Extensive Organizational Changes Research Articles

Patient and Staff Satisfaction and Experience While Transforming Health Center Systems

Patient satisfaction and experience are important measures of overall quality of care. In 2017, the National Association of Community Health Centers (NACHC) launched an initiative to facilitate changes across organizational systems within Federally Qualified Health Centers (FQHCs) with the goal of improving value-driven care. NACHC worked with eight health centers, four in Georgia and four in Iowa, along with their state Primary Care Associations, to apply the Value Transformation Framework (VTF). This framework distills evidence-based practices into practical knowledge for goal-driven systems change. It provides actionable steps to help health centers reach value-driven goals of improved health outcomes, improved patient and staff experience, reduced costs, and improved equity (referred to as the Quintuple Aim goals). This paper reports on the patient and staff experience when applying VTF systems changes to improve colorectal cancer screening rates. Patient and staff satisfaction and experience remained highly rated even after extensive organizational changes were implemented as part of this project. Implementation of a systems-approach to organizational change, through application of the VTF, did not negatively impact patient or staff experiences. Patient and staff satisfaction and experience were positive despite the application of the VTF and systems-wide organizational changes. These experience results were alongside improved cancer screening rates, as observed from full project results. Investigators are encouraged that the application of systems change using the VTF may result in the achievement of Quintuple Aim goals without disrupting the experience of patients and staff. Investigators recommend continued exploration of this transformation approach.

Mapping and Building Organizational Capacity for Stronger Local Institutions

Local CSOs have been concerned about increasing their project success rates as well as in ensuring that their capacities facilitate the delivery of their strategic mandates. However, few of them have been able to effectively address the capacity gaps they encounter during periods of massive growth experienced as community needs and project management requirements increase. Capacity building seeks to understand what exists, to utilize and strengthen existing capacities and therefore does not mean starting from scratch. It is evidence driven process to improve the ability and performance of the organization and its employees. However, in some situations radical and extensive organizational changes may be needed to build the competence of the organizations. This article highlights the importance of designing capacity building interventions that are context specific and guided by evidence collected from individual organizations. The aim of the capacity assessment exercise was to identify the existing capacity of the selected organizations so as to improve systems and technical capacity that is required to support project implementation. The exercise revealed that eighty (80) percent of the organizations had a functional governance structure in place; most of the organizations had relevant organizational policies in place, staff job descriptions and contracts were in place; some of the organizations had strong networks and linkages with the government and other stakeholders. However, gaps observed related to insufficient governance structures and management processes that were barriers to sustaining the growth of the organizations. A recommended approach to facilitate and enhance CSOs’ organizational capacity was the establishment of a proactive system that encourages learning and empowers the organizations to initiate relevant changes to enhance its capacity within the operating context.

Implementation of Self-Government Tasks in the Field of Social and Vocational Rehabilitation of Disabled People in the Lubelskie Voivodeship in 2008-2017

Abstract Disability is an interdisciplinary-medical, social and professional phenomenon. The goal of medical professionals is to treat a person and restore his or her fitness. The group of disabled people in Poland is characterized by a lower level of education than among non-disabled people and high unemployment. The purpose of vocational rehabilitation is to make it easier for a disabled person to obtain and maintain appropriate employment and career advancement. Social rehabilitation is defined as an activity aimed at enabling a disabled person to fully participate in social life. The tasks of the local government addressed to disabled people include conducting occupational therapy workshops (WTZ), occupational activity establishments (ZAZ), community self-help homes (ŚDS) and social welfare homes (DPS). The aim of the study was to analyze the implementation of self-government tasks in the field of social and vocational rehabilitation of disabled people, with particular emphasis on ZAZ in the Lubelskie Voivodeship in 2008-2017. The work uses data collected in 2008-2017 by the Regional Center for Social Policy (ROPS) in Lublin. In addition, in December 2017, they were sent by e-mail to ROPS and Marshal’s Offices in voivodship cities in Poland, inquiries about tasks and ways of implementing these tasks in the field of social and vocational rehabilitation of disabled people in 2008-2017. The available data on expenditure from the State Fund for Rehabilitation of the Disabled (PFRON) was collected. The research material was statistically developed using the IBM SPSS Statistics (v. 25) and Statistica (v. 13) statistical packages. In the years 2008-2017 in the Lubelskie Voivodeship, PLN 75,529,959 was allocated for vocational and social rehabilitation of people with disabilities, the most (PLN 9,158,243) in 2016. In the same year, the largest number of people used the ZAZ. In 2008-2017, the average annual amount of expenditure on social and vocational rehabilitation of disabled people in all Polish provinces was PLN 7 576 718.9. In the discussed period, the highest amounts from PFRON were allocated to the rehabilitation of disabled people in the Śląskie Voivodeship, and the lowest in Lubuskie, while Lubelskie received average amounts. In Poland, in the field of social and vocational rehabilitation and employment of disabled people, solutions similar to those already developed are applied in the countries of Western Europe. The costs of financing vocational rehabilitation, understood as financing the functioning of the ZAZ by voivodship self-governments, are constantly growing. The growing expenses incurred on the activities of the ZAZ do not significantly improve the situation related to vocational rehabilitation and employment of disabled people. Improving the operation of the system of vocational and social rehabilitation of people with disabilities should not only consist in increasing the funds spent under the current inefficient system, but should be preceded by a thorough analysis of the current state and the development of extensive organizational changes.

Data Processing Languages for Business Intelligence. SQL vs. R

(ProQuest: ... denotes formulae omitted.)1 IntroductionOften seen as a reincarnation of Decision Sup-port Systems [1] and sometimes referred as Business Intelligence and Analytics [2], Busi-ness intelligence (BI) is a broad category of applications, technologies, and processes for gathering, storing, accessing, and analyzing data to help business users make better deci-sions [3]. Figure 1 displays a classical BI ar-chitecture [4].Common business intelligence related tasks are:* data storage* data extraction-transformation-load from various sources in a different for-mats, more or less structured, to the stor-age layer* data processing* information integration* visualization* exploratory analysis* data mining/data science etc.Slightly outdated, the schema in figure 1 is still valid in suggesting the vast array of tech-nologies, processes and tools gathered (or re-branded) within BI umbrella. Chen et al [Chen 2012] identified three generations of BI and Analytics (BI&A) systems whore core tech-nologies have been:* data management and warehousing [5] [6]* text and web analytics for unstructured web contents [7]* mobile technologies [8].Implementation of BI platforms requires vast quantity of organizational resources. Some of the most important current BI solutions are shown in figure 2 [9]. As with Enterprise Re-source Planning applications, BI systems im-plementation requires extensive organiza-tional changes and business expertise and sometimes it requires full vendor participa-tion.Apart from impressive costs, BI platforms have the drawback of keeping captive the cus-tomer. Every organizational change and also new or updated external data source and ser-vice must be negotiated with BI platform pro-vider, which usually attracts new costs and also delays.In this paper we scrutinize two languages, SQL and R, involved not only in BI applica-tion development but especially in the de-mocratization of BI as they allow various types of data professionals and users to access and process vast quantity of data in an inter-active, ad-hoc, way. Using two reliable sources, their role and popularity in current BI market will be outlined, taking into account job demand and a survey concerning BI tools and languages usage. Next the range of BI ac-tivities that can be supported by each SQL and R will be presented. The main section will compare SQL and R features syntax for the most common data processing/reporting prob-lems, particularly important for BI users.2 Languages and Tools for Business Intel-ligenceThere is a vast array of tools, languages and technologies covering large extents of BI tasks. Some of them target regular users who are unable to write code and scripts in any pro-gramming language. Others are BI application developer's toolbox. But there some technol-ogies that serve both users and developers in data processing, integration, visualization and analysis. Comparison of BI tools and lan-guages is also problematic because they can be available as programming languages, de-velopment environments, ecosystems or inte-grated platforms.In evaluating the popularity of Business Intel-ligence languages and tools, we gather infor-mation from two reliable sources. Search en-gine www.indeed.com provides data about job trends. Figure 3 compares job demand in 2012-2016 interval for some of the most im-portant data processing and analysis lan-guages [10].SQL and R share most of the job postings. In 2012 SQL was by far the most demanded data language. Its share decreased slightly and seems to have stabilized since the end of 2014. R grew spectacularly in 2012-2014 interval, overpass SQL in 2014 for a brief period, and then fell back. Since 2014 it has fluctuated around 2% share. After SQL and R, the next popular is Python followed by SAS, SPSS, Stata and Julia. Currently there is still a visible lag between SQL-R group and the rest of the languages/tools, although Python seems to in-crease steadily and might catch up with the leading group. …

The Impact of Organizational Changes on Work Stress, Sleep, Recovery and Health

The study objective was to investigate the impact of different kinds of organizational changes, as well as anticipation of such changes, on work-related stress, sleep, recovery and health. It was hypothesized that impaired sleep and recovery increase the adverse health consequences of organizational changes. The data consisted of cross sectional questionnaire data from a random sample of 1,523 employees in the Swedish police force. It could be shown that extensive organizational changes including downsizing or a change in job tasks were associated with a small increase in work stress, disturbed sleep, incomplete recovery and health complaints. However, less extensive organizational changes like relocation did not affect these outcome variables. Anticipation of extensive organizational changes had almost the same effect as actual changes. Furthermore a moderating effect of sleep and work stress on gastrointestinal complaints and depressive symptoms was found. Thus, like former studies already suggested, extensive organizational changes resulted in increased stress levels, poorer health and impaired sleep and recovery. Furthermore, organizational instability due to anticipation of changes was as negative as actual changes. There was also some evidence that disturbed sleep increased these adverse health effects, in particular with respect to anticipation of organizational changes.

Segregation and Integration of Cortical Connections in the Developing Brain

Segregation and Integration of Cortical Connections in the Developing Brain

The Impact of Leadership on Change Readiness in the US Military

The current study explored the concept of change leadership in a US military organization that was undergoing extensive organizational changes. Participants' (N = 395) leadership perceptions, change readiness indices, and intentions to engage in the change were collected during an organizational assessment. Results indicated that change leadership from senior executives was most predictive of individuals' reported change readiness for military officers and civilian personnel. In addition to change leadership from senior executives, general leadership was also predictive of change readiness for enlisted personnel. Both leadership and change readiness were significantly related to higher intentions to engage in the change initiative. The change readiness of personnel appeared to increase according to the stages outlined by the Transtheoretical Model of behavior change (TTM), thus suggesting that this may be a useful model for predicting intentions to engage in and support organizational change initiatives. Implications for government organizations and the US military are discussed.

The role of HR managers in international mergers and acquisitions: a multiple case study

In recent years human resource (HR) managers have been encouraged to play a more strategic role in their organizations, especially in the case of extensive organizational change processes such as international mergers and acquisitions (IM&As). Today this requirement is even more acute since the past decade has been characterized by enormous growth in IM&As. In addition, it has been argued that the challenge in making M&As work is the management of people. In a case of IM&As the role of HR managers is very demanding because they needs to integrate HR practices and, moreover, perform two other roles simultaneously: a strategic role for company-wide integration and a support role for business unit transaction. Considering the importance of human resource management (HRM) in IM&As, it is surprising how little is known about the role and activities of HR managers in these processes. This study addresses the existing research gap by investigating the role of HR managers in the IM&A process. Based on semi-structured theme interviews among corporate level managers in three Finnish international industrial organizations, the roles of corporate HR managers at different stages of the IM&A process are analysed. This study applies Ulrich's (1997) theory of the four HR roles in combination with the HR issues which are present at the different stages of the IM&A process. This paper demonstrates that HRM is an essential part of M&As and that HR issues are given a lot of emphasis throughout the process. In addition, HR managers play an important role in the IM&A process, although it is not self-evident in every case.

Rho kinase, myosin-II, and p42/44 MAPK control extracellular matrix-mediated apical bile canalicular lumen morphogenesis in HepG2 cells.

The molecular mechanisms that regulate multicellular architecture and the development of extended apical bile canalicular lumens in hepatocytes are poorly understood. Here, we show that hepatic HepG2 cells cultured on glass coverslips first develop intercellular apical lumens typically formed by a pair of cells. Prolonged cell culture results in extensive organizational changes, including cell clustering, multilayering, and apical lumen morphogenesis. The latter includes the development of large acinar structures and subsequent elongated canalicular lumens that span multiple cells. These morphological changes closely resemble the early organizational pattern during development, regeneration, and neoplasia of the liver and are rapidly induced when cells are cultured on predeposited extracellular matrix (ECM). Inhibition of Rho kinase or its target myosin-II ATPase in cells cultured on glass coverslips mimics the morphogenic response to ECM. Consistently, stimulation of Rho kinase and subsequent myosin-II ATPase activity by lipoxygenase-controlled eicosatetranoic acid metabolism inhibits ECM-mediated cell multilayering and apical lumen morphogenesis but not initial apical lumen formation. Furthermore, apical lumen remodeling but not cell multilayering requires basal p42/44 MAPK activity. Together, the data suggest a role for hepatocyte-derived ECM in the spatial organization of hepatocytes and apical lumen morphogenesis and identify Rho kinase, myosin-II, and MAPK as potentially important players in different aspects of bile canalicular lumen morphogenesis.

What Goes Around, Comes Around

This article examines the ideological and philosophical antecedents of current popular management approaches that advocate empowerment through teamwork. These approaches frequently assume that a predisposition toward teamwork is an uncontested historical fact. The author argues that this invokes largely an invented tradition of teamwork, one based on romanticized and mythical depictions of preindustrial work. This invention serves useful ideological and practical purposes for advocates of teamwork, as it depicts extensive organizational change as a return to a more natural form of organization. Accepting, without question, the myth that we have always worked in teams can even give rise to the view that any other way of organizing must be anomalous. In its most extreme form, this involves the assertion that teamwork is an expression of our biologically determined human nature. By revealing the mythical roots of this tradition, this article contributes to a developing critique of the relationship between teamwork and empowerment.

The American Psychoanalytic Association: a decade of change.

The American Psychoanalytic Association in the last decade has undergone the most extensive organizational changes in its history. Efforts at inclusion, outreach, and democratization have halted a decline in candidates, active members, and cultural influence and led to a vibrant, growing organization, as new professional groups have gradually been included in the association's training programs. The goal of increasing training opportunities for minority candidates has only partially been achieved. A recent effort to offer affiliate status to psychotherapists and students has begun, though with modest results. Alliances with otherpsychoanalytic groups have led to creation of the Psychoanalytic Consortium and steady progress toward external accreditation of institutes and licensure of psychoanalysts. In the interest of unification there is a need to develop pathways of affiliation and membership for independent institutes and societies that desire to join the association. Democracy has in large measure already been enhanced at the national level. Deliberations are now transparent, and an invigorated Executive Committee willingly shares power with the Executive Council. Candidates now are deeply involved in the governance of Board and Council and their committees. But only when all members and candidates enjoy full voting rights and all members are able to serve as officers and Executive Councilors will the decades-long effort to democratize the association be concluded.

Designing a viable organization structure

Stafford Beer's Viable Systems Model (VSM) is an exceptionally insightful organizational analysis tool that is conspicuous by its absence from the mainstream strategic planning literature. The authors argue that this is largely due to the theoretically daunting manner in which the model has been presented, and the lack of practical, easy to follow, case studies focused on business organizations. This paper seeks to rectify this, and encourage a wider dissemination of the approach, by providing an introduction to the model and reporting on a consulting assignment with a telecommunications company during a period of extensive organizational change.

Continuous improvement in British manufacturing

Continuous improvement (CI) — sustained, focused, company-wide incremental innovation — is increasingly recognized as a powerful potential source of competitive advantage. Experience — particularly but not exclusively in Japan — suggests that major gains in quality, flexibility and cost saving can result from CI programmes, and as a result there is increasing interest in adopting this approach. However, although simple in concept, CI is difficult to implement and maintain since it requires extensive organizational change and development. This paper reviews experience with CI and outlines some of the key areas in which effective management of such innovations needs to be concentrated.