Are you growing systems thinking managers? Use a systems model to teach and practice organizational analysis and planning,management policy,and organizational development

This paper discusses the use of the Kast and Rosenzweig systems and contingency model for teaching and practice in organizational analysis and planning, management policy, and organizational development. The need for an organizational model for graduate students and field-based managers and executives is identified. The model is presented beginning with the Kast and Rosenzweig work, with integration of research by Daft, Schein, Trist, Deal and Kennedy, Ackoff, Delbecq, and Mintzberg. The teaching and practice uses of the model in four areas are presented, including organizational analysis and planning, management policy making, and organizational development. In each area case examples of the use of the model in teaching and practice are presented. Needs for future research and implications for the use of the model are discussed.     

Organization Change in a University Hospital: A Six Year Evaluation Report of the HORIZONS Project

Many health care organizations are currently engaged in changing the design of their health care services delivery system. The issues of cost containment, quality, and access are prominent. This paper reports on the impact of the implementation of a new organization design at one university hospital. The organization change effort (named HORIZONS) was a five year project funded in part by the Robert Wood Johnson Foundation and the Pew Charitable Trusts. In a changing health care environment, the project was undertaken with three goals in mind: (1) to maintain and enhance quality of patient care; (2) to improve the quality of working life; and (3) to accomplish this in a budget neutral manner. Initiated as a program to strengthen hospital nursing, the project became a patient-focused redesign effort encompassing both clinical and administrative affairs. The core ideas of the project approach included systems thinking, interactive planning and idealized design. This evaluation reports on the project's progress after six years.     

All together now: The circular organization in a university Hospital. Part II. Implementation

The first part of this two-part series described the initial impetus driving a university hospital's planned change project, the planning process itself, and the interventions that were identified to meet our goals. This article describes and discusses the interventions—the implementation of our version of Ackoff's circular organization and issues related to barriers, selected outcomes, the change process, evaluation, and the project's significance to nursing.     

Implementing Cost Control in Health Care: Strategies Driven by an Organizational Systems Approach

In this paper, we offer a systems approach to assist health care organizations in their cost-containment efforts. A general model of the organization which specifies the various components of this approach is offered. Each system—technology, structure, psychosocial, managerial, and cultural—is linked to illustrative selected actions designed to improve cost performance. In our view, the key to successful interventions to contain costs lies in careful consideration of both the direct and interactive impacts on all systems of the health care organization. A case example of an Academic Medical Center's effort to curtail costs illustrates both the model and the sample actions.     

Draper-dependent glial phagocytic activity is mediated by Src and Syk family kinase signalling

The cellular machinery promoting phagocytosis of corpses of apoptotic cells is well conserved from worms to mammals. An important component is the Caenorhabditis elegans engulfment receptor CED-1 (ref. 1) and its Drosophila orthologue, Draper. The CED-1/Draper signalling pathway is also essential for the phagocytosis of other types of 'modified self' including necrotic cells, developmentally pruned axons and dendrites, and axons undergoing Wallerian degeneration. Here we show that Drosophila Shark, a non-receptor tyrosine kinase similar to mammalian Syk and Zap-70, binds Draper through an immunoreceptor tyrosine-based activation motif (ITAM) in the Draper intracellular domain. We show that Shark activity is essential for Draper-mediated signalling events in vivo, including the recruitment of glial membranes to severed axons and the phagocytosis of axonal debris and neuronal cell corpses by glia. We also show that the Src family kinase (SFK) Src42A can markedly increase Draper phosphorylation and is essential for glial phagocytic activity. We propose that ligand-dependent Draper receptor activation initiates the Src42A-dependent tyrosine phosphorylation of Draper, the association of Shark and the activation of the Draper pathway. These Draper-Src42A-Shark interactions are strikingly similar to mammalian immunoreceptor-SFK-Syk signalling events in mammalian myeloid and lymphoid cells. Thus, Draper seems to be an ancient immunoreceptor with an extracellular domain tuned to modified self, and an intracellular domain promoting phagocytosis through an ITAM-domain-SFK-Syk-mediated signalling cascade.