Chapter 5 synthesizes practical strategies, ethical frameworks, and policy recommendations for integrating Metaverse technologies into career development, building on Super&s;s ( 1980 ) career stages. It demonstrates how immersive environments, AI-driven mentorship, and blockchain-secured credentials enhance career exploration, skill acquisition, and lifelong learning while outlining best practices for implementation. Case studies illustrate virtual internships, AR/XR simulations for high-risk professions, and IoT-enabled haptic feedback devices that improve accessibility for individuals with disabilities, ensuring equitable access to Metaverse resources. Ethical considerations address data privacy, algorithmic bias, and the psychological impacts of prolonged virtual immersion. The discussion advocates for transparent AI systems audited for fairness in career recommendations, zero-knowledge proofs for privacy-preserving credential verification, and robust cybersecurity protocols to protect user data. Policy implications highlight updated regulatory frameworks for digital credentialing, intellectual property in virtual spaces, and cross-border recognition of Metaverse-acquired skills. The chapter calls for international collaboration to standardize ethical guidelines, mitigate the digital divide, and ensure marginalized populations benefit from Metaverse advancements. It provides educators, policymakers, and organizations with an actionable roadmap to balance innovation with critical analysis and foster equitable, sustainable career development in the digital age.
Massimo Sargiacomo, Daniel E. Martínez, Stefania Servalli, Antonio Gitto · 5 authors
Purpose This study aims to examine how hospitals and regional and local health authorities in the Italian region of Marche accounted for and reported the use of emergency funds from the EU, the Ministry of Economic and Finance and administrative bodies called actuator subjects. Unlike a sudden impact disaster, such as an earthquake, the pandemic was slow moving and novel. This meant that the guidelines for medical, legislative, financial and administrative action were not as developed as those for sudden impact emergencies with which the Italian state was, unfortunately, experienced. Design/methodology/approach The paper investigates the Italian public healthcare setting since the declaration of the State of Emergency until its end—that is, from January 2020 to July 2021. We conducted 31 semi-structured interviews with nine key-actors working for national, regional and local administrative bodies. A range of related official documents were analyzed. Findings We show a non-linear and emergent account of standardization and coordination. We show how different state and transnational actors developed their own procedures to standardize COVID-related cost classifications and reports. These attempts also involved coordinating assemblages, at the center of which are templates imposed on hospitals and regional authorities by national state entities for cost-reporting practices and aggregation. Importantly, templates’ visual features enabled coordination across the different standardization initiatives that populated the emergency response effort. Research limitations/implications The paper provides academics and policy makers with insights into the role played by accounting tools, templates, reports and guidelines to coordinate different cost standardization initiatives. Originality/value Accounting guidelines that standardize costs are known to be deployed hierarchically by states and transnational organizations for coordination purposes. We highlight, however, the emergence of not only hierarchical forms of coordination but also their interrelation with decentralized forms of coordination. These two types of coordinating assemblages, each standardizes cost through the accounting templates that they use. We demonstrate the emergent nature of coordination even within hierarchical entities like the state. Reporting templates are pivotal for understanding this coordination process. However, when a centralized coordinating body is absent, it is the visual features of accounting, rather than its imposition, that enable coordination.
Health care organizations function in multidimensional environments and their organizational cultures are complex and demanding. The expectations from health care services are high and as a result patients want the most effective and latest possible treatments, while the politicians demand responsible services. As far as healthcare professionals are concerned they require motivating and challenging work environments. All these goals and objectives can be at the root of wicked problems in healthcare management. Thus, this research paper aims to assess the impact of reforms like decentralization, health care financing and the use of information communication technology (ICT) on Patients satisfaction in public hospitals of KPK (Pakistan). The aim of these reforms was to solve the problems encountered in health care systems and to improve healthcare systems. Findings show that there is positive relationship between reforms and increase in Patient’s satisfaction Keywords: Reforms, Decentralization, Health care Financing, ICT'S in the Health Care, Quality of service, Patient Satisfaction
Sabina Nuti, Federico Vola, Anna Bonini, Milena Vainieri
The Italian Health care System provides universal coverage for comprehensive health services and is mainly financed through general taxation. Since the early 1990s, a strong decentralization policy has been adopted in Italy and the state has gradually ceded its jurisdiction to regional governments, of which there are twenty. These regions now have political, administrative, fiscal and organizational responsibility for the provision of health care. This paper examines the different governance models that the regions have adopted and investigates the performance evaluation systems (PESs) associated with them, focusing on the experience of a network of ten regional governments that share the same PES. The article draws on the wide range of governance models and PESs in order to design a natural experiment. Through an analysis of 14 indicators measured in 2007 and in 2012 for all the regions, the study examines how different performance evaluation models are associated with different health care performances and whether the network-shared PES has made any difference to the results achieved by the regions involved. The initial results support the idea that systematic benchmarking and public disclosure of data are powerful tools to guarantee the balanced and sustained improvement of the health care systems, but only if they are integrated with the regional governance mechanisms.
Open access
Healthcare Quality and Management
Patient Satisfaction in Healthcare
Health Systems, Economic Evaluations, Quality of Life
Under the trusteeship cooperation model,the public hospital may adopt centralization,decentralization or middle course as its finance management policy.The finance management system features of different polices is analyzed,the precondition of applications is explained,the individual accounting methods are described,the financial function is defined,the capital management is expatiated and the advantages and disadvantages of each model are summarized.Meanwhile,proposals on trusteeship property management policy and how to enhance finance management as well are proposed.Furthermore,theory guideline and practical references for the finance management development of public hospital are offered under the trusteeship operation.
Using Medical Record Reviews in Single Audits Invite doctors, nurses and other medical specialists to join you at the document review desk in the midst of an audit? The idea has caused some controversy in the nonfederal audit community-and may seem revolutionary to the traditional auditor-but the involvement of medical professionals is necessary, according to recently issued federal guidance. It is also highly desirable. In fact, erroneous Medicare payments estimated to total billions of dollars were uncovered this past year by the U.S. Department of Health and Human Services (HHS), Office of the Inspector General (OIG), thanks largely to the help of medical professionals. The need for using medical specialists to review patient records during single audits is detailed in the Office of Management and Budget (OMB) Circular A-133 Compliance Supplement, which was last updated June 30,1997. The circular requires that state and local governments, colleges and universities, and nonprofit organizations receiving federal awards have an organizationwide audit of all federal money they receive. These audits, known as single audits, are conducted by nonfederal auditors, such as public accounting firms and state auditors. To assist the auditors in planning and conducting these reviews, OMB publishes guidance in the form of the Compliance Supplement, covering most federal programs subject to single audits. This article focuses on the Medicaid portion of the supplement and on two of the supplement's new requirements-clustering and review of medical records-that have caused some concern among nonfederal auditors. Both of these requirements were based primarily on experience gained during recent HHS/OIG audits of the Medicare and Medicaid programs. The Medicaid Program The Medicaid program, which is the largest federal program covered by the single audit, provides payments for medical assistance to low-income persons who are age 65 or over, blind, disabled, members of families with dependent children, or qualified pregnant women or qualified children. The HHS Health Care Financing Administration (HCFA) administers the Medicaid program in cooperation with state governments, and the program is jointly financed by federal and state governments. Total federal expenditures for this program were $91 billion in federal fiscal year 1996. Within broad federal guidelines, each state decides eligible groups for Medicaid assistance, the types and range of services, the payment levels for services as well as administrative and operating procedures. This is a highly complex, decentralized program, as illustrated below: The program depends on large, complex automated data processing systems to process a huge volume of transactions. Payment systems do not normally include a review of original detailed documentation supporting the claim prior to payment. Medical services are provided directly to an eligible beneficiary, normally without prior state approval. Medical service providers normally determine the scope and medical necessity of the services. The program involves complex billing structures, with different payment rates for various types of medical services such as inpatient hospital care, physicians, prescription drugs and drug rebates. Obviously, any audit of such a complex program will present a challenge in terms of both audit cost and time expended. To assist auditors in planning and performing audits of the Medicaid program, the revised Compliance Supplement clusters Medicaid with two additional programs: the State Medicaid Fraud Control Units program and the State Survey and Certification of Health Care Providers and Suppliers program. Clustering is defined as treating multiple programs as a single program for the purpose of meeting Circular A-133 audit requirements. Believing that more effort will be needed to test the two additional programs, some nonfederal auditors have taken issue with the new cluster. …