bluuebunny/crossref_metadata_2025 huggingface dataset:
Hamilton Health Sciences Laboratory Program: A Provider Developed Model for Hospital, University and Community Laboratory Services
Authors: McQueen M.J. , Bailey A.J.
Published: July 2010

Clinical Laboratory Sciences are under pressure to reduce the number of tests and cut staff and supply costs. The ability of academic centres to continue to deliver high quality service, teaching and research is threatened. In difficult economic times imaginative strategies are needed to look for solutions which will permit continued advancement in academic and clinical standards. Rationalization of service and cost-effective use of resources are not new concepts; however, there is a scarcity of models which have been developed and promoted by the providers of laboratory services, rather than those imposed by governments and other paying agencies. A model developed and evolved over the last two decades by The Hamilton Health Sciences Laboratory Program (HHSLP) is outlined.
Staff Participation in Administrative Decision-Making
Authors: Frelick Kathryn M. , Bartlett Glenn S. , Frelick Linden F. , Malek Phyllis A.
Published: July 2010

Victoria Hospital Corporation in London has adopted a collaborative management model that involves the participation of medical, union and non-union staff in the administrative decision-making process within predetermined parameters. Reactions have been favourable from all sides — positive feedback from the groups involved and minimal negative public response to the sensitive decisions made concerning downsizing. Early indicators suggest increasing further the participation of union and non-union staff in decision-making on multiple levels, but with clearly defined “boundaries of responsibility.”
Case Mix Management: A Cautionary Note
Authors: Long Michael J.
Published: July 2010

Using data from a study that involved 500 U.S. acute care hospitals, the author examines the relationship between the profitability of Diagnostic Related Groups (DRGs) and their DRG weight, and the similarity/difference of the most/least profitable DRGs across hospital types. Hospital administrators are cautioned that to engage in case mix management, they must use a management information system that provides the data necessary for determining the cost of treating each patient type within their own institution, not information derived from other facilities or other systems.
Changing Perspectives on Hospital Governance
Authors: Chenoy Neville C. , Carlow Donald R.
Published: July 2010

In the light of fundamental changes in the delivery of health and social services in Canada, hospital governance must be concerned with protection and enhancement of the organization on behalf of the owner (i.e., taxpayer) as well as accountability to the community it was established to serve. Based on a review of current literature, the authors suggest that the roles and responsibilities of a hospital board entail seven major activities: establish the mission, philosophy and future directions of the institution; choose and evaluate the chief executive officer; establish the ethical principles for the organization; ensure high quality care and services; attract resources to the institution and ensure their effective use; integrate the organization with its environment; and undertake its own self-evaluation, education and development.

To play these roles effectively, hospital boards will need to develop more direct links with their communities and learn to share decision making with them.
The Attitudes of Ontario Hospitals toward Transitional Funding: Response to a Survey
Authors: Lave Judith R. , Jacobs Philip
Published: July 2010

A survey of hospital administrators throughout Ontario was conducted to determine their views about the strengths and weaknesses of the new Transitional Funding system, especially as it existed between Phase One and Phase Two when many changes were taking place.

The basic findings of the survey are presented. The authors go on to explore some of the answers and determine whether the hospital's reponses were influenced by their participation in the process and whether they were “winners” or “losers” as a result of the changes.

This type of information should be useful to policy makers in Ontario as they modify the overall hospital financial system, and also be useful to policy makers outside the province who are contemplating making such changes.
Work Force Planning in the 90s, Part I: Efficiency, Economy and Political Will — The Need for a New Approach
Authors: Turner Linda A. , Østbye Truls , Pederson Linda L.
Published: July 2010

Critical to health services management in today's economic climate is efficient utilization of our costly and sometimes limited supply of health care professionals. This two-part article gives an overview of current issues in health care work force planning in Canada. In Part I, the problems of estimating current supply are discussed. Needs-based and demand-based forecasting are contrasted. Comprehensive needs-based planning is recommended and changes needed in order to move toward this type of planning are discussed.

In Part II, the maldistribution of health care professionals and various corrective measures within the context of needs-based comprehensive planning are discussed.
A “Partnership” — A Case Study
Authors: Ross Michael , Hiebert Gerry , Reynolds Dave
Published: July 2010

The Misericordia and The General Hospital (Grey Nuns) of Edmonton (two sites) have formed a partnership and established one board and management structure responsible for the three sites. Described are the processes and techniques used during the assessment stage to determine the viability and desirability of such an action. To study the issue, a task force was formed, drawing equally from the boards of the two hospitals, and involving the participation of the Catholic Archbishop of Edmonton. The responsibilities and actions of the task force are described, along with the observations of the other participants — the owners, management, medical staff, employees and the community.
Patient-Focused Care: The Systemic Implications of Change
Authors: Jirsch Dennis
Published: July 2010

Continuous quality improvement and customer identification have become pivotal concerns for modern management. It is evident that much past activity in health care has been narrowly focused, technologically based and of unknown efficiency. Identifying the patient as primary and overarching customer for health service organizations serves to simplify, refocus and redesign institutions so that resources and personnel are organized and allocated based on patient-care needs. Health care facilities can, accordingly, be ranked on the basis of their commitment and achievement with regard to patient-focused care.

Quality becomes a matter of providing excellent and efficient medical care and satisfying the demands of the larger patient experience. Redefining the organization in the context of patient need profoundly changes the work place, creating less rigid, flattened organizational structures and emphasizing leadership rather than managerial activities.
The Merger That Wasn't: Lessons for Senior Administrators
Authors: Neufeld Marianne M. , Holt Andrew J. , Deber Raisa B.
Published: July 2010

A turbulent health care environment has prompted some hospitals to consider integrating services and in some cases merge entirely. Fundamental lessons may be learned by studying how an attempted merger between Women's College Hospital and The Toronto Hospital in Toronto failed — despite board and senior executive support. Clarity of purpose, involvement of essential external and internal stakeholders, rational analysis, ideological fit and political expediency are a few key elements to consider. Once initiated, changes of this magnitude may take on a life of their own with often unpredictable results.
Hospital Rightsizing: In Line with Long-Term Strategies and Economic Realities
Authors: Collins A.L. , Noble Ron
Published: July 2010

After two years of difficult financial times, the Kitchener-Waterloo Hospital was faced with another upcoming year of tight fiscal constraint. In February 1991, the hospital implemented a program review process to align its services with the hospital's long-term strategy and economic realities.

The authors present a thorough review of the literature pertaining to downsizing decisions. From a practical perspective they demonstrate a downsizing process, its implications and lessons to be learned so that a “rightsizing” exercise can be implemented to minimize the effects of the program and staff reductions while focusing on the positive long-term benefits of strategic planning.

Although downsizing is a difficult process, the Kitchener-Waterloo Hospital was able to develop and implement a plan that minimized the impact on the hospital services and its staff. A reduction in expenses of over $2 million was achieved without having to lay off any permanent hospital staff. This was achieved by streamlining programs, reducing management supervisory positions and eliminating 50 full-time equivalent positions through attrition.

Ultimately, the hospital's board, senior management, medical staff and employees felt that a rightsizing decision had been made, one which minimized the negative impact of restructuring on service delivery, hospital employees and the community served.
Optimalisation des hôpitaux: Conformité aux stratégies à long terme et aux réalités économiques
Authors: Collins A.L. , Noble Ron
Published: July 2010

Après deux ans de difficultés financières, l'hôpital Kitchener-Waterloo entamait une autre année de sévères restrictions budgétaires. En février 1991, l'hôpital a mis en oeuvre un processus d'examen des programmes pour aligner ses services sur la stratégie à long terme de l'hôpital et les réalités économiques.

Les auteurs présentent une étude exhaustive de la littérature traitant des décisions de compression. D'un point de vue pratique, ils illustrent un processus de compression, ses conséquences et les leçons à en tirer pour qu'un exercice d'«optimalisation» puisse être mis en oeuvre afin de minimiser les effets du programme et les réductions d'effectif, tout en mettant l'accent sur les avantages à long terme de la planification stratégique.

Bien que la compression soit un processus difficile, l'hôpital Kitchener-Waterloo a réussi à élaborer et mettre en oeuvre un plan qui minimise son incidence sur les services hospitaliers et l'effectif. Sans avoir à mettre en disponibilité un seul employé permanent de l'hôpital, on a réussi à réduire les dépenses de plus de 2 millions de dollars. Grâce à des programmes de rationalisation, on a réussi à réduire les postes de cadres subalternes et éliminer 50 postes équivalents à plein temps au moyen de l'attrition.

En définitive, le Conseil d'administration de l'hôpital, la haute direction, le personnel médical et les employés ont estimé qu'on avait pris une décision d'optimalisation qui minimisait les conséquences de la restructuration sur la prestation des services, sur les employés de l'hôpital et la collectivité desservie.
Paradigmes et gestion des soins infirmiers, analyse de la structure organisationnelle actuelle d'un grand hôpital
Authors: Wilson Donna
Published: July 2010

Les hôpitaux se sont développés à une époque où le positivisme devenait une perception prédominante du monde. Le positivisme se fondait sur quatre tendances occidentales: prépondérance de la hiérarchie et de l'autocratie, expansion de la bureaucratie, application généralisée d'une orientation mécaniste au travail et prédominance de l'enquête «scientifique». La théorie organisationnelle s'est en grande partie développée à partir des constatations tirées des recherches quantitatives découlant d'une perception positiviste du monde.

Nous présentons une étude de cas dans laquelle on analyse la structure organisationnelle actuelle des soins infirmiers d'un grand hôpital. On constate que la gestion des soins infirmiers repose sur un paradigme positiviste, à preuve la prédominance de l'orientation mécaniste et une structure autocratique et bureaucratique. On a fait l'essai d'un changement dont l'objet était de passer à la régie partagée, indice d'une évolution vers une structure organisationnelle plus moderne, reposant sur un paradigme différent. L'auteur termine en rappelant que les gestionnaires sont en grande partie responsables de la facilitation du changement, changement qui répondra aux besoins internes de ressources humaines et aux crises de rentabilité des hôpitaux actuels par une utilisation plus efficace des ressources humaines.
The Importance of Exterior Environment for Alzheimer Residents: Effective Care and Risk Management
Authors: Mooney Patrick , Nicell P. Lenore
Published: July 2010

Evidence shows that environments especially designed for cognitively impaired seniors can maintain or increase their level of functioning. Little emphasis has so far been placed on the prosthetic role that may be played by exterior environments. This study attempted to determine the value that specially designed exterior spaces may have in reducing undesired behaviours, thereby minimizing risks to the patients and potential liability to the institution.

The researchers tested that (a) poor environments increase residents' frustrations and can precipitate catastrophic behaviour and (b) freedom of movement and opportunities to avoid crowding, noise and excess stimulation minimize the frequency of aggressive behaviour.

The researchers found that the use of exterior environments reduced incidents of aggressive behaviour, and contributed significantly to a risk management program.
Biomedical and Health Services Research in Canada: A Review
Authors: Eni Godwin O.
Published: July 2010

Using published evidence of research grants, the historical development of funding sources for biomedical and health services research in Canada is discussed. The imbalance between health services research, which includes health services administration and biomedical research, is examined. It is argued that the current funding arrangement should be restructured to accommodate field-based, application research through an independent agency. Needs-focused and integrated research activities that are policy relevant and which involve practitioners are required if current limitations in the system are to be addressed. Thus, health administration as a discipline will receive the necessary technological assistance needed to improve management practices.
A Specialized Home Care Team Does Make a Difference
Authors: Larson Dorothy , Odegard Ralph , Brown N.E.
Published: July 2010

Results of a study done in a large teaching and research facility in Alberta reveal that a specialized home care team can substantially lower the cost of caring for people who are ventilator dependent.

With the assistance of a pulmonary physician, the Respiratory Home Care program has shown excellent results. Patients report that they “feel as safe at home as in the hospital”, and the savings to the health care system are estimated to be about $2,000,000 per year.
Satisfaction of Country Doctors
Authors: Lepnurm Rein , Trowell Mark
Published: July 2010

A survey of doctors in Saskatchewan communities with fewer than 5,000 residents was conducted to determine which factors were important in maintaining job satisfaction. The response rate was 57 percent. A three-item measure of satisfaction linked the doctors' responses to a 62-item questionnaire covering professional and non-professional issues related to their rural practice. Individual variables of importance in explaining satisfaction were family factors ranging from spousal employment to children's education, availability of recreational facilities or activities and entertainment, the opportunity for social interaction, ability to have periodic rests, workload and compensation.
Variability in Nursing Workload within CMGs
Authors: O'Brien-Pallas Linda , Tritchler David , Till James
Published: July 2010

This study examines the differences in workload estimates of three patient classification systems in nursing, within selected Case Mix Groups (CMGs). The amount of variation explained by selected patient-specific variables within CMGs on average nursing workload by each system is also analyzed. Results show that, when patient classification data are used to explain nursing time within the Diagnosis Related Group (DRG) context, absolute hours of care estimates of the various systems may not be equivalent. This inequality may result in biased budget review practices unless relational statements are developed between systems.
Restructuring to Create a Climate for Clinical Excellence in Nursing
Authors: Monk Marilyn C. , Edgar Linda
Published: July 2010

A fundamental responsibility and urgent requirement of health care leaders is to create and develop organizational structures and environments that support nurses and nurses' work—whose ultimate goal is to support the analytical, interpersonal and technical skills that combine with knowledge to produce wise and thoughtful caring. The ways in which structure can facilitate and enhance care delivery often are not clearly understood. This article describes a strategic reorientation and reorganization of the Department of Nursing of the Sir Mortimer B. Davis Jewish General Hospital in Montréal, designed to meet the needs of patients, nurses and the hospital more effectively.
Publicly Financed Competition in Health Care: Legislative Issues
Authors: Muldoon Jacqueline
Published: July 2010

The concept of publicly financed competition serves as a possible strategy for controlling expenditures and improving the efficiency of the health care system in Ontario. Potential cost savings, although rough estimates, for a 10-year period range from $1.0 billion to $1.6 billion, depending upon the model structure. This paper investigates the assumptions and structure of a publicly financed competition proposal and addresses legislative issues concerning the feasibility and desirability of such a system.
La place des considérations économiques et éthiques dans les services de soins intensifs
Authors: Noseworthy Thomas W. , Jacobs Phil
Published: July 2010

Les services de soins intensifs (SSI) maintiennent en vie, mais, dans certains cas, ils prolongent l'agonie; cela occasionne des douleurs physiques, des souffrances morales et des pertes financières considérables. Le traitement des patients revient au moins trois fois plus chers au SSI que dans les autres services hospitaliers; le SSI représente en conséquence l'un des plus importants centres de coûts de l'hôpital. Les pressions économiques nous obligent à porter plus d'attention au choix des patients que l'on admet au SSI et à la durée de leur séjour.

Le personnel soignant des SSI doit soupeser les fondements éthiques de sa conduite et de ses actes. Cette démarche l'amènera probablement à retenir le droit du patient à l'autodétermination et les devoirs d'assistance et de non-nuisance du médecin comme grands axes de la morale en médecine.

Dans les cas particuliers, on peut examiner les intérêts et les droits du patient au moyen d'un modèle circulaire. On base alors les décisions sur les faits médicaux et le pronostic, sur le droit du patient à l'autodétermination, sur le bien du patient et sur les facteurs externes. Le personnel soignant devrait être tenu de prendre en compte tous ces aspects de la situation. Dans ce contexte, la prévention ou la résolution des dilemmes moraux peut avoir lieu dans un cadre clinique plutôt que dans un cadre juridique.
Setting Community Health Goals: One District Health Council's Experience
Authors: Zalot Gary N. , Elson Steve , Capindale-Smith Karen , Rea-Mahoney Angela
Published: July 2010

The Niagara District Health Council has embarked on a strategic planning exercise to develop health goals, objectives and preliminary targets for action. This process was approached in three phases: establishment of a Health Goals Task Force and adoption of the five goals developed by the Premier's Council on Health Strategy; planning and implementation of a Health Goals Consultation Day to involve community members in the identification and priority ranking of objectives; and development of measurable and realistic preliminary targets through consultations with expert groups and individuals. This process is a practical planning tool applicable across sectors and communities.
Aperçu des programmes provinciaux de soins à domicile au Canada
Authors: Richardson Blair G.
Published: July 2010

Le Luccès extraordinaire des soins à domicile dans toutes les régions du pays a provoqué une croissance rapide, un dépassement des ressources par la demande et une fragilisation des services. Les gestionnaires des soins à domicile sont aujourd' hui aux prises avec ces problèmes et de nombreux autres. Quatre questions controversées font l'objet de discussions et de commentaires sur la façon dont elles peuvent (ou doivent) être résolues: a) quels groupes devraient bénéficier des soins à domicile? b) quel devrait être le lien entre les soins à domicile et les autres volets des services de santé? c) la coordination de la gamme de services qui s'adressent aux personnes âgées et d) la gestion des soins à domicile.
L'aménagement des services de santé en français: Le cas de la région du Niagara
Authors: Zalot Gary N. , Langstaff James H.
Published: July 2010

Le plan de santé de la région du Niagara pour les armées 1990 comporte un volet de services en français, et il s'agit d'un effort conjoint du Conseil régional de santé du Niagara (CRSN) et de l'Association canadienne française de l'Ontario (ACFO) dont le mandat est de promouvoir les objectifs et les intérêts des francophones en Ontario.

Le processus d'aménagement entrepris comporte les éléments habituels «objectifs», comme la cueillette de données, l'analyse des données et la rédaction de recommandations. Il comporte aussi des éléments «subjectifs» qui sont abordés dans l'examen des principales tâches: élaboration de la structure du projet; détermination des méthodes de recherche; création d'un réseau de services de santé et de services sociaux connexes; obtention d'un consensus sur le plan d'action définitif.

L'étude a eu pour résultats la rédaction de 23 recommandations qui portent sur cinq secteurs clés et qui feront en sorte que les plans se traduisent dans la réalité de façon tangible pour la collectivité francophone du Niagara.
Executive Performance: The Demands of the 1990s
Authors: Noble Ron
Published: July 2010

Top executivè will be required to have strong leadership skills, combined with solid communication and team-building skills, to move their organizations through a decade that will promise tight fiscal constraint, increasing involvement in the decision-making process from medical staff, trustees, government officials and facility personnel.

The evaluation of the chief executive officer (CEO) will continue along traditional lines with the development of goals and objectives in defined areas of accountability. There will, however, be increased emphasis on the development of measurable standards, and the CEO's ability to lead the organization, motivate the organization's people resources and reallocate resources to meet the organization's mission and the health care needs of the community.
Principles for Funding on a Case Mix Basis: Construction of Case Weights (RIWs)
Authors: Botz Charles K.
Published: July 2010

The construct of Resource Intensity Weights (RIWs) contains implicit financial incentives if they are used for hospital funding purposes. This paper compares the RIW (funding) credit to the expected average per diem cost for each of the new subcategories (typicals, deaths, transfers, signouts and outliers) of Case Mix Groups (CMGs). RIW construction, and inherent incentives for a hospital to reduce costs or length of stay(LOS), differ significantly for each subcategory. At some point or points in a patient's LOS, when RIW credit equals case cost, RIWs are incentive neutral. However, it can also be demonstrated that RIW credit is not generally congruent with average costs on each day of a patient's stay. Financial incentives (both positive and negative) arise when RIW credit and costs differ. Only by being fully aware of these differences can hospitals determine how to respond to the introduction of case mix funding to maintain financial viability. Funding agencies, too, need to appreciate the sometimes subtle policy implications that come with the adoption of RIWs for funding purposes.
The Implications of Urban Social and Economic Realities on Strategic Management of Hospitals
Authors: Shah Narendra , Vatieri Giovanni
Published: July 2010

As Ontario embarks on restructuring its health care system and realigning resources to meet population-based needs, health care providers and planning agencies need to link epidemiological data (a community's socioeconomic, demographics and health status) and assess its implications on hospital utilization trends. A fundamental challenge for hospitals and other providers is to “know their communities” along these lines.

This article summarizes the results of a multidimensional review of a section of a large urban community and integrates it with utilization of acute inpatient beds. General observations are offered for policy makers and hospital management.
Promoting Physician-Nurse Collaboration Throughout the Organization
Authors: Andrews Heather A. , Wensel Ronald H.
Published: July 2010

For health care institutions embracing the total quality approach to management, interdisciplinary collaboration focused on the processes associated with patient care is vital. To attain a vision of effective physician-nurse collaboration, specific initiatives at all levels of the University of Alberta Hospitals have helped to transform the vision into current reality.
Health Promotion: From Concepts to Strategies
Authors: Labonte Ronald
Published: July 2010

Just 20 years ago, health promotion was a little understood aspect of healthcare. Although still secondary to disease treatment, especially in hospitals, it now has gained a great deal of support.

A number of charters, frameworks and reports have been put forth in the last several years which have tried to establish that social conditions and personal actions are also important in determining health, not only physicians and sophisticated medical equipment.

Community leadership, consisting of collective discussion, decision making and action is the key. Two successful groups illustrate how social action can produce beneficial results, and how professionals and agencies can help communities put health promotion into operation.
Physician Impact Analysis: An Imperative for the Modern Hospital
Authors: Carlow Donald R. , Rea Patricia A.
Published: July 2010

In the majority of Canadian hospitals, medical personnel planning is seldom apart of the strategic plan, and the total impact of physician appointments is rarely assessed. By developing a physician impact analysis, the Health Sciences Centre in Winnipeg has attempted to pinpoint key elements associated with physician appointments, such as the impact on financial and physical resources. This development process has been an ongoing one, however, as the institution faced new situations.

Because interrelationships between a teaching hospital and faculties of medicine are multifaceted, implementation of the physician impact analysis process allows a better understanding of the impact of medical personnel recruitment on hospital services, on behalf of both parties.
Cost-Containing Medical Technology
Authors: Manga Pran
Published: July 2010

The types of technologies most likely to contain healthcare costs are ones which (a) bring about a reduction in the volume of contact between the non-institutionalized populations and the medical profession, (b) permit the delivery of services and care in non-institutional settings, (c) enhance self-care or caregiving by the informal sector, and (d) shift the provision of services from the highly trained and costly fee-for-service professions and hospitals to those in the primary care subsector.

To translate new technologies into cost savings or reduction in the rate of growth of healthcare expenditure, provincial governments must make some essential organizational changes and resource allocation decisions. As well, some form of technology assessment, if not essential, would be a very useful adjunct.
Program-Based Quality Assurance: A Reconciliation of Quality Assurance and Program Evaluation
Authors: Rennebohm Heather , O'Brien Nancy
Published: July 2010

This paper addresses the need for action by examining the underlying shortcomings in current quality assurance (QA) principles and programs. An attempt is made to find some solutions through examining theories of program evaluation (PE). Developed through the use of QA and PE principles, a conceptual model for program-based QA is presented, and examples of program-based QA are given. Conclusions are drawn regarding the utility of a properly designed QA program to address the criticisms levied against many current systems.
The Concept of Critical Success Factors (CSFs) as a Planning Tool for Healthcare Managers
Authors: Eni Godwin O.
Published: July 2010

A well-used concept in business, the Critical Success Factor (CSF) is just beginning to be applied to healthcare organizations. This article discusses the utility of the CSF approach to the management of health services, explains how senior healthcare executives can use it to consider, define and direct the planning needs of healthcare organizations, and demonstrates how it can be applied in hospital management.

Managers can use the CSF planning approach to achieve the organization's goals in accordance with its mission, be competitive, and evaluate and restructure existing programs to satisfy needs to meet specific objectives.
Quality of Care and Utilization Management: Contemporary Tools and Strategies
Authors: Harrison Fernande P. , Juzwishin Donald , Roger Rick
Published: July 2010

An effective Quality-Utilization Management Program requires a contemporary and clinically relevant information system. Involvement of the medical staff and support of hospital personnel are critical to implement such a program. Equally important is the commitment of government and community representatives to address hospital quality and utilization issues in the context of the full range of community services.

Outlining the background leading to the inception of a Quality-Utilization Management Program in a multi-hospital system, the authors also present the rationale for selecting a concurrent and retrospective review system.
Enhancing Health — A New Agenda for Ontario
Authors: Chenoy Neville , Jackson Suzanne , Hancock Trevor , Pierre Karin Domnick
Published: July 2010

Recognizing that changes in demography, the social environment, economics, technology and political trends are under-lying factors affecting health, Paradigm Health in Toronto examined these considerations to assess change to achieve a positive vision of health.

Phase I of the study looked at opportunities and threats from the broad external environment affecting health, examined the internal strengths and weaknesses of the present Ontario health system, and analyzed the participants in the system.

Phase II identified the important strategic issues gathered from the environmental study, and the strategies which could deal with these issues.
Partners in Care
Authors: Beyers Marjorie
Published: July 2010

In the United States, healthcare industry changes are affecting the manner in which hospitals and physicians are paid, the number of acute care beds is dwindling, and hospitals are becoming more efficient using the same or slightly reduced resources. These factors are leading to new methods in healthcare delivery, including the formation of partnerships among physicians, nurses, trustees and administrators. Leaders must not only have certain characteristics, but learn methods of business planning and work with cost centres for budgeting. Partnerships between key disciplines are becoming the bridge to the future.
Management Partnerships: Improving Patient Care in Healthcare Organizations of the Future
Authors: Shortell Stephen
Published: July 2010

The hospital of the future will have to be part of a system or network which will provide a continuum of care in primary care services, acute in-patient care and post-hospital care. Additionally, hospitals will become increasingly diversified and, at the same time, integrated, not only horizontally but more importantly, vertically. This amalgamation will be achieved either by acting alone or by a joint venture with another group, through shared services or through contract management.

Technology and computerization will play an even larger role than currently, and there will be tremendous demands placed on the micro and macro levels of management partnership.
Management Partnerships: A Reaction
Authors: Leatt Peggy
Published: July 2010

Although there are important differences that will affect future changes in the Canadian system, health care in Canada often parallels that in the United States.

The concept of the hospital is changing from sickness care to health care. There is a growth of multi-institutional arrangements, bureaucracy is on the rise, and the number of nursing and other allied health professionals is growing.

These trends are having an impact on the physician-nurse-administrator partnerships of program management.
Removing Barriers to Partnerships
Authors: Gill Sandra
Published: July 2010

One of the six corollaries to high quality healthcare identified in a 1987 study indicated that a team approach is required, although it challenges the notion of the professional autonomy of the medical staff. There are both individual and delivery system barriers to formation of partnerships and resistance to the change process. Combined with different views between physicians and executives, partnership building is a complicated process, and a number of recommendations are suggested to promote better relationships.
Who's Caring for the Care Givers—A Nursing Dilemma
Authors: Langill George
Published: July 2010

With our hospital system generally in crisis, exemplified by problems of access, rapid patient turnover and increasing acuity, one of the obvious first breaking points will be with those closest to the patient—our nurses.

Nurses are experiencing increasing stress and burnout, which leads to disillusionment, turnover and attrition. The effect these problems have in enrollment in the care professions, especially nursing, is obvious now with lower enrollment and a general apathy toward the profession.

Nurses view themselves as the tow person on the totem pole of clinical professions, an image which must be improved if people are to choose nursing as their career.
Using Means-End Chains for Analysing Occasions - Not Buyers
Authors: Hall John , Lockshin Larry
Published: July 2010

Understanding consumer's behaviour must take into account both product usage and the situation in which it is used. Little research has combined these two areas. Means-end chains are used to gather information on the attributes, consequences and values associated with product choice and how the use of these vary across occasions. We categorise over 600 chains derived from wine purchases into eight occasions. Our analysis shows the most important elements for each occasion and demonstrates the dominant means-end chains for three occasions and the use of the major chains for positioning and promotion. We conclude that situation-based usage behaviour can be analysed using the means-end chain methodology.
Uncertainty and Opportunity as Determinants of Strategic Alliances: Evidence from Four Case Studies
Authors: Beverland Michael
Published: July 2010

With the emergence of relationship marketing there has been an increased focus on the use of inter-firm relationships or strategic alliances to deliver a total service package to the consumer. Despite a number of studies, there is still much to be learned about why alliances form and why they take the form they do. Based upon case based methodology this research found that the formation of strategic alliances is due to firms seeking out new market opportunities under conditions of increased uncertainty and competition. We argue that alliances are a means of reducing the uncertainty that surrounds the undertaking of new market opportunities. The role of marketing was also examined and was found to be dependent on the strategy and structure of the alliance.
What Can be Done to Enhance the Research Productivity of Junior Staff?
Authors: Uncles Mark
Published: July 2010

Research productivity is a sign of the intellectual vigour of marketing as an academic discipline. However, there are at least three impediments to research productivity: inadequate training, sub-optimal concentrations of research activity, and competing commitments. Initiatives to enhance research productivity must address these issues. This is possible through formal research training and on-the-job practice, by creating research concentrations in physical and virtual space, and by being more efficient. The latter include researching the solvable, pursuing a limited number of lines of inquiry, developing synergies between research and teaching/consulting, and finding partners to assist in fieldwork and analysis.
Mood and Framing Effects in Advertising
Authors: Martin Brett , Lawson Robert
Published: July 2010

This study examines how moods elicited by television programmes influence viewer attitudes, intentions, cognitive responses and recall when considered in conjunction with a commercial's affective tone, and message framing. Three hypotheses are tested addressing: (1) The predictions of the mood congruency and mood consistency models. (2) Whether mood effects for the two models are moderated by self-esteem. (3) The interaction of mood state and message framing.

An experiment using actual television programmes and differentially framed and affectively toned commercials found that sad commercials resulted in more favorable intentions and greater recall than happy commercials under both happy and sad mood conditions. These findings contradict prevailing mood theory, yet are supported by protection motivation theory, cognitive priming, stereotyping and self-discrepancy perspectives. The mood, affective tone and self-esteem interaction was not evident. Framing results support research on the negative bias and the notion that incongruent information prompts more elaborative processing.
A Structured Approach for Presenting Theses
Authors: Perry Chad
Published: July 2010

How should a postgraduate research student present a thesis? This paper provides a structure as a starting point for understanding what a thesis should set out to achieve, and also provides a basis for communication between a student and his or her supervisor. Firstly, criteria for judging a thesis are reviewed and justification for its structure is provided. Then writing style is considered. Finally, each of the five sections are described in some detail: introduction, literature review, methodology, analysis of data, and conclusions and implications.
The ‘Country-Of-Origin Effect’ and Consumer Attitudes to ‘Buy Local’ Campaigns: Australian Evidence
Authors: Cameron Ross C. , Elliott Gregory R.
Published: July 2010

Universally, governments promote the purchase of locally made products via a variety of ‘buy local’ campaigns. The common expectation is that the country-of-origin effect will work systematically to bias purchase preference in favour of locally-made products. Promotional activity employing appeals based on country-of-origin, and the practice of labelling products with the country of origin are premised on this expectation.

A survey of 401 Australian consumers about their evaluations of an ‘Australian Made’ campaign showed high levels of campaign awareness and of its specific appeals, together with attitudes highly favourable to both the underlying concept and the operation of the campaign. These attitudes were widely held by respondents. Moreover, awareness and favourable attitudes towards the campaign were found to be associated with purchase predispositions, suggesting potential for behavioural change as an outcome of such campaigns.
Perspectives on Academic Publishing: Advice for Those Just Starting
Authors: Polonsky Michael J. , Lawson Rob , Uncles Mark , Johnson Lester W. , Wilkinson Ian , Alpert Frank
Published: July 2010

Advice on academic publishing is offered for those just starting their research careers. Themes include: how to link teaching, administration and consulting to research; the benefits and challenges of co-authorship; how to develop a publication strategy; ways to develop a publication portfolio and how to target journals; and how to deal with comments from reviewers and the rejection of a paper.
A Review of the ‘Value’ Literature and Implications for Relationship Marketing
Authors: Payne Adrian , Holt Sue
Published: July 2010

The creation and delivery of value to customers is of increasing interest to researchers and practitioners. This paper identifies and reviews nine core streams of literature that have been influential on current research in the field of customer value. It argues that while much of the literature has focused on value creation for the customer, the relationship-marketing paradigm demands a broader view that includes other stakeholders. Two new perspectives that fit this broader view, customer value and shareholder value and relationship value are investigated and the implications of integrating a value orientation with a relationship marketing approach are discussed.
Total Relationship Marketing: Experimenting with a Synthesis of Research Frontiers
Authors: Gummesson Evert
Published: July 2010

This article examines theoretical contributions to a comprehensive relationship marketing concept, total relationship marketing. With reference to modern natural sciences and the new mathematics as well as social sciences, the author claims that interaction in networks of relationships constitutes both the essence of life itself and the essence of society. Marketing is myopic in just applying the perspective of its own discipline and not properly considering the context within which marketing operates. The article offers an overview of the contributions to total relationship marketing from traditional consumer goods marketing, services marketing, business marketing, total quality management, new organisation theory, and new accounting theory. The article is the outcome of inductive and theory-generating research.
Marketing Relationships in a Computer-Mediated Environment
Authors: Davis Robert , Buchanan-Oliver Margo
Published: July 2010

We propose a conceptual model of the retailer-consumer relationship in a computer-mediated environment (CME) and suggest that a trust-based approach to consumer marketing relationships be applied. We believe that the relationship between the retailer and their customers can be defined through the dis-confirmation of expected virtual (service brand related) and real (service process related) experiences of flow while shopping on-line.

We argue that the consumer has two experiential images in their mind in the interaction between the consumer and on-line shopping CME: (1) the inter-organisational service brand and, (2) the inter-organisational service process interaction. Consequently, the consumer assesses their overall quality of the on-line shopping service experience through the phenomenological process of dis-confirmation. That is, high levels of service quality are perceived when the actual- real service experience is greater than the expected- virtual experience resulting in the development of trust. In the long term this leads to consumer motivation to the service brand and can be described as leading to loyalty (customer retention) to the on-line shopping service.

The paper uses the setting of an interactive home-shopping supermarket to examine the changing nature of relationships in a computer-mediated environment. We present a discussion of preliminary, qualitative, empirical evidence from executive interview case studies that support our propositions. Implications and future research directions are also considered.
Language and Its Effects on Advertising Modality: The Case of Chinese and English
Authors: Hung Kineta , Heeler Roger M.
Published: July 2010

This study examines how visual and musical stimuli contribute to perceived trendiness of the commercial across native Chinese- and English-speakers. Research results indicate that, though visual stimuli have stronger effects on both Chinese- and English-speakers, visual stimuli have stronger effects on Chinese-speakers than English-speakers. These findings are consistent with suggested differences between the Chinese and English language that could have affected the processing orientation of native speakers. The implications of the results are discussed.
A Preliminary Study Investigating the Mere Exposure Effect Using Divided and Full Attention Conditions
Authors: Sutherland Scott , Gabbott Mark , Jackson Kerryn
Published: July 2010

There has been considerable concern exposed by marketers and advertisers about the effectiveness of different forms of message presentation. This, in turn has fuelled an on-going debate about the most efficient means of measuring advertising effectiveness. Two experiments were conducted with undergraduate and postgraduate students to investigate the application of mere exposure to marketing practice. Results indicate support for the use of mere exposure in developing consumers’ liking for a previously unfamiliar brand. Results also showed limited support for the mere exposure effect under the presentation of stimuli with divided attention. No support was found for the correction process proposed by Bornstein and D'Agostino (1992; 1994), with a greater mere exposure effect under full attention (supraliminal presentation of stimuli) than under divided attention (subliminal presentation of stimuli). The implications for applying mere exposure to the planning, placement, pricing and measurement of advertising, are discussed.
Trans-8,cis-10+cis-9,trans-11-conjugated linoleic acid mixture alters body composition in Syrian golden hamsters fed a hypercholesterolaemic diet
Authors: Joseph Shama V. , Liu Xiaoran , Wakefield Andrew , Chouinard P. Yvan , Aukema Harold , Jones Peter J. H. , Jacques Hélène
Published: July 2010

The effectiveness of conjugated linoleic acid (CLA) as a weight-loss nutraceutical continues to be debatable, suggesting that there may be value in exploring the physiological effects of the lesser-known isomers. The effects of the minor isomer,trans-8,cis-10 (t8,c10)-CLA, in the form of an equimolar mixture with thecis-9,trans-11 (c9,t11) isomer, on body weight and body composition, circulating glucose and lipid concentrations, and liver weights were studied in sixty male Syrian golden hamsters. Animals were randomised to receive for 28 d a semi-purified, hypercholesterolaemic diet (5 % dietary fat and 0·25 % cholesterol) supplemented at the 2 % level with either thet8,c10+c9,t11-CLA mixture,c9,t11-CLA ortrans-10,cis-12 (t10,c12)-CLA replacing lard and safflower-seed oil (control). Results show that compared with control, thet8,c10+c9,t11-CLA mixture andt10,c12-CLA-fed animals had lower (P < 0·0001) fat mass following supplementation. Animals consumingt10,c12-CLA also possessed higher lean mass compared with control andc9,t11-CLA groups (P < 0·001). However, the livers of these animals were larger (P < 0·0001) compared with those in the control and other CLA groups. Body weights of the hamsters did not differ across the experimental groups. CLA treatments had no effect on serum glucose or lipid profile, except for inducing higher (P < 0·05) non-HDL-cholesterol concentration witht10,c12-CLA compared with thec9,t11 isomer. Overall, these results indicate that in male hamsters fed a hypercholesterolaemic diet, thet8,c10+c9,t11-CLA mixture does not have an impact on blood lipid profile, but is able to effectively reduce fat mass, without incurring an accompanying liver enlargement.