Managing health care in the digital world:A comparative analysis

Recently, most reforms affecting healthcare systems have focused on improving the quality of care and containing costs. This has led many scholars to advocate the adoption of Health Information systems, especially electronic medical records, by highlighting their potential benefits. This study is based on a comparative analysis using a multiple method approach to examine the implementation of the same electronic medical record system at two different hospitals. Its findings offer insights into the processes of the adoption of innovation and its implementation in a healthcare context. The need to innovate, the decision to innovate, the implementation process and consequently, the results produced are quite distinctive at each study site. This comparative case study reveals that what appears to be the same can be quite different: this can be due to several conditions at the organization, the organization’s characteristics, and the process of implementation adopted. We need to understand these elements in order to be able to plan and manage such programs in the future

Examining mindfulness and its relation to self-differentiation and alexithymia

Published online first in 10 July 2013Research supports the association between mindfulness, emotion regulation, stress reduction, and interpersonal/relational wellness. The present study evaluated the potential effect of mindfulness on some indicators of psychological imbalance such as low self-differentiation and alexithymia. In this cross-sectional study, a sample of 168 undergraduates (72 % women) completed measures of perceived mindfulness (CAMS-R and PHLMS), self-differentiation (SIPI), and alexithymia (TAS-20). Results revealed positive correlations between the different dimensions of mindfulness and negative correlations between those dimensions, selfdifferentiation, and alexithymia. The dimensions of quality of mindfulness and acceptance were mediators in the relationship between self-differentiation and alexithymia. A nonsignificant interaction between gender and alexithymia was found. All mindfulness dimensions, but self-differentiation, contributed to explain the allocation of the non-alexithymic group. These results indicate that mindfulness seems to be a construct with great therapeutic and research potential at different levels, suggesting that some aspects of mindfulness seem to promote a better self-differentiation and prevent alexithymia

Demostración de resultado económico: percepción del comando da aeronáutica de Brasil

No ano de 2010, uma alteração no quadro normativo brasileiro introduziu a Demonstração do Resultado Econômico (DRE) para o setor público, que busca comparar custos internos de produção com valores de mercado, segundo o conceito de custo de oportunidade. Este estudo procura analisar as possíveis respostas estratégicas dos gestores , buscando perceber se a cultura contábil existente no País permite a aceitação do novo instrumento. Por meio das percepções dos agentes públicos do Comando da Aeronáutica (Comaer), no Brasil, conclui-se que a resposta estratégica dos entrevistados tende para a atitude de aceitação da nova rotina, demonstrando traços de menor conservadorismo e maior interesse pela evidenciação de resultados.In 2010, a change in the Brazilian accounting regulatory framework introduced the Demonstração do Resultado Econômico (DRE) [Economic Income Statement] for the public sector, which seeks to compare the internal costs of production to market values, according to the concept of opportunity cost. This study aims to analyse the possible strategic responses of managers and tries to understand if the existing accounting culture in Brazil facilitates the introduction of the new statement. By means of perceptions of officials of the Aeronautical Command (Comaer), in Brazil, it is possible to conclude that the strategic response of respondents is closer to acceptance of the new routine, showing traces of less conservatism and greater interest for displaying results.En el año 2010, una modificación del cuadro normativo brasileño introdujo la Demostración del Resultado Económico (DRE) para el sector público, que busca comparar los costos internos de producción con los valores del mercado, según el concepto de costo de oportunidad. Este estudio tiene como objetivo analizar las posibles respuestas estratégicas de los gestores, con el fin de percibir si la cultura contable existente en el país permite la aceptación del nuevo instrumento. Por medio de las percepciones de los agentes públicos del Comando da Aeronáutica (Comaer), en Brasil, se concluyó que la respuesta estratégica de los entrevistados tiende a aceptar la nueva rutina, mostrando rasgos de menos conservadurismo y más interés por la manifestación de resultados.Fundação para a Ciência e a Tecnologia (FCT

Assessing the Effectiveness of a Performance Evaluation System in the Public Health Care Sector: Some Novel Evidence from the Tuscany Region Experience

Since 80's the introduction of New Public Management principles has promoted the use of performance measurement to drive a more efficient, effective and accountable public sector. The adoption of a sophisticated and comprehensive multidimensional performance measurement system, which looks beyond traditional financial measures, based on organization strategies, such as the balanced scorecard, has thus been suggested. This revolution in the public management came together with the devolution processes that involved most European public health systems. Set within this context, in the last decade, each of the twenty Italian regions developed its own management tools. Among others, the Tuscan performance evaluation system (PES) has been valued as a particularly innovative and comprehensive system. This paper reports the novel experience of the Tuscan PES; in particular, it measures PES effectiveness and discusses the critical factors that could have led to the PES success. Five are the critical success factors identified by researchers: the visual reporting system, the linkage between PES and CEO's reward system, the public disclosure of data, the high level of employees and managers involvement into the entire process and the strong political commitment. All those factors run together to achieve better results; however, the process of development of the system plays a pivotal role. Scholars suggest the use of a constructive approach in order to gain effective changes in human organization. According to this stream of literature, this paper contributes by the novel experience of the Tuscan PES in addressing as a further fruitful application of the constructivist approach in healthcare

NPM Reforms in Napoleonic Countries: A Comparative Study of Management Accounting Innovations in Greek and Italian Municipalities

his is a comparative study of the rationale and effects of management accounting innovations in Greek and Italian municipalities, as part of the NPM reform in the public sector. This article aims to understand the extent of adoption of accounting innovations in Greek and Italian municipalities, and the factors affecting the specific techniques in use. The study reports on a survey based on medium-sized and large Italian and Greek municipalities, targeted at public municipalities’ accountants, the users of accounting techniques. The study identifies the intended purposes of NPM reform and, particularly, management accounting innovations, analyzes a set of factors that affect the implementation of management accounting technologies, and discusses determinants and features of such innovation on a comparative perspective