Management Control Systems and Contextual Variables in the Hospitality Industry

Purpose – The paper examined management control systems (MCS) in Indonesian hospitality sector. This study examines the impact of six contextual factors at one time to determine the importance of each factor on the design of MCS. Design/methodology/approach – The paper is based upon data collected through a survey sent to “star” hotels in Central Java, Indonesia. Using Chenhall (2003) design, a regression equation is run to examine the relationship between MCS and the contextual variables of environment, technology, structure, size, strategy and culture. Findings – The paper finds that higher levels of the contextual variables of technology, structure, and culture are related to more sophisticated MCS while size is related to more traditional MCS. Research limitations/implications –These findings are related to the hospitality industry in Indonesia. Future research could examine different settings (i.e. country, industry, etc) and investigate the effect of each contextual variable on the relationships between MCS and firm performance. Originality/value – The present study extends the scope of MCS system in accounting literature by testing Chenhall (2003) works on the relationship between contextual variables and MCS. It attempts to fill the gap in contingency-based studies that have previously focused on one aspect of contingency by considering six contextual factors. Furthermore, this paper also contributes to a fuller understanding of MCS practices in Indonesia and the hospitality industry and helps management in determining its most effective design. Keywords Hospitality management, Management Control Systems, Indonesia, Contextual Variable

The Performance Implications of Fit Among Environment, Strategy, Structure, Control System and Social Performance

Purpose – The paper examined concept of corporate performance. The paper seeks to examine the impact of corporate social performance on the relationship among business environment, strategy, organization, and control system and corporate performance. Design/methodology/approach – The paper is based on a synthesis of the existing literatures in strategic management and accounting filed. Findings – The paper finds that corporate social performance defined as stakeholder relationship become one important dimension of the strategic behaviors that an organization can set to improve corporate performance. Research implication – the contextual variables as discussed in strategic management and accounting domain will be contingent upon strategic behaviors, which are behaviors of members in an organization. Originality/value – The paper integrates the contextual variables including business environment, strategy, organization structure, and control system with corporate performance by using corporate social performance as moderating variable by means of a recent literatures study from strategic management and accounting field. Keywords Contextual variable, strategic behavior, corporate social performance, corporate performanc

An Examination of the Maternal Health Quality of Care Landscape in India

India has made significant strides in maternal health over the past several decades, reducingits maternal mortality ratio (MMR) from 556 to 174 maternal deaths per 100,000 live births from1990 to 2015 (World Bank 2016a). Policies and initiatives to increase access to maternal healthservices largely account for this progress. However, the rate of improvement has slowed, and thecountry continues to contribute almost one-quarter of maternal deaths globally (Nair 2011). Inaddition, India is home to a high but difficult to measure rate of so-called near-miss maternaldeaths that often lead to maternal morbidity. Although the incidence of maternal morbidity inIndia is largely unknown due to the country's lack of diagnoses and under-reporting, it isestimated that millions of Indian women experience pregnancy-related morbidity; the GlobalBurden of Disease estimates that India contributes one-fifth of the disability-adjusted life yearslost globally due to maternal health conditions (World Health Organization 2008). These patternssuggest there is still progress to be made in maternal health in India.The John D. and Catherine T. MacArthur Foundation seeks to continue its more than 20-year history supporting population and reproductive health in India and accelerate the country'sadvancement in maternal health. It has chosen to fund a three-and-a-half-year grantmakingstrategy to improve maternal health quality of care, which has emerged as a key means to furtherreduce MMR and related outcomes. This review is intended to describe current issues andinterventions in the delivery of maternal health care and provide a backdrop for the Foundation'sgrantmaking effort

Enterprise within the enterprise : a study of management and performance in a public health care delivery organisation

Background The challenges in healthcare are an everyday struggle for managers. Efficiency and responsiveness of public sector services have been of interest over the past decades. Different reforms have been launched. One important factor that has been identified is the degree of autonomy in decision-making, typically calling for a decentralised management model. Aim The overarching aim of this thesis is to explore decentralisation of management authority and accountability in a public healthcare provider organisation in primary and community care, and to assess its impact on organisational outcomes and how managers perceive a decentralised management model in ordinary and pandemic conditions. Methods Study I was a scoping review to explore the impact of decentralisation as evidenced by the literature. In the empirical studies II, III and IV qualitative research approaches were used with an explanatory case study research design. Purposive sampling, data collected in semistructured, in-depth interviews and analysed with directed content analysis guided by theoretical frameworks. Balance score card data were used in study III. Findings In study I, a theoretical model was developed from Bossert’s decision space conceptual framework to be used in the further empirical studies. Study II found support in the scientific literature for the underlying assumptions that increased responsibility will empower managers, since clinical directors know their local prerequisites best and are able to adapt to patient needs. In study III managers’ perceptions of the decentralised management model supported the intentions to enable the front-line to make decisions to better meet customer needs and flexibly adapt to local conditions. In study IV we found a high grade of operational effectiveness, which is imperative in an emergency situation, and also a driver of new strategic positions to even better meet new demands. Conclusions Decentralisation can create conditions that support innovation and improvements locally. Activities for decentralisation have to be consistent with underlying assumptions, supported by evidence, and timely planned to give managers decision space and the ability to use their delegated authority, not disregarding accountability and fostering necessary organisational and individual capacities to avoid sub-optimisation. Congruence between the rationale of a management model, the managers’ perceptions of the authority and accountability as well as management practices is crucial. The empirical findings of our case study are synthesised into a theoretical model potentially possible to apply in other organisational settings too

Strategies to improve effectiveness of hospital leadership in Addis Ababa

In hospitals of Addis Ababa, there is a high turnover of leaders while patient and health workers’ satisfaction is low, and safety and quality are in dire situations. The purpose of this study was to explore and propose strategies to improve effectiveness of hospital leadership in order to enhance the quality of health care provided in hospitals through improving health workers’ empowerment, job satisfaction and patient safety culture. Thus, a sequential explanatory mixed method research design was used. The research had three phases, in which the first phase used five structured questionnaires explored leadership styles, the health workers’ satisfaction and empowerment, patient safety culture, and the patient experience of quality of health care; while the second involved a qualitative study (content analysis); and third phase focused on the preparation of a strategy document. Data in the form of interview responses was gathered from 75 leaders, 542 health workers, 532 patients and 11 key informants. The analysis shows that, overall, hospital leaders considered themselves more transformational (M=2.98, SD=0.41) than transactional (M=2.85, SD=0.46). Job satisfaction of private and public hospital health workers were 70.8 % and 57.1 % respectively (P-value<0.001). In addition, private hospital workers had a higher score in structural and psychological empowerment than their pubic hospital counterparts; the difference was statistically significant in all dimensions (P-value <=0.03). The analysis reveals that public and private hospitals’ mean total patient safety scores were 3.58 and 3.77 respectively (P-value=0.02). Finally, the “overall rating of hospital” was better for private hospitals: 84.8% and 88.4 % respectively (P-value=0.03). The study makes a number of observations. It notes that, firstly, transformational leadership has direct and strong correlation with structural and psychological empowerment (r=0.70, P-value=0.04 and r=0.83, P-value=0.01 respectively). Secondly, structural empowerment has a direct and significant effect on psychological empowerment (β=0.28, P-value=<0.01); and minimal indirect effect on patient safety culture through psychological empowerment (β=0.05, P-value=<0.05). Thirdly, health worker job satisfaction also has had a direct effect on patient safety culture (β=0.44, Pvalue=< 0.01. The fourth and final observation is that psychological empowerment has had a direct and statistically significant effect on patient safety culture (β=0.19, Pvalue=< 0.01). These observations indicate that, although private hospitals are better in every dimension of this study, the current hospitals situation in Addis Ababa needs urgent attention. Hence, the identification and recommendation for the preparation of eight strategic priority areas along with key interventions seeking to improve the hospital leaders’ effectiveness.Health StudiesD. Litt. et Phil. (Health Studies

An Empirical Investigation of the Influence of Preparation and Implementation Capabilities on Lean Management Competence

This research offers several noteworthy contributions to advancing a more comprehensive scholarly theorization and managerial understanding of the prerequisites for deploying a “strategically ready” approach to lean management (LM). The first contribution is the conceptualization of a productive LM deployment model as a three phased value generation approach: (1) value design, (2) value delivery, and (3) value capture. This conceptualization is theoretically framed by Resource Advantage Theory and resource orchestration. Supporting this value generation conceptualization is a LM Competence comprised of two operational capabilities: (1) LM Preparation and (2) LM Implementation. In concert, these two capabilities generate a resource comparative advantage, reflecting the firm’s LM Competence. This competence produces potential marketplace competitive advantages and the accruing of Lean-Based Benefits for and from customers. The second contribution made by this research is the development of reliable and valid measurement instruments for the model constructs. By conducting a review of the literature, four inductive case studies, and two rounds of knowledgeable judge pre-testing, potential measurement items were rigorously scrutinized for adequacy. Subsequently, survey data collected from a sample of 201 US emergency department nurses, experienced in the deployment of lean-based initiatives, was used to subject the scales to further refinements until acceptable reliability and validity levels were attained. The third contribution this research makes is the empirical measurement of the firm’s LM Competence. An empirical study of the organizational and operational capabilities that underpin the possession of a LM Competence had not been previously been completed; quantification of the effects of LM Preparation Capability (and its dimensions) on LM Competence were significant and meaningful. The results of this research place explicit focus on the productiveness of managerial preparation decisions and actions critical to the cultivation, leveraging and possession of resources, capabilities and competency that ensure the efficient and effective throughput functionality of work efforts and work flows central to any LM deployment initiative. The conceptualization and empirical findings highlights the need for adopting firms to undertake a more mindful and productively purposeful, “strategically ready” approach to LM deployment and should complement existing lean practices and outcomes research and enrich future scholarly investigations

Human resource issues and its implications for health sector reforms

Given the growing complexities and challenges the health sector faces, reforms in this sector are inevitable. Often health sector reforms aimed to address many of these deficiencies and ensuring effectiveness and efficiency of resource use, they focus on making the health systems responsive through strengthening financial systems, ensuring local participation and public private partnerships, and autonomy of health facilities. The reform process, among other things, intrinsically makes some fundamental assumptions some of which are as follows: high organisational commitment of health care providers, high professional commitment of health care providers, and adequate skills of health care providers. This paper examines the commitment of district level health officials in the newly carved out state of Chhattisgarh in India. Since development oriented HR practices (HRD) are powerful tools to commit people working in health sector to enhance the quality of care, we believe that health sector reforms will have to concentrate on human resource issues and practices more than ever before in near future. The papers attempts to examine the following questions: (i) what is status of professional commitment, organisational commitment and technical competencies of health officials? (ii) what are the characteristics of human resource management practices in the health sector in the state? and (iii) how these management practices are linked with professional and organisational commitment? Finally the paper discusses the implications of these to health sector reform process.

Predictors of Language Service Availability in U.S. Hospitals

Background: Hispanics comprise 17% of the total U.S. population, surpassing African-Americans as the largest minority group. Linguistically, almost 60 million people speak a language other than English. This language diversity can create barriers and additional burden and risk when seeking health services. Patients with Limited English Proficiency (LEP) for example, have been shown to experience a disproportionate risk of poor health outcomes, making the provision of Language Services (LS) in healthcare facilities critical. Research on the determinants of LS adoption has focused more on overall cultural competence and internal managerial decision-making than on measuring LS adoption as a process outcome influenced by contextual or external factors. The current investigation examines the relationship between state policy, service area factors, and hospital characteristics on hospital LS adoption. Methods:We employ a cross-sectional analysis of survey data from a national sample of hospitals in the American Hospital Association (AHA) database for 2011 (N= 4876) to analyze hospital characteristics and outcomes, augmented with additional population data from the American Community Survey (ACS) to estimate language diversity in the hospital service area. Additional data from the National Health Law Program (NHeLP) facilitated the state level Medicaid reimbursement factor. Results:Only 64%of hospitals offered LS. Hospitals that adopted LS were more likely to be not-for-profit, in areas with higher than average language diversity, larger, and urban. Hospitals in above average language diverse counties had more than 2-fold greater odds of adopting LS than less language diverse areas [Adjusted Odds Ratio (AOR): 2.26, P< 0.01]. Further, hospitals with a strategic orientation toward diversity had nearly 2-fold greater odds of adopting LS (AOR: 1.90, P< 0.001). Conclusion:Our findings support the importance of structural and contextual factors as they relate to healthcare delivery. Healthcare organizations must address the needs of the population they serve and align their efforts internally. Current financial incentives do not appear to influence adoption of LS, nor do Medicaid reimbursement funds, thus suggesting that further alignment of incentives. Organizational and system level factors have a place in disparities research and warrant further analysis; additional spatial methods could enhance our understanding of population factors critical to system-level health services research