The role of institutional entrepreneurs in shaping the renewable energy subfield in the UK during the period 1986-2016

Historically, energy systems have contributed significantly to global carbon emissions. To address this concern, countries such as the United Kingdom (UK) have embraced technologies such as renewable energy to try and reduce their carbon footprints. In the case of the UK, this led to the renewable energy subfield becoming partially institutionalised under the enabling role of actors, which suggests that this type of institutional change warrants being examined through the lens of institutional entrepreneurship theory. This doctoral thesis rises to the challenge by conducting institutional entrepreneurship research to investigate the institutionalisation of the renewable energy subfield in the UK during the period 1986-2016. Such an investigation is of social significance because the institutionalisation of the renewable energy subfield is likely to contribute to deinstitutionalising polluting technologies such as fossil fuels, thus contributing to the UK’s transition to a low carbon economy. The thesis is an exploratory, qualitative case study that combines thirty-nine semi-structured interviews of respondents connected to the field of energy provision in the UK with an analysis of archival documents. It finds that multiple actors practised as institutional entrepreneurs during the period, these being the state and its various agencies; renewable energy practitioners/activists; incumbent energy practitioners; the European Union and the United Nations. These institutional entrepreneurs played significant roles in shaping the renewable energy subfield by either creating new institutions and/or reforming existing ones, however, this had little impact on reshaping the field of energy provision in which it is embedded. This thesis makes three major contributions to knowledge: (1) it proposes the construct of a subfield; (2) it shows that institutionalised structural myths may serve as enabling conditions; and (3) it offers partial institutionalisation as a novel account of the state of the renewable energy subfield in the UK. The idea of an organisational subfield contributes to knowledge by showing that this sub-community has its own unique features. For example, a subfield is embedded within an overarching organisational field, consequently, it is constrained by factors such as subordinacy and competing institutional logics. The thesis also shows that institutionalised structural myths, such as energy policy (un)certainty, (de)motivated some actors from practising as institutional entrepreneurs during the study period. The partial institutionalisation of the renewable energy subfield in the UK has caused it to be relatively vulnerable to any major environmental shocks it may face and less widely accepted than the fossil fuels subfield. Being partially institutionalised also has three major implications: (1) business-as-usual for energy provision in the UK; (2) renewable energy deployment being patchy, and (3) most renewable energy practitioners remaining constrained as embedded agents. The conclusions of this thesis inform and deepen understanding of the role of actors’ agency in facilitating or hindering the institutionalisation of renewable energy in the UK

What Factors Influence Physicians' Billing Accuracy?

Every year, medical billing errors cost the United States government billions in public funds wrongfully or erroneously paid out. While recent reports indicate modest decline in hospital billing errors, the rate of physician evaluation and management billing errors show no signs of improvement. Opinions vary on the causes of these billing errors and consequently on the appropriate countermeasures. Despite this national crisis, to date, no strategies have proven to improve physician billing accuracy. This research examines the existing literature to explore theories and constructs that explain causal factors of physician billing errors and to illuminate gaps in the research which if explored, may result in potential strategies for improving billing accuracy.</jats:p

Physician Self-Efficacy and Risk-Taking Attitudes as Determinants of Upcoding and Downcoding Errors: An Empirical Investigation

Physicians across the United States are burdened with the pressure of accurate coding while trying to maintain quality patient care. Despite the economic importance of coding accuracy, investigators have not reached consensus on the factors that contribute to coding errors. This study fills this gap by investigating physician characteristics that explain the variation in physician coding accuracy, specifically evaluation and management upcoding and downcoding errors. An electronic survey was distributed to 325 physicians that measured physicians’ attitudes towards risk and coding self-efficacy. Regression analysis found physicians with low self-efficacy had more conservative coding behaviors, resulting in higher incidences of downcoding. Physicians with high risk-seeking attitudes coded more aggressively, resulting in higher incidences of upcoding. This study is the first to empirically investigate physician personality characteristics that determine upcoding and downcoding behavior and suggests that physician payment policies, to be effective, must neutralize the effect of physician personality on code selection and reimbursement outcomes

Decentralized Multi-Agent Coverage Path Planning with Greedy Entropy Maximization

In this paper, we present GEM, a novel approach to online coverage path planning in which a swarm of homogeneous agents act to maximize the entropy of pheromone deposited within their environment. We show that entropy maximization (EM) coincides with many conventional goals in offline coverage path planning, while also generalizing to online settings. We first propose the concept of uniformity, which is a generalised metric that allows offline and online CPP approaches to be viewed through a unified lens. We then evaluate our approach by measuring the rate at which entropy is maximized within a variety of static and dynamic environments. Our experimental results demonstrate that GEM achieves state-of-the-art performance in online coverage, competitive with offline methods, despite requiring no direct communication among agents