Work on applying physical and physiological principles for determining cardiac output by analysis of pressure measurements has been pursued for decades. Reference measurements for this kind of cardiac output analysis rely on the pulmonary artery catheter (PAC), considered the clinical gold standard for cardiac output monitoring. Recent advances in signal processing, as well as applied information on the relationships that enable arterial pulse pressure to be used to determine stroke volume, have led to the development of a novel system that can continuously measure cardiac output from an arterial pressure waveform that does not require an external calibration reference method. There are significant challenges in applying statistical- and signal-processing practices to the analysis of complex physiological waveforms. This paper reviews the historical basis for measuring flow from the analysis of pressure in a vessel, establishes the physiological and mathematical basis for this new system and describes its performance under various physiological conditions.

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Summary The rankings literature implicitly assumes that rankings success universally benefits organizations. However, in some instances, this assumption may be unwarranted. In this study, we employ a mixed‐methods approach that moves the literature beyond examining whether employees leave, to examine who leaves elite Best Places to Work (BPTW), defined as organizations which place in the top 10 in BPTW rankings perennially (i.e., year after year). In Study 1, examination of elite BPTW organizations shows that proportions of voluntary turnover comprising high performers increase over associated BPTW ranking cycles. Study 2 commences with 40 semistructured interviews among employees in an elite BPTW organization, from which two relevant and explanatory themes emerge. First, some employees interpret BPTW success as restricting opportunities for advancement within the organization, a phenomenon we term “perceived promotion constraint.” Second, some employees perceive BPTW success as building their own personal resumes. Integrating our findings from Study 1 and the qualitative portion of Study 2 with the career management literature, we propose and deductively test “perceived promotion constraint” and “perceived resume building” as two potential high performer turnover mechanisms, finding that perceived promotion constraint mediates the relationship between performance status and turnover intentions.

While specialized infusion clinical services remain the standard of care, widespread curtailing and disbanding of infusion teams as a cost-cutting measure has been documented in health care organizations for nearly 2 decades. Owing to this trend, as well as recent government interventions in medical error control, the authors engaged in an exploratory study of infusion administration practices in the US health care industry. This article presents the authors' exploratory findings, as well as their potential implications.

Purpose Open source software (OSS) communities devoted to the development of electronic medical records (EMRs) have grown in recent years. The purpose of this paper is to focus on the challenge the leaders of these communities face in terms of building perceptions of psychological ownership among community members. Design/methodology/approach Surveys (n = 50) and brief interviews (n = 56) with individual members of an open source EMR community (most of whom are based in African nations) were used. Findings Among community members, normative commitment (in comparison to extrinsic motivation and affective commitment) was the strongest predictor of psychological ownership. Interviews revealed that community members tended to feel a greater sense of ownership toward the end user (i.e. hospitals and clinics) than toward the community itself. Practical implications To foster engagement and retention – and enhance the worldwide impact of their community on healthcare practices – leaders of open source EMR communities can offer incentives related to certifications and status-based rewards, hold annual meetings to allow members to develop a better understanding of the community and encourage members to “pay it forward” by involving end users (i.e. hospital and clinic employees) within the community, thus furthering public health initiatives. Originality/value OSS communities experience unique challenges compared to traditional organizations. This necessitates a reconsideration of the applicability of commonly accepted principles, tenets and recommendations from the management literature.