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Improving community primary care access is a difficult and dynamic undertaking. Realizing a need to improve appointment availability, a systematic approach based on measurement, empowerment, and interaction was developed. The model fostered exchange of information and problem solving between interdependent staff sections within a managed care system. Measuring appointments demanded but not available proved to be a credible customer-focused approach to benchmark against set goals. Changing the organizational culture to become more sensitive to changing beneficiary needs was a paramount consideration. Dependent-group t tests were performed to compare the pretreatment and posttreatment effect. The empowerment-interaction model significantly improved the availability of routine and wellness-type appointments. The availability of urgent appointments improved but not significantly; a better prospective model needs to be developed. In aggregate, appointments demanded but not available (empowerment-interaction model) were more than 10% before the treatment and less than 3% with the treatment.

A global economy requires business organizations to cultivate their international holdings by respecting the national differences of their host countries and coordi nating efforts for rapid innovation. In this essay we first review relevant literature in the areas of communication and innovation and explore how efforts toward innovative practices are directly related to globalism and business strategy. We then focus on issues associated with national culture, corporate culture, and pro fessional culture that are relevant to strategies for researching business communi cation in global contexts. Finally, we suggest directions for future work.