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Many accounting departments have implemented assurance of learning (AoL) processes in the last few years because accreditation agencies have mandated it. In prior articles, we described an early assessment process (Stivers, Campbell, & Hermanson, 2000), a revised assessment process, and a suggested systems-oriented methodology for implementing an AoL process (Hill & Campbell, 2007). The purpose of this article is to provide the post-implementation review of our revised AoL process. We evaluate whether the AoL process is meeting the users’ goals effectively and efficiently. To do this, we provide the feedback we received from our Association to Advance Collegiate Schools of Business (AACSB) accreditation visit, the results of a faculty survey, and some output from our AoL system. Our review indicates that while the AACSB accreditation team viewed our AoL process as a “best practice,” the faculty members evaluated the process less positively. Faculty members were concerned about the number and clarity of the learning goals, the usefulness of the information generated, and the cost/benefit of the process with respect to the time involved. We conclude that different goals for the AoL process, accountability versus course improvement, drive the difference in opinion between the accreditation team and the faculty. Changes in senior management in the college along with faculty opinions have led to significant changes in the college’s AoL process including changing the name from AoL to TLC (Teaching and Learning Community). The results of this research emphasize the importance of treating the AoL program as a dynamic process that must be periodically evaluated to determine if it is meeting the organizations’ goals for the process. If the AoL program is not meeting goals or costing too much to meet them, then it should be revised and improved.

Inappropriate cardiac monitoring leads to increased hospital resource utilization and alarm fatigue, which is ultimately detrimental to patient safety. Our institution implemented a continuous cardiac monitoring (CCM) policy that focused on selective monitoring for patients based on the American Heart Association (AHA) guidelines. The primary goal of this study was to perform a three-year median follow-up review on the longitudinal impact of a selective CCM policy on usage rates, length of stay (LOS), and mortality rates across the medical center. A secondary goal was to determine the effect of smaller-scale interventions focused on reeducating the nursing population on the importance of cardiac alarms.

A system-wide policy was developed at The Ohio State University in December 2013 based on guidelines for selective CCM in all patient populations. Patients were stratified into Critical Class I, II, and III with 72 hours, 48 hours, or 36 hours of CCM, respectively. Pre- and post-implementation measures included average cardiac monitoring days (CMD), emergency department (ED) boarding rate, mortality rates, and LOS. A 12-week evaluation period was analyzed prior to, directly after, and three years after implementation.

There was an overall decrease of 53.5% CMDs directly after implementation of selective CCM. This had remained stable at the three-year follow-up with slight increase of 0.5% (p = 0.2764). Subsequent analysis by hospital type revealed that the largest and most stable reductions in CMD were in noncardiac hospitals. The cardiac hospital CMD reduction was stable for roughly one year, then dipped into a lower stable level for nine months, then returned to the previous post-implementation levels. This change coincided with a smaller intervention to further reduce CMD in the cardiac hospital. There was no significant change in mortality rates with a slight decrease of 3.1% at follow-up (p = 0.781). Furthermore, there was no significant difference in LOS with a slight increase of 1.1% on follow-up (p = 0.649). However, there was a significant increase in ED boarding rate of 7.7% (p < 0.001) likely due to other hospital factors altering boarding times.

Implementing selective CCM decreases average cardiac monitoring rate without affecting LOS or overall mortality rate. Selective cardiac monitoring is also a sustainable way to decrease overall hospital resource utilization and more appropriately focus on patient care.

The Institute of Medicine (IOM) views Health Information Technology (HIT) as an essential organizational prerequisite for the delivery of safe, reliable, and cost-effective health services. However, HIT presents the proverbial double-edged sword in generating solutions to improve system performance while facilitating the genesis of novel iatrogenic problems. Incongruent organizational processes give rise to technological iatrogenesis or the unintended consequences to system integrity and the resulting organizational outcomes potentiated by incongruent organizational–technological interfaces. HIT is a disruptive innovation for health services organizations but remains an overlooked organizational development (OD) concern.

Recognizing the technology–organizational misalignments that result from HIT adoption is important for leaders seeking to eliminate sources of system instability. The Health Information Technology Iatrogenesis Model (HITIM) provides leaders with a conceptual framework from which to consider HIT as an instrument for organizational development. Complexity and Diffusion of Innovation theories support the framework that suggests each HIT adoption functions as a technological change agent. As such, leaders need to provide operational oversight to managers undertaking system change via HIT implementation. Traditional risk management tools, such as Failure Mode Effect Analysis and Root Cause Analysis, provide proactive pre- and post-implementation appraisals to verify system stability and to enhance system reliability. Reconsidering the use of these tools within the context of a new framework offers leaders guidance when adopting HIT to achieve performance improvement and better outcomes.

When responsibility for an individual patient is transferred within or between groups of medical professionals, a “handoff” occurs so that patient-specific medical information can be provided to the medical professional(s) assuming responsibility for that patient. Providing an appropriate summary supports safe, high-quality, effective medical care; inadequate or incorrect information may create risk for the patient. A handoff approach was developed to facilitate this process, using the mnemonic “S*T*A*R*T” (S: situation; T: therapies; A: anticipated course; R: reconciliation; T: transfer). Surveys of handoffs occurring before and after introduction of the S*T*A*R*T system document areas with potential for process improvement.

This research aims to investigate the process of value creation, value delivery, and value capture in project-based companies. Most previous research focused on companies that operate regularly and offer manufactured products or services. This research used companies in the field of information technology that developed software to explain how value creation, value delivery, and value capture occurred. A case study with qualitative research was applied to analyze between cases. Empirical findings showed that companies carry out six activities to ensure that value creation, value delivery, and value capture can be realized in the software development process. The six activities were iterative and not a rigid sequence. This research was limited to the software industry, and further research can test the results of this study by using a survey to increase the generalizability theory developed in this study.

We investigate the interaction of debt covenants and tax accounting on the adoption of Financial Interpretation No. 48 (FIN 48). We examine how firms respond to the potential tightening of covenant slack upon FIN 48 adoption and whether these actions are penalized by creditors and anticipated by equity markets. We find that upon FIN 48 adoption, the majority of sample corporate borrowers increase their tax reserves and reduce equity. Firms close to debt covenant violation were even more likely to increase tax reserves upon FIN 48 adoption; however, the size of the adjustment was relatively smaller, suggesting that the FIN 48 standards limited, but did not eliminate, firms use of discretion in reporting uncertain tax positions to avoid costly covenant violations. For firms near net worth debt covenant violation, the act of decreasing equity upon FIN 48 adoption imposes real economic costs, as the average cost of debt increased by 43 basis points. Finally, we extend prior research on the market response to FIN 48 by showing how the market response to FIN 48 adoption is a function of debt covenant slack and tax aggressiveness. Specifically, the cumulative abnormal return at the FIN 48 exposure draft release date is negative only for tax aggressive firms that are close to debt covenant violation.

This study examines challenges to the retrospective financial evaluation of continuous improvement (CI) activities. Through a review of the literature and active engagement with CI implementations, we identify several issues that may lead to divergence between operational and financial assessments. Out of this conflict emerges a set of concepts that we find important − the delineation of soft versus hard capacity benefits, the distinction between capacity used and capacity paid for, and the data gaps that relate to these benefits – and recognize operational improvement and financial improvement as distinct, yet interrelated, theoretical constructs. This study helps explain a series of persistent gaps in the management accounting literature: Conflict between operations and accounting managers, the divergent perspectives of Johnson and Kaplan after their publication of Relevance Lost (Johnson & Kaplan, 1987), and the need for both operational control (including detailed capacity control) and accounting control in CI firms. Instead of one control system being at odds with the other, or co-existing despite each other, each of these systems support a different component of the financial improvement process. Operational control systems in CI firms emphasize non-financial information and social and behavioral controls that empower decision-making by employees, while accounting control systems seek to motivate and translate operational gains into financial gains. Soft and hard benefits linked to capacity play an integral role in understanding the difference in focus of each control system, while data limitations help to explain why these systems remain loosely coupled in practice (or absent, as seems to be the case with detailed Capacity Management Systems).

Purpose – The technologies teams use in organizations have dramatically changed in the 11 years since the 2000 Volume, Research on Managing Groups and Teams: Technology. This is an update focusing on new research and perspectives.

Approach – I recall where we left off in 2000 and then present a plea for changing our research approach to one that focuses on actionable research more aligned on how teams design their work than the effects we see when they do. I review a variety of literatures relevant to teams and technology and then suggest what the next 10 years may bring.

Findings – The scholarship on teams, technology, and teams and technology has blossomed, though not evenly. We are only beginning to see actionable research related to teams and technology.

Practical implications – The pace of organizationally relevant technology change has outstripped our ability to provide high-quality research in a timely manner if we maintain our current practices of studying individual or even interactions of effects as they exist in organizations. Our research will be more helpful if we shift our focus to how team members design their work.

Originality – I make two direct and dramatic requests of my colleagues. First, that they become more precise in their presentation of or at least specify the technological settings used in their research. Second, that they shift to actionable research that explicitly considers team, technology, and the processes through which team members design their work.

Change within health care systems is constant as it relates to the external and internal demands that require continual adaptation by providers. This chapter provides a summary of the history and research contributions related to the study of culture and change through the lens of the nursing profession. The review focuses upon nursing research publications and the knowledge gained, ranging from the earliest to current studies. There has been a substantial increase in research interest regarding the relationship between nursing culture and ability to change; however, there is a considerable gap that remains in understanding subgroups such as individual nursing units or departments, consistent use of tools to measure culture, and interventions that have made a difference over time. From a practical perspective, this discussion provides insight into the importance of recognizing the importance of assessing culture and integrating cultural feedback into operational improvement plans.