Supplier transaction, TMT characteristics, and the persistence of earnings: do their relationship contribute towards sustainable performance of Chinese listed manufacturing sector firms?

The construction of supplier transaction is one of the strategic choices of many firms. However, the impact of business strategies on the persistence of earnings remains to be further investigated. The innovation of this paper lies in interpreting the impact of supplier transaction on earnings persistence from the perspective of characteristics of the top management team (TMT). We consider Chinese listed manufacturing firms from 2012 to 2019 to examine the relationship between the supplier transaction and the persistence of earnings. Statistical results show that supplier transaction characteristics of the TMT have a significant moderating effect on the relationship between the supplier transaction and the persistence of earnings. This implies that the behavior of TMT can be vital to the firm in maintaining sustainable performance. The higher age level or longer average tenure of TMT can significantly improve the positive effect of the supplier transaction tenure heterogeneity of TMT that will significantly improve the negative effect. This paper expands the literature on supplier relationship, and corporate earnings from a new perspective that improves the empirical evidence of the upper echelons theory, and also provides evidence support for the construction of supplier relationship and TMT.

The process of developing dynamic capabilities: The conceptualization attempt and the results of empirical studies.

While most researchers interested in the concept of dynamic capabilities focus their attention on analyzing how companies transform their resources to compete in their environment, the process of developing dynamic capabilities is treated as a marginal issue. Although the literature suggests various approaches to developing dynamic capabilities, they are formulated in general terms, and doubts can be raised about the links between actions. There is also a lack of empirical research indicating the links between activities in the process of developing dynamic capabilities and their influence on the effectiveness of an organization. The aim of the study is to formulate a proposal for a model of the process of developing dynamic capabilities aimed at increasing the economic effectiveness of a company and to determine the links between the activities in the model. The theoretical contribution of the paper consists in presenting a model of the process of developing dynamic capabilities aimed at increasing the economic effectiveness of the company. The results presented in the paper refer to an empirical examination of the model of developing dynamic capabilities, covering five activities: searching for opportunities; knowledge management and learning; coordination; configuration and reconfiguration; and organizational adaptation. The study also includes an examination of the possible impact the components of the dynamic capabilities building process have on a company's performance. The study uses the survey method and data was obtained from top managers. The conclusion, based on data from 471 Polish companies, was made using structural equation modelling. The results of the empirical research suggest that the individual activities in the process of developing dynamic capabilities are interconnected, and through mutual interactions and couplings, they positively affect the economic effectiveness of an enterprise. The results indicate that searching for opportunities is the precursor, and the main factor influencing the other activities in the process, which suggests that managers should focus on improving activities in this area.

Applied systems thinking: The impact of system optimization strategies on financial and quality performance in a team-based simulation.

At its core, this research was undertaken to explore the extent to which system optimization leadership strategies such as innovation, collaboration, and data-driven decision-making affect financial and quality performance in organizations. A quasi-experimental pretest-posttest research design was used to examine the increase or decrease in system performance as a result of treatment in the form of a systems thinking workshop and strategy discussion. The application of three-core system strategies lead to significant gains in financial performance across all teams, and an increase in quality performance in all but one team. In addition to an increase in performance, this research also revealed the tendency of social systems to reflexively sub-optimize their performance and at times lose focus on higher order system goals. Helpful recommendations for leadership practice and future research are presented with a view to helping optimize whole systems and not solely their parts.

Development of a person-centered interdisciplinary plan-of-care program for dialysis.

BACKGROUND: Dialysis care often focuses on outcomes that are of lesser importance to patients than to clinicians. There is growing international interest in individualizing care based on patient priorities, but evidence-based approaches are lacking. The objective of this study was to develop a person-centered dialysis care planning program. To achieve this objective we performed qualitative interviews, responsively developed a novel care planning program and then assessed program content and burden. METHODS: We conducted 25 concept elicitation interviews with US hemodialysis patients, care partners and care providers, using thematic analysis to analyze transcripts. Interview findings and interdisciplinary stakeholder panel input informed the development of a new care planning program, My Dialysis Plan. We then conducted 19 cognitive debriefing interviews with patients, care partners and care providers to assess the program's content and face validities, comprehensibility and burden. RESULTS: We identified five themes in concept elicitation interviews: feeling boxed in by the system, navigating dual lives, acknowledging an evolving identity, respecting the individual as a whole person and increasing individualization to enhance care. We then developed a person-centered care planning program and supporting materials that underwent 32 stakeholder-informed iterations. Data from subsequent cognitive interviews led to program revisions intended to improve contextualization and understanding, decrease burden and facilitate implementation. CONCLUSIONS: My Dialysis Plan is a content-valid, person-centered dialysis care planning program that aims to promote care individualization. Investigation of the program's capacity to improve patient experiences and outcomes is needed.

Examining the role of value congruence, professional identity, and managerial job engagement in the budgetary participation-performance link.

BACKGROUND: In health care, important phenomena of perceived incompatibility between professional and managerial values have emerged as consequences of New Public Management reforms. Although there is a growing evidence on the variation in the enactment of hybrid roles by medical managers, existing research in health care management is mostly descriptive with little emphasis on the conditions under which hybrid roles are enacted and, importantly, on the effects of this variation on performance. PURPOSE: In this article, we seek to fill this research gap by empirically examining (a) whether budgetary participation aligns professional and organizational values, (b) the impact of this alignment on employees' work-related feelings and managerial performance, and (c) the effect of professional identity on value congruence. METHODOLOGY: Data were collected by a survey conducted in an Italian hospital, and partial least square was used to test the relationships among variables. RESULTS: Overall, results show that (a) high involvement in budgeting is instrumental in facilitating medical managers' value congruence, and this, in turn, positively effects managerial job engagement; (b) the effect of budgetary participation on value congruence depends on the extent of professional identity; and (c) as a result of enhanced value congruence and managerial job engagement, employees tend to deliver superior role performance. PRACTICE IMPLICATION: Findings of this study provide some guidance for managers on how organizations can take steps to guarantee effective support to hybrid professionals.

Guía de conteo poblacional / Population counting guide

Conteo poblacional se comprenderá como la serie de acciones y procedimientos de recolección de datos de personas, identificación de viviendas y familias, comunidades, sectores y territorios con fines eminentemente sanitarios, relacionando las condiciones de vida, los problemas de salud, sus determinantes sociales y factores de riesgo presentes en ellas. Debido a que las características de la población de una comunidad son dinámicas, se hace necesario realizar cada año una actualización de la información que es de uso necesario para las acciones de salud, lo cual lo diferencia del censo de población que es estático, de cohorte, con otro tipo de indicadores dado por el ente rector el Instituto Nacional de Estadística ­INE-. Además permite el contacto directo entre los equipos de salud del Ministerio de Salud y la población a su cargo Este documento además, forma parte de las herramientas para la implementación del Modelo de Atención y Gestión, junto a la "Guía para la elaboración de un croquis" y a la "Guía de acercamiento y negociación", que forman parte de los documentos que hay en esta App. Este documento contiene los lineamientos y ruta a seguir para el desarrollo del conteo poblacional, describe conceptos básicos, sus características, la secuencia de fases y pasos que incluyen preparación y organización de los equipos de trabajo, herramientas y registro de datos, revisión, análisis y certificación de la información recolectada. Los principales usuarios son el personal que conforman los equipos de salud ­ES- responsables de cada sector y territorio de los distritos de salud.

Estrategia nacional de redes integradas de servicios de salud de Guatemala, ENRISSG / National strategy of integrated health services networks of Guatemala, ENRISSG

(Acuerdo ministerial No. 246-2019) Este documento propone un marco conceptual y operativo para entender las RISS desde la perspectiva y realidad de Guatemala, brinda los lineamientos orientadores y las acciones estratégicas para que los actores y prestadores de salud de un distrito o departamento se articulen en redes, optimicen las capacidades instaladas, garanticen la continuidad de la atención y consoliden vínculos interinstitucionales e intersectoriales que permitan abordajes integrales para mejorar la calidad de vida de las personas, las familias y las comunidades. La Estrategia de RISS se promueve como uno de los mecanismos para reducir la fragmentación de los sistemas de salud y como una de las principales expresiones operativas del enfoque de la APS en el proceso de atención integral, integrada y continua a las personas; contribuyendo a hacer una realidad varios de sus elementos más esenciales, tales como la cobertura y el acceso universal; la atención integral, integrada y continua; el cuidado apropiado, y la organización y gestión de los servicios de salud. El objetivo general del acuerdo ministerial que la avala es lograr acceso y cobertura de la salud, a través de la implementación de la Estrategia de Redes integradas, basada en la atención primaria de la salud, que permita una atención de salud equitativa, integral, integrada, continua y de calidad con en el derecho de la salud. Es de aplicación obligatoria para todas las dependencias que organicen e implementen redes integradas de servicios de salud a nivel de la república y permitirá orientar a los gerentes y los equipos multidisciplinarios, interinstitucionales e intersectoriales de un territorio definido, con lineamientos y acciones para el reordenamiento, articulación, coordinación, fortalecimiento y funcionamiento de los servicios de salud en red, fomentando la planificación, implementación, monitoreo, evaluación y rendición de cuentas.

Guía de acciones extramuros / Outside Walls Guide

Este modelo: "de atención y gestión basado en la estrategia atención primaria en salud renovada", tiene como prioridad las intervenciones en el marco de la prevención de la enfermedad, promoción de la salud y vigilancia epidemiológica, con el objetivo de incidir en determinantes de la salud, contribuyendo con el desarrollo de las comunidades y promoviendo la reducción de daños a la población. Fundamentalmente el modelo de acciones extramuros, considera la implementación de acciones fuera de los establecimientos de salud, que permitan identificar las necesidades de la comunidad y establecer medidas preventivas que contribuyan a mejorar la salud de la población de manera oportuna. Por lo que, el personal de salud debe facilitar el acceso a los servicios a la población de acuerdo a los riesgos de la salud identificados en el análisis de situación de salud, a la demanda y oferta para establecer acciones oportunas.

Institutional Responses to Campus Sexual Assault: Examining the Development and Work of A Multidisciplinary Team.

Responding to campus sexual assault can involve complex processes and procedures that span campus, criminal justice, and community-based institutions, particularly when there are co-occurring Title IX and criminal investigations. This study investigated the development of a multidisciplinary team (MDT) that involved campus, criminal justice, and community-based institutions seeking to improve coordinated responses to campus sexual assault. Data included observations of MDT monthly meetings over 16 months as well as individual interviews with MDT members. Transcripts of the MDT meetings and individual interviews were coded to capture major themes. The MDT meetings were dynamic and flexible with a structure that involved intentional agenda setting along with responsiveness to current events and collaborative processes. The MDT invested more time during the meetings addressing the complexity of navigating existing procedures than developing new protocols. Individual interviews with MDT members highlighted logistical challenges that were relevant to MDT effectiveness, such as consistent attendance, supervisor legitimacy, and differences in stakeholder priorities. Implications for future MDT work are discussed.

Quality improvement methods - Part II.

To solve complex problems in healthcare, providers need the will to make change, well thought-out or evidence-based ideas, and a quality improvement methodology for executing those ideas. This review will focus on specific elements of execution. A previous review by Picarillo (1) discussed the Model for Improvement, process maps, Pareto charts, Ishikawa diagrams, and driver diagrams. Here, Lean/Six Sigma (LSS) is introduced as an additional methodology for quality improvement (QI), including a selected discussion of some associated LSS tools. Specifically, the Failure Modes and Effects Analysis (FMEA) will be reviewed in more detail. This is a tool to proactively identify possible errors in processes of care, prioritize those which may have the biggest impact if they reached the patient, and develop action plans to address them. Finally, Planned Experimentation is presented as a mechanism to organize your testing strategy for ideas for change. Having an understanding of the concepts in this review and that by Picarillo (1) will provide a sound foundation in the methodology and tools needed to address quality problems in healthcare.

A single-center multidisciplinary approach to managing the global Erwinia asparaginase shortage.

The availability of Erwinia Asparaginase has been limited across the world due to manufacturing shortages or for some countries due to the high acquisition cost, putting patients at risk for inferior outcomes. This manuscript provides guidance on how to manage hypersensitivity reactions and utilize therapeutic drug monitoring (TDM) to conserve and limit Erwinia use. The clinical and financial impact of a multidisciplinary committee are also discussed. Faced with a global Erwinia shortage, a multidisciplinary asparaginase allergy committee was created to review all hypersensitivity reactions to asparaginase therapy, staff education was performed on the management of asparaginase hypersensitivity reactions, an institution-wide premedication policy was mandated, and standardized guidelines were created for TDM. This multidisciplinary approach reduced the PEG-asparaginase to Erwinia switch rate from 21% (35 of 163) to 7% (10 of 134) (p = .0035). A multifaceted approach can safely maintain patients on PEG-asparaginase and conserve Erwinia for patients who need it most.

The Importance of a Radiologist-Administrator Partnership to Future Health Care.

Successful physician and administrator leader partnerships are a key differentiator in today's volatile, unpredictable, ever-changing health care landscape. Whether they are leading a division, a department, or an organization, intentional and mindful physician-administrator partnerships affect success from the micro individual level to the macro organizational level. Mayo Clinic's physician and administrative leaders are leveraging a long-held tradition of partnership by elevating their own competence as effective partners to ensure organizational sustainability. Specifically, physician and administrator leaders in the department of radiology have positioned collaboration at the foundation of their leadership practice, surrounded by the institutional values of respect, excellence, stewardship, and teamwork. From this framework, team leaders are better equipped and in a more stable position to prepare themselves and their colleagues for the very complex and unknown future.

Impact of organisational change for leaders in mental health.

PURPOSE: The purpose of this paper is to examine the impact of organisational and structural change on the evolution of quality and safety in health organisations, specifically in mental health services. DESIGN/METHODOLOGY/APPROACH: Data were gathered through semi-structured interviews. In total, 25 executive management team members in both public and private mental health services were interviewed and data were analysed using Burnard's framework. FINDINGS: Three overarching themes emerged: organisational characteristics, leadership and accountability; sustaining collaboration and engagement with stakeholders; and challenges to and facilitators of quality and safety. Taken together, the findings speak to the disruptive and disorienting impact of on-going organisational change and restructuring on leaders' ability to focus on, and advance, the quality and safety agenda. RESEARCH LIMITATIONS/IMPLICATIONS: Typical with qualitative research of this nature, the potentially limited generalisability of the findings must be acknowledged. PRACTICAL IMPLICATIONS: There is a need for strategies to implement change that are informed by evidence and theory and informed by decades of research on this topic, rather than introduced ad hoc. Change agents must pair effective change management and implementation science strategies to specific contexts, depending on what is being implemented and ensure appropriate evaluation of organisational change to bolster the evidence base around quality and safety and inform future decision-making. ORIGINALITY/VALUE: The study explores an identified gap in the literature on the impact of on-going organisational re-structuring and transformation on the evolution of quality and safety in mental health services.

Evaluating the Clinical Practice Model's Strengths and Improvement Opportunities Using the Professional Practice Framework Assessment Survey: One Integrated Healthcare System's Experience.

OBJECTIVES: The aims of this study are (1) to describe the division, organizational strengths, and improvement opportunities of self-reported behaviors indicative of the multidimensional construct of professional practice and (2) to understand demographic characteristics that contributed to these strengths and improvement opportunities. BACKGROUND: Prior to implementing a system-wide interdisciplinary shared governance structure, ProHealth Care measured staff attitudes toward the multidimensional construct of professional practice as proposed within the Clinical Practice Model framework using the Professional Practice Framework Assessment Survey (PPFA-S). METHODS: Clinical and support staff were invited to share their views toward professional practice using the previously validated, reliable tool, the PPFA-S. RESULTS: Partnering relationships, scope of practice, and shared purpose were strengths. Strategies were initiated to strengthen networking councils, integrated competency, evidence-based practice, transformative capacity, and clinical tools. CONCLUSIONS: The survey identified professional practice strengths and improvement opportunities across the organization as well as factors contributing to these strengths and opportunities. These findings were useful to help guide system integration.

A Unique Institutional Response to the Zika Virus Epidemic.

In 2015, Zika virus rapidly emerged as a concern for obstetric patients and health care providers as the disease spread geographically and it was discovered that Zika virus infection had the potential to cause devastating birth defects. Essentially overnight, obstetric care providers were faced with an influx of rapidly evolving information and an increased workload. New systems, workflows, and personnel were needed to effectively address the new patient care needs fueled by the burgeoning Zika virus epidemic. The University of California, San Francisco responded by filling a Zika Response Nurse Coordinator position to take on tasks necessary to design a systematic approach for Zika virus management. The Zika Response Coordinator at the University of California, San Francisco serves as a subject matter expert who counsels patients and health care providers, arranges testing and follow-up care after potential Zika virus exposure, and helps design the screening tools, protocols, and educational material needed to manage the evolving Zika virus response. The position has enabled a Zika virus response that has been tightly coordinated, consistent, and thorough without overburdening health care providers. The Zika Response Nurse Coordinator Role serves as a template for how institutions can model coordinated Zika virus care and prepare for future threats that will necessitate a focused and rapid response. Timely institutional financial support is critical for an appropriate response to emerging diseases for not only Zika virus but future epidemics as well.

A Health Care Project Management Office's Strategies for Continual Change and Continuous Improvement.

Health care organizations need project and change management support in order to achieve successful transformations. A project management office (PMO) helps support the organizations through their transformations along with increasing their capabilities in project and change management. The aim of the present study was to extend understanding of the continuous improvement mechanisms used by PMOs and to describe PMO's strategies for continual change and continuous improvement in the context of major transformation in health care. This study is a descriptive case study design with interviews conducted from October to December 2015 with PMO's members (3 managers and 1 director) and 3 clients working with the PMO after a major redevelopment project ended (transition to the new facility). Participants suggested a number of elements including carefully selecting the members of the PMO, having a clear mandate for the PMO, having a method and a discipline at the same time as allowing openness and flexibility, clearly prioritizing projects, optimizing collaboration, planning for everything the PMO will need, not overlooking organizational culture, and retaining the existing support model. This study presents a number of factors ensuring the sustainability of changes.

Managing hundreds of improvement teams.

Recognizing the notable scale of USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project activities and sizable number of improvement teams, which in some cases is close to 1,000 improvement teams managed in one country at a point in time, we sought to answer the questions: How do we manage hundreds of improvement teams in one country alone? How do we manage more than 4,000 improvement teams globally? The leaders of our improvement programs manage such efforts as though they are second-nature, without pointing to the specific skills and strategies needed to manage thousands of teams. This paper was developed to capture the lessons, considerations, and insights shared in discussions with leaders on the USAID ASSIST Project, including country Chiefs of Party and Regional Directors. More specifically, this paper seeks to describe what is involved in scaling up and managing large numbers of improvement teams. Through focus group discussions and individual interviews, participants discussed the key skills, strategies, and lessons needed to successfully manage large numbers of teams on the USAID ASSIST Project. We concluded that the six key components in managing large numbers of teams are 1) leadership; 2) management structures and capacities; 3) clear and open communication; 4) shared learning, collaboration, and support; 5) ownership, engagement, and empowerment; and 6) partnerships. We further analyzed these six components as being interrelated to one another based on the relationship between culture, strategy, and technique in implementing quality improvement activities.

Stakeholder Perspectives on the Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) Project.

Background and Objectives: The need to reduce burdensome and costly hospitalizations of frail nursing home residents is well documented. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project achieved this reduction through a multicomponent collaborative care model. We conducted an implementation-focused project evaluation to describe stakeholders' perspectives on (a) the most and least effective components of the intervention; (b) barriers to implementation; and (c) program features that promoted its adoption. Research Design and Methods: Nineteen nursing homes participated in OPTIMISTIC. We conducted semistructured, qualitative interviews with 63 stakeholders: 23 nursing home staff and leaders, 4 primary care providers, 10 family members, and 26 OPTIMISTIC clinical staff. We used directed content analysis to analyze the data. Results: We found universal endorsement of the value of in-depth advance care planning (ACP) discussions in reducing hospitalizations and improving care. Similarly, all stakeholder groups emphasized that nursing home access to specially trained, project registered nurses (RNs) and nurse practitioners (NPs) with time to focus on ACP, comprehensive resident assessment, and staff education was particularly valuable in identifying residents' goals for care. Challenges to implementation included inadequately trained facility staff and resistance to changing practice. In addition, the program sometimes failed to communicate its goals and activities clearly, leaving facilities uncertain about the OPTIMISTIC clinical staff's roles in the facilities. Discussion and Implications: These findings are important for dissemination efforts related to the OPTIMISTIC care model and may be applicable to other innovations in nursing homes.