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Article
Publication date: 5 January 2024

Ahmed Diab

The study examines how calculative practices and accountability appear in a rural community of marginalised people in Egypt who depend on jasmine plantations that contribute to…

Abstract

Purpose

The study examines how calculative practices and accountability appear in a rural community of marginalised people in Egypt who depend on jasmine plantations that contribute to the production of global essences.

Design/methodology/approach

The data were collected from various sources, namely conversations with villagers, documents and relevant videos and news available on social media and the Internet. This study draws on the concepts of social accountability, the politics of blame avoidance and using calculative practices as a language to explain accountability in context.

Findings

The author found a lack of accountability on the part of the government and business owners, with serious implications for the livelihoods of people in a community that has been wholly dependent on jasmine plantations for a century. Power holders have deployed a blame-shifting game to avoid social responsibility. In response, calculative practices rather than advanced accounting tools are used by the poor in the community to induce power holders to be accountable.

Social implications

The findings of this study show that authorities need to take proactive steps to address the disadvantaged position of powerless people in the lower echelons of society, recognising their accountability for those people.

Originality/value

This paper enhances the understanding of the status of calculative practices and accountability in a community of marginalised people who contribute to the production of global commodities. The paper also enhances the understanding of what goes on behind the scenes with popular and prestigious commodities, whose development is initiated in poor countries, with the end product marketed in rich Western countries.

Details

Journal of Accounting in Emerging Economies, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-1168

Keywords

Open Access
Article
Publication date: 8 March 2023

Rianne Appel-Meulenbroek and Vitalija Danivska

Business case (BC) analyses are performed in many different business fields, to create a report on the feasibility and competitive advantage of an intervention within an existing…

1662

Abstract

Purpose

Business case (BC) analyses are performed in many different business fields, to create a report on the feasibility and competitive advantage of an intervention within an existing organisation to secure commitment from management to invest. However, most BC research papers on decisions regarding internal funding are either based on anecdotal insights, on analyses of standards from practice, or focused on very specific BC calculations for a certain project, investment or field. A clear BC process method is missing.

Design/methodology/approach

This paper aims to describe the results of a systematic literature review of 52 BC papers that report on further conceptualisation of what a BC process should behold.

Findings

Synthesis of the findings has led to a BC definition and composition of a 20 step BC process method. In addition, 29 relevant theories are identified to tackle the main challenges of BC analyses in future studies to make them more effective. This supports further theoretical development of academic BC research and provides a tool for BC processes in practice.

Originality/value

Although there is substantial scientific research on BCs, there was not much theoretical development nor a general stepwise method to perform the most optimal BC analysis.

Details

Business Process Management Journal, vol. 29 no. 8
Type: Research Article
ISSN: 1463-7154

Keywords

Book part
Publication date: 7 February 2024

Tory H. Hogan, Larry R. Hearld, Ganisher Davlyatov, Akbar Ghiasi, Jeff Szychowski and Robert Weech-Maldonado

High-quality nursing home (NH) care has long been a challenge within the United States. For decades, policymakers at the state and federal levels have adopted and implemented…

Abstract

High-quality nursing home (NH) care has long been a challenge within the United States. For decades, policymakers at the state and federal levels have adopted and implemented regulations to target critical components of NH care outcomes. Simultaneously, our delivery system continues to change the role of NHs in patient care. For example, more acute patients are cared for in NHs, and the Center for Medicare and Medicaid Services (CMS) has implemented value payment programs targeting NH settings. As a part of these growing pressures from the broader healthcare delivery system, the culture-change movement has emerged among NHs over the past two decades, prompting NHs to embody more person-centered care as well as promote settings which resemble someone's home, as opposed to institutionalized healthcare settings.

Researchers have linked culture change to high-quality outcomes and the ability to adapt and respond to the ever-changing pressures brought on by changes in our regulatory and delivery system. Making enduring culture change within organizations has long been a challenge and focus in NHs. Despite research suggesting that culture-change initiatives that promote greater resident-centered care are associated with several desirable patient outcomes, their adoption and implementation by NHs are resource intensive, and research has shown that NHs with high percentages of low-income residents are especially challenged to adopt these initiatives.

This chapter takes a novel approach to examine factors that impact the adoption of culture-change initiatives by assessing knowledge management and the role of knowledge management activities in promoting the adoption of innovative care delivery models among under-resourced NHs throughout the United States. Using primary data from a survey of NH administrators, we conducted logistic regression models to assess the relationship between knowledge management and the adoption of a culture-change initiative as well as whether these relationships were moderated by leadership and staffing stability. Our study found that NHs were more likely to adopt a culture-change initiative when they had more robust knowledge management activities. Moreover, knowledge management activities were particularly effective at promoting adoption in NHs that struggle with leadership and nursing staff instability. Our findings support the notion that knowledge management activities can help NHs acquire and mobilize informational resources to support the adoption of care delivery innovations, thus highlighting opportunities to more effectively target efforts to stimulate the adoption and spread of these initiatives.

Book part
Publication date: 7 February 2024

Anne M. Hewitt

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public…

Abstract

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

Article
Publication date: 23 June 2020

Nicole F. Stowell, Carl Pacini, Martina K. Schmidt and Nathan Wadlinger

This study aims to increase awareness and educate the reader about health-care fraud targeting seniors in the USA to help stakeholders better understand, recognize and prevent…

Abstract

Purpose

This study aims to increase awareness and educate the reader about health-care fraud targeting seniors in the USA to help stakeholders better understand, recognize and prevent this type of fraud.

Design/methodology/approach

This paper collects statistics on the current state of health care frauds committed against seniors, and examines related cases and laws.

Findings

The authors find this type of fraud is highly prevalent and expected to increase. Current laws preventing this fraud from occurring are multifold and complex. While prevention strategies through law enforcement have been somewhat successful, a reduction in resources may put seniors at an increased risk in the years to come.

Research limitations/implications

Without additional prevention strategies, the problem will likely escalate with a growing population of older adults. This study encourages further research into effective prevention strategies and methods to fight health-care fraud against seniors.

Practical implications

Health-care fraud and its associated costs pose a significant threat to the society and economy of the USA. Reducing this fraud will not only reduce the costs to the US economy but also improve the physical and mental well-being of senior victims, reduce their mortality and hospitalization rates and improve the public trust placed to health-care providers.

Originality/value

This study highlights how health-care fraud is committed against seniors. With the projected trend of an aging US population, educating stakeholders, increasing awareness and applying tools to protect seniors will be important to reduce the absolute scope of this problem in the future.

Book part
Publication date: 7 February 2024

Nathan W. Carroll, Shu-Fang Shih, Saleema A. Karim and Shoou-Yih D. Lee

The COVID-19 pandemic created a broad array of challenges for hospitals. These challenges included restrictions on admissions and procedures, patient surges, rising costs of labor…

Abstract

The COVID-19 pandemic created a broad array of challenges for hospitals. These challenges included restrictions on admissions and procedures, patient surges, rising costs of labor and supplies, and a disparate impact on already disadvantaged populations. Many of these intersecting challenges put pressure on hospitals' finances. There was concern that financial pressure would be particularly acute for hospitals serving vulnerable populations, including safety-net (SN) hospitals and critical access hospitals (CAHs). Using data from hospitals in Washington State, we examined changes in operating margins for SN hospitals, CAHs, and other acute care hospitals in 2020 and 2021. We found that the operating margins for all three categories of hospitals fell from 2019 to 2020, with SNs and CAHs sustaining the largest declines. During 2021, operating margins improved for all three hospital categories but SN operating margins still remained negative. Both changes in revenue and changes in expenses contributed to observed changes in operating margins. Our study is one of the first to describe how the financial effects of COVID-19 differed for SNs, CAHs, and other acute care hospitals over the first two years of the pandemic. Our results highlight the continuing financial vulnerability of SNs and demonstrate how the factors that contribute to profitability can shift over time.

Details

Research and Theory to Foster Change in the Face of Grand Health Care Challenges
Type: Book
ISBN: 978-1-83797-655-3

Keywords

Book part
Publication date: 7 February 2024

Clair Reynolds Kueny, Alex Price and Casey Canfield

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower…

Abstract

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

Details

Research and Theory to Foster Change in the Face of Grand Health Care Challenges
Type: Book
ISBN: 978-1-83797-655-3

Keywords

Case study
Publication date: 1 January 2024

John McVea, Daniel McLaughlin and Danielle Ailts Campeau

The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and…

Abstract

Theoretical basis

The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and Woerner, 2015) and is referred to as the W & W framework. This approach provides a useful structure for thinking through the strategic options facing environments ripe for digital transformation.

Research methodology

Research for this case was conducted through face-to-face interviews with the protagonist, as well as through a review of their business planning documents and other data and documentation provided by the founder. Some of the market and industry data were obtained using secondary research and industry reports. Interviews were digitally recorded and transcribed to ensure accuracy.

Case overview/synopsis

The case follows the story of Kurt Waltenbaugh, a Minnesota entrepreneur who shared the dream of using data analytics to reduce costs within the US health-care system. In early 2014, Waltenbaugh and a physician colleague founded Carrot Health to bring together their personal experience and expertise in both consumer data analytics and health care. From the beginning, they focused on how to use data analytics to help identify high-risk/high-cost patients who had not yet sought medical treatment. They believed that they could use these insights to encourage early medical interventions and, as a result, lower the long-term cost of care.

Carrot’s initial success found them in a consultative role, working on behalf of insurance companies. Through this work, they honed their capabilities by helping their clients combine existing claims data with external consumer behavioral data to identify new potential customers. These initial consulting contracts gave Carrot the opportunity to develop its analytic tools, business model and, importantly, to earn some much-needed cash flow during the start-up phase. However, they also learned that, while insurance companies were willing to purchase data insights for one-off market expansion projects, it was much more difficult to motivate them to use data proactively to eliminate costs on an ongoing basis. Waltenbaugh believed that Carrot’s greatest potential lay in their ability to develop predictive models of health outcomes, and this case explores Carrot’s journey through strategic decisions and company transformation.

Complexity academic level

This case is intended for either an undergraduate or graduate course on entrepreneurial strategy. It provides an effective introduction to the unique structure and constraints which apply to an innovative start-up within the health-care industry. The case also serves as a platform to explore the critical criteria to be considered when developing a digital transformation strategy and exposing students to the digital business model developed by Weill and Woerner (2015) at MIT (referred to in this instructor’s manual as the W&W framework). The case was written to be used in an advanced strategy Master of Business Administration (MBA) class, an undergraduate specialty health-care course or as part of a health-care concentration in a regular MBA, Master of Health Care Administration (MHA) or Master of Public Health (MPH). It may be taught toward the end of a course on business strategy when students are building on generic strategy frameworks and adapting their strategic thinking to the characteristics of specific industries or sectors. However, the case can also be taught as part of a course on health-care innovation in which case it also serves well as an introduction to the health-care payments and insurance system in the USA. Finally, the case can be used in a specialized course on digital transformation strategy in which case it serves as an introduction to the MIT W&W framework.

The case is particularly well-suited to students who are familiar with traditional frameworks for business strategy and business models. The analysis builds on this knowledge and introduces students interested in learning about the opportunities and challenges of digital strategy. Equally, the case works well for students with clinical backgrounds, who are interested in how business strategy can influence changes within the health-care sphere. Finally, an important aspect of the case design was to develop students’ analytical confidence by encouraging them to “get their hands dirty” and to carry out some basic exploratory data analytics themselves. As such, the case requires students to combine and correlate data and to experience the potentially powerful combination of clinical and consumer data. Instructors should find that the insights from these activities give students unique insights into the potential for of data analytics to move health care from a reactive/treatment ethos to a proactive/intervention ethos. This experience can be particularly revealing for students with clinical backgrounds who may initially be resistant to the use of clinical data by commercial organizations.

Details

The CASE Journal, vol. ahead-of-print no. ahead-of-print
Type: Case Study
ISSN: 1544-9106

Keywords

Book part
Publication date: 7 February 2024

Minakshi Raj

Family care partners are significantly involved in healthcare tasks in order to support adult relatives. Yet, unlike pediatric models of care where caregivers of children are…

Abstract

Family care partners are significantly involved in healthcare tasks in order to support adult relatives. Yet, unlike pediatric models of care where caregivers of children are formally integrated into healthcare teams, care partners of adults are rarely engaged in a formal, structured, or consistent manner. Their inclusion in the healthcare team is critical to their capacity to continue supporting their relative. A meaningful dialogue between policy and healthcare management is required to identify feasible and effective ways of engaging family care partners in healthcare teams.

Details

Research and Theory to Foster Change in the Face of Grand Health Care Challenges
Type: Book
ISBN: 978-1-83797-655-3

Keywords

Book part
Publication date: 12 December 2023

Monica Bhatia

A growing body of literature suggests that creating a just sustainable society will require reorganizing economic arrangements and, in particular, rethinking work. Previous…

Abstract

A growing body of literature suggests that creating a just sustainable society will require reorganizing economic arrangements and, in particular, rethinking work. Previous studies have recognized alternative organizations, such as cooperatives and intentional communities, as sites for building more democratic, sustainable models of work. This study contributes a description and analysis of work and sustainability at Twin Oaks Intentional Community, an 80-person income- and resource-sharing commune in Louisa, Virginia. Some measures show that Twin Oaks members live more sustainably in terms of energy consumption than the average US resident. In this article, I investigate the relationship between sustainability and work at Twin Oaks. I find that sustainable work is linked to the following key principles: broadening definitions of work, prioritizing community well-being, and democratizing decision making. In doing so, I contribute to previous literature on work, sustainability, and alternative organizations by suggesting that (1) sustainability in intentional communities is deeply intertwined with systems of work; (2) broadening definitions of work to include social reproductive labour contributes to sustainability; and (3) the democratization of work can further goals of sustainability.

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