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An empirical study of 71 hospitals in the United States revealed that strategic factors are highly correlated with a hospital′s financial risk position. Finds strong statistical evidence that ownership status, location, and level of service affect the hospital′s financial risk position, as measured by the Financial Viability Ratio Index.

The purpose of this paper is to describe the use of oral history to teach students about management history and the implementation of principles of management during the evolution of an organization.

The paper describes the oral history methodology and how the process was adapted to classroom learning.

By studying the historical development of a multispeciality physician practice, students were able to see firsthand the incredible impact of the founders on the future of the organization and understand how the early culture and strategy of the organization set the stage for its successful future. Other findings involved the evolution of the organizational structure and incentive system, staff and recruiting policies, and the impact of the environment overtime. In addition, the use of oral history in the classroom proved to be an effective way of making management history come alive for students.

Although designed to benefit students, the researchers found that the project provided an exciting learning experience that revealed numerous new research ideas and avenues to explore.

This project was an invaluable learning experience for the students since it allowed them to witness the real world through the eyes of experienced practitioners. The students had the opportunity to talk with dynamic individuals who are successful business leaders. Their impact as role models for the students was a strong subsidiary. Furthermore, an oral history such as this leaves a memorial that can be referenced for years to come by researchers, community historians, and the organization itself.

In this paper, we argue that the opportunities created from the recent transformational change in the health care industry have provided the environment for entrepreneurship to thrive. As a result, new and innovative organizational forms have flourished particularly when embedded in communities of entrepreneurial activity where networks of experience, access, and social/work relationships exist. The major purpose of this paper is to initiate a theoretical dialogue in which entrepreneurship is introduced as a field of research that can be used to explain how and why health care organizations have emerged and changed into their present forms. First, we present the basic elements for understanding the process of entrepreneurship and how entrepreneurial activity is important to the innovation of new organizational forms. Second, we relate this to the field of health care by focusing on the three stages in the entrepreneurial model: creation, discovery, and exploitation of entrepreneurial opportunities. Third, we argue that the degree of entrepreneurial activity within a given community is the outcome of a dynamic process involving social networks along with positive economic and legal activities that reduce transaction costs and encourage entrepreneurship. To demonstrate this, we focus on the area known as the “health care business capital” in the U.S. – Nashville, Tennessee – and describe the entrepreneurial activity in that city beginning in the 1960s and relate this to the existing theory. We believe this research represents a juxtaposition of the practical and theoretical, so critical in understanding entrepreneurial activity and new organizational forms in health care.

The major objective of this research is to examine and characterize service delivery systems for persons with mental illness in a resource scarce environment, i.e. a rural area characterized by persistent poverty and disadvantaged poulations. Although a number of studies have investigated the integration of mental health, general health, and social services, few have focused on systems of care in rural areas. To characterize service delivery systems, this exploratory study uses a case study approach that includes network analysis, quantitative analysis, and a system assessment. The findings suggest that scarcity of resources in these rural environments is an overriding factor in the development of an integrated service delivery system for persons with a mental illness. With no psychiatrists, long waits for commitment, and few emergency accomodations, these rural environments afford service providers little opportunity for proactive or strategic planning. In fact, we view the development of integrated (e.g. client referral and technical information exchange) service networks in rural communities, especially areas of extreme resource scarcity, as problematic. The resource exchange networks that exist are best characterized as informal, moderately centralized, and of limited density. This translates into a system of care that is provider-driven and crisis-oriented.

There are approximately 120 academic health centers (AHC) in the U.S. today whose mission is to deliver critical, tertiary care while also providing graduate medical education and conducting cutting-edge medical research. This traditional mission is overlaid by the social mission or the provision of highly specialized, complex or innovative care not readily available from other community providers to those who need it, including the poor. These missions make AHCs unique; however, they also are the focus of much controversy surrounding the management of AHCs. On one hand, there are those who advocate that AHCs operate similar to business organizations, thereby adapting strategies accordingly and revising their missions as necessary. On the other hand, there are those who believe in the uniqueness of AHCs and the necessity of upholding their traditional missions. Following from this, this paper presents a review of the literature that focuses on the changing environment facing AHCs and their strategic responses. In doing this, we argue that many are “copy cat” strategies that may have been successful for community hospitals and general business organizations but may not necessarily be appropriate for AHCs. At the end, this paper provides a debate on the mission and strategic direction of AHCs, particularly in light of the business or enterprise model and raises questions about the future management of these institutions.

The purpose of this paper is to detail how the adoption of enterprise resource planning (ERP) systems creates major distortions in the corporate decision‐making process.

The approach is to focus on the distortion in the capital – budgeting process of corporations emanating from the rigidity of ERP software. The rigidity negatively influences decision‐making because ERP software often dictates that the firm must change its core business procedures and processes to fit the software.

Lack of flexibility limits the introduction of new products, or targeting a new customer segment by increasing costs and imposing delays in implementation.

Firms would benefit from performing detailed analysis of the impact of ERP systems on their ability to make operational decisions.

This paper focuses on the problem of decreased flexibility in making changes in the production and accounting components of the firm when purchasing and installing ERP systems that cannot accommodate minor or major changes in the corporation.