This paper explores differences in decision-making approaches between physician executives and nonphysician executives in a managerial setting.
Fredrickson and Mitchell's (1984) conceptualization of the construct of comprehensiveness in strategic decision making is the central construct of this paper. Theories of professional identity, socialization, and institutional/dominant logics are applied to illustrate their impact on strategic decision-making approaches of physician and nonphysician executives.
This paper proposes that high-status professionals, specifically physicians, occupying senior management roles are likely to approach decision making in a way that is consistent with their professional identity, and by extension, that departments led by physician executives are less likely to exhibit comprehensiveness in strategic decision-making processes than departments led by nonphysician executives.
This paper provides conceptual evidence that physicians and nonphysicians approach management differently, and introduces the utility of comprehensiveness as a construct for strategic decision making in the context of health care management.
BACKGROUND: In 2007, the Danish Cancer Society and the Tryg Fonden launched a campaign to prevent skin cancer and melanoma. As a part of this intervention program, the Danish Cancer Society prepared a "sun policy," which recommends how children in Danish kindergartens can be protected from the sun.
AIMS: The aim of this study was to determine the factors that influence a decision to implement the sun policy in Danish kindergartens.
METHODS: We conducted a comparative qualitative study. Data were collected at semi-structured interviews with the principals of five kindergartens with a sun policy and five without. RESULTS: The key factor in making a decision is the priority given to the sun policy by the principal, which in turn depends on the principal's perception of his or her resources. Further factors are the principal's attitude toward parental responsibility and media focus on sun protection.
CONCLUSIONS: Principals must be convinced of the importance of a written sun policy. A mailed reminder containing arguments about its importance to accompany the draft sun policy might reinforce the formulation and implementation of sun policies nationwide.
Risk management is a concept central to present-day occupational health and safety. Decisions concerning the regulations of risks are based on the results of risk assessment. To date, no systematic approach to the assessment and management of risk has been developed. The issue is a difficult one because it involves combining scientific analyses with societal and political decision making. It is crucial that that risk assessor and risk manager identify the model according to which risk is regulated in his particular society. This review presents the consecutive steps used to assess risks. Also described is the linking of the assessed risks to the setting of priorities in decisions of risk management.
The Melbourne Decision-Making Questionnaire (MDMQ) is an attempt to capture and measure coping strategies that people use. The instrument had not previously been translated into Swedish. The aim of this study was to evaluate validity and reliability of the Swedish version of the MDMQ.
A Swedish translation was performed and back-translated. A group of five pilot readers evaluated content validity. The translated questionnaire was tested among 735 patients, healthcare workers, healthcare students and teachers. A parallel analysis (PA), exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed.
An initial EFA with a four-factor solution showed a low concordance with the original 22-item four-factor model with a very low Cronbach's alpha in one of the dimensions. However, a second EFA with a three-factor solution showed a good model fit for the Swedish translation of the Melbourne Decision-Making Questionnaire (MDMQ-S) with a satisfactory Cronbach's alpha. A CFA showed a goodness of fit after deleting six items.
After testing the MDMQ-S, we found support for validity and reliability of the instrument. We found the 16-item version of MDMQ-S to be satisfactory concerning the subscales vigilance, procrastination and buck-passing. However, we found no support that the hypervigilance dimension could be measured by the MDMQ-S.
The Swedish welfare debate increasingly focuses on market liberal notions and its healthcare perspective aims for more patient-centered care. This article examines the new Swedish Patient Act describing and analyzing how the patient is constructed in government documents. This study takes a Foucauldian discourse analysis approach following Willig's analysis guide. The act contains an entitlement discourse for patients and a requirement discourse for healthcare personnel. These two discourses are governed by a values-based healthcare discourse. Neo-liberal ideology, in the form of New Public Management discourse, focusing on the value of efficiency and competition, is given a hegemonic position as laws and regulations are used to strengthen it. The new Swedish Patient Act seems to further strengthen this development. The Act underlines the increased entitlement for patients, but it is not legally binding as it offers patients only indirect entitlement to influence and control their care. To safeguard the patient's entitlement under the Patient Act, healthcare personnel should be made aware of the contents of the Act, so that they can contribute to the creation of systems and working methods that facilitate respect of the Act's provisions in daily healthcare work.