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PubMedDate not supplied

Designing high-performance jobs.

Tales of great strategies derailed by poor execution are all too common. That's because some organizations are designed to fail. For a company to achieve its potential, each employee's supply of organizational resources should equal the demand, and the same balance must apply to every business unit and to the company as a whole. To carry out his or her job, each employee has to know the answers to four basic questions: What resources do I control to accomplish my tasks? What measures will be used to evaluate my performance? Who do I need to interact with and influence to achieve my goals? And how much support can I expect when I reach out to others for help? The questions correspond to what the author calls the four basic spans of a job-control, accountability, influence, and support. Each span can be adjusted so that it is narrow or wide or somewhere in between. If you get the settings right, you can design a job in which a talented individual can successfully execute on your company's strategy. If you get the settings wrong, it will be difficult for an employee to be effective. The first step is to set the span of control to reflect the resources allocated to each position and unit that plays an important role in delivering customer value. This setting, like the others, is determined by how the business creates value for customers and differentiates its products and services. Next, you can dial in different levels of entrepreneurial behavior and creative tension by widening or narrowing spans of accountability and influence. Finally, you must adjust the span of support to ensure that the job or unit will get the informal help it needs.

Achievement↗
PubMed1990

Survey: managed care led '89 diversification improvements.

As providers gain increased experience with managed care contracting, they are reporting greater success, especially with preferred provider organizations. And for the second year in a row, the profitability of substance abuse treatment units has declined. These are just a few of the highlights from Hospitals' third annual diversification survey.

Data Collection↗
PubMed2002

Why entrepreneurs don't scale.

It's well known that many executives who excel at starting businesses or projects fizzle out--in other words, they fail to "scale"--as their ventures grow. But the reasons have remained fuzzy. In this article, leadership coach John Hamm identifies four management tendencies that work for small-company or business-unit leaders but become Achilles' heels as those individuals try to run larger organizations. The first tendency is loyalty to comrades. In entrepreneurial mode, you need to lead as though you're in charge of a combat unit on the wrong side of enemy lines. But blind loyalty can become a liability in managing a complex organization. The second tendency, task orientation, is critical in driving toward a big product launch, but excessive attention to detail can cause a large organization to lose sight of its long-term goals. The third tendency, single-mindedness, is important in a visionary unleashing a revolutionary product or service on the world but can limit the company's potential as it grows. And the fourth tendency, working in isolation, is fine for the brilliant scientist focused on an ingenious idea. But it's disastrous for a leader whose expanding organization increasingly relies on many other people. Leaders who scale deal honestly with problems and quickly weed out nonperformers. They see past distractions and establish strategic priorities. They learn how to deal effectively with diverse employees, customers, and external constituencies. And, most important, they make the company's continuing health and welfare their top concern.

Administrative Personnel↗
PubMed2000

Supply chain optimization: a practitioner's perspective on the next logistics breakthrough.

The objective of this paper is to profile a practitioner's perspective on supply chain optimization and highlight the critical elements of this potential new logistics breakthrough idea. The introduction will briefly describe the existing distribution network, and business environment. This will include operational statistics, manufacturing software, and hardware configurations. The first segment will cover the critical success factors or foundations elements that are prerequisites for success. The second segment will give you a glimpse of a "working game plan" for successful migration to supply chain optimization. The final segment will briefly profile "bottom-line" benefits to be derived from the use of supply chain optimization as a strategy, tactical tool, and competitive advantage.

Commerce↗
PubMed1997

Managing conflicts in systems development.

Conflict in systems development is nothing new. It can vary in intensity, but there will always be two possible outcomes--one constructive and the other destructive. The common approach to conflict management is to draw the battle lines and apply brute force. However, there are other ways to deal with conflict that are more effective and more people oriented.

Communication↗
PubMed2000

Purchasing in a supply chain environment.

Why the interest in purchasing? In the typical company, material costs are 40% to 75% of the cost of goods sold, labor is 5% to 15%, and the balance is burden. The typical company has $4-$5 in purchased cost to $1 in labor. Most companies are implementing material requirements planning (MRP II) and enterprise resource planning systems to control the $1 in labor and have little expectation in the area of purchasing savings. Yet a dollar saved in purchasing goes directly to the bottom line. I ran a survey of 100 Class A users of MRP II; in all 100 of the companies, the biggest payback was in the area of purchasing.

Appointments and Schedules↗
PubMed1991

An endangered resource. Hospital emergency departments are threatened by closures and a reduction in services.

Many factors threaten the hospital emergency department. Socioeconomic and healthcare trends are forcing facilities to eliminate some services. Society's failure to deal with these issues portend disaster for high-quality care and for timely access to emergency care. Hospital administrators must collaborate with emergency department managers and plan strategies to ensure the survival of this valuable resource. Hospital emergency departments will have to redefine the scope of services they provide to meet specific consumer needs. The number of older Americans is increasing rapidly. Emergency departments must understand and cater to their unique needs. Some emergency department staffs are collaborating with competitors to share resources and reduce overlapping services. The emergency department has an impact on the facility's bottom line. The emergency department can positively affect this by ensuring accurate billing, analyzing fee schedules, and requesting payment at the time service is provided. Other survival issues include developing strategies to retain staff, develop management, negotiate managed care, and reassess the department's design.

Aged↗
PubMedDate not supplied

Developing an outpatient ventricular assist device program to meet the needs of a "too successful" heart transplant program.

The VAD independent living program has clearly demonstrated that a traditional inpatient population can be successfully moved to an outpatient setting. Such a move can result in significant cost savings for the institution while increasing patient satisfaction. By moving the assist device patients to an outpatient facility, we improved the overall operational efficiency of the Medical Center and the MIMCU. Because of the overwhelming success of this project, the Medical Center's administration has become receptive to the benefits of exploring alternative outpatient care delivery systems. Faced with increased demands to decrease operational expenses cardiovascular managers must restructure service line programs and explore opportunities to move traditional inpatient care delivery systems to outpatient settings.

Academic Medical Centers↗
PubMedDate not supplied

How Hermann Hospital is saving resources through enterprise-wide reengineering.

Hermann Hospital, a 650-bed tertiary care facility and teaching hospital (Houston, TX), recognized the need for institution wide reengineering if they were to remain viable in a changing healthcare environment. Having already implemented total quality management (TQM) programs in various departments, Hermann wanted to provide a comprehensive line of healthcare services that worked cohesively with other areas, such as business development, community relations, and finance, and to do it competitively. Management knew that anticipated changes would require a holistic understanding of their system, so that reengineering efforts in one area didn't ¿break things¿ in another.

Cost Savings↗
PubMed2005

The relative value of growth.

Most executives would say that adding a point of growth and gaining a point of operating-profit margin contribute about equally to shareholder value. Margin improvements hit the bottom line immediately, while growth compounds value over time. But the reality is that the two are rarely equivalent. Growth often is far more valuable than managers think. For some companies, convincing the market that they can grow by just one additional percentage point can be worth six, seven, or even ten points of margin improvement. This article presents a new strategic metric, called the relative value of growth (RVG), which gives managers a clear picture of how growth projects and margin improvement initiatives affect shareholder value. Using basic balance sheet and income sheet data, managers can determine their companies' RVGs, as well as those of their competitors. Calculating RVGs gives managers insights into which corporate strategies are working to deliver value and whether their companies are pulling the most powerful value-creation levers. The author examines a number of well-known companies and explains what their RVG numbers say about their strategies. He reviews the unspoken assumption that growth and profits are incompatible over the long term and shows that a fair number of companies are effective at delivering both. Finally, he explains how managers can use the RVG framework to help them define strategies that balance growth and profitability at both the corporate and business unit levels.

Accounting↗
PubMed1991

A new approach to optimal selection of services in health care organizations.

A new reimbursement policy adopted by Medicare in 1983 caused financial difficulties for many hospitals and health care organizations. Several organizations responded to these difficulties by developing systems to carefully measure their costs of providing services. The purpose of such systems was to provide relevant information about the profitability of hospital services. This paper presents a new method of making hospital service selection decisions: it is based on an optimization model that avoids arbitrary cost allocations as a basis for computing the costs of offering a given service. The new method provides more reliable information about which services are profitable or unprofitable, and it provides an accurate measure of the degree to which a service is profitable or unprofitable. The new method also provides useful information about the sensitivity of the optimal decision to changes in costs and revenues. Specialized algorithms for the optimization model lead to very efficient implementation of the method, even for the largest health care organizations.

Accounting↗
PubMed1991

Hospitals and material management in the coming decade.

The 1990s will be a decade of increasing dramatic and traumatic change for hospitals. Reimbursement, technology, and consumers, either alone or in concert, will be the forces that will shape hospitals in the future. At the end of the 1990s we will have hospitals that offer technology to the critically ill, outpatient surgical services, and comforting care for those in the late years of life. Material management will be important to hospitals because expense control will be as important as ever. However, I believe the role of a material manager will diminish as the services provided change and as the role is folded into the responsibilities of those who manage one of the three critical business areas hospitals will be in. This new hybrid of today's manager will still apply all of the concepts to the distribution of supplies in a hospital as today's material managers do but will use them as only a part of their overall management responsibility.

Forecasting↗
PubMed1990

Cost accounting in hospitals.

Cost accounting in hospitals has presented until recently serious difficulties because every patient was considered a unique case. However, it is possible to establish statistically homogeneous groups of patients and to identify inputs needed. As hospitals are multiproduct companies it is advisable to have recourse to direct cost techniques and information technology.

Accounting↗
PubMed1993

Curaflex finds its niche.

Rather than being a jack of all trades, one company decided to become master of one: infusion therapy. By working collaboratively with the community and experts in the field to develop programs to serve patients and the community, Curaflex has become a top competitor in the field.

Drug Therapy↗