Search results

Healthcare tribalism refers to the phenomenon through which different groups in a healthcare setting strictly adhere to their profession-based silo, within which they exhibit stereotypical behaviours. In turn, this can lead to deleterious downstream effects upon productivity and care delivered to patients. This study highlights a clinician-led governance model, implemented at a National Health Service (NHS) trust, to investigate whether it successfully overcame tribalism and helped drive innovation.

This was a convergent mixed-methods study including qualitative and quantitative data collected in parallel. Qualitative data included 27 semi-structured interviews with representatives from four professional groups. Quantitative data were collected through a verbally administered survey and scored on a 10-point scale.

The trust arranged its services under five autonomous business units, with a clinician and a manager sharing the leadership role at each unit. According to interviewees replies, this equivalent authority was cascaded down and enabled breaking down professional siloes, which in turn aided in the adoption of an innovative clinical model restructure.

This study contributes to the literature by characterizing a real-world example in which healthcare tribalism was mitigated while reflecting on the advantages yielded as a result.

Previous studies from all over the world identified major differences in the perspectives of different healthcare professional groups. In the United Kingdom, clinicians largely felt cut off from decision-making and dissatisfied with their managerial role. The study findings explain a governance model that allowed harmony and inclusion of different professions. Given the long-standing strains on healthcare systems worldwide, stakeholders can leverage the study findings for guidance in developing and implementing innovative managerial approaches.

As management innovations become more complex, infrastructure needs to change in order to accommodate new work practices. Different challenges are associated with work practice redesign and infrastructure change however; combining these presents a dual challenge and additional challenges associated with this interaction. The purpose of this paper is to ask: what are the challenges which arise from work practice redesign, infrastructure change and simultaneously attempting both in a single transformation?

The authors present a longitudinal study of three hospitals in three different countries (UK, USA and Canada) transforming both their infrastructure and work practices. Data consists of 155 ethnographic interviews complemented by 205 documents and 36 hours of observations collected over two phases for each case study.

This paper identifies that work practice redesign challenges the cognitive load of organizational members whilst infrastructure change challenges the project management and structure of the organization. Simultaneous transformation represents a disconnect between the two aspects of change resulting in a failure to understand the relationship between work and design.

These challenges suggest that organizations need to make a distinction between the two aspects of transformation and understand the unique tensions of simultaneously tackling these dual challenges. They must ensure that they have adequate skills and resources with which to build this distinction into their change planning.

This paper unpacks two different aspects of complex change and considers the neglected challenges associated with modern change management objectives.

The purpose of this paper is to investigate what happens when a lack of role-sending results in ambiguous change agent roles during a large scale organisational reconfiguration. The authors consider the role of sensemaking in resolving role ambiguity of middle manager change agents and the consequences of this for organisational restructuring.

Data were collected from a case study analysis of significant organisational reconfiguration across a local National Health Service Trust in the UK. Data consists of 82 interviews, complemented by analysis of over 100 documents and field notes from 51 hours of observations collected over five phases covering a three year period before, during and after the reconfiguration. An inductive qualitative analysis revealed the sensemaking processes by which ambiguity in role definition was resolved.

The data explains how change agents collectively make sense of a role in their own way, drawing on their own experiences and views as well as cues from other organisational members. The authors also identified the organisational outcomes which resulted from this freedom in sensemaking. This study demonstrates that by leaving too much flexibility in the definition of the role, agents developed their own sensemaking which was subsequently very difficult to manipulate.

In creating new roles, management first needs to have a realistic vision of the task and roles that their agents will perform, and second, to communicate these expectations to both those responsible for recruiting these roles and to the agents themselves.

Much of the focus in sensemaking research has been on the importance of change agents’ sensemaking of the change but there has been little focus on how change agents sensemake their own role in the change.

The paper explores the role of construction industry “partnering” ‐ the development of closer collaborative links between firms ‐ in stimulating organisational learning. Drawing on case studies of partnering relationships involving large clients (British Petroleum, NatWest Bank, McDonald’s, Selfridges, Safeway) and over 40 of their contractors and suppliers, discusses the factors which influence the transfer of knowledge between organisations, the different levels at which learning takes place (e.g. individual, team, organisational) and the extent to which double‐loop learning can be observed.

The Financial Services Authority (FSA) issued in July 1999 draft Statements of Principle and Code of Practice for Approved Persons in preparation for the new regulatory regime to be introduced under the proposed new Financial Services and Markets Act. In December it issued draft rules and guidance relating to firms' systems and controls and responsibilities of senior managers. This paper summarises the proposed new regime and highlights some of the main issues that will arise for employees of regulated firms, and particularly for senior managers. It goes on to discuss senior managers' powers to delegate their functions and lessons learned from the courts on that issue.

Purpose – The purpose of this chapter is to conduct a critical literature review that examines the origins and development of research on service robots in organizations, as well as the key emotional and cognitive issues between service employees, customers, and robots. This review provides a foundation for future research that leverages the emotional connection between service robots and humans.

Design/Methodology/Approach – A critical literature review that examines robotics, artificial intelligence, emotions, approach/avoid behavior, and cognitive biases is conducted.

Findings – This research provides six key themes that emerge from the current state of research in the field of service robotics with 14 accompanying research questions forming the basis of a research agenda. The themes presented are as follows: Theme 1: Employees have a forgotten “dual role”; Theme 2: The influence of groups is neglected; Theme 3: Opposing emotions lead to uncertain outcomes; Theme 4: We know how robots influence engagement, but not experience; Theme 5: Trust is necessary but poorly understood; and Theme 6: Bias is contagious: if the human mind is irrational…so too are robot minds.

Practical Implications – Practically, this research provides guidance for researchers and practitioners alike regarding the current state of research, gaps, and future directions. Importantly for practitioners, it sheds light on themes in the use of AI and robotics in services, highlighting opportunities to consider the dual role of the employee, examines how incorporating a service robot influences all levels of the organization, addresses motivational conflicts for employees and customers, explores how service robots influence the whole customer experience and how trust is formed, and how we are (often inadvertently) creating biased robots.