Efficient Organizational Structure Research Articles

Integrated care reform in urban China: a qualitative study on design, supporting environment and implementation

BackgroundInitiatives on integrated care between hospitals and community health centers (CHCs) have been introduced to transform the current fragmented health care delivery system into an integrated system in China. Up to date no research has analyzed in-depth the experiences of these initiatives based on perspectives from various stakeholders. This study analyzed the integrated care pilot in Hangzhou City by investigating stakeholders’ perspectives on its design features and supporting environment, their acceptability of this pilot, and further identifying the enabling and constraining factors that may influence the implementation of the integrated care reform.MethodsThe qualitative study was carried out based on in-depth interviews and focus group discussions with 50 key informants who were involved in the policy-making process and implementation. Relevant policy documents were also collected for analysis.ResultsThe pilot in Hangzhou was established as a CHC-led delivery system based on cooperation agreement between CHCs and hospitals to deliver primary and specialty care together for patients with chronic diseases. An innovative learning-from-practice mentorship system between specialists and general practitioners was also introduced to solve the poor capacity of general practitioners. The design of the pilot, its governance and organizational structure and human resources were enabling factors, which facilitated the integrated care reform. However, the main constraining factors were a lack of an integrated payment mechanism from health insurance and a lack of tailored information system to ensure its sustainability.ConclusionsThe integrated care pilot in Hangzhou enabled CHCs to play as gate-keeper and care coordinator for the full continuum of services across the health care providers. The government put integrated care a priority, and constructed an efficient design, governance and organizational structure to enable its implementation. Health insurance should play a proactive role, and adopt a shared financial incentive system to support integrated care across providers in the future.

NU02.03 Ethical Decision Making

NU02.03 Ethical Decision Making

Providing an Efficient Organization Structure and Company Culture by Embedding Group Dynamic Consciousness

As being a psychosocial creature, the human composing the organization has series of behavioral talents like feeling, idea, desire, ambition, hope and fear. Humans, besides their technical abilities, bring their hopes and concerns, their life philosophy, all exclusive behaviors with them to organizations where they belive they realize their porsonel hopes and desires and establish cooperation. As aresult, established organization has social, human structural property including different personal ideas and behaviors. It was understood that, humans in the organization do not always behave according to rules, which were set by management, and the economical human logic. Human behave in accordance with their emotions and feeling. Because organizations can not satisfy all needs of humans by assigning formal tasks and physical facilities. As a result of these complex reasons generally the members of the organizations, which are established to perform certain official tasks, establish unofficial organizations by developing relations among themselves in order to satisfy their personal needs and feelings. In this study, accepting the value and importance of the official organization, it is desired to tell that unofficial organization is real and important at least the official organization. Becouse at the same time organizations are feelings system, it is beneficial to determine the role of the human in the organization and to regulate the organizationto this fact.

Design of organizational innovations: model of virtual organizational structure for enterprise management

The objects of research are the organizational enterprise management structures. It was revealed that enterprises have mixed types of their own organizational structures, among which the network organizational forms are the most effective. It was established that the main requirements for the development of an efficient organizational structure is its ability to quickly and adequately respond to the nature of the disturbance problem. It was revealed the key issue of traditional types of organizational structures – remarkable inertia of mechanisms for generation and management decisions that require immediate response of management system in response to the emergence of problem situations. A constructive way to overcome the mentioned conflict is a simulation of virtual organizational structures for enterprise management, which exist in parallel with real organizational structures using the principles of modelability andscientificity. This will transfer the management of problematic situations in cyberspace, enable «programmed» accelerated transformation of base virtual organizational structure in the «problem» with predetermined properties. The main preferences is the speed and adequacy of solving actual problems using a virtual model of organizational structure provided «physical» immutability of real management structure. The author developed methodological principles for virtual modeling of virtual organizational structures and for enterprise management and build the model in analytical and graphical forms. Areas for further prospective studies were marked.

CHANGING ORGANIZATIONAL FORM: DEMUTUALIZATION AND THE PRIVATIZATION OF COMMUNAL WEALTH – AUSTRALIAN CREDIT UNION EXPERIENCES

ABSTRACTRecent decades have seen substantial demutualization of financial institutions around the world, involving the conversion of accumulated communally owned wealth into private wealth. Whether driven by a quest for a more efficient organizational structure or by wealth expropriation incentives, different methods of demutualization have different implications for wealth allocation among current members and transfers of wealth to outsiders. While credit union sectors internationally have, to date, experienced few demutualizations, there are increasing incentives for such organizational change. Three alternative demutualization strategies (share issue to members plus an external capital raising, liquidation and cash distribution to members (a quasi‐demutualization), and merger with a listed company) recently used by Australian credit unions are analysed to highlight wealth implications, survival risks for the mutual form and potential problems arising in the demutualization process.

Stroke unit treatment: long-term effects

Summary Since the 1990s, stroke units have emerged as core elements in effective acute stroke treatment. Consistent adherence to key processes of stroke care, primarily based on effic ient organisational structures, has been the cornerstone of success. On the basis of huge datasets of high quality there is now conclusive evidence of the signific ant contribution of stroke unit care to diminished mortality and functional dependency in the long term. In the subjective awareness of the affected individuals quality of life has improved considerably. Meanwhile the concept has emerged as a platform for new ideas and research promoting stroke care and early neurorehabilitation. This dynamic process includes exploring specifi c treatment of comorbidities and the prevention of early recurrence of stroke, as well as the contribution of occupational and speech and language therapy in the acute phase and their interaction with long-term outcome. Current issues include strategies in assessment and treatment of atrial fi brillation, hypertension and diabetes mellitus at hyperacute and acute stage, models of prognostic value in dysphagia used to prevent its inherent risks, and concepts of early language and speech therapy to enhance functional communication. In neurorehabilitation, targeted treatment referred to pathophysiological mechanisms and perception of idiosyncratic in addition to common aspects of functional impairment are major concerns.

Corporate social responsibility and organisation behaviour.

This study shows how the non-parametic optimisation model of Data Envelopment Analysis can be applied to Corporate Social Responsibility in a company-wide analysis of the capacity of people, processes, and other resources to meet the expected social obligations to all stakeholders under the organisation’s promulgated corporate citizenship. Data used in the analysis are the scores of empirical results from an Australian bank study. The DEA model identified 11 decision making units, from a cohort of 231, that were leading exponents of the behavioural characteristics required to be rated as the most efficient in meeting the corporate social responsibility criteria set by the firm. These findings can be used to investigate why some units succeeded so well while others wallowed. The analysis can provide valuable information for developing an efficient organizational structure for the company for achieving good corporate governance.

The Analysis of Information Architecture in Mobile Web Design

The development and design of mobile web should lucubrate mobile users’ psychological perception, thinking patterns, and behavior habits, etc, namely, to look at the mobile web from the users’ points of view. In order to help users to save time and energy in the mission operation and reduce their cognitive load, Information Architecture, as an important part of the mobile web design, should accord with the users’ cognitive and behavioral patterns. This thesis applies algorithms to help organize and classify information so that the web’s organization system is optimized and even more concise and effective. Besides, it puts forwards a number of principles to establish an efficient information organization structure, and proves the operability and validity of this method by means of practical examples. Finally, it outlooks the Information Architecture design and researches of mobile web in future

Design features of organizational structures of the executive branch at regional and municipal levels

The article investigates the question of the optimal and efficient organizational structure of the regional management system based on the analysis of the identified strengths and weaknesses of organizational structures at the regional and municipal levels.

Enforcement at the EPA: High Stakes and Hard Choices. By JOEL A. MINTZ

The approach to enforcing federal environmental law adopted by the United States Environmental Protection Agency (EPA) has been the source of significant controversy since the Agency was established in 1970. Since its inception, the EPA has at various junctures faced public criticism for failing to enforce environmental law effectively, while at other times has been lambasted for seemingly over-zealous wielding of its not insubstantial enforcement powers. In this updated edition (the first edition was published back in 1995), Mintz conveys the turbulent tale of how the EPA’s approach to a critical aspect of its work has evolved in response to pressure from a variety of sources: civil society, external political developments, industry resistance and shifting internal regulatory culture. In doing so, he considers a plethora of features of the enforcement experience that environmental regulators in any jurisdiction will be familiar with—coping with budgetary constraints, acquiring and retaining public confidence, developing effective sanctioning tools, maintaining a consistent enforcement policy, dealing with staff attrition, managing regulatory discretion, avoiding agency capture, establishing effective and efficient organisational structures, negotiating successful interagency and institutional relationships, and responding to official scrutiny of enforcement practice. These diverse issues are explored through an historical account of enforcement at the EPA during different eras of its operation, creating a narrative that not only gives a fascinating insight into the impact of wider political developments in the USA on day-to-day environmental regulation, but which also clearly conveys the challenges faced by enforcement staff who actually implement environmental law ‘on the ground’.

El espacio catalán de relaciones laborales: breve reflexión sobre el modelo de participación institucional

La actual situación económica ha reabierto el debate sobre la reforma de la administración pública, concretamente desde la vertiente del gasto que realiza y el tipo de servicios que debe seguir prestando o no. Asimismo, se han promovido diversos estudios e informes que cuestionan la viabilidad de determinados organismos públicos, con el objetivo de buscar una mejor eficiencia y evitar duplicidades. En este sentido, se plantea la reflexión sobre tres organismos que forman parte del marco de relaciones laborales de Catalunya (El Consejo de Relaciones Laborales, El Tribunal Laboral de Catalunya y el Consejo de Trabajo, Económico y Social de Catalunya), con el fin de explorar posibles modelos institucionales alternativos, que se construiran aplicando la metodología de los MOE’s (modelos de orientación estratégica), que se ajusten mejor a la realidad económica y laboral y que, en todo caso, den respuesta a la necesidad de establecer estructuras organizativas más eficientes.

The institutional representation of the main religions in Europe

The institutional and organisational presence of the main religions in Europe is diverse. Representatives of Christianity, Islam or Judaism hold different status in their relations with the EU structures. The forms, range and dynamics of their actions vary as well. The position of Christianity in the discussions over the various issues of European policies is strengthened by the preponderance of Christianity in Europe, its proven and efficient organisational structures within the European Union, as well as the support granted to the Catholic Church by the Holy See.

A Generic Model for SOA Governance

A large number of concepts such as, composition, abstraction, autonomy, lose-coupling, are introduced with Service Oriented Architecture (SOA). This diversity of concept is at the same time the strength and weakness of SOA because it may affect the realization of its benefits if not well controlled. Therefore, it is necessary to adopt an appropriate model based on SOA governance. In this paper, we propose a generic SOA governance model for all service life cycle, from design Time, Run Time to change Time. This model is mainly based on the communication of each phase within a service life cycle among all stakeholders, developers and different department leaders of the organization, so as to check services concerning capability, security and strategic business alignment. This model contains 3 kinds of groups: SOA Board Team is concerned with applying enterprise governance strategy; SOA Core Team is a group of business which takes direction from the SOA Board to help implement the required services, and IT team department which oversees the implementation of SOA related activities. The Case study and its analysis show that the more flexible & efficient organization structure, and a permanent supervisor of the service’s operations and organization goals can be obtained by using our proposed model.

A New Organizational Structure for the International Atomic Energy Agency (IAEA): A Proposal for the Future

The IAEA is one of the most important international organizations within the United Nations system, with a relevant mandate in the field of international peace, security, and the transfer of nuclear technology for its use with peaceful purposes only. The Peace Nobel Prize won by the organization in 2005 in recognition of its work in the promotion of the peaceful uses of nuclear energy is the confirmation of what has been said before. To accomplish its mandate, the IAEA should carry out its activities in the most efficient and effective manner, taking into account the limited human and financial resources now available in the Secretariat, and the level of the resources that could be available during the coming years. For this reason, the IAEA should periodically revise its internal organizational structure, the management process used by the Secretariat to carry out the supervision of the activities to be implemented, the contents of its programs, the working procedures used to implement the approved programs, enhance the training of its staff, among others things. If an organization wants to succeed in achieving the mission for which was established in the most efficient and effective manner, then it should choose adequately its goals, identify the correct course of actions or the best strategies to fulfil the adopted goals, adopt the most efficient internal organizational structure, and allocate the necessary resources to ensure the full implementation of the approved programs. To make sure that the adopted strategies are working, the organization needs to adopt the correct internal organizational structure. Choosing the correct internal organizational structure entails allocating tasks, responsibilities, and decision-making authority within the organization in the most effective manner. One of the main changes that the Secretariat should introduce in its working procedures during the coming years is the establishment of multidisciplinary working teams. These teams will have the responsibility to implement all IAEA technical programs, including all technical cooperation projects approved by the policy making organs of the organization, in the most effective and economical manner.

Administration of Physical Education and Sports in Nigeria

Physical Education is a vital part of total education. It is that process of education that concerns physical activities, which develop and maintain human body. The attainment of its goals depends on its administrative control structure more than any other thing. Physical Education Curriculum is entrenched in the National Policy on Education and thus, it is taught at all levels of educational development in Nigeria. The administration of Physical education is divided into four parts i.e. 6-3-3-4. However, it has not received the required attention from the government partly because of the economic situation in the country. This has greatly affected its growth and development. It is believed in some quarters that despite the negative attitude of the government that Physical Education can survive and still attain its goals in Nigeria with efficient and effective organizational structure. Therefore, this study is proposing an organizational structure model for achieving developmental goal of Physical Education in Nigeria.

公共施設マネジメントの効率化のための研究；地方自治体の組織構造とマネジメント関連業務プロセス

A large amount of infrastructures and public facilities were built with high economic growth in Japan. A lot of municipalities have had a large amount of public facilities since that time. Those huge amounts of public facilities have become deteriorated for several decades and have need of efficient management. However, the problem is that municipalities don't know how to start the facilities management. Further, it is a problem that they have recognized the facilities management as work only of the maintenance department. This study investigates organizational structures and process of construction, improvement, repair of each municipality to propose an efficient organizational structures and management process. The following three are the key problems for the facilities management efficiency improvement.(1) Unification and sharing of information related to facilities(2) Regular building deterioration check(3) Making of the communications between departmentsMoreover, it is also important to advance making of the gross quantity reduction and the appropriate relocation of facilities.

Managing maritime automobile terminals: an approach toward decision-support model for higher productivity

The article describes actions and strategies to obtain higher productivity on maritime automobile terminals. The main focus is on elaboration of efficient and effective organizational structure to model and implement short-term, mid-term and long-term strategies. In addition, with an empiric approach we combined the analyses of current findings in important scientific papers and our acknowledgments in practical research of north Adriatic maritime automobile terminals. The main goal is to propose actions towards increasing system's productivity. Based on our research of the north Adriatic maritime automobile terminals and with Lambert's model an in-deep analysis of limiting factors, user's expectations and possibilities for productivity increase has been performed. Moreover, with our acknowledgments a three-level decision-support model is presented. With an adequate model implementation it is possible to efficiently develop and implement different strategies of productivity measurement and productivity increase, especially in the fields of internal transport productivity, entrance/exit truck gates operations and wagon manipulations. According to our observation a significant increase might be achieved in all three fields.

DGRW-Update: Neurologie – Von empirischen Strategien hin zu evidenzbasierten Interventionen

Stroke, Multiple Sclerosis (MS), traumatic brain injuries (TBI) and neuropathies are the most important diseases in neurological rehabilitation financed by the German Pension Insurance. The primary goal is vocational (re)integration. Driven by multiple findings of neuroscience research the traditional holistic approach with mainly empirically derived strategies was developed further and improved by new evidence-based interventions. This process had been, and continues to be, necessary to meet the health-economic pressures for ever shorter and more efficient rehab measures. Evidence-based interventions refer to symptom-oriented measures, to team-management concepts, as well as to education and psychosocial interventions. Drug therapy and/or neurophysiological measures can be added to increase neuroregeneration and neuroplasticity. Evidence-based aftercare concepts support sustainability and steadiness of rehab results.Mirror therapy, robot-assisted training, mental training, task-specific training, and above all constraint-induced movement therapy (CIMT) can restore motor arm and hand functions. Treadmill training and robot-assisted training improve stance and gait. Botulinum toxine injections in combination with physical and redressing methods are superior in managing spasticity. Guideline-oriented management of associated pain syndromes (myofascial, neuropathic, complex-regional=dystrophic) improve primary outcome and quality of life. Drug therapy with so-called co-analgetics and physical therapy play an important role in pain management. Swallowing disorders lead to higher mortality and morbidity in the acute phase; stepwise diagnostics (screening, endoscopy, radiology) and specific swallowing therapy can reduce these risks and frequently can restore normal eating und drinking.In our modern industrial societies communicative and cognitive disturbances are more impairing than the above mentioned disorders. Speech and language therapy (SLT) is dominant in communicative disorders; the therapists use communicative and/or linguistics-oriented strategies. SLT must begin early after disease onset and with high frequency to elicit good results. PC-assisted (self-)training, possibly telemedically applied, can increase training frequency and time and, hence, improve outcome in aphasia. High-frequency and task-specific training, often PC-assisted, were found to be relevant for improving cognitive functions in all dimensions. Several strategies seem to be efficient in neglect. Visual field deficits can be treated restitutively and compensatingly by PC-assisted training. Attention, memory and executive dysfunctions each require multimodal specific treatment strategies, performed in single and group therapy and in PC-assisted training. Also, education of patients to cope with their impairments and disabilities is another important part. Combined medically and vocationally oriented rehabilitation settings are necessary for raising the rate of return-to-work, especially in patients with motor hand impairments or cognitive disorders. Education of patients and relatives to cope with the chronic neurological diseases and disablements highly improve the sustainability of rehab results and can, in the long run, also reduce mortality and admission to nursing homes. Appropriate physical activity and sports are relevant in the phase of aftercare, by stabilizing both motor coordination and cognitive factors; in MS patients fatigue can be diminished effectively.The main mental comorbidities are anxiety and depression. Pharmacological and psychological treatments have been found to be equally important in this context. Frequently, these mental disorders appear in the phase of aftercare and long-term course only, then worsening outcome sustainability. Efficient concepts to deal with this aspect are still missing. The ambulatory health care system can not cope with it until now.The multitude of evidence-based interventions have over the last 20 years after the Rehab Commission of the Federation of the German Pension Insurance Institutes contributed decisively to even improving primary outcomes and quality of life of neurological patients in spite of shortened length of stay and other restrictions. Neurorehabilitative research, especially the clinically oriented part, had a major influence on the process of professionalization of all members in the neurorehabilitative team. This fact enables new and more efficient organizational structures and working processes within the team; the discussion on this topic has however only just started.

Managing maritime automobile terminals: an approach toward decision-support model for higher productivity

The article describes actions and strategies to obtain higher productivity on maritime automobile terminals. The main focus is on elaboration of efficient and effective organizational structure to model and implement short-term, mid-term and long-term strategies. In addition, with an empiric approach we combined the analyses of current findings in important scientific papers and our acknowledgments in practical research of north Adriatic maritime automobile terminals. The main goal is to propose actions towards increasing system's productivity. Based on our research of the north Adriatic maritime automobile terminals and with Lambert's model an in-deep analysis of limiting factors, user's expectations and possibilities for productivity increase has been performed. Moreover, with our acknowledgments a three-level decision-support model is presented. With an adequate model implementation it is possible to efficiently develop and implement different strategies of productivity measurement and productivity increase, especially in the fields of internal transport productivity, entrance/exit truck gates operations and wagon manipulations. According to our observation a significant increase might be achieved in all three fields.

Individual entrepreneurship capacity and small and medium enterprises (SME) performance: A human and organizational capital approach

This paper adds to the eclectic framework of entrepreneurship, through the evaluation of the impact of human capital and organizational capital determined by the entrepreneur on SME performance. The use of the stepwise method provides the selection of significant variables that have an impact on small and medium enterprises (SME) performance. When non-economic performance is considered, regarding human capital, the study finds out that the only significant variable is enthusiasm at work. In relation to organizational capital, the significant variables are: efficient organizational structure, participative management and incentives for interdisciplinary discussion and dialogue. In turn, when the economic performance is analyzed, the study reveals that the unique significant human capital determinant is the entrepreneur’s intuition and the only organizational capital that the study detects is related to the building of an efficient organizational structure. Key words: Individual entrepreneurship capacity, human capital, organizational capital, performance.