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Federal and state governments collaborate on state Medicaid nursing facility long-term care (SMNF-LTC) programs. These programs are increasingly expensive as the baby-boomers retire. Yet serious resident outcome problems continue in spite of the Centers for Medicare and Medicaid Services’ (CMS) extensive process-focused regulatory efforts. This study identifies a promising and simpler auxiliary path for improving resident outcomes.

Drawing on a longitudinal (1997–2005), 48-state data set and panel-corrected, time-series regression, we compare the effects on resident outcomes of CMS process-focused surveys and four minimally regulated program structural features on which the states vary considerably.

We find that each of these four structural features exerts a greater effect on resident outcomes than process quality.

We suggest augmenting current process-focused regulation with a less arduous approach of more extensive regulation of these program features.

To date SMNF-LTC program regulation has focused largely on member facility processes. While regulating processes is appropriate, we show that regulating program structural features directly, an arguably easier task, might well produce considerable improvement in the quality of resident outcomes.

The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care.

We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit.

We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level.

This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators.

Incentives are effective at enhancing productivity, but research also suggests that performance incentives can have “unintended negative consequences” including increases in hazard/injuries, increases in errors, and reduction in cooperation, prosocial behaviors, and creativity. Relatively overlooked is whether, when, and how incentives can be designed to prevent such negative consequences. The authors review literature in several disciplines (construction, healthcare delivery, economics, psychology, and [some] management) on this issue. This chapter, in toto, sheds a generally positive light and suggests that, beyond productivity, incentives can be used to improve other outcomes such as safety, quality, prosocial behaviors, and creativity, particularly when the incentives are thoughtfully designed. The review concludes with several potential fruitful areas for future research such as investigations of incentive-effect duration.

Purpose – The numbers of health care transparency initiatives are increasing. Despite the growing availability of quality data, there seems to be a shortage of evidence about the effects and effectiveness of such initiatives. The aim of this systematic review is to document the effects of transparency, defined as the public release of quality performance data, on hospital care outcomes.

Design/methodology/approach – Through a review of the literature, we chose 46 keywords to use in our searches and focused on empirical studies published in English between 2010 and 2015. The use of combinations of these keywords in searches of four databases (PubMed, Scopus, Web of Science, and the Cochrane Library) generated 13,849 publications. The removal of duplicates and exclusion of studies that were not empirical or not relevant to transparency and quality resulted in 39 studies to be reviewed.

Findings – Our review of the literature confirmed the growth of health care transparency efforts, led by the United States, and found mixed results regarding the effects of transparency on hospital care outcomes. For example, mortality, the most frequently researched performance measure (n = 15), exhibited this mixed pattern by having studies showing a reduction (n = 4), increase (n = 1), mixed findings (n = 4), and no significant relationship (n = 6) as a result of public release. We also found a limited number of articles related to unintended consequences of public reporting. When compared with earlier systematic reviews, there seems to be a trend in the reduction of unintended consequences. Therefore, we recommend exploration of this potential trend in future studies empirically.

Practical Implications – The research findings summarized in this systematic review can be used to understand the results of existing transparency efforts and to develop future transparency initiatives that may better enhance hospital quality performance.

Originality/value – This is the latest and most comprehensive systematic review summarizing the effects of transparency of quality metrics on hospital care outcomes.

This research explores perceptions of knowledge management processes held by managers and employees in a service industry. To date, empirical research on knowledge management in the service industry is sparse. This research seeks to examine absorptive capacity and its four capabilities of acquisition, assimilation, transformation and exploitation and their impact on effective knowledge management. All of these capabilities are strategies that enable external knowledge to be recognized, imported and integrated into, and further developed within the organization effectively. The research tests the relationships between absorptive capacity and effective knowledge management through analysis of quantitative data (n = 549) drawn from managers and employees in 35 residential aged care organizations in Western Australia. Responses were analysed using Partial Least Square-based Structural Equation Modelling. Additional analysis was conducted to assess if the job role (of manager or employee) and three industry context variables of profit motive, size of business and length of time the organization has been in business, impacted on the hypothesized relationships.

Structural model analysis examines the relationships between variables as hypothesized in the research framework. Analysis found that absorptive capacity and the four capabilities correlated significantly with effective knowledge management, with absorptive capacity explaining 56% of the total variability for effective knowledge management. Findings from this research also show that absorptive capacity and the four capabilities provide a useful framework for examining knowledge management in the service industry. Additionally, there were no significant differences in the perceptions held between managers and employees, nor between respondents in for-profit and not-for-profit organizations. Furthermore, the size of the organization and length of time the organization has been in business did not impact on absorptive capacity, the four capabilities and effective knowledge management.

The research considers implications for business in light of these findings. The role of managers in providing leadership across the knowledge management process was confirmed, as well as the importance of guiding routines and knowledge sharing throughout the organization. Further, the results indicate that within the participating organizations there are discernible differences in the way that some organizations manage their knowledge, compared to others. To achieve effective knowledge management, managers need to provide a supportive workplace culture, facilitate strong employee relationships, encourage employees to seek out new knowledge, continually engage in two-way communication with employees and provide up-to-date policies and procedures that guide employees in doing their work. The implementation of knowledge management strategies has also been shown in this research to enhance the delivery and quality of residential aged care.

This study investigates the motivation among customers to be more loyal to online food delivery applications (OFDA) services even after the COVID-19 epidemic by using perceived service quality aspects in Sri Lanka. The data were gathered by physically distributing a self-administrated questionnaire to clients in Sri Lanka who continue to use OFDA services on platform to customer (P2C) service delivery platforms to buy food despite the COVID-19 outbreak. Multiple regression is employed to analyse 287 effective observations, and the data revealed the significant positive effect of interaction, environment, outcome, and food qualities on customer loyalty to OFDA services. In fact, there is no impact from the delivery quality on customer loyalty to OFDA services due to outsourced food delivery. The findings suggest regular improvements in attributes such as interaction, environment, outcome, and food qualities in this hyper-competitive business environment. Further, this study sets substantial facts for the interested parties to establish an exemplary delivery system and other technological advancements to have a sustainable competitive advantage and solid customer base in the long run.

The goal of this contribution is to shed light on the benefits for research in health care coming from the use of administrative data, especially in terms of measuring hospitals’ outcomes. The main approaches to health outcome evaluation are reviewed and the possible improvements deriving from the use of administrative data are highlighted. Administrative data may be an essential element in the process of gathering to the public true rankings of health care organizations, reducing the degree of asymmetric information that typically arises in health care. Patients will be more aware of the best institutions, which will induce most of them to demand to be admitted in them, taking into account the costs associated with distance and with the severity of the illness. This in turn may ask for a reorganization of the sector, closing some organizations and expanding others, having as final goal to improve the health status of the population, without income barriers. This is one of the first attempts to provide an overview of the advantages that administrative data may gather in health care.

Report cards, performance evaluations, and quality assessments continue to penetrate the lexicon of the healthcare sector. The value of report cards is typically couched as enhancing consumerism among patients, increasing accountability among healthcare providers, and more broadly increasing the transparency of healthcare information. This paper discusses the potential benefits and pitfalls of these performance assessments.

This paper briefly reviews empirical evidence regarding the impact of report cards for healthcare providers and synthesizes the role and limitations of these performance measures into distinct evaluation criteria. The rapid proliferation of report cards for healthcare providers suggests a growing need to develop mechanisms and tools to evaluate their impact. The risks associated with utilizing report cards for provider oversight include the deleterious impact on vulnerable populations and a failure to accurately measure quality of care. The capacity to create report cards should not be the sole criterion to develop and utilize report cards to evaluate healthcare providers. Rather, careful consideration of the benefits and risks should accompany the implementation and utilization of report cards into regulatory processes. This report proposes an evaluation checklist by which to assess the role of report cards in a given healthcare context.

Since the spread of mass education around the world in the mid- to late-twentieth century, teacher quality has been heralded as the key factor to improve education quality nationwide. National education systems worldwide are also engaged in ongoing and often high stakes cross-national comparisons. As a result, policy-makers and educators in most national education systems are looking at and implementing new ways to improve education overall by raising teacher quality levels, and India is no exception. In India, teacher quality is publicly blamed for both perceived low education quality and demonstrated low average student performance, especially following Indian students’ performance on the 2009 Programme for International Student Assessment. Indian education policy-makers are, therefore, looking at teacher quality as a key factor to improve student performance. Little is known about the impact or implementation of Indian policy frameworks on teacher quality and associated student outcomes in India. This introductory chapter identifies and analyzes various measures of teacher quality and how teacher quality varies in India both in response to and in spite of national policies related to teacher quality. It begins by providing evidence regarding the global importance of teacher quality on student outcomes and then addresses the ambiguity of the term “teacher quality.” This chapter then briefly discussed national education policy in India and the role teacher quality has played in these national policies, especially in the early twenty-first century, including NCF 2005, NCFTE 2009, Draft NPE 2016, Draft NPE 2019, and NPE 2020.

The inconsistency between the appearance of incoherence and chaos in the US policymaking process bringing about a historic record of legislative achievements in the 1960s and 1970s, on the one hand, and the emergence of hierarchical order bringing about a prolonged period of legislative impotence in the early 2000s, on the other hand, has led legislative scholars to revisit strongly held prior beliefs about legislative organization. Similar reevaluations of the garbage can model that emphasize the potential for conflict-ridden and chaotic organizations to be adaptively rational are ongoing in organizational theory. This paper adapts recent research on organizational design to explore the conditions under which decentralized, chaotic decision making facilitates more desirable legislative outcomes than centralized decision making controlled by a benevolent dictator. The author demonstrates that normative claims about legislative organization – much like normative claims about organizational design – should vary depending on the task environment faced by the legislature. In the face of rugged uncertainty in the mapping from policies to outcomes, decentralized decision making among modestly polarized legislators with fluid participation in decisions facilitates a functional mix of exploitative and exploratory search.