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Article
Publication date: 24 October 2008

Role of transparency in managing outcome successes: Causes and end use/least cost as decision guides

Russell Jaffe, Robert A. Nash, Richard Ash, Norm Schwartz, Robert Corish, Tammy Born, James P. Carter and Harold Lazarus

Healthcare is both the largest (17 + percent) and the most rapidly growing (three plus times the consumer product index (measure of inflation) and half a percent of gross…

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Abstract

Purpose

Healthcare is both the largest (17 + percent) and the most rapidly growing (three plus times the consumer product index (measure of inflation) and half a percent of gross domestic product each year) segment of the US economy. The purpose of this paper is to focus on outcome successes that illustrate application of a previously reported health equation. The health equation allows an organized and more transparent assessment of healthcare outcomes.

Design/methodology/approach

The approach includes “end use/least cost” techniques that identifies healthful care as a big unmet need (BUN) and equally attractive business opportunity in identifying health promotion that improves outcome at lower net costs.

Findings

Opportunity exists to reduce costs while also reducing adverse events, healthcare morbidity and morality. Transparency is essential to find what works more effectively to yield desired outcomes. Metrics and measures, particularly more precise tools to assess true outcome in promoting health or managing ill health, are given priority as they allow quantified and, often econometric, outcome opportunities in the midst of current uncertainties.

Practical implications

This paper is for consumers and businesses, managers and administrators, professionals and allied health professionals. The successes described herein illustrate fundamental opportunities driving change and innovation within healthcare and in our society.

Originality/value

Attention is called to opportunity areas that can fund out of savings the transition from the authors' current “sickness care” system to a healthful care, proactive prevention approach to delivering care. Novel application of transparency and end use/least cost can help guide choices to achieve healthier outcomes.

Details

Journal of Management Development, vol. 27 no. 10
Type: Research Article
DOI: https://doi.org/10.1108/02621710810916321
ISSN: 0262-1711

Keywords

  • Health services
  • Medical care
  • United States of America
  • Management

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Article
Publication date: 29 May 2007

An equation of health: Role of transparency and opacity in developing healthcare efficacy measures and metrics

Russell Jaffe, Robert A. Nash, Richard Ash, Norm Schwartz, Robert Corish, Tammy Born and Harold Lazarus

This article aims to present an equation of health to allow measurement and more precise comparison of what is more or less effective in promoting health or managing ill…

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Abstract

Purpose

This article aims to present an equation of health to allow measurement and more precise comparison of what is more or less effective in promoting health or managing ill health. It builds upon and extends a prior report (JMD, Volume 25 Number 10, 2006, pp. 981‐995).

Design/methodology/approach

Applying basic scientific methods and empiric observations, the equation proposed in this article is a state of the current science. Such an equation allows for more systematic and predictive comparison of health initiatives.

Findings

The pace of scientific progress is outstripping our institutional adaptive response mechanisms. An approach to the causes of ill health appears more promising than re‐configuration of current disease reactive, symptom treatment care. This paper starts from first principles and builds a model that results in an equation of health.

Research limitations/implications

Refinement of the model and replication by others are needed to fully determine the predictive value of this approach.

Practical implications

The opportunity to reduce costs while also reducing adverse events, healthcare morbidity and morality.

Originality/value

This article calls attention to areas of opportunity to fund out of savings the transition from our current “sick care” system to a health promotion/proactive prevention approach to caring.

Details

Journal of Management Development, vol. 26 no. 5
Type: Research Article
DOI: https://doi.org/10.1108/02621710710748275
ISSN: 0262-1711

Keywords

  • Health services
  • Medical care
  • United States of America

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Article
Publication date: 1 December 2006

Healthcare transparency: opportunity or mirage

Russell Jaffe, Robert A. Nash, Richard Ash, Norman Schwartz, Robert Corish, Tammy Born, Harold Lazarus and ASIMP Working Group on Healthcare Transparency

Healthcare is an ever‐growing segment of the American economy. Transparency facilitates better decision‐making and better outcomes measures. The purpose of this paper is…

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Abstract

Purpose

Healthcare is an ever‐growing segment of the American economy. Transparency facilitates better decision‐making and better outcomes measures. The purpose of this paper is to present the human and economic results of increasing transparency.

Design/methodology/approach

The ASIMP Working Group on Healthcare Transparency represents a diverse yet conscilient group of practitioners, researchers, regulators, economists, and academics. Given the need for re‐envisioning healthcare to include more accountability, evidence of efficacy and transparency, this integrative medicine (ASIMP) working group is suitable to address the above purpose.

Findings

Substantial opportunity exists to reduce morbidity and mortality, suffering and excess death, unnecessary costs and risks. Greater transparency facilitates the transition to safer, more effective, more humane healthcare.

Research limitations/implications

This paper starts from a need to improve clinical outcomes and value for resources devoted. Best efforts of a national working group are presented. The implications of the report, when tested, will determine the enduring value of this work.

Practical implications

Consumers and business, administrators and practitioners can improve care at lower cost by increasing transparency. This will accelerate the diffusion of effective approaches that are not yet in widespread use despite replication of efficacy.

Originality/value

This is the first time an integrative approach has been compared with conventional healthcare models, particularly with regard to the role of transparency in healthcare management.

Details

Journal of Management Development, vol. 25 no. 10
Type: Research Article
DOI: https://doi.org/10.1108/02621710610708603
ISSN: 0262-1711

Keywords

  • Health services
  • Medical care
  • Society
  • United States of America

Content available
Article
Publication date: 29 May 2007

Special issue: transparency and other hot topics revisited

Tom McManus, Yair Holtzman, Harold Lazarus and Johan Anderberg

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Abstract

Details

Journal of Management Development, vol. 26 no. 5
Type: Research Article
DOI: https://doi.org/10.1108/jmd.2007.02626eaa.001
ISSN: 0262-1711

Content available
Article
Publication date: 1 December 2006

Transparency guru: an interview with Tom McManus

Tom McManus

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Abstract

Details

Journal of Management Development, vol. 25 no. 10
Type: Research Article
DOI: https://doi.org/10.1108/jmd.2006.02625jaa.001
ISSN: 0262-1711

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Article
Publication date: 1 March 1976

Whisker Formation on Electronic Materials

B.D. Dunn

The filamentary growths of single crystals on material surfaces are termed whiskers. They are seen to nucleate and grow on certain electronic materials either from vapour…

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Abstract

The filamentary growths of single crystals on material surfaces are termed whiskers. They are seen to nucleate and grow on certain electronic materials either from vapour and liquid phases or by a process induced by residual stresses in electroplated surfaces. Whisker growth does not depend on the existence of an electric field and surfaces prone to their growth may nucleate and form whiskers as a result of exposure to a space environment. This paper includes a detailed examination of tin whiskers which were found to have 1 to 4 micron diameters and lengths exceeding 2 mm. Some were found to carry currents between 22 and 32 mA before burning out. Conductive whiskers can cause extensive short circuit damage to spacecraft electronics particularly as miniature devices progressively employ closer spacings between conductors. Several modes of whisker growth on spacecraft electronic materials (molybdenum, tungsten, Kovar, tin) have been observed and are described. Tin, cadmium and zinc surfaces can support stress‐induced whisker growth and it is recommended that these metal finishes are excluded from spacecraft design and possibly replaced by a tin‐lead alloy.

Details

Circuit World, vol. 2 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/eb043543
ISSN: 0305-6120

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Article
Publication date: 27 August 2020

Whose experience is it anyway? Toward a constructive engagement of tensions in patient-centered health care

Timothy J. Vogus, Andrew Gallan, Cheryl Rathert, Dahlia El-Manstrly and Alexis Strong

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions…

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Abstract

Purpose

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

Design/methodology/approach

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

Findings

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

Originality/value

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.

Details

Journal of Service Management, vol. 31 no. 5
Type: Research Article
DOI: https://doi.org/10.1108/JOSM-04-2020-0095
ISSN: 1757-5818

Keywords

  • Patient-centered
  • Patient experience
  • Paradox
  • Tension
  • Health care

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