Lorella Cannavacciuolo, Adelaide Ippolito, Cristina Ponsiglione, Gaetano Rossi and Giuseppe Zollo
This paper aims to investigate the performances of decision-making process of emergency department’s nurses involved in the triage level assessment.
Abstract
Purpose
This paper aims to investigate the performances of decision-making process of emergency department’s nurses involved in the triage level assessment.
Design/methodology/approach
The authors developed a case study in two public hospitals in the South of Italy. The authors administered 25 clinical cases to nurses responsible of priority code assignment in the triage station. The authors simulated the attribution of the priority levels, and through a semi-structured questionnaire, the authors collected data and information about the cognitive process adopted for the final choice.
Findings
The quantitative and qualitative data allowed the authors to verify that there is an impact of the organizational context on heuristics used in the decision-making process.
Research limitations/implications
The research limitations are that empirical data have been collected only in two emergency departments.
Practical implications
The practical implications of this paper are that organizations for improving business performances must consider the judgements are often the results of heuristics embedded in a specific structure of social and physical environment, according with the “ecological view” of rationality.
Originality/value
The authors’ methodological approach contributes to analyze the performances of the triage process, verifying if the eventual errors are linked to individual or organizational factors, but above all how organizational constraints influence decision-making processes in organizations and, consequently, business performances.
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Lorella Cannavacciuolo, Luca Iandoli, Cristina Ponsiglione, Virginia Maracine, Emil Scarlat and Adriana Sarah Nica
The purpose of this paper is to present a social network approach for identification of micro-organizational re-design interventions to make more efficient and fluid the knowledge…
Abstract
Purpose
The purpose of this paper is to present a social network approach for identification of micro-organizational re-design interventions to make more efficient and fluid the knowledge flow in a rehabilitation multidisciplinary team. The structural information of different kinds of knowledge networks within a team is augmented with additional analyses aimed at collecting information about the ways through which participants use knowledge, the motivation behind knowledge exchange, and the non-human knowledge sources used by subjects to perform their work. This paperwork was supported by CNCSIS – UEFISCDI, project number PNII – IDEI 810/2008.
Design/methodology/approach
The authors propose a definition of knowledge network including human and non-human knowledge source (documents and knowledge repositories) as it is more adequate for the analysis of knowledge flows in multidisciplary medical teams. The mapping and analysis of the network are carried out through: elicitation of knowledge flows between people within and outside the team through a structured questionnaire; mapping of the knowledge flows toward non-human knowledge sources; and identification of critical aspects and proposal of re-engineering interventions to make knowledge flow more efficient and effective.
Findings
The analysis of the critical aspects emerged in the field study identifies a number of opportunities to improve the efficiency and effectiveness of knowledge sharing through the re-design of the team network. The re-design interventions concern three main features of knowledge network: “knowledge centralization,” “Over-reliance on External experts,” “Unshared knowledge tools and sources.”
Originality/value
The originality of the work resides in applying social network analysis (SNA) for healthcare management settings, proving evidence and guidelines to show how healthcare organizations can benefit from the adoption of SNA-based approaches.
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M. Glòria Barberà-Mariné, Lorella Cannavacciuolo, Adelaide Ippolito, Cristina Ponsiglione and Giuseppe Zollo
The purpose of this paper is to investigate the influence of organizational factors on individual decision-making under conditions of uncertainty and time pressure. A method to…
Abstract
Purpose
The purpose of this paper is to investigate the influence of organizational factors on individual decision-making under conditions of uncertainty and time pressure. A method to assess the impact of individual and organizational factors on individual decisions is proposed and experimented in the context of triage decision-making process.
Design/methodology/approach
The adopted methodology is based on the bias-variance decomposition formula. The method, usually applied to assess the predictive accuracy of heuristics, has been adjusted to discriminate between the impact of organizational and individual factors affecting heuristic processes. To test the methodology, 25 clinical scenarios have been designed and submitted, through simulations, to the triage nurses of two Spanish hospitals.
Findings
Nurses’ decisions are affected by organizational factors in certain task conditions, such as situations characterized by complete and coherent information. When relevant information is lacking and available information is not coherent, decision-makers base their assessments on their personal experience and gut feeling.
Research limitations/implications
Discriminating between the influence of organizational factors and individual ones is the starting point for a more in-depth understanding of how organization can guide the decision process. Using simulations of clinical scenarios in field research does not allow for capturing the influence of some contextual factors, such as the nurses’ stress levels, on individual decisions. This issue will be addressed in further research.
Practical implications
Bias and variance are useful measurements for detecting process improvement actions. A bias prevalence requires a re-design of organizational settings, whereas training would be preferred when variance prevails.
Originality/value
The main contribution of this work concerns the novel interpretation of bias and variance concepts to assess organizational factors’ influence on heuristic decision-making processes, taking into account the level of complexity of decision-related tasks.
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Pierluigi Rippa, Cristina Ponsiglione, Anca Bocanet, Guido Capaldo and Giuseppe Zollo
The purpose of this paper is to contribute to the debate on exploration–exploitation trade-off in the context of new ventures creation, where, particularly at the empirical level…
Abstract
Purpose
The purpose of this paper is to contribute to the debate on exploration–exploitation trade-off in the context of new ventures creation, where, particularly at the empirical level, there is a limited understanding of whether and how this trade-off is achieved and how start-ups performances are affected by the way in which they face the exploration–exploitation dilemma.
Design/methodology/approach
A qualitative case study approach has been adopted as a methodology to conduct the research. Six Italian innovative start-ups were selected and analyzed through in-depth interviews with founders and data collection to understand whether and how start-ups adopt exploration and exploitation solutions to face critical events in their business lives.
Findings
The most evident result of this study is that start-ups adopt more frequently a temporal separation of exploration and exploitation activities as the preferred mode for balancing learning and innovation tension. They do not seem to exhibit a defined or a common path in the way they realize the temporal separation between exploration and exploitation. Instead, they mostly oscillate. The ambidextrous solution is selected in only a few cases and not consecutively. The pre-entry knowledge profile seems to influence the choice of start-ups at the beginning of their lives.
Practical implications
This research has implications for the whole start-up’s ecosystem, comprising incubators/accelerators, advisors, intermediaries, venture capitalists, new venture founders and policymakers. For example, by knowing the typology of knowledge and competence gaps start-ups usually aim to fill when they face particular events, intermediaries (such as incubators) could better plan initiatives and strategies supporting new ventures in the process of growth and stabilization. Furthermore, the venture capitalists can benefit from this research, by planning specific interventions for each critical event based on specific resources and competencies gaps and guiding for more promising start-ups.
Originality/value
This paper presents a novel application of entrepreneurial learning approach in the context of new venture creation. To reach this aim, a classification of exploration/exploitation solutions has been developed.
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Cristina Ponsiglione, Adelaide Ippolito, Simonetta Primario and Giuseppe Zollo
The purpose of this paper is to explore the configuration of factors affecting the accuracy of triage decision-making. The contribution of the work is twofold: first, it develops…
Abstract
Purpose
The purpose of this paper is to explore the configuration of factors affecting the accuracy of triage decision-making. The contribution of the work is twofold: first, it develops a protocol for applying a fuzzy-set qualitative comparative analysis (fsQCA) in the context of triage decision-making, and second, it studies, through two pilot cases, the interplay between individual and organizational factors in determining the emergence of errors in different decisional situations.
Design/methodology/approach
The methodology adopted in this paper is the qualitative comparative analysis (QCA). The fuzzy-set variant of QCA (fsQCA) is implemented. The data set has been collected during field research carried out in the Emergency Departments (EDs) of two Italian public hospitals.
Findings
The results of this study show that the interplay between individual and contextual/organizational factors determines the emergence of errors in triage assessment. Furthermore, there are some regularities in the patterns discovered in each of the investigated organizational contexts. These findings suggest that we should avoid isolating individual factors from the context in which nurses make their decisions.
Originality/value
Previous research on triage has mainly explored the impact of homogeneous groups of factors on the accuracy of the triage process, without considering the complexity of the phenomenon under investigation. This study outlines the need to consider the not-linear relationships among different factors in the study of triage’s decision-making. The definition and implementation of a protocol to apply fsQCA to the triage process in EDs further contributes to the originality of the research.
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Lorella Cannavacciuolo, Luca Iandoli, Cristina Ponsiglione and Giuseppe Zollo
The purpose of this paper is to explain the emergence of collaboration networks in entrepreneurial clusters as determined by the way entrepreneurs exchange knowledge and learn…
Abstract
Purpose
The purpose of this paper is to explain the emergence of collaboration networks in entrepreneurial clusters as determined by the way entrepreneurs exchange knowledge and learn through business transactions needed to implement temporary supply chains in networks of co-located firms.
Design/methodology/approach
A socio-computational approach is adopted to model business transactions and supply chain formation in Marshallian industrial districts (IDs). An agent-based model is presented and used as a virtual lab to test the hypotheses between the firms’ behaviour and the emergence of structural properties at the system level.
Findings
The simulation findings and their validation based on the comparison with a real world cluster show that the topological properties of the emerging network are influenced by the learning strategies and decision-making criteria firms use when choosing partners. With reference to the specific case of Marshallian IDs it is shown that inertial learning based on history and past collaboration represents in the long term a major impediment for the emergence of hubs and of a network topology that is more conducive to innovation and growth.
Research limitations/implications
The paper offers an alternative view of entrepreneurial learning (EL) as opposed to the dominant view in which learning occurs as a result of exceptional circumstances (e.g. failure). The results presented in this work show that adaptive, situated, and day-by-day learning has a profound impact on the performance of entrepreneurial clusters. These results are encouraging to motivate additional research in areas such as in modelling learning or in the application of the proposed approach to the analysis of other types of entrepreneurial ecosystems, such as start-up networks and makers’ communities.
Practical implications
Agent-based model can support policymakers in identifying situated factors that can be leveraged to produce changes at the macro-level through the identification of suitable incentives and social networks re-engineering.
Originality/value
The paper presents a novel perspective on EL and offers evidence that micro-learning strategies adopted and developed in routine business transactions do have an impact on firms’ performances (survival and growth) as well as on systemic performances related to the creation and diffusion of innovation in firms networks.
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Lorella Cannavacciuolo, Maddalena Illario, Adelaide Ippolito and Cristina Ponsiglione
The purpose of this paper is to set out a methodological framework to investigate how the integration of an activity-based costing (ABC) logic into the pre-existent accounting…
Abstract
Purpose
The purpose of this paper is to set out a methodological framework to investigate how the integration of an activity-based costing (ABC) logic into the pre-existent accounting system supports healthcare organizations in identifying the inefficiencies related to their diagnostic therapeutic pathways (DTP) and related reengineering interventions.
Design/methodology/approach
The BPM-ABC methodological framework has been applied to the case of a specific surgery pathway, at the Orthopaedic Division of a University Hospital in Italy.
Findings
The case-study described in the paper points out: first, how the Business Process Management (BPM)-ABC methodology is able to produce significant information about consumed resources and the costs of the activities, useful to highlight opportunities for DTPs improvement; second, the barriers related to a pre-existing accounting system based on cost centres that can hinder the implementation of the BPM-ABC model.
Practical implications
The case study points out the role of the ABC as a management tool for supporting decision-making processes. The ABC allows inferring information for two purposes. First, ABC supports a cost containment process as it allows highlighting the most cost-consuming activities and resources. Second, the ABC allows identifying reengineering paths, distinguishing between incremental and radical ones.
Originality/value
This study represents a remarkable reference raising the awareness of the pivotal role accounting systems play in the management of the organizational processes.
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Anca Bocanet and Cristina Ponsiglione
The objective of this study is to model and analyze the exploration‐exploitation dynamics of March's model of mutual learning in a complex environment. By enhancing the above…
Abstract
Purpose
The objective of this study is to model and analyze the exploration‐exploitation dynamics of March's model of mutual learning in a complex environment. By enhancing the above mentioned model, the paper seeks to propose a new agent‐based model of mutual learning within an organization.
Design/methodology/approach
The paper replicates March's model of simulating learning within an organization using an agent‐based simulation approach, and extends it by modelling the problem space as a fitness landscape using Kauffman's NK model technique.
Findings
It was found that it is impossible to find a right balance between exploration and exploitation using the communication structure of March's model.
Practical implications
The proposed model could help create a virtual laboratory for experimenting organizations' behavior in a complex co‐evolving environment. This virtual laboratory may be used in the future to support the decision‐making process of managers and policy makers.
Originality/value
Designing the external environment as a fitness landscape helps in discovering what effect the environmental complexity has on the emerging balance between exploration and exploitation. It is the first study to design the environment of a model which analyzes the mutual learning between an organization and its members as a complex non‐linear space.
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Lorella Cannavacciuolo, Luca Iandoli, Cristina Ponsiglione and Giuseppe Zollo
This paper aims to present a methodology for the mapping and evaluation of suppliers’ competencies and know-how. The authors operationalize the concept of organizational…
Abstract
Purpose
This paper aims to present a methodology for the mapping and evaluation of suppliers’ competencies and know-how. The authors operationalize the concept of organizational competence and provide companies with a customized management tool to map suppliers’ critical competencies for screening strategic from non-strategic suppliers and providing inputs for suppliers’ development.
Design/methodology/approach
Competencies assessment, carried out through a fuzzy knowledge management system (VINCI), is performed through the aggregation of indicators related to the control of critical resources, the degree of implementation of critical processes, the competitive positioning and the financial situation of a supplier. Competencies description and operationalization are based on the bottom-up elicitation of the subjective knowledge managers actually use to assess suppliers’ capability. Such subjective knowledge is then validated and formalized through a top-down approach based on strategic literature.
Findings
The authors tested VINCI on a sample of 38 suppliers of a large company. The results show that the methodology provides its users with a highly customizable knowledge map and its associated decision support tool that keeps into account the peculiar strategic needs of the company in the management of an existing portfolio of suppliers.
Practical implications
VINCI outcomes can be used to perform benchmarking analyses, define entry criteria and thresholds for suppliers’, identify improvement targets and service levels to be considered in the definition of supply contracts, supporting the alignment of supplier’s management with business strategy.
Originality/value
The most important original contribution of this work resides in the operationalization and measurements of firms’ competencies based on the elicitation of subjective knowledge that managers use in the actual assessment. A further distinctive feature of this paper is that the method is applied to small and medium companies, whereas large part of the literature on core or organizational competencies assessment is focused on large companies.
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Giovanni Schiuma, Daniela Carlucci and Antonio Lerro
Nowadays organizations have realized that knowledge, its effective use and the fast acquisition and utilization of new knowledge represent the only source of sustainable…
Abstract
Purpose
Nowadays organizations have realized that knowledge, its effective use and the fast acquisition and utilization of new knowledge represent the only source of sustainable competitive advantage. In fact, an effective exploitation and management of knowledge resources are the basis of the development of those capabilities that ground the organization's capacity to deliver successfully targeted value propositions. During recent decades, there has been a growing interest in the processes of management of knowledge resources. Currently the debate on knowledge management processes is still lively. The dynamics which link knowledge processes to value creation, the valuation of their impact on organizational performance and the role of some organizational and technological resources as enablers or restraints of successful knowledge management emerge as relevant topics to be investigated. This introduction to the special issue aims to develop some theoretical and managerial reasons explaining the importance of an effective management of knowledge processes to deal with the uncertainty, change, and turbulence of the current socio‐economic scenario.
Design/methodology/approach
The approaches, evidences and insights discussed in this introduction are largely based on the discussion of the topics of the conference “International forum on knowledge assets dynamics” organized in June 2010 in Matera, Italy. At this conference, leading experts discussed the challenges and practices of measuring and managing knowledge resources to support value creation and business performance improvement of organisational systems.
Findings
The outcomes of this introduction and of all the contributions to the special issue reflect the emerging discussion about the role of knowledge processes and, more generally, of the management of knowledge resources, in value creation. This discussion is largely focused on the dynamics at the base of the translation of knowledge processes and resources into value, highlighting properly approaches and tools or application in different contexts of analysis.
Originality/value
This introduction, as well as all the contributions to the special issue, deal with different aspects which are important in the discussion both of the role played by knowledge processes in achieving outstanding organisational performance and the approaches, tools, methods and techniques to structure, organize knowledge resources and optimize their use in order to support effective organizational processes execution and value creation.