Jase R Ramsey, Livia Barakat, Matthew C. Mitchell, Thomas Ganey and Olesea Voloshin
The purpose of this paper is to provide evidence that firms that are more committed to internationalization, systematically differ from firms that are less committed to…
Abstract
Purpose
The purpose of this paper is to provide evidence that firms that are more committed to internationalization, systematically differ from firms that are less committed to internationalization in their future intention to engage in foreign direct investment (FDI). The authors analyzed data from 42 large Brazilian multinational enterprises (MNEs) and found that results support previous research on the degree of satisfaction with prior internationalization efforts and future intent to internationalize, such that the relationship between the two is positive. Yet contrary to existing literature, the degree to which a firm was committed to internationalization has a negative influence on the positive relationship between satisfaction and intent.
Design/methodology/approach
All Brazilian firms that have entered foreign markets via FDI were surveyed to measure the firm’s: intent to internationalize; satisfaction with prior internationalization; and commitment to internationalization. Intent to internationalize is future based while both satisfaction and commitment reflect previous year’s activities. The potential response pool included publically traded companies listed on the Bovespa (São Paulo Stock Exchange) and private limited companies (Ltda.). The authors conducted a hierarchical moderated regression analysis to test the moderating effect of commitment to internationalization on the relationship between international satisfaction and intent to internationalize.
Findings
This study adds to the literature by examining how past international satisfaction and commitment affect the future intent to internationalize for large Brazilian MNEs. The results confirm that the degree of past satisfaction regarding a firm’s international business is positively related to the firm’s future intent to internationalize. However, the results diverge from past research in two important ways. First, contrary to the organizational behavior literature, past commitment to internationalization does not have a significant relationship with future intention to internationalize. Second, the results show the relationship between satisfaction and intent is weakened by a high degree of international commitment.
Research limitations/implications
A limitation of this study is the small sample size. While it encompasses the vast majority of large MNEs in Brazil, the authors still do not have enough data points to test more hypotheses such as the effects of firm size, number of countries the firm is in, and age of the firm. Future studies should attempt to expand the work done here by examining these effects. Another limitation of this study is that it is based on solely one country; Brazil. Future studies should attempt to replicate these findings in other emerging market countries.
Practical implications
These results have three main managerial implications. First, international strategists analyzing the trajectory of a firm’s future intentions to internationalize should focus on how satisfied the firm has been with its past efforts. Second, managers should not assume that just because their firms have a large presence abroad that this will subsequently lead to future plans to internationalize. Finally, for emerging market MNEs in a period of the financial crises, committing more to internationalization may reduce the positive relationship between satisfaction and intention.
Originality/value
The purpose of this study is to add to the small but growing work on large MNEs from Brazil in order to better understand their internationalization strategies. While there are literally hundreds of articles investigating the individual-level relationship between satisfaction and the intent to do something, there are a dearth at the firm level (see Wood et al., 2011, as a notable exception). The authors therefore attempt to extend the literature on internationalization by discussing how satisfaction at the firm level affects a firm-level decision.
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The purpose of this research is to investigate the practices of the interim and current CEOs employed in managing a supportive environment conducive for learning as well as…
Abstract
Purpose
The purpose of this research is to investigate the practices of the interim and current CEOs employed in managing a supportive environment conducive for learning as well as sustaining organizational change; and second, to describe the theory of practice guiding their efforts.
Design/methodology/approach
An action science approach, coupled with the case‐study data‐gathering method to enable a pragmatic grounding of the change processes and organizational learning.
Findings
A theory of practice defined as three process principles of power that aid in managing a supportive environment conducive for learning as well as organizational change.
Research limitations/implications
The theory of practice set forth combines two advocated views in using power (position power and empowerment) into a framework of reciprocal‐relational power. The theory needs to undergo further research to test its applicable knowledge in an action context.
Practical implications
Potential guide in helping practitioners in recognizing and implementing processes of reciprocal‐relational power to improve organizational learning and the success of change.
Originality/value
The paper presents a new way to recognize and see reciprocal‐relational forces within a cultural‐social‐political context.
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Dana M. Johnson, Roberta S. Russell and Sheneeta W. White
This research models the impact of patient perceptions of care quality on overall patient satisfaction in a rural healthcare organization over a three-year time period. The…
Abstract
Purpose
This research models the impact of patient perceptions of care quality on overall patient satisfaction in a rural healthcare organization over a three-year time period. The purpose of this paper is to determine if the factors that influence perceptions of service quality change over time and if the change affects overall patient satisfaction.
Design/methodology/approach
Data were collected for three fiscal years (2012-2014) using a 36-question, Likert-scaled attitudinal survey. Multiple regression analysis was performed to identify which constructs of five different service quality dimensions were statistically significant in predicting overall patient satisfaction. Paired comparison of means and ANOVA F-tests highlighted significant differences across years and demographics.
Findings
Multiple regression models of overall patient satisfaction over a three-year time period had significant repeat variables, indicating salience of the dimensions and constructs of service quality that predict patient satisfaction. However, some dimensions of service quality did not remain significant from one year to another, indicating there may be a gap in the patient service cycle over an extended time frame.
Originality/value
This paper explored the sequential relationship between patient satisfaction survey data and perceptions of service quality over a multi-year time frame. The research focussed on outpatient medical clinics, while the majority of previous studies have focussed on acute care or inpatient stays. A longitudinal study is especially relevant for outpatient clinics where continuity of care is important.
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Roberta S. Russell, Dana M. Johnson and Sheneeta W White
Healthcare facilities are entering an era of increased oversight and heightened expectations concerning both reduced costs and measureable quality. The US Affordable Care Act…
Abstract
Purpose
Healthcare facilities are entering an era of increased oversight and heightened expectations concerning both reduced costs and measureable quality. The US Affordable Care Act requires healthcare organizations to collect certain metrics, including patient assessments of quality, in order to monitor and improve the quality of healthcare. These metrics are used as a basis for graduated insurance reimbursements, and are available to consumers as an aid in selecting healthcare providers and insurance plans. The purpose of this paper is to provide healthcare providers with the analytic capabilities to better understand quality of care from the patient’s point of view.
Design/methodology/approach
This research examines patient satisfaction data from a multi-specialty Medical Practice Group, and uses regression analysis and paired comparisons to provide insight into patient perceptions of care quality.
Findings
Results show that variables related to Access, Moving Through the Visit, Nurse/Assistant, Care Provider and Personal Issues significantly impact overall assessments of care quality. In addition, while gender and type of care provider do not appear to have an impact on overall patient satisfaction, significant differences do exist based on age group, specialty of the physician and clinic type.
Originality/value
This study differs from most academic research as it focusses on medical practices, rather than hospitals, and includes multiple clinic types, medical specialties and physician types in the analysis. The study demonstrates how analytics and patient perceptions of quality can inform policy decisions.
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Howard L. Smith, J. Deane Waldman, Jacqueline N. Hood and Myron D. Fottler
This paper analyzes health care as a context for building value through human capital and culture. We examine how health care managers can nurture a favorable culture for…
Abstract
This paper analyzes health care as a context for building value through human capital and culture. We examine how health care managers can nurture a favorable culture for providers enabling them to focus on customer service. A case study of a large medical center examines how organization culture affects clinicians versus support and managerial staff while adversely impacting patient satisfaction and organizational costs associated with turnover and the cost of replacing personnel. An agenda for managing internal customers and organization culture is presented.
Pracha Peter Eamranond, Arti Bhukhen, Donna DiPalma, Schawan Kunuakaphun, Thomas Burke, John Rodis and Michael Grey
The purpose of this explanatory case study is to explain the implementation of interprofessional, multitiered lean daily management (LDM) and to quantitatively report its impact…
Abstract
Purpose
The purpose of this explanatory case study is to explain the implementation of interprofessional, multitiered lean daily management (LDM) and to quantitatively report its impact on hospital safety.
Design/methodology/approach
This case study explained the framework for LDM implementation and changes in quality metrics associated with the interprofessional, multitiered LDM, implemented at Saint Francis Hospital and Medical Center (SFHMC) at the end of 2018. Concepts from lean, Total Quality Management (TQM) and high reliability science were applied to develop the four tiers and gemba rounding components of LDM. A two-tailed t-test analysis was utilized to determine statistical significance for serious safety events (SSEs) comparing the intervention period (January 2019–December 2019) to the baseline period (calendar years 2017 and 2018). Other quality and efficiency metrics were also tracked.
Findings
LDM was associated with decreased SSEs in 2019 compared to 2017 and 2018 (p ≤ 0.01). There were no reportable central line-associated blood stream infection (CLABSI) or catheter-associated urinary tract infection (CAUTI) for first full calendar quarter in the hospital's history. Hospital-acquired pressure injuries were at 0.2 per 1,000 patient days, meeting the annual target of <0.5 per 1,000 patient days. Outcomes for falls with injury, hand hygiene and patient experience also trended toward target. These improvements occurred while also observing a lower observed to expected length of stay (O/E LOS), which is the organizational marker for hospital’s efficiency.
Research limitations/implications
LDM may contribute greatly to improve safety outcomes. This observational study was performed in an urban, high-acuity, low cost hospital which may not be representative of other hospitals. Further study is warranted to determine whether this model can be applied more broadly to other settings.
Practical implications
LDM can be implemented quickly to achieve an improvement in hospital safety and other health-care quality outcomes. This required a redistribution of time for hospital staff but did not require any significant capital or other investment.
Social implications
As hospital systems move from a volume-based to value-based health-care delivery model, dynamic interventions using LDM can play a pivotal role in helping all patients, particularly in underserved settings where lower cost care is required for sustainability, given limited available resources.
Originality/value
While many hospital systems promote organizational rounding as a routine quality improvement process, this study shows that a dynamic, intense LDM model can dramatically improve safety within months. This was done in a challenging urban environment for a high-acuity population with limited resources.
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A PILGRIMAGE to West Cornwall can be heartily recommended to any librarian in search of rest, fresh air, and complete change from the monotony of town life. Here he will find…
Abstract
A PILGRIMAGE to West Cornwall can be heartily recommended to any librarian in search of rest, fresh air, and complete change from the monotony of town life. Here he will find abundance of interest and novelty in connection with the habits and customs of the ancient Britons still extant, and derive many impressions of pleasure from the magnificent rock scenery with which the coast abounds. Dairy‐farming, tin‐mining, pilchard fishing, druidical monuments, and wild flowers can also be studied with profit; and even Public Libraries, in a condition of arrested development not uncommon in other districts of England. Cornwall is pre‐eminently the county for Public Libraries. Geographically it is remote from the populous parts of England, and the Great‐Western Railway Company, with commendable forethought, have taken enormous pains to maintain this seclusion by a most pitiful and inadequate service of trains. I was once assured by the Public Librarian of Penzance that no thief would ever raid his institution, for the simple reason that it was impossible to get away quick enough to avoid detection ! A place thus difficult to get away from, is manifestly one which requires strong home interests to make it attractive, and, as theatres, music halls, and other light diversions, find little favour in Cornish towns, the Public Library, with its wealth of varied reading, is practically the only after‐dark resource left. But there are other circumstances which make Cornwall an ideal county for a liberal provision of Public Libraries. The decline of the mining industry has driven many of the men away to other centres, such as South Africa, and it is well‐known that, at the present time, more money is coming into the county from exiled sons abroad than is being made locally. There is thus an enormous surplus of that great natural reader— woman—and to her should be offered in profusion plenty of romantic and other reading as a solace and compensation for the loss of her natural companion—man.
Dawn Bendall‐Lyon and Thomas L. Powers
This paper reports research on the impact of mass communication and the passage of time on consumer satisfaction and loyalty in a high‐involvement service setting. The study was…
Abstract
This paper reports research on the impact of mass communication and the passage of time on consumer satisfaction and loyalty in a high‐involvement service setting. The study was based on a survey of two groups of individuals. A short‐time lag group consisted of individuals who were surveyed immediately after receiving a service and one year later. A long‐time lag group consisted of individuals who were surveyed immediately after they received a service and two years later. Satisfaction and loyalty decreased from the initial time of the service encounter for both the short‐time and long‐time groups. While satisfaction and loyalty declined over time for both groups, the results revealed no difference in the change in satisfaction between the two groups. In addition, exposure to mass communication did not influence the change in satisfaction and intention to return over time.
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K.A. Van Peursem, M.J. Prat and S.R. Lawrence
A bewildering variety of performance measures and indicators inhealth management is evident in the literature and in practice. Reviewsmeasures useful for health management…
Abstract
A bewildering variety of performance measures and indicators in health management is evident in the literature and in practice. Reviews measures useful for health management performance accountability, and expands on the traditional notion of health performance measures to incorporate nominal and ordinal measures. The research is performed in the interest of stimulating discussion in the public domain and with the intent of expanding current notions of the term “performance indicator”. Develops a comprehensive framework from measurement and accountability theory, and the medical management, accounting and accountability literatures are reviewed. Highlights the importance of using non‐ratio measures to capture outcomes, structure and processes influenced by management; and suggests that disclosures which include measures from all elements of the framework would most closely account for management activity.