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The purpose of this paper is to describe and analyze nurses’ perceptions and evaluations of healthcare developmental work after the introduction of Lean and Six Sigma and, how nurses aspire to maintain a high reliability organization (HRO).

Nurses’ roles and the way they respond to new efficiency and quality working methods are crucial. Underlying themes were analyzed from in-depth, semi-structured interviews with (n=17) nurses at two Swedish hospitals.

The nurses perceived that Lean worked better than Six Sigma, because of its bottom-up approach, and its similarities with nurses’ well-known work qualities. Nurses coordinate patients care, collaborate in teams and take leadership roles. To maintain high reliability and to become quality developers, nurses need stable resources. However, professional’s logic collides with management’s logic. Expert knowledge (top-down approach) without nurses’ local knowledge (bottom-up approach) can lead to problems. Healthcare quality methods are standardized but must be used with flexibility. However, HROs ensue not only from method quality but also from work attitudes, commitment and continuous work-improvement.

Management can support personnel in developmental work with: continuous education, training, teamwork, knowledge sharing and cooperation. Authoritarian method structures that limit the healthcare professionals’ autonomy should be softened or abandoned.

The study uses theoretical concepts from HROs, which were developed for unexpected events, to explain the consequences of implementing Lean and Six Sigma in healthcare.

The clear specification of leadership efforts spanning levels of analysis has lagged behind leadership research in general. Simulation modeling, such as agent-based modeling, provides research platforms for exploring these interesting issues. This chapter uses agent-based models, along with Dionne and Dionne's (2009) choices of leadership styles, to examine the impact of those styles on the generation of an emergent group resource, context-for-learning (CFL), instead of the specific task outcome (group decision making) described by Dionne and Dionne. Consistent effectiveness is found across leadership styles for workgroups with high and slightly lower initial individual levels of a CFL. A second agent-based model includes the ability of agents to forget previous learned skills and reveals a reduced effectiveness of all leadership styles. However, the effectiveness of the leadership styles differs between the two outcomes (the specific group task model and the emergent group resource model). Reasons for these differences are explored, and implications from the comparisons of the two models are delineated.

The purpose of this article is to examine whether the incentivizing type of performance appraisal (typical of New Public Management) has indeed been superseded by a post-New Public Management (NPM), developmental type of performance appraisal in European Civil Services.

The literature review lead to a unidimensional, twofold typology: incentivizing (NPM) and developmental (post-NPM) performance appraisal. The empirical basis of the research is two surveys conducted among top civil servants in 18 European countries.

First, there are crucial discrepancies between performance appraisal systems in contemporary European central government administrations and current theorizing on performance appraisal. Contrary to our expectations developed on the basis of the latter, “developmental” and “incentivizing” do not seem to be two distinct types of performance appraisal; rather, they are two independent dimensions, defining altogether four different types of performance appraisal systems.

The authors results give orientation to policymakers and public service managers to engage in designing or applying performance appraisal systems, in particular by identifying assailable presumptions underlying many present-time reform trends.

Citizens and communities are direct stakeholders in the development of public service performance appraisal both as possible or actual employees of public service organizations and as recipients of public services.

The paper proposes a new fourfold typology of performance appraisal systems: incentivizing, developmental, symbolic and want-it-all.

This paper presents the initial results of a project on organizational and professional cultures prevalent in hospital organizations. The purpose of this paper is to identify the cultural differences that make it possible to anticipate, with the aid of subsequent studies, consequences in the communication and coordination of the future integration of the Mexican public health system, which is currently fragmented.

A qualitative tool was used to identify the cultures in a secondary-level public hospital.

The diversity inherent to hospital organizations was confirmed.

The real value of the findings lies in the classification of the subcultures and their possible effects on human interaction and cooperation.

This study aims to use an environomics method to assess the environmental impacts of selected gas turbine power plants in Nigeria.

In this study, exergoenvironomic analysis has been carried out to investigate the environmental impact of selected gas turbine power plants in Nigeria from an exergetic point of view.

The exergy analysis reveals that the combustion chamber is the most exergy destructive component compared to other cycle components. The exergy destruction of this component can be reduced by increasing gas turbine inlet temperature (GTIT). The results of the study show that thermodynamic inefficiency is responsible for the environmental impact associated with gas turbine components. The study further shows that CO₂ emissions and cost of environmental impact decrease with increasing GTIT.

The exergo-environomic parameters computed in this study are CO₂ emission in kg per MWh of electricity generated, depletion number, sustainability index, cost flow rate of environmental impacts (Ċ_env) in $/h and total cost rates of products (Ċ_Tot) in $/hr. For the period considered, the CO₂ emissions for the selected plants vary from 100.18 to 408.78 kgCO₂/MWhm, while cost flow rate of environmental impacts varies from $40.18 /h to $276.97 /h and the total cost rates of products vary from $2935.69/h to $12,232.84/h. The depletion number and sustainability index vary from 0.69 to 0.84 and 1.20 to 1.44, respectively.

With a start in the observation that there is a large variation in how companies interact with each other, the paper aims to anlayse the economic consequences of this variation. As the more extensive interaction is costly, the variation also indicates a variation in the economic dimension.

This is a conceptual paper.

Three different economic streams can be identified. Firstly, the interaction costs can be reduced by taking advantage of time and scope. Interaction over time give opportunity to use some of the costs as investments through creation of relationships. By using the same counterpart for several products, scope can be used to reduce interaction costs. Secondly, developed business relationships can be used to create relation revenues. The counterparts can use each other for developing better solutions and for development of knowledge. Finally, the actors can also get positive network effects. One example is the joint development with third parties such as sub-suppliers or customer’s customer.

The discussion ends in two major implications. One is the central role of managers and the other the crucial role of economic deals. Managers are crucial both to identify relevant cost and revenue items as well as to exploit them. Deals are important as it is only with direct counterparts where there are monetary streams. In all other relationships, there is only indirect consequences.

It is obvious that the type of cost and revenue streams identified above will require new and different economic tools. A base for this is given here.

In defining smart city and its effects on the citizens, the ideas and generalisation of the team members that makes up the smart city team must be thoroughly considered. It is one thing to have the concepts and processes on ground on smart city, it is another to have qualified team members that can deliver such city within a targeted standard. Stakeholders, construction professionals, citizens, concerned individuals among all make up the smart city team members. These members can also be spread across disciplines in order to facilitate effectiveness in every activity designed. Activities such as dissecting characteristics, control and management of smart city are controlled by these team members as they seek for maximisation of output from the resources available.

The stock market in the Kingdom of Saudi Arabia is quickly developing and maturing. While the inefficiencies of this market have already been attributed to its mechanics (Abdeen and Shook, 1984; Butler and Malaikah, 1992; Abdelkader, 1993), information concerning the market players has not been available. This research reports descriptive results of 74 interviews with Saudi investors. The results provide insight into the information that is used for investing decisions, support prior evidence of market inefficiency, and encourage more research in this area.

There is a global convergence on issues pertaining to sustainability, such as water sharing, energy security and waste management. Symbiosis focus the need to secure an enduring relationship satisfying the quality of life need for novelty aspirations of the customers and stakeholders. This is addressed as sustainable differentiation. This study aims: to understand the need to develop the symbiosis of sustainable development and sustainable differentiation, to analyze the research framework of sustainability symbiosis though the underlying attributes of: need to develop, need to innovate and need to differentiate.

The research design conceptualizes sustainable development as a process or evolution where firms may be symbiotically configured on the attributes of sustainability, development and differentiation. The logit analysis methodology addresses competitiveness coupled with environmentally benign technology to sustain the customers' preference for products and services that satisfy their quality of life needs. The approach is to estimate the symbiotic index of a local, regional or globally scalable habitat. The competitiveness coupled with environmentally benign technology can be sustained when the customers' preference for products and services satisfies their quality of life needs.

The output indicates the significance (0.037 at 95 percent confidence level) of the constant term representing “quality of life need for novelty” justifying symbiotic linkage of sustainability, development and differentiation. There is goodness of fit (α 0.5617, Wald statistic 0.093) to establish the significance of the three variables of GDP (representing intensity of eco-efficient technology), population (standing for intensity of competitiveness) and sustaining empathy (in response to climate change). Their statistical significance indicates the propensity to differentiation given sustainable development would substantively improve the overall construct.

There is need for further research with primary data. The assumption that sustainable differentiation may become an indicator variable that may assume binary form needs thorough justification. The key implication is that differentiation creates grassroots distinctiveness to development that transforms sustainability into opportunity. This cost to benefit gap is bridged through the symbiotic chain of sustainability, development and differentiation.

This sustainable differentiation metric harnesses a dormant, yet fundamental key to the success of sustainable development, the emotive linkage. This explanatory variable adds robustness to sustainable development models by way of etching a long-term memory trace for the sustainability practices of the organization as well as innovation efforts to differentiate long term providing an essence of competitiveness.