Kate Jelinek and Pamela S. Stuerke
This paper aims to examine the impact of managerial equity ownership on return on assets as a measure of profitability and two financial statement‐based agency cost measures, i.e…
Abstract
Purpose
This paper aims to examine the impact of managerial equity ownership on return on assets as a measure of profitability and two financial statement‐based agency cost measures, i.e. asset utilization and an expense ratio, which proxy for management's efficiency in use of assets and perquisite consumption, respectively.
Design/methodology/approach
Multivariate tests are constructed to examine the nonlinear relation between managerial equity ownership and both profitability and agency costs, using interaction terms to capture the relation at various levels of managerial ownership.
Findings
The paper documents that managerial equity ownership is nonlinearly and positively associated with return on assets and asset utilization, and nonlinearly and negatively associated with the expense ratio, after controlling for firm size, leverage, corporate diversification, institutional ownership, research intensity, firm age, and executive stock options.
Research limitations/implications
The results imply that the ability of managerial equity ownership to reduce agency costs decreases as levels of ownership increase. Further, the results indicate that, in some industries, high levels of ownership lead to increased expense ratios, suggesting increased perquisite consumption. Finally, these results suggest that, above a certain level in some industries, managerial equity ownership only marginally encourages efficient asset utilization but does not significantly deter excessive spending.
Originality/value
The paper provides a link between research that demonstrates a linear relation between managerial equity ownership and financial‐statement based profitability and agency cost measures and research that finds a nonlinear relation between managerial equity ownership and Tobin's Q, a proxy for firm performance.
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Rachael L. Narel, Therese Yaeger and Peter F. Sorensen
The environment in which businesses operate today is uncertain, chaotic, and changing at a more rapid pace than ever before. In this new dynamic world, current approaches to…
Abstract
The environment in which businesses operate today is uncertain, chaotic, and changing at a more rapid pace than ever before. In this new dynamic world, current approaches to organizational design and processes are not as effective as they have been. Recent research has provided insight into organizational agility as a method to help organizations survive and thrive in these environments. A divergent body of literature is presented that explores agility, learning, and thriving. An exploratory mixed-methods study was conducted at the team level to examine the relationship between these constructs as well as their relationship to performance. Based on the results, we present a series of propositions for future research and provide an illustration of the Components of Agile and Thriving teams to be used as its foundation. The discussion serves to synthesize these initial findings and provide both implications for practice as well as theory.
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Kate Silvester, Paul Harriman, Paul Walley and Glen Burley
– The purpose of the paper is to investigate the potential relationships between emergency-care flow, patient mortality and healthcare costs using a patient-flow model.
Abstract
Purpose
The purpose of the paper is to investigate the potential relationships between emergency-care flow, patient mortality and healthcare costs using a patient-flow model.
Design/methodology/approach
The researchers used performance data from one UK NHS trust collected over three years to identify periods where patient flow was compromised. The delays’ root causes in the entire emergency care system were investigated. Event time-lines that disrupted patient flow and patient mortality statistics were compared.
Findings
Data showed that patient mortality increases at times when accident and emergency (A&E) department staff were struggling to admit patients. Four delays influenced mortality: first, volume increase and mixed admissions; second, process delays; third, unplanned hospital capacity adjustments and finally, long-term capacity restructuring downstream.
Research limitations/implications
This is an observational study that uses process control data to find times when mortality increases coincide with other events. It captures contextual background to whole system issues that affect patient mortality.
Practical implications
Managers must consider cost-decisions and flow in the whole system. Localised, cost-focused decisions can have a detrimental effect on patient care. Attention must also be paid to mortality reports as existing data-presentation methods do not allow correlation analysis.
Originality/value
Previous studies correlate A&E overcrowding and mortality. This method allows the whole system to be studied and increased mortality root causes to be understood.
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Nicole Gross, David Carson and Rosalind Jones
– The purpose of this paper is to propose the application of social practice theory for the investigation of entrepreneurial marketing (EM) practices.
Abstract
Purpose
The purpose of this paper is to propose the application of social practice theory for the investigation of entrepreneurial marketing (EM) practices.
Design/methodology/approach
A theoretical gap has been found between scholarly efforts to explain the nature of EM practice and the actual marketing practice or marketing doings of small firms.
Findings
The paper covers some of the EM literature and perspectives and examining the notion of “practice” in small- and medium-sized enterprises (SME) and entrepreneurship research. Based on an increasing focus on practice in the social theory literature and the contributions of key social theorists, a discussion is framed in terms of how EM practice can be studied through the investigation material and bodily observations and common interpretations.
Research limitations/implications
The paper offers a proposal that the observations of practitioners’ actions and activities and the investigation of common interpretations can be conceptualized to explain the nature of EM practice. It also gives avenues for future research.
Practical implications
The paper suggests that marketing comprises a wide scope of activities or practices and, in the case of a small firm, is all-pervasive. It also suggests that scholars engage in understanding the collective, distributed, situated, ongoing and tacit nature of EM.
Originality/value
The paper provides a fresh conceptual approach about how EM practice can be studied through the investigation material and bodily observations as well as common interpretations.
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The purpose of this paper is to examine the motives of female childless self-initiated expatriates (SIEs) in deciding to work abroad, so far under-researched.
Abstract
Purpose
The purpose of this paper is to examine the motives of female childless self-initiated expatriates (SIEs) in deciding to work abroad, so far under-researched.
Design/methodology/approach
The study departs from prior research in using a new methodological approach, i.e. the analysis of online diaries (blogs) to explore the motives of a specific population to relocate.
Findings
The emergent model of motivations is based upon four main dimensions that emerged from the socially constructed experience of these single childless female SIEs: escape as main motivation, confrontation to reality, identity reconstruction and purpose of expatriation.
Originality/value
The findings reveal new elements of motivations to move abroad such as the complete absence of the notion of career from the blog posts, replaced, however, by a feminist and existentialist reflection.
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Rowena Catipay Buyan, Jill Aylott and Duncan Carratt
Over half of adults under the age of 65 years will be diagnosed with cancer at some point in their lives (Ahmad et al., 2015). Demand for services is outstripping the capacity in…
Abstract
Purpose
Over half of adults under the age of 65 years will be diagnosed with cancer at some point in their lives (Ahmad et al., 2015). Demand for services is outstripping the capacity in the NHS, as 77% of NHS Trusts are unable to start treatment within 62 days (Baker, 2019; NHS England, 2019). Side effects of treatment can be life threatening (Tsai et al., 2010) with many patients attending ED; however, these can be managed through a hospital’s Acute Oncology Service (AOS). This paper aims to explore a collaborative leadership approach to improve services for patients [Rubin et al., 2015; Department of Health (DOH), 2012].
Design/methodology/approach
A case study of an AOS in an NHS Trust was the focus for the development of a strategy of ‘Collaborative’ leadership, with the aim to increase the engagement of a wide network of clinical and non-clinical stakeholders in a review of the AOS. The case study identified the level of effectiveness of the service since its inception in 2012. Using a quality improvement methodology (Deming 2000; Health Foundation, 2011; Aylott, 2019) resulted in learning and increased collaboration between clinical and non-clinical staff.
Findings
Action learning processes revealed that AOS staff had been frustrated for some time about the dysfunction of the current process to manage the increased demand for the service. They reported their perceptions and frustrations with the current process of referral and patient discharge. Data revealed alerts from the Emergency Department (ED) to AOS resulted in 72% of patients inappropriately referred, with an over representation of patients who had a previous existing cancer condition. Clinical engagement with the data informatics manager (DC) revealed a need to improve data quality through improvements made to the database.
Research limitations/implications
Increasing demand for cancer services requires a continuous need for improvement to meet patient needs. Cancer waits for diagnostic tests are at their highest level since 2008, with 4% of patients waiting over 6 weeks to be tested compared to the tested target of 1% (Baker, 2019). This paper draws on data collected from 2017 to 2018, but a continuous review of data is required to measure the performance of the AOS against its service specification. Every AOS team across the NHS could benefit from a collaborative learning approach.
Practical implications
Clinical services need collaborative support from informatics to implement a Quality Improvement methodology such as the IHI Model for Improvement (IHI, 2003). Without collaboration the implementation of a quality improvement strategy for all NHS Trusts will not come to fruition (Kings Fund, 2016). Quality Improvement Strategies must be developed with a collaborative leadership implementation plan that includes patient collaboration strategies (Okpala, 2018), as this is the only way that services will be improved while also becoming cost effective (Okpala, 2018).
Social implications
In the UK, 20-25% of new cancer diagnoses are made following an initial presentation to the ED (Young et al., 2016). Cancer-related attendances at ED had a higher level of acuity, requiring longer management time and length of stay in ED. With cancer care contributing to 12% of all hospital admissions, an increase of 25% over the past two decades (Kuo et al., 2017) the AOS will need continued collaboration between clinical staff, informatic managers, patients and all stakeholder organisations to continuously improve its services to be “fit for purpose”.
Originality/value
This case study reports the innovative collaborative work between a Medical Oncologist, an NHS Trust Informatics manager and a QI academic facilitator. The Health Foundation and Kings Fund have identified the continued challenges presented to the NHS in the transformation of its services, with the Health Foundation (2011) reporting the need for more collaborative working between clinicians and non-clinicians to drive improvement. This model of collaboration creates a new way of working to drive improvement initiatives and sets out a rationale to develop this model further to involve patients. However, this will call for a new way of working for all.