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Article
Publication date: 16 May 2016

Mia von Knorring, Kristina Alexanderson and Miriam A Eliasson

– The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations.

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2857

Abstract

Purpose

The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations.

Design/methodology/approach

In total, 18 of Sweden’s 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians’ sickness certification practice. A discourse analysis approach was used for data analysis.

Findings

Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes “physician” or “non-physician” to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of “yes, but […]” approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers.

Research limitations/implications

Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians.

Practical implications

The results suggest that there is a need to address the organisational conditions for managers’ role taking in healthcare organisations.

Originality/value

Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations.

Details

Journal of Health Organization and Management, vol. 30 no. 3
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 12 June 2017

Christian Gadolin and Thomas Andersson

The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work.

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2267

Abstract

Purpose

The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work.

Design/methodology/approach

Qualitative case study based on interviews (n=27) and observations (n=10).

Findings

The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute.

Practical implications

Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed.

Originality/value

Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 5
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 5 September 2018

Alba Barbarà-i-Molinero, Cristina Sancha and Rosalia Cascón-Pereira

The purpose of this paper is to analyse and compare the level of professional identity strength between healthcare and social sciences students.

Abstract

Purpose

The purpose of this paper is to analyse and compare the level of professional identity strength between healthcare and social sciences students.

Design/methodology/approach

Based on a sample of 339 students, the authors conduct an ANOVA analysis in order to compare students’ professional identity strength across the abovementioned groups.

Findings

The authors’ results show that there are significant differences in professional identity strength between healthcare and social sciences students. In particular, healthcare sciences students show stronger professional identity than social sciences students.

Originality/value

This study contributes to the existing literature on professional identity in higher education by being the first study comparing student’s professional identity between bachelor degrees from different professional fields of study and by showing the relevance of discipline as a contextual variable in the study of students’ professional identity.

Details

Journal of Applied Research in Higher Education, vol. 10 no. 4
Type: Research Article
ISSN: 2050-7003

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Article
Publication date: 8 July 2014

Halcyon St Hill and Hulya Julie Yazici

The purpose of this paper is to present an integrated model of didactic, practice and interdisciplinary service learning in healthcare education, and determine the…

Abstract

Purpose

The purpose of this paper is to present an integrated model of didactic, practice and interdisciplinary service learning in healthcare education, and determine the students’ perceptions on the benefits of this integration.

Design/methodology/approach

A pre and post survey design was utilized to examine health professions students’ perspectives with respect to learning outcomes relevant to professional benefits of a service learning capstone. The surveys consisted of 36 items for measuring the interdisciplinary course characteristics and perceived benefits of the integrated approach. The required interdisciplinary (used interchangeably with interprofessional) course was constructed as an integrated didactic, practice interdisciplinary service learning model. The sample consisted of undergraduate students (n=53) who completed the interdisciplinary senior seminar capstone course taught by one faculty member in one of three course sections. Structural equation modeling based on partial least squares was used to analyze the significance of constructs. Students’ reflections on interdisciplinary service learning were also collected and summarized.

Findings

The study demonstrated the significance of interdisciplinary course and team preparation on perceived professional benefits and positive community service learning experience.

Research limitations/implications

Further studies are needed and being pursued to address practitioners’ perceptions of interdisciplinary education. To fully complete the assessment of interdisciplinary education, longitudinal studies must be pursued with graduates and their employers. A larger sample size could be used to repeat this study.

Practical implications

The model employed in this study may be utilized as a component of practice education and clinical practice to address accreditation requirements, quality patient-centred care, and engaging students in valuing interprofessionalism and service.

Originality/value

This study presents an integrated model of didactic, practice and interdisciplinary service learning in health professions education, and demonstrates the benefits of the model with health profession students’ perceptions of interprofessional education (IPE). This study contributes to professional learning research as the impact of IPE has been questionable due to lack of rigorous evidence.

Details

Education + Training, vol. 56 no. 5
Type: Research Article
ISSN: 0040-0912

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Article
Publication date: 19 June 2017

Sarah Wise, Christine Duffield, Margaret Fry and Michael Roche

The desirability of having a more flexible workforce is emphasised across many health systems yet this goal is as ambiguous as it is ubiquitous. In the absence of…

Abstract

Purpose

The desirability of having a more flexible workforce is emphasised across many health systems yet this goal is as ambiguous as it is ubiquitous. In the absence of empirical studies in healthcare that have defined flexibility as an outcome, the purpose of this paper is to draw on classic management and sociological theory to reduce this ambiguity.

Design/methodology/approach

The paper uses the Weberian tool of “ideal types”. Key workforce reforms are held against Atkinson’s model of functional flexibility which aims to increase responsiveness and adaptability through multiskilling, autonomy and teams; and Taylorism which seeks stability and reduced costs through specialisation, fragmentation and management control.

Findings

Appeals to an amorphous goal of increasing workforce flexibility make an assumption that any reform will increase flexibility. However, this paper finds that the work of healthcare professionals already displays most of the essential features of functional flexibility but many widespread reforms are shifting healthcare work in a Taylorist direction. This contradiction is symptomatic of a failure to confront inevitable trade-offs in reform: between the benefits of specialisation and the costs of fragmentation; and between management control and professional autonomy.

Originality/value

The paper questions the conventional conception of “the problem” of workforce reform as primarily one of professional control over tasks. Holding reforms against the ideal types of Taylorism and functional flexibility is a simple, effective way the costs and benefits of workforce reform can be revealed.

Details

Journal of Health Organization and Management, vol. 31 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 18 May 2018

Anne Koskiniemi, Hanna Vakkala and Ville Pietiläinen

The purpose of this study is to take an existential-phenomenological perspective to understand and describe the experienced leader identity development of healthcare

Abstract

Purpose

The purpose of this study is to take an existential-phenomenological perspective to understand and describe the experienced leader identity development of healthcare leaders working in dual roles. Leader identity development under the influence of strong professional identities of nurses and doctors has remained an under-researched phenomenon to which the study contributes.

Design/methodology/approach

Existential-phenomenology serves as a perspective underpinning the whole research, and an existential-phenomenological method is applied in the interview data analysis.

Findings

The study showed leader identity development in healthcare to be most strongly influenced and affected by clinical work and its meanings and followers’ needs and leader–follower relationships. In addition, four other key categories were presented as meaningful in leader identity development; leader identity development is an ongoing process occurring in relations of the key categories.

Originality/value

The existential-phenomenological approach and analysis method offer a novel way to understand leader identity development and work identities as experienced.

Details

Leadership in Health Services, vol. 32 no. 1
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 2 March 2015

Kristina Schoemmel, Thomas Skriver Jønsson and Hans-Jeppe Jeppesen

In order to contribute to the understanding of affective commitment towards distinct workplace targets, the purpose of this paper is to develop and validate a Multitarget…

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1233

Abstract

Purpose

In order to contribute to the understanding of affective commitment towards distinct workplace targets, the purpose of this paper is to develop and validate a Multitarget Affective Commitment Scale (MACS) through two data collections. The MACS uses similarly worded items for distinct targets and reflects the most recent theoretical development of affective commitment.

Design/methodology/approach

In the first data collection, items from previous commitment scales were tested through the social network service Facebook (n=305). The second data collection was conducted in the healthcare system of Denmark (n=496) using survey questionnaires.

Findings

In Study 1, exploratory factor analyses were conducted to reduce the items based on the Facebook data. In Study 2, the authors confirm the findings of Study 1 and further reduce the items based on the healthcare sample. The healthcare sample is also used in Study 3, where the authors validate the MACS by investigating its relationship with predictors, correlates, and outcomes.

Originality/value

The results suggest that the MACS are a reliable and valid measure of affective commitment compatible with the diverse targets to which affective commitment often occurs. Consequently, the MACS is applicable for research investigating multiply affective commitments, thereby advancing the understanding of interactions between affective commitments and diverse targets, among other applications.

Details

Personnel Review, vol. 44 no. 2
Type: Research Article
ISSN: 0048-3486

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Article
Publication date: 18 October 2019

John Blenkinsopp, Nick Snowden, Russell Mannion, Martin Powell, Huw Davies, Ross Millar and Jean McHale

The purpose of this paper is to review existing research on whistleblowing in healthcare in order to develop an evidence base for policy and research.

Abstract

Purpose

The purpose of this paper is to review existing research on whistleblowing in healthcare in order to develop an evidence base for policy and research.

Design/methodology/approach

A narrative review, based on systematic literature protocols developed within the management field.

Findings

The authors identify valuable insights on the factors that influence healthcare whistleblowing, and how organizations respond, but also substantial gaps in the coverage of the literature, which is overly focused on nursing, has been largely carried out in the UK and Australia, and concentrates on the earlier stages of the whistleblowing process.

Research limitations/implications

The review identifies gaps in the literature on whistleblowing in healthcare, but also draws attention to an unhelpful lack of connection with the much larger mainstream literature on whistleblowing.

Practical implications

Despite the limitations to the existing literature important implications for practice can be identified, including enhancing employees’ sense of security and providing ethics training.

Originality/value

This paper provides a platform for future research on whistleblowing in healthcare, at a time when policymakers are increasingly aware of its role in ensuring patient safety and care quality.

Details

Journal of Health Organization and Management, vol. 33 no. 6
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 5 September 2016

Rafael Paguio and Beverley Jackling

The ability to work effectively in a team is highly regarded by employers of accounting graduates, yet they have expressed concern that many university graduates lack…

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4690

Abstract

Purpose

The ability to work effectively in a team is highly regarded by employers of accounting graduates, yet they have expressed concern that many university graduates lack teamwork skills. Furthermore, in the context of the accounting curriculum, a “conceptual vagueness” surrounds a workplace-relevant definition of teamwork. Drawing on the theoretical perspectives of the healthcare sector where teamwork skills are required to be taught and assessed as part of accreditation processes, this study investigates what teamwork means from the perspective of accounting employers.

Design/methodology/approach

Semi-structured interviews were conducted with a purposive sample of employers to acquire descriptions of teamwork observed from graduate recruits. Using an analyst triangulation process, resulting teamwork items were analysed and emerging themes were identified.

Findings

Teamwork in accounting work contexts were identified, confirmed and explained. Mapped against the healthcare teamwork theories, many teamwork items from the interview analysis clustered around the mutual support competency and the dimensions of traits and motives.

Research Limitations/implications

The study was restricted to employers collaborating in one university’s placement program. Further research could investigate more diverse employer groups, determine importance ranking of identified teamwork themes and seek explanations for differences among different employer groups.

Practical implications

An enhanced description of teamwork is significant in supporting student awareness and informing teaching innovations/assessments of this generic skill in the accounting curriculum.

Originality/value

The paper provides a unique contribution of evidence-based descriptions of teamwork expected of accounting graduates, thus addressing conceptual and practical ambiguity of the meaning of teamwork skills in the accounting profession.

Details

Accounting Research Journal, vol. 29 no. 3
Type: Research Article
ISSN: 1030-9616

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Article
Publication date: 7 July 2014

Laila Nordstrand Berg and Haldor Byrkjeflot

The hospital sector has expanded in Norway with reforms and a strong demand for better management. The purpose of this paper is to examine: first, how this has affected…

Abstract

Purpose

The hospital sector has expanded in Norway with reforms and a strong demand for better management. The purpose of this paper is to examine: first, how this has affected physicians and nurses in management; second, how management roles in hospitals are changing; and third, how these two professions are tackling their new roles.

Design/methodology/approach

The paper presents a review of the secondary literature and a case study undertaken in the spring, 2012.

Findings

In Norway, two reforms have been introduced aimed at creating stronger management positions with less professional influence. The leader has full responsibility for a particular unit, which means that the jurisdiction of managers has expanded and that management has become more time consuming. Physicians – traditionally those in charge of hospitals – are facing competition from other professions, especially nursing, which has gained representation in top management positions, particularly at middle management level.

Originality/value

The originality of this paper is the comparison of the evolvement of management among physicians and nurses since the reforms. While the medical profession was critical of management to begin with, i.e. viewing management positions as a trap, it is gradually adapting to the new ideas. Physicians are facing competition from nurses, who readily adjust to the new conditions, and perceive management as a new career track.

Details

International Journal of Public Sector Management, vol. 27 no. 5
Type: Research Article
ISSN: 0951-3558

Keywords

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