validation of a framework to guide this manufacturing system design process.

Beyond the blue horizon : the role of industry in global environmental politics

by Joanne M. Kaufman.

Suppliers' Associations in the Japanese Automobile Industry

This paper analyzes the structure and functions of suppliers' associations (kyoryokukai) in the automobile industry in Japan. The bilateral assembler-supplier relationship has received much attention recently as a source of Japanese industrial competitiveness. However, this paper argues that the hitherto neglected area of inter-supplier coordination in technology diffusion is at least as important as the bilateral assembler-supplier relationship in accounting for the overall performance of the Japanese automotive industry. On the basis of company visits and a largescale survey of first-tier suppliers conducted by the author, the paper analyzes the reasons why suppliers' associations were established, why they continue to exist today, and their effects on economic performance.

El Cos com a instrument musical: creativitat i activitat grupal col·laborativa com a proposta didàctica més enllà del context de l'aula

Sabem que l’educació no es circumscriu només en l’àmbit acadèmic ni dins el marc físic d’un centre docent, sinó que la societat i els productes que genera són elements importants a tenir en compte. En base a aquests supòsits, els nous corrents pedagògics de l’Escola Nova sorgits a començaments del segle XX ja recomanaven obrir les escoles a l’entorn immediat i aprofitar les seves possibilitats tant com a recurs educatiu com a contingut curricular en sí mateix. Aquesta premissa –plenament vigent a l’actualitat– es fa palesa especialment a l’àrea de música, no només per la gran quantitat d’informació –immediata i diversificada- i per les possibilitats didàctiques i educatives de caràcter multimèdia i interactiu de les Noves Tecnologies (NNTT), les Tecnologies de la Informació i la Comunicació (TIC) i les Tecnologies de l’Aprenentatge i la Comunicació (TAC) que configuren l’actual realitat virtual a la que ens veiem abocats, sinó per l’ampli ventall d’estils i gèneres que inclouen les programacions d’espectacles musicals al nostre abast. De la mateixa manera que l’audició de música en directe és del tot imprescindible en aquesta àrea artística i humanística per tal de desenvolupar les destreses que li són pròpies, també ho és la participació activa. En aquest sentit, constatem que la realització d’activitats educatives a nivell col·lectiu permet la interacció entre iguals i la descoberta, desenvolupament o aprofundiment d’actituds com la cooperació, la tolerància, el respecte mutu, la cohesió, etc., valors imprescindibles en una societat democràtica i plural com la nostra. I encara més, que l’activitat col·lectiva realitzada amb l’objectiu de produir un producte propi, afavoreix la satisfacció personal final que conduirà a la veritable integració dels continguts a assimilar. Per tant, la pràctica aplicada d’aquestes actituds i destreses socials es fa imprescindible en els estudis dels futurs docents. L'Espai Europeu de Educació Superior (EEES) ens aporta la incorporació d'un concepte provinent del món professional, les competències, que són un nou referent de rang superior que orienta globalment els estudis universitaris. Els objectius i continguts d'aquests tindran sentit en la mesura que contribueixin a desenvolupar algunes d'aquestes competències, ja que seran l'objecte principal d'avaluació de les titulacions. Pensem que a través d’activitats que es poden fer fora de l'aula com la que presentem en aquesta comunicació, s'ajuda a mobilitzar algunes d'aquestes competències que permetran configurar el perfil de graduat que tots desitgem

Testing for multigroup equivalence of a measuring instrument : a walk through the process

Resumen tomado de la publicaci??n

Els contorns de les Illes Balears : instrument de diagnòstic, d'informació i d'instrucció en geografia. 'Los contornos de las Illes Balears : instrumento de diagnóstico, de información i de instrucción en geografía'.

Describe una experiencia didáctica-cartográfica llevada a cabo con alumnos de quinto de primaria en un centro educativo de Palma de Mallorca. Se basa en el estudio de los contornos de las Illes Balears a partir de mapas mentales o cognitivos.

L'educació com a instrument de resistència al neoliberalisme. 'La educación como instrumento de resistencia al neoliberalismo'.

Texto resumen de la conferencia

SDANC RECERCA : l'instrument de l'Arxiu Nacional de Catalunya per facilitar la creació del laboratori d'història a l'aula.'SDANC RECERCA : el instrumento del Archivo Nacional de Catalunya para facilitar la creación del laboratorio de historia del aula'.

El Arxiu Nacional de Catalunya, asumiendo su responsabilidad de comunicar el patrimonio documental a la ciudadanía, y con la finalidad de contribuir a la democratización de la cultura, ha implementado un servicio didáctico (SDANC) que tiene por objetivo principal el de promover la didáctica con fuentes de archivo. El instrumento principal del SDANC es la base de datos SDANC RECERCA, que reúne la descripción de fuentes de archivo a la cual se asocia la imagen digitalizada de los documentos que han sido seleccionados por su utilidad didáctica. Este aplicativo, que actualmente reúne 5000 documentos, será accesible a través de internet en los próximos meses.

Esport per a immigrants : instrument d'integració?.

Se muestran fotografías y esquema.Resumen tomado del autor