Nurses are key to building effective teams in primary care, but it has proved difficult to develop 'teams' in a service based on a small-business model. Current organisational arrangements fragment the different clinical professionals into tribes who have different employers and managers. This book brings together the work of pioneers in the field, to provide models for the future. As the need to define the primary care team becomes more urgent, this book is essential reading for all nursing professionals in primary care, nursing management, general practitioners, and primary care leaders at health authorities and Primary Care Organisations. 'The authors present an understanding of the context within which change is taking place, the elements to be addressed in the change process and a challenge for the future direction and pace of change.' From the Foreword by Marion Bull, Chief Nursing Officer, Welsh Office

This study examines the impact of the prevalence of long-term equity-based chief executive officer (CEO) compensation incentives on GDP growth, and we address the moderating role of individualist versus collectivist cultures on this relationship. We argue that long-term incentives given to CEOs in some firms may convey to other CEOs that they too may be able to receive such incentives and rewards if they emulate the incentivized and rewarded CEOs. In a longitudinal study across 22 nations over a 5-year period, we find that the higher proportion of CEOs in a country are awarded long-term equity-based incentive compensation, the greater future real GDP growth, particularly in collectivist countries.

The philosophy and methodology of Bayesian statistics bring with it a “style of reasoning” which may inform organizational researchers as they seek to conceptualize and model managerial decision-making processes. The style of reasoning of the Bayesian approach, in which posterior probabilities of the hypothesis are rigorously and continuously updated given new data, appears to closely model the researched observed decision behavior of a very important subset of managers: innovative entrepreneurs. That is, Bayesian reasoning may serve as a model of the cognitive processes undertaken by innovative entrepreneurs as they engage in knowledge creation through recombination of resources in response to new information from the environment (Schumpeter, 1934). Modeling disciplined intuitive implementation of Bayesian reasoning may assist researchers in building a cognitive theory of how and why innovative entrepreneurs are better at estimating the probabilities of success of newly recognized opportunities than the general public. Because innovative entrepreneurs are thought to play a very important role in the development of economic growth and productivity (Baumol, Sheshinski & Strom, 2007), a theory of their decision processes may assist organizational researchers devoted toward uncovering the here-to-fore poorly understood cognitive dynamics of the innovative entrepreneur, and may play a role in enhancing the efficacy of managerial decision behavior more generally.

Entrepreneurship is viewed as an important driver of economic development. Scholars have differentiated two dimensions of entrepreneurship: (1) opportunistic entrepreneurship driven primarily by the recognition of opportunity arising from an innovative idea and, (2) necessity entrepreneurship driven primarily by the belief that one's own business offers the likelihood of the highest utility. Both opportunistic and necessity entrepreneurship contribute to economic development. However, cultural norms of comfort with uncertainty may impact these two dimensions of entrepreneurship differentially. Therefore, in order to maximize economic development through entrepreneurial activities, differential national policy and managerial approaches may be advised across diverse nation states.

In this paper, we suggest a model of international entrepreneurship that links cognition, noticing opportunities, absorbing uncertainty, and bearing uncertainty, to international entrepreneurial action, which is important because of the increased interest in international entrepreneurship. The ways in which cognition affects opportunity identification are discussed to show how international entrepreneurs' cognitive processes work in terms of identifying opportunities. We also explore the role of cultural differences, with respect to tolerance for bearing uncertainty, on international entrepreneurship. Finally, the model is used to identify areas for future international entrepreneurship research.

Two landmark studies of national culture undertaken approximately a quarter century apart present a unique opportunity for a longitudinal analysis of the shift in cultural values in work organizations over time. Using comparable data from Hofstede and GLO BE, we investigate the hypothesis that, in the rapidly developing nations of Asia, there has been a convergence of collectivist values in work organizations toward the level of collectivist values found in work organizations in the highly developed nations of the major economies. Findings suggest that collectivist values in rapidly developing nations are converging towards collectivist values of highly developed countries. This convergence is not exclusively due to economic growth or wealth but rather due to the speed of the economic growth. Specifically, periods of prolonged rapid economic transformation appear to also have a transforming effect on national cultural values. Implications of this finding and directions for future research are discussed.

This paper analyzes the existence of a potential link between the prevalence of long term incentive compensation schemes and the economic prosperity of a country. This issue is previously not addressed in the literature. In a panel regression with fixed effects a strongly significant, positive effect is found between growth of GDP/capita in real terms and this prevalence, while controlling for general investment and institutional variables. However, when the 22 countries of the study are divided into European and non-European, the growth effect found for the entire material accrues only to the non-European countries. It is concluded that long term incentive contracts seem to have no effect in the European countries due to labor market and cultural reasons.

The pragmatic correspondence thesis regarding strategic management theory and moral philosophy is adapted in this paper to apply it to the constructs of entrepreneurship and wisdom. Accordingly, a mapping between elements of both constructs is set out. The resulting qualities of wise entrepreneurship include (1) the selection of good purposes, (2) a mindfulness of the business and personal life cycles, (3) authentic prioritisation and (4) explication: the demonstration as well as explanation of enterprise purposes and plans.

Estimated 80% of all referrals to Tertiary Care for Thyroid disease in Serbia are deemed unnecessary or ill-timed by the specialty care providers, and detract from time and effort available to treat the remaining appropriate referrals. Documentation on patient treatment rarely is delivered from Primary Care to the Specialty Care center, necessitating costly duplication of laboratory and radiology testing. Documentation from the Specialty Care center often does not return to the Primary Care center, rendering follow up care more difficult, and denying Primary Care clinicians the opportunity to learn from each case. A deployed web-based electronic consultation system is proposed to alleviate the problems noted above. Appropriate organizational interventions will be designed into the pilot project to overcome inertial resistance to change, monitor utilization, and proactively ensure cost-effective systems implementation. The use of an electronic system will optimize the time a specialist spends with a referred patient, as complete diagnostic workups will have been completed and this needy patient will not be competing for specialist time with inappropriately referred patients. Additionally, modern database information supports detailed data analysis to observe clinical patterns and treatment effectiveness. .

When introducing a new technology that changes the core processes of an organization, such as an e-health initiative, it is important that the structural design and culture of the organization is aligned with the predominant national culture in which the organization is embedded. When a harmonious alignment is achieved, speedy and effective organizational learning can occur. This, in turn, promotes effective utilization of the new technology. The cultural dimension of uncertainty avoidance provides guidance on the type of organizational culture and structure to establish. Our research in five countries supports the believe that in national cultures in which high uncertainty avoidance is predominant, such as France, a highly mechanistic organization is favored; in cultures in which a low uncertainty avoidance dominates, such as the USA, a more organic organizational form should increase the probability of success in promoting effective organizational learning and thereby successfully implementing an e-health strategic intent.

Management is the act of co-ordinating and controlling disparate entities so as to achieve common goals. Co-ordination and control have both a formal bureaucratic, structural side and an informal, social, and cultural side. In studies of e-health systems, well-designed formal bureaucratic structures were not sufficient to ensure acceptable utilisation rates of e-health technologies. Qualitative research has yielded organisational, structural and cultural dimensions related to uncertainty avoidance which may explain some of the variance in utilisation rates. Cross-national studies of e-health utilisation and cultural levels of uncertainty avoidance supply evidence of the role this dimension of culture may play in effective e-health implementations. High uncertainty avoidance nations, such as South Korea and France appear to have higher utilisation success in e-health implementations than in low uncertainty avoidance nations such as Great Britain and the United States.

: To bring together some of the best minds in the field of Human Factors as it relates to Telemedicine. The group will explore how the utilization rates can be improved and document the thinking in the form of a book that will be valuable to the military health care system and to scholars. Bangert/Doktor, Inc. will manage a virtual learning community that interacts continually for two years using the Internet and attends two meetings sponsored by TATRC, devoted to the theme Human Factors in Telemedicine. At the first meeting the invitees will explore general topics and discuss their individual thought pieces. They will have an opportunity to react to each other's ideas. Between the meetings, the invitees will refine and prepare their articles. At the second meeting, final drafts will be exchanged and discussed. Dominant themes identified. The editors will then finalize the articles, organize the edited edition, and prepare the necessary introductory and conductive passages. Bangert/Doktor, Inc. will review designated TATRC-sponsored projects and present conclusions pertaining to human factors issues inherent in each project.

The research here presented focuses upon theinformal, social, and cultural side of managerialcoordination and control as manifested inclinical e-health systems. Specifically, theresearch seeks to analyze and determine the rolespecific dimensions of organizational culturemay have upon effective managerialcoordination and control in clinical e-healthsystems.

The research reported here involved a longitudinal study, lasting three years, of the utilisation of an IS system designed to enhance the quality and accessibility of healthcare for the US military and their dependents. This study employed elements of a positivist methodology and an intensive research method. A discussion of the difficulties and conflicts inherent in multimethodological studies is presented. Findings indicate that low utilisation rates arose from a cultural mind set mismatch. This is compared to findings in India concerning the implementation of GIS systems. The mismatch was between the cultural variables conducive to organisational learning found in the implementing organisation. The Primary Care Clinic yielded low organisational learning cultural variables that were non-conducive to rapid adoption of the new and intrusive IS technology.

As part of an overall research program to create a set of web-based interactive distance learning modules, an educational needs assessment was conducted. The educational needs assessment is undertaken to collect information via observation and interview as to which knowledge areas are most desirable for incorporation into the interactive distance learning modules. This research is best undertaken with a neutral stance and without any preconceptions or hypotheses as to which knowledge areas are likely to be most useful. The interactive modules were designed to enhance the utilization of telemedicine by health care providers. This paper is a report on the methodology used and the findings of the needs assessment. The educational needs assessment acts as a compass to guide the creation of curricula. In the design of interactive learning, the needs assessment may be an important tool that informs not only the selection of the content, but also the selection of technology and courseware processes. The methodology described herein may be useful as a template for other authors of interactive learning courseware. The results of this study identified four clusters of content to be offered and confirmed the selection of interactive, web-based distance learning as the most appropriate delivery approach.

BACKGROUND:The purpose of the study was to ascertain those learning objectives that will initiate increased use of telemedicine by military health care providers. Telemedicine is increasingly moving to the center of the health care industry's service offerings. As this migration occurs, health professionals will require training for proper and effective change management. The United States Department of Defense (DoD) is embracing the use of telemedicine and wishes to use Web-based training as a tool for effective change management to increase use. This article summarizes the findings of an educational needs assessment of military health care providers for the creation of the DoD Web-based telemedicine training curriculum. METHODS:Forty-eight health care professionals were interviewed and surveyed to capture their opinions on what learning objectives a telemedicine training curriculum should include. RESULTS:Twenty learning objectives were found to be needed in a telemedicine training program. These 20 learning objectives were grouped into four learning clusters that formed the structure for the training program. In order of importance, the learning clusters were clinical, technical, organizational, and introduction to telemedicine. FINDINGS:From these clusters, five Web-based modules were created, with two addressing clinical learning needs and one for each of the other learning objective clusters.

Healthcare is changing in certain predictable directions, and telemedicine can effectively deploy informatics and decision theory to positively impact the quality, cost and access to healthcare. As diagnostic and treatment protocols gain acceptance and use by healthcare providers, feedback loops will lead to individual and organisational learning. Through the data capture of informatics and the analytical ability of decision theory, the most important learning will occur at the organisational level as protocols are refined, updated, and expanded based on carefully tracked outcome evaluations.