Grant T Savage

Grant T Savage
University of Alabama at Birmingham | UAB · Department of Management, Information Systems and Quantitative Methods

PhD

About

116
Publications
176,156
Reads
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5,491
Citations
Additional affiliations
January 2011 - present
University of Alabama at Birmingham
Position
  • Professor Management, Medical Education, and Health Care Organization & Policy
August 2007 - December 2010
University of Missouri
Position
  • Chair and Health Management and Informatics Distinguished Professor
January 2000 - July 2007
University of Alabama
Position
  • HealthSouth Chair and Professor of Healthcare Management
Education
September 1979 - May 1984
The Ohio State University
Field of study
  • Organizational Communication; Labor & Human Resources

Publications

Publications (116)
Article
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We build on the adaptive leadership framework to include reasoning (i.e., a cognitive ability) and emotional intelligence (EI) (i.e., social ability) factors in predicting potential leader adaptability. We incorporate adaptive and situational leadership theories along with trait process models to examine two types of reasoning abilities, inductive...
Article
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This article uses a modified Altman Z-score to predict financial distress within the nursing home industry. The modified Altman Z-score model uses multiple discriminant analysis (MDA) to examine multiple financial ratios simultaneously to assess a firm’s financial distress. This study utilized data from Medicare Cost Reports, LTCFocus, and the Area...
Article
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Although the importance of safety regulations is highly emphasized in hospitals, nurses frequently work around, or intentionally bypass, safety regulations. We argue that work-arounds occur because adhering to safety regulations usually requires more time and work process design often lacks complementarity with safety regulations. Our main proposit...
Article
In this special issue on project stakeholder management, the aim is to advance the understanding of this topic by looking into theory outside the project management field and by presenting findings from case studies. In this overview article, we identify the theoretical roots of the stakeholder concept and the current state of the field. We point t...
Article
In this special issue on project stakeholder management, the aim is to advance the understanding of this topic by looking into theory outside the project management field and by presenting findings from case studies. In this overview article, we identify the theoretical roots of the stakeholder concept and the current state of the field. We point t...
Article
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Understanding stakeholder dynamics and their impact on project management is crucial, especially for large and complex projects such as nuclear waste repositories. This study examines the stakeholder dynamics during the project front-end stage of two pioneering nuclear waste repository projects. To analyze changes in stakeholders' importance and po...
Conference Paper
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For the functioning of American democracy, the Lobbying Disclosure Act (LDA), for the very first time, provides data to empirically research interest groups behaviors and their influence on congressional policymaking. One of the main research challenges is to automatically find the topic(s), by short & sparse text classification, in a large corpus...
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Explores recent approaches to international best practices and how they relate to context and innovation in health services. Critical review of existing research on best practices and how they created, diffused, and translate in the international setting. Best practices are widely used and discussed, but processes by which they are developed and di...
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This commentary argues in favor of international research in the 21st century. Advances in technology, science, communication, transport, and infrastructure have transformed the world into a global village. Industries have increasingly adopted globalization strategies. Likewise, the health sector is more internationalized whereby comparisons betwee...
Article
The U.S. Department of Labor has identified the health care industry as a major source of all U.S. workplace injuries. Studies have shown that injury within the health care workforce is related to high turnover rates, burnout, poor job satisfaction, and leaving the health care workforce permanently, thus contributing to the existing health care wor...
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Given the ongoing concerns about health care quality and costs during the 21st century, significant attention has been focused on the clinical and financial performance of US hospitals. On one hand, hospitals have been adopting various clinical technologies to improve their clinical quality and financial performance. On the other hand, there is no...
Article
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This study aims at replicating and extending Xiao and Savage's (2008) research to understand the multidimensional aspect of HMOs distinguished by HMOs' consumer-friendliness, and their relationship to consumers' preventive care utilization. This study develops a dynamic model to consider both concurrent and time lagging effects of HMOs' consumer-fr...
Article
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A fuzzy-matching clustering algorithm is applied to clustering similar client names in the lobbying Disclosure Database. Due to errors and inconsistencies in manual typing, the name of a client often has multiple representations including erroneously spelled names and sometimes shorthand forms, presenting difficulties in associating lobbying activi...
Article
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Background: Studies using the Resource Dependency Theory (RDT) perspective commonly focus on one or more of the following environmental dimensions: munificence, dynamism, and complexity. To date, no one has reviewed the use of this theory in the health care management literature and there exists no consensus on how to operationalize the market envi...
Article
Leadership is a crucial influence on employee engagement within a firm. Yet, despite the importance of employee engagement to organizational outcomes, rigorous empirical study of the relationship between leadership and employee engagement is only just beginning. Of particular interest and importance is the question of how leaders can facilitate eng...
Conference Paper
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Social partnerships involve complex collaborations, and the partners enmeshed within these interorganizational relationships can be expected to seek out effective strategies for managing these associations. Building upon the stakeholder management literature, and drawing from exchange and resource dependence theories, we contend that the relational...
Article
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While previous research has identified that leaders' safety expectations and safety actions are important in fostering occupational safety, research has yet to demonstrate the importance of leader alignment between safety expectations and actions for improving occupational safety. We build on safety climate literature and theory on behavioral integ...
Article
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Hospitals within the United States consistently have injury rates that are over twice the national employee injury rate. Hospital safety studies typically investigate care providers rather than support service employees. Compounding the lack of evidence for this understudied population is the scant evidence that is available to examine the relation...
Article
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Data provided by 7380 middle managers from 60 nations are used to determine whether demographic variables are correlated with managers’ reliance on vertical sources of guidance in different nations and whether these correlations differ depending on national culture characteristics. Significant effects of Hofstede’s national culture scores, age, gen...
Article
Objective: On the basis of resource dependency theory and the uncertainty principle, this study examines the relationship between the local public health market environment and the use of quality improvement (QI) strategies in local health departments. Design: This cross-sectional study uses secondary data from the 2008 National Association of C...
Article
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This article clarifies how leader behavioral integrity for safety helps solve follower's double bind between adhering to safety protocols and speaking up about mistakes against protocols. Path modeling of survey data in 54 nursing teams showed that head nurse behavioral integrity for safety positively relates to both team priority of safety and psy...
Article
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This chapter reports on experts' perspectives on health information technology (HIT) and how it may be used to improve health care quality and to lower health care costs. Two roundtables were convened that focused on how to best use HIT to improve the quality of health care while ensuring it is accessible and affordable. Participants drew upon less...
Article
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Declining reimbursements, resulting from the 1997 Balanced Budget Act (BBA), have placed an enormous strain on small, rural hospitals that are typically dependent on Medicare patients for the majority of their revenue. Under the BBA, new managed care and private options are available, payments to hospitals are reduced, Part B premiums are increased...
Article
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Managerial leadership within 56 nations is examined in terms of the sources of guidance that managers use to handle work events. Correlations between the sources of guidance that managers use and the perceived effectiveness of how well these events are handled are employed to represent their schemas and attributional propensities for effectiveness....
Article
Full-text available
Managerial leadership within 56 nations is examined in terms of the sources of guidance that managers use to handle work events. Correlations between the sources of guidance that managers use and the perceived effectiveness of how well these events are handled are employed to represent their schemas and attributional propensities for effectiveness....
Article
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The present study examines the separate and combined effects of environmental and organizational variables on hospitals' clinical IT sophistication in a multivariate framework. The analyses focused on two distinct but related questions. First, in the context of the bivariate hypotheses, what is the relative significance empirically of each of the e...
Article
The present study examines the separate and combined effects of environmental and organizational variables on hospitals’ clinical IT sophistication in a multivariate framework. The analyses focused on two distinct but related questions. First, in the context of the bivariate hypotheses, what is the relative significance empirically of each of the e...
Article
Visit nonadherence, that is, "no shows," in psychiatry costs the US healthcare $100 billion every year. Nonadherent visits undermine healthcare quality improvement efforts and erode patients' health. Previous research has focused on patient demographics or on redundant scheduling, rather than on the actual structure of visit nonadherence. Drawing o...
Article
Health care organizations have redesigned existing and implemented new work processes intended to improve patient safety. As a consequence of these process changes, there are now intentionally designed "blocks" or barriers that limit how specific work actions, such as ordering and administering medication, are to be carried out. Health care profess...
Article
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We offer an anatomic analysis of a social partnership among a complex network of stakeholder organizations. Contributions of this research are twofold. First, we use explanatory case data to develop a framework of stakeholder collaboration in a complex setting involving a mix of for-profit and non-profit organizations. Our study is motivated by a n...
Article
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Technology cannot be effectively used to drive improvements in health care quality and health care cost reduction until significantly more healthcare visits are attended. Visit attendance is often perceived as an intractable problem. This formative study identified and analyzed a set of visit adherence determinants to delineate a structure of adher...
Article
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Eric Williams and his colleagues review the literature on both physician burnout and physician–patient communication. A major contribution in this chapter is a model based on these two literatures, which outlines the impact that physician burnout can have on the physician–patient interaction and, therefore, patient outcomes. When physicians become...
Article
The needs for health system change and improved patient safety have been pointed out by policymakers, researchers, and managers for several decades. Patient safety is now widely accepted as being fundamental to all aspects of health care. The question motivating this special volume on patient safety is: How can the increased emphasis on patient saf...
Article
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Purpose – The purpose of this paper is to offer an explanatory process model of stakeholder management. The model shows how and why path dependence is manifested in stakeholder management issues. Design/methodology/approach – The paper integrates stakeholder theory with key ideas from path dependence literature. The resulting propositions are exami...
Article
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Research should move beyond the simple dichotomy between HMO and non-HMO care provision, and embrace the multidimensional aspects of HMOs. Doing so, we argue, helps address the issue of HMO performance. We used a consumer-centered approach to distinguish multiform HMOs and asked the questions, "Do HMOs differ in their consumer-friendly characterist...
Article
A fundamental assumption by the Institute of Medicine (IOM) is that evidence-based medicine (EBM) improves the effectiveness of medical diagnosis and treatment and, thus, the safety of patients. However, EBM remains controversial, especially its links to patient safety. This chapter addresses three research questions: (1) How does EBM contribute to...
Article
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The purpose of this paper is to provide a general review about the major programs and factors characteristic of major changes in the health care access, from both consumer and provider perspectives. Customers' perspective emphasizes the fiscal control, with particular focus on the agencies that function as fiscal intermediaries and enablers, such a...
Article
Understanding the effect that physician stress and burnout have on patient outcomes is important to improving the quality of care. The physician–patient cycle model documents the virtuous or vicious cycles which can ensue when clinicians deal effectively or ineffectively with stress and burnout. The model starts with excessive stress beginning the...
Article
Studies of journal ratings are often controversial. Indices, including impact factors, acceptance rates, expert opinions, and ratings of knowledge, relevance, and quality have been used to organize journals hierarchically. While there may be some validity in consensus rankings, it is unclear what purpose is actually achieved by these endeavors. Imp...
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To underscore the significance of international health care management, we focus on three themes: the problem of global blindness; global health care challenges and opportunities; and learning from international health care management. The problem of global blindness highlights how health care managers’ inattentional blindness to competitors’ opera...
Article
A common observation is that both single- and multi-payer health care systems will achieve lower overall costs if they use primary care gatekeeping. Questioning this common wisdom, we focus on the health care access system, that is, the way in which patients gain access to health care. Gatekeeping, the use of primary care providers to control acces...
Article
During revolutionary organizational transitions, the established strategic stakeholder models and frameworks may have limited applicability. Using a case analysis of the United Airlines and US Airways failed merger process in 2000-2001, this paper illustrates that strategic stakeholder and governance perspectives produce different but complementary...
Article
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On May 11, 2001, the Bureau of Primary Health Care notified West Alabama Health Services, doing business as Family HealthCare of Alabama, that it was terminating $6 million in grants due to non-compliance and amid allegations of financial mismanagement and fraud. West Alabama Health Services, a not-for-profit organization, operated 19 community hea...
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While telemedicine's clinical effectiveness and educational benefits are accepted, its cost-effectiveness is controversial. This study focuses on telemedicine's cost-effectiveness from a provider's perspective. Reviews of the cost-effectiveness literature in telemedicine are critical of past studies' (a) methodological and analytical weaknesses; (b...
Article
Handheld computers are being proposed as a resource for ambulatory care, yet physician reluctance to use the devices in the presence of patients is reported to be a barrier to optimal use. This study examined patient attitudes toward the use of handheld computers and the impact of those attitudes on the physicians' use of the handheld computers in...
Article
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The use of downsizing as management's strategic response to environmental and institutional changes is prevalent in all U.S. industries, including healthcare. The popular and research literature is inundated with reports on companies undergoing various stages of restructuring, which often include one or more staff reductions. This article provides...
Article
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Employee stock ownership programs (ESOP) may become a source of competitive advantage but a threat to a firm's survival as well. Strategic stakeholder negotiation, on the other hand, is a process through which an organization negotiates with multiple stakeholders in order to achieve a strategic goal. Such perspective helps to illustrate the importa...
Article
The authors analyze competing forces affecting the diffusion of telemedicine practices across organizations, potential learning effects from telemedicine practice, and their implications for the development of telemedicine-based networks. They also speculate on the learning, diffusion, and institutional effects that telemedical collaboration may tr...
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How health care managers make sense of stakeholders and act strategically within these inter-organizational relationships has significant impact on organizational survival and performance. Existing research on stakeholder management has focused on managing dyadic relationships with individual stakeholders. We propose, based on serendipitous finding...
Article
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The ongoing discussion of our intellectual community requires that occasionally an effort be made to value the outlets for our research and erect guideposts for our colleagues to signal important contributions to our discipline. This study extends previous work through a survey sent to 1,254 academics involved in health care management research tha...
Article
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Business-to-business technology development firms face a unique set of challenges when participating in the opportunities made possible by emerging multi-sector innovations. The greatest challenge involves the firm's efforts to influence and shape the market in its favor. This requires strategies for dealing numerous stakeholders -- many with which...
Article
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Data are presented showing how middle managers in 47 countries report handling 8 specific work events, including events focused on the manager's subordinate work team and other referring to relations with the wider organization. The data are used to test the ability of cultural value dimensions derived from the work of G. Hofstede (1994), F. Trompe...
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In this study we analyze possible links between new institutional economics and stakeholder management models. Our preliminary findings fit with the traditional political organization argument: namely that firms' organizational decision-making include explicit and implicit aspects, shaped by institutional and technical constraints, and that decisio...
Article
Vertical and horizontal integration has transformed the organization and delivery of health services, with hundreds of systems or networks providing a range of services to regional populations by the late 1990s. The advantages and disadvantages of vertical integration are well known in other industries, with most strategists suggesting that it is i...
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The Balanced Budget Act (BBA) of 1997 created an opportunity for improving long-term care for the rural frail elderly by granting permanent provider status to the Program of All-Inclusive Care for Elders (PACE) under Medicare. PACE is a unique managed care model that provides comprehensive, integrated acute and long-term services for frail elders a...
Article
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Labor-management group facilitation is a complex but increasingly necessary skill. Facilitators need both clear practice guidelines and an understanding of why those guidelines are legitimate. To meet these needs, this paper first provides a descriptive (structural-functional) framework for understanding the facilitator's role and the communicative...
Article
Vertical and horizontal integration in health care services has progressed remarkably since the early 1990s, with over 850 systems or networks now providing a continuum of care to regional populations. The advantages and disadvantages of vertical integration are well known in other industries, with most strategists suggesting that it is inherently...
Article
Managed care organizations (MCOs) face an uncertain future. While consolidation and price competition have expanded their market share, health care expenditures are expected to rise in the near future, and the cost containment premise--and promise--of MCOs is being threatened by mixed blessing and nonsupportive stakeholders. To shed light on MCOs'...
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Dual-concern models suggest that “concern about self” and “concern about other” motivate individuals to choose conflict-handling strategies. We test those assumptions with a study of the cognitions associated with the choice of conflict strategies. Consistent with dual-concern model conceptualizations, regression analyses that account for up to 41%...
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The growth of for-profit managed care organizations raises serious ethical questions for managers in these settings, such as whether contemporary business ethics are most appropriate for health care organizations or how the principles of biomedical ethics can be integrated into profit-seeking firms. A model is proposed that seeks to consolidate bot...
Article
The health care environment is complex and turbulent, and traditional governance forms face many challenges. As integrated delivery systems/networks are formed, governance structures must be responsive to both internal and external stakeholders. Both internal efficiencies and socially responsible actions are required of these relatively new organiz...
Article
The Postanesthesia Care Unit (PACU) is an area of high risk for the transmission of Mycobacterium tuberculosis. The Centers for Disease Control (CDC) have recommended administrative controls, engineering controls, and personal protection devices to reduce the risks; nevertheless, perianesthesia nurses inhale airborne pathogens. The CDC guidelines a...
Article
The contrast of face‐to‐face (FTF) communication with computer‐mediated communication (CMC), either experimentally or experientially, may be a valuable way for teaching group dynamics and group decision making in educational settings. Our review of the literature and a controlled study illustrate the potential strengths of FTF and CMC formats for g...
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This is the fourth in a series of articles describing and interpreting the results from the Facing the Uncertain Future (FUF) study. This article focuses on one vital aspect of strategic stakeholder management: assessment of key stakeholders. Specifically, the article uses Round Two data and presents an assessment of four key medical group practice...
Article
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The extent of role conflict, role ambiguity, and role overload reported by middle managers from 21 nations was related to national scores on power distance, individualism, uncertainty avoidance, and masculinity. We adapted earlier role stress scales and assessed equivalence using multigroup confimatory factor analysis. Role stresses varied more by...
Article
Entrepreneurship researchers operate from various paradigms that embrace a wide range of methods from quantitative to qualitative. The studies in this special issue offer an interesting mixture of field methods. We examine the authors’ epistemological (“How do we know?”) and teleological (“Why do we know?”) choices, which affect the types of data g...
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This study examines how instructors may motivate students to improve their writing skills. According to the motivation research in the psychology and management litera tures, two of the most prominent motivational techniques are goal setting and reinforce ment. We examine what these literatures suggest about the effective use of such motivation tec...
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Urban-rural hospital affiliations are an outgrowth of both the external pressures on rural hospitals to survive and the need for urban hospitals to maintain or increase their share of the tertiary referral market. This article discusses the significant role of stakeholders in these affiliations, develops a fourfold typology of urban-rural hospital...
Article
Physician executives need to negotiate effectively with a wide range of parties. In those negotiations, they should consider the relative importance of both substantive and relationship outcomes in selecting initial negotiation strategies. Of course, these strategies may or may not be successful, depending on the strategies used by the other party....