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The purpose of this paper is to describe standardized clinical process of care and quality performance metrics at Roane Medical Center (RMC) and compare data from 2005 to 2015.

Information was extracted from a nationwide sample of short-term acute care hospitals using the Hospital Quality Alliance (HQA) database, evaluating multiple parameters measured at RMC. HQA data from RMC were matched against state and national benchmarks; findings were also compared with similar reports from the same facility in 2005.

Information collected by HQA expanded substantially in ten years and queried different parameters over time, thus exact comparisons between 2005 and 2015 cannot be easily calculated. Nevertheless, analysis of process of care data for 2015 placed RMC at or above state- and national-average performance in 64.9 percent (24 of 37) and 56.5 percent (26 of 46) categories, respectively. RMC registered superior process of care scores in heart failure care, pneumonia care, thrombus prevention and care, as well as stroke care. While RMC continues to perform favorably against state and national reference groups, the differences between RMC vs state and RMC vs national averages using current reporting metrics were both statistically smaller in 2015 compared to 2005 (p<0.05).

Perhaps the most significant interval health event for the RMC service area since 2005 was a coal ash spill at the nearby Tennessee Valley Authority facility in December 2008. Although reports on environmental and health effects following one of the largest domestic industrial toxin releases reached a number of important conclusions, the consequences for RMC in terms of potential added clinical burden on emergency services and impact on chronic health conditions have not been specifically studied. This could explain data reported on emergency department services at RMC but additional research will be needed to establish causality.

While tracking of care processes at all US hospitals will be facilitated by refinements in HQA tools, longitudinal evaluations for any specific unit will be more meaningful if the assessment instrument undergoes limited change over time.

Appalachia remains one of several regions in the USA often identified as medically underserved. Hospitals here have confronted the challenge of diminished reimbursement, high expenses, limited staffing and other financial hardships in a variety of ways. Since the last published report on RMC, a particularly severe global recession has placed additional stress on organizations offering crucial health services in the region.

As a follow-up study to track potential changes which have been registered in the decade 2005-2015, this is the first report to provide original, longitudinal analysis on RMC, an institution operating in a rural and underserved area.

The paper aims to study the relationship between hospital quality and hospital profits for a sample of 88 Alabama hospitals.

Quality is measured by three groups of procedures performed on newly admitted patients as suggested by the health quality alliance (HQA). Profit is measured for eight hospital services. Regression analyses tested the underlying relationships.

Quality of care for newly admitted cardiac and pneumonia patients are indicators of quality translatable into profits. Given a choice between the two, the pneumonia procedures were more effective in predicting profits.

As one of the early extensions of the HQA methodology, this paper does demonstrate linkages between quality and profits. Total number of employees was not significant, but governmental versus non‐governmental hospital analyses provide promise for future research.

Management of subsidiaries of multinational companies and subsidiary evolution have emerged as important topics in the international business literature. This strand of literature on multinational subsidiaries has provided the necessary analytical models and research tools to study the phenomenon. Nonetheless, while many studies exist on the roles, strategies and evolutions of subsidiaries, and despite its high importance, this area of academic research is still lacking critical mass. Moreover, the extant studies have been conducted in the context of advanced economies, and yet it has been under-researched in the context of emerging economies, and particularly the economies of Eastern Europe, the so-called new EU member states. The study of the phenomenon of subsidiary evolution is the main aim of this paper.

The paper makes use of a proprietary dataset, collected in a self-administered web-based survey conducted among foreign-owned companies in Czech Republic, Hungary and Poland. To test the interrelations between different variables, the paper uses the structural equitation modelling, an advanced technique that allows to account for multiple interdependencies in a model. This approach enables the authors to escape the rigid division between dependent and independent variables, inherent to most conventional econometric models. In the paper, three analytical structural equation modelling (SEM) models were developed, tested and compared.

The empirical analyses show a strong positive relation between the main drivers of subsidiary evolution and the key outcomes of this process. It shows that the tenets of the theory originally developed to describe strategic behaviour of subsidiaries in advanced Western countries, broadly holds for emerging economies too. Moreover, the paper shows that subsidiaries operating in dynamic environments and led by pro-active subsidiary management achieve better results.

The study has its limitations. It is of quantitative nature, whereby the most common feature and characteristics of the research object are studied. Despite the convincing results, the phenomenon of subsidiary evolution can be further investigated in a number of case studies in a dynamic perspective, where specific details may come under the spotlight. On the other hand, such results cannot be easily generalised.

This study contributes to the extant body of academic literature on subsidiary evolution. The main contribution comes from investigation of this complex phenomenon in the context of emerging economies of new EU member states. Their transitionary dynamics and transformative change have had a profound impact on the functioning of economic agents and foreign subsidiaries in particular. The paper finds important particularities of this context.

In community question and answer (CQA) services, because of user subjectivity and the limits of knowledge, the distribution of answer quality can vary drastically – from highly related to irrelevant or even spam answers. Previous studies of CQA portals have faced two important issues: answer quality analysis and spam answer filtering. Therefore, the purposes of this study are to filter spam answers in advance using two-phase identification methods and then automatically classify the different types of question and answer (QA) pairs by deep learning. Finally, this study proposes a comprehensive study of answer quality prediction for different types of QA pairs.

This study proposes an integrated model with a two-phase identification method that filters spam answers in advance and uses a deep learning method [recurrent convolutional neural network (R-CNN)] to automatically classify various types of questions. Logistic regression (LR) is further applied to examine which answer quality features significantly indicate high-quality answers to different types of questions.

There are four prominent findings. (1) This study confirms that conducting spam filtering before an answer quality analysis can reduce the proportion of high-quality answers that are misjudged as spam answers. (2) The experimental results show that answer quality is better when question types are included. (3) The analysis results for different classifiers show that the R-CNN achieves the best macro-F1 scores (74.8%) in the question type classification module. (4) Finally, the experimental results by LR show that author ranking, answer length and common words could significantly impact answer quality for different types of questions.

The proposed system is simultaneously able to detect spam answers and provide users with quick and efficient retrieval mechanisms for high-quality answers to different types of questions in CQA. Moreover, this study further validates that crucial features exist among the different types of questions that can impact answer quality. Overall, an identification system automatically summarises high-quality answers for each different type of questions from the pool of messy answers in CQA, which can be very useful in helping users make decisions.

The purpose of this study is to compare of the way intellectual capital (IC) is disclosed in the websites of the universities in three European countries to assess the way universities decide to communicate IC to their stakeholders and identify potential patterns and trends. In addition, the relation between the level and the type of IC Web disclosure in universities and academic rankings as a proxy of performance is explored to reveal interrelations.

The study is based on a sample of 128 universities coming from Greece (22), Italy (58) and Spain (48). The websites of the universities are content-analysed to measure the level of IC disclosure. The IC disclosure metrics are then correlated with the academic rankings of the World Ranking.

While the level of IC disclosure among universities and among countries is not homogeneous, human capital and internal capital items are more heavily disclosed compared to external capital items in all three countries. In addition, larger universities in terms of number of students tend to disclose more on IC. Moreover, there is a positive correlation between the level of IC Web disclosure and the academic ranking that challenges the IC disclosure strategies followed by the universities.

The paper represents an innovative contribution to the existing literature as it investigates websites to assess the level of IC disclosure provided by universities in a comparative perspective. Furthermore, it analyses the relationship between the online IC disclosure and European universities’ academic rankings and provides evidence on the interaction between the IC disclosure and the ecosystem in which the universities operate contributing to the fourth stage of IC research.

As the world of healthcare changes rapidly, healthcare leaders and managers must hone their leadership competencies in order to remain effective in their organizations. With changes such as the Affordable Care Act, increasing medical school costs, decreased graduation rates, and increased needs for care, how are current and future healthcare leaders adapting? In light of the large-scale changes in the healthcare field in recent years, the purpose of this study was to investigate which National Center for Healthcare Leadership (NCHL) competencies were referenced by exemplary healthcare leaders as most important for success in today’s changing healthcare environment. Interviews were conducted with 26 mid- and upper-level healthcare leaders identified by the C-level executives in their organizations as exemplary performers. Change leadership, self-development, talent development, and team leadership were the top four NCHL competencies most frequently referenced, with thematic analysis revealing additional underlying themes in the exemplary leaders’ dialogue.

The purpose of this paper is to introduce the concept of an Enterprise Risk Scorecard.

With the accelerating growth in global risk levels leading to an intense current demand for risk management solutions, an analysis was conducted on whether a scorecard framework could be applied to risk measurement. This analysis included a survey of Kaplan and Norton's voluminous and seminal writings on the Balanced Scorecard, in which, surprisingly, relatively little on the measurement of risk was found.

The findings suggest that a scorecard framework could be an effective risk measurement, management and communication tool. For both design and organizational reasons it is recommended that risk scorecards be separate from performance scorecards.

Utilizing two scorecards – one for performance and a separate one for risk – could provide strategy‐focused organizations with a more comprehensive diagnostic control system. The research implications of this approach could be significant, as it essentially opens up a new field of research.

This is assumed to be the first formal paper on risk and a scorecard framework. Previous work on integrating risk measurement frameworks is very different from the approach proposed here.

By the view of attention-building activities as “tools of power,” the authors investigate the impact of subsidiary involvement in attention-building activities on the strategic influence of subsidiaries within multinational corporations (MNCs).

The study is based on survey data from 110 international subsidiaries located in Sweden. Five hypotheses were tested using structural equation modeling with linear structural relations.

The study shows that organizational commitment and external scouting activities, as two attention-building activities, do not directly affect the ability of subsidiaries to gain a strategic influence in MNCs. Rather, the results provide support for the importance of headquarters’ positive attention as a mediator between such activities and subsidiary strategic influence. This implies that subsidiaries do not receive any strategic influence through these activities unless they receive explicit positive attention from the corporate headquarters.

This study contributes to the micro-political view of the MNC by offering insights into the impact of attention-building activities of subsidiaries as a potential source of strategic influence for MNC subsidiaries.