Towards a business-IT alignment maturity model for collaborative networked organizations

Aligning business and IT in networked organizations is a complex endeavor because in such settings, business-IT alignment is driven by economic processes instead of by centralized decision-making processes. In order to facilitate managing business-IT alignment in networked organizations, we need a maturity model that allows collaborating organizations to assess the current state of alignment and take appropriate action to improve it where needed. In this paper we propose the first version of such a model, which we derive from various alignment models and theories

Improving Value Based Purchasing Through the Implementation of the Clinical Nurse Leader Role: The Chief Nursing Officer’s Case for Change

The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical Nurse Leader. This Master’s prepared advanced generalist has been educated in healthcare reform and its impact on patient safety, quality, and the organization’s financial condition. An evidence-based business case will demonstrate the outcomes and a return on investment for the Clinical Nurse Leader role. The Chief Nursing Officer can employ transformational leadership skills to articulate the need and benefit of such a role, and influence an organization to invest in this valuable intervention. Keywords: Chief Nursing Officer, CNO, Clinical Nurse Leader, CNL, Value Based Purchasing, VBP, education, quality, pay for performance, evidenced-based practice

A Framework to Build a Big Data Ecosystem Oriented to the Collaborative Networked Organization

A Collaborative Networked Organization (CNO) is a set of entities that operate in heterogeneous contexts and aim to collaborate to take advantage of a business opportunity or solve a problem. Big data allows CNOs to be more competitive by improving their strategy, management and business processes. To support the development of big data ecosystems in CNOs, several frameworks have been reported in the literature. However, these frameworks limit their application to a specific CNO manifestation and cannot conduct intelligent processing of big data to support decision making at the CNO. This paper makes two main contributions: (1) the proposal of a metaframework to analyze existing and future frameworks for the development of big data ecosystems in CNOs and (2) to show the Collaborative Networked Organizations–big data (CNO-BD) framework, which includes guidelines, tools, techniques, conceptual solutions and good practices for the building of a big data ecosystem in different kinds of Collaborative Networked Organizations, overcoming the weaknesses of previous issues. The CNO-BD framework consists of seven dimensions: levels, approaches, data fusion, interoperability, data sources, big data assurance and programmable modules. The framework was validated through expert assessment and a case study

Innovative Workforce Plan: Recently Graduated Nurses as Super Users for EHR Implementation in a Multi-Hospital Organization

A regional health system’s decision to rapidly implement a new electronic health record (EHR) in order to meet Stage 2 meaningful use requirements led to a need for innovative cost-containment strategies. Tapping the local pool of unemployed newly graduated nurses as half the required super user workforce leveraged the technology skills of novice nurses registered nurses as trainers of experienced nurses in five hospitals. The novel workforce migrated from hospital to hospital, thereby reducing the number of experienced nurses reassigned to super user duties in each hospital. This strategy also reduced the amount of contract labor required to backfill nurse super users’ clinical shifts. The innovative model reduced labor costs associated with super user staffing by 31.8%, while positioning the organization for successful attestation to Stage 2 meaningful use objectives. Employment of the recently graduated nurses as RN Residents upon completion of the EHR implementation enabled the organization to augment its clinical workforce with expert users of its EHR, and to rapidly achieve Stage 2 meaningful use compliance

Trust categories and their impacts on information exchange processes in vertical collaborative networked organisations

Whereas small and medium enterprises can answer the different business challenges through cooperation within collaborative networked organisations (CNOs), human aspects constitute a fundamental issue in these networks since it is neither organisations nor information systems but people that cooperate. This paper addresses the major human aspect considered in vertical CNOs, namely trust that can significantly impact knowledge and know-how exchange as well as information sharing. A case study on Swiss Microtech, a vertical collaborative network from the industry of machining operations, is presented and discussed with respect to these issues. With the help of an analytic hierarchy process technique designed and developed, different trust types are identified, their corresponding weights are evaluated and their relationships with information sharing and exchange are discussed. The results show that the institutional perceptions of trust and its attributes in the enterprises studied are very close to each other. Furthermore, out of the five identified types, only competence, relational and contractual trust categories have a significant impact on strengthening the relationships between enterprises belonging to a vertical CNO

Manager Leadership: Beginning at Novice

To meet the current and anticipated nursing leadership gaps, there is a critical need for tools and programs to develop of future leaders. Unfortunately, there is a deficiency related to the preparation and readiness of novice nurse managers which impacts turnover, burnout, and the quality, safety and cost of care for patients. The aim of this Doctor of Nursing evidence-based change in practice project was to create an online training program that integrated two national nursing leadership competencies to assist the development of novice nurse managers as they transition to a formal leadership role. A video-based module system with active learning objectives established on adult learning principles was created for sixteen participants in healthcare organizations in Washington and Oregon recruited through a nursing leadership organization. Although limited results from program participants impacted the overall program, survey outcomes indicated seventy-five percent of respondents strongly agreed the program improved their knowledge and reparation as a nursing leader indicating the program can provide an effective, efficient process for novice leader development that is not cost or time prohibitive. Keywords: Leadership development, nurse manager, novice manager development, online learning

Decision Making in Healthcare Systems: Roles and Responsibilities

In the modern healthcare system, many different decision-makers interact to care for patients and manage operations. To clarify the roles and responsibilities of different decision-makers, we reviewed previous work that described the decision-makers in healthcare organizations and the decisions that they make. We searched online databases for articles that described decision making in healthcare and manually searched journals and the bibliographies for other review articles. We identified six key roles: doctors, nurses, front-line managers, middle managers, senior level managers, and the board of directors. We classified clinical decisions into three categories: diagnosis, treatment and therapy, and medication prescription and administration. We classified non-clinical decisions into five categories: budget, resource allocation, technology acquisition, service additions and reductions, and strategic planning. We then summarized these roles and responsibilities. We also conducted information-gathering interviews with 27 executives at 7 hospitals to collect details about these and related decisions. These activities yielded a comprehensive picture of which personnel in a hospital make which decisions. Since organizations are decision making systems, this comprehensive picture of decisions and their decision makers will be instrumental in not only analyzing the underlying conditions of the administrative processes in healthcare, but aid in developing tools that healthcare organizations can use to assess their own decision-making processes, and thereby design solutions