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The purpose of this paper is to apply the image theory to the hospital context in order to add a perspective into the known complex relationship between physicians and hospital managers. This insight can enrich current intervention schemes used in health care to facilitate organisational change.

In this paper, the image theory of Alexander et al. on the known complex intergroup context of physicians and hospital managers is applied. The theory is operationalised in relative status, power, and goal incompatibility.

The data show the three variables are highly relevant and representative. Hospital managers see physicians as higher in professional status and power, and having different goals. Physicians see hospital managers to have higher power, lower status, and different goals. The study validates the applicability of the image theory in the Dutch hospital context. This results in a questionnaire suitable for performing a quick scan on the strength and direction of intergroup stereotyping within hospital organisations.

Data from the questionnaire give the opportunity to have insight in the way physicians and hospital managers perceive each other. This insight helps to focus attention on bottlenecks and possibilities in enhancing the co‐operation between physicians and hospital managers. Research on the relationship between physicians and hospital managers is scarce and mostly of a qualitative nature. This paper is executed in both qualitative and quantitative way, which enables us to empirically and statistically validate the data. The resulting questionnaire is applicable on an organisational intergroup level, while the focus in the extant literature is mostly on the interpersonal or intragroup level.

The purpose of this paper is to gain a better understanding of the difficulties encountered in the hybrid roles of physician−managers (P−Ms), examine the impact of organizational constraints on the role conflicts experienced by P−Ms and explore the different ways their two roles are integrated.

A qualitative approach was adopted, using six focus groups made up of clinical co-managers, medical directors and P−Ms. In all, 43 different people were interviewed to obtain their perceptions of the day-to-day realities of the role of the P−M. The data collected were subsequently validated.

Although the expectations of the different groups involved regarding the role of P−Ms are well understood and shared, there are significant organizational constraints affecting what P−Ms are able to do in their day-to-day activities, and these constraints can result in role conflicts for the people involved. Such constraints also affect the ways P−Ms integrate the two roles. The authors identify three role hybridization profiles.

The results afford a better understanding of how organizational constraints might be used as levers of organizational change to achieve a better hybridization of the dual roles of P−Ms.

This paper seeks to reach beyond a simple identification of constraints affecting the dual roles of P−Ms by analyzing how such constraints impact on these professionals’ day-to-day activities. Results also enable us to further refine Katz and Kahn’s (1966) role model, in addition to identifying hybridization profiles.

For accountability purposes, performance information sharing and clear divisions of responsibilities between medical specialists and executive boards are critical. The purpose of this paper is to explore whether these aspects of clinical governance have been taken up by executive boards and medical specialists in the Netherlands.

This cross-sectional study aimed to explore the information-sharing between medical specialists and executive boards in Dutch hospitals as one key aspect of clinical governance. Between November 2010 and February 2011, 67 medical staff board chairs and 40 chief executive officers completed an online questionnaire concerning information-sharing and the clinical governance practices within their respective hospitals.

Almost all respondents acknowledged the importance of information-sharing. However, the actual sharing differed per type of performance information. Policy/management information was shared more often than patient care information. Similarly, medical specialists differ in the degree of responsibility the take for specific clinical governance tasks. Almost all were involved in managing complication registries (99 per cent), while few managed hospital accreditation (55 per cent).

With executive boards and medical specialists being increasingly dependent of a shared budget, they have an extra incentive to share information and to take up clinical governance tasks. The study showed that Dutch medical specialists are sharing many types of performance information with the executive board, but that this should be increased to comply with the codes. Thus far, few hospital managers in the study have formalised this in an information protocol, which is potentially the next step for other hospital staff to incorporate as well. Those who have an information protocol seem to be aware of the business case for quality.

This study is the first attempt to explore to what extent Dutch medical specialists share performance information with their respective executive boards and take up clinical governance tasks.

The aim of this paper is to describe the factors that contribute to understanding how collaboration improves performance in operating rooms (ORs) after introducing the concept of cross‐functional OR scheduling teams.

The concept was investigated at Radboud University Nijmegen Medical Center (RUNMC) in The Netherlands and used on an innovative path based on socio‐technical systems (STS) principles designed to address non‐routine tasks, variety, interferences and errors related to OR scheduling, with the aim of increasing both staff productivity and patient safety. The effects of implementing preoperative cross‐functional teams in the OR were compared qualitatively. The researcher observed all of the team meetings, available data and documentation, and 13 semi‐structured interviews were performed with team members for collecting additional data.

In the literature, it was found that the theory of socio‐technical systems and the fields of group dynamics and self‐managing teams fit the OR setting. The author applied six elements of these theories (setting common goals, cohesion, openness, single‐loop and double‐loop learning, feedback, and control options) to the aspects found in the study. The qualitative findings revealed that high‐performing teams were able to identify bottlenecks in order to improve continuity of care. The cross‐functional teams used several performance indicators to gain insight into their own performance. Consequently, through collaboration, these teams were able to minimise interference and therefore learn. Cross‐functional teams learned how to address interferences and improve their quality of service through improved collaboration and the improved use of control mechanisms.

This research highlights the importance of team‐based approaches and the need to improve collaboration between healthcare professionals.

The paper confirms the value of implementing the socio‐technical systems theory to improve collaboration between healthcare professionals. This case study is a valuable contribution, as it focuses on team‐based organisation in preparing an OR schedule.