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Article
Publication date: 9 October 2017

Jette Ernst

The purpose of this paper is to examine the role of organizational space in attempts at practice redesign and innovation that involve a break with the traditional professional…

Abstract

Purpose

The purpose of this paper is to examine the role of organizational space in attempts at practice redesign and innovation that involve a break with the traditional professional boundaries in a recently established Danish hospital department.

Design/methodology/approach

Organizational ethnography combined with Bourdieusian theorization. The data used for this paper are derived from 13 months of ethnographic fieldwork. The author performed participant and meeting observations combined with interviews and the reading of internal and external documents.

Findings

Despite the department’s attempts at pursuing practice redesign and innovation by breaking with the institutionalized professional boundaries as well as role hierarchies, and emphasizing collaboration between nurses and doctors, the paper demonstrates how the attempts at change meet invisible impediments in practice and how organizational space plays an important yet, overlooked part in reproducing field tradition.

Originality/value

By virtue of Bourdieusian theorization in combination with organizational ethnography, the paper contributes with unique insights into a seldom studied part of hospital organization, which is how organizational space, rather than being a backdrop for organizational life, is constructed and used by professionals whose habitus renders this space an active component in delimiting professional work as well as the scope of change.

Details

Journal of Organizational Ethnography, vol. 6 no. 3
Type: Research Article
ISSN: 2046-6749

Keywords

Article
Publication date: 4 June 2018

Jette Ernst, Anette Lykke Hindhede and Vibeke Andersen

The purpose of this paper is to examine, first, how social capital was crafted and transformed from a theoretical concept to an organizational tool for public sector improvement…

Abstract

Purpose

The purpose of this paper is to examine, first, how social capital was crafted and transformed from a theoretical concept to an organizational tool for public sector improvement that was adopted by a Danish region and implemented in all regional hospitals. Second, the paper examines the application of social capital in one of these hospitals and, further, in a department of the hospital with the purpose of showing how it was applied by the managerial levels and responded to by the nurses of the department.

Design/methodology/approach

A Bourdieusian ethnographic approach was used for understanding the local and subjective understandings of social capital as well as the wider context in which the new tool was crafted.

Findings

Social capital as a tool for organizational improvement was constructed in a gray zone between science and consultancy. The paper demonstrates that the application of social capital in practice is connected with paradoxes because the concept is inherently ambiguous and Janus-faced in that its official representation is “soft” and voluntary with a working environment focus yet, it envelopes concealed steering intentions. These contrary working features of the concept produce a pressure on the department management and the nurses.

Originality/value

The explanatory critical framework combined with the ethnographic approach is a useful approach for theorizing and understanding social capital as an example of the emergence and consequences of new managerial tools in public organizations.

Details

International Journal of Public Sector Management, vol. 31 no. 5
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 26 July 2018

Jette Ernst and Astrid Jensen Schleiter

The purpose of this paper is to look at the ways in which standardization for patient safety is approached from different positions in the field, namely nurses and managers in a…

Abstract

Purpose

The purpose of this paper is to look at the ways in which standardization for patient safety is approached from different positions in the field, namely nurses and managers in a hospital department, the hospital management and standard inventers. We understand safety standardization and the responses to it as a strategizing process, where standards are legitimized, taken up, handled or countered.

Design/methodology/approach

Ethnographic fieldwork was conducted in a Danish hospital department. The study included observations, interviews and documents studies. The authors apply a Bourdieusian perspective, where the authors focus on the narratives told by standard inventers, managers and nurses to examine and understand their strategizing activities in relation to safety standardization. We understand strategizing as interested action emerging in the dialectics between a habitus and a position in a field.

Findings

The authors show how the standardization of work rests on the master narrative of patient safety management and how this narrative clashes with the nurses’ practical perception of good care, which rests on the counter-narrative of the clinical judgment.

Originality/value

Safety standardization in healthcare is often studied within the broader framework of performance management using functionalist outside-in and prescriptive approaches. This study contributes to this literature by approaching standardization and the responses to it as taking place in a dialectic movement between subjective shop floor experiences and wider field-level forces. Furthermore, the study contributes to the organization and management literature concerned with change and strategic action by endorsing the Bourdieusian conception of strategizing.

Details

Qualitative Research in Organizations and Management: An International Journal, vol. 13 no. 4
Type: Research Article
ISSN: 1746-5648

Keywords

Article
Publication date: 16 April 2020

Jiexun Li and Xiaohui Chang

The emergence of mobile health (mHealth) products has created a capability of monitoring and managing the health of patients with chronic diseases. These mHealth technologies…

Abstract

Purpose

The emergence of mobile health (mHealth) products has created a capability of monitoring and managing the health of patients with chronic diseases. These mHealth technologies would not be beneficial unless they are adopted and used by their target users. This study identifies key factors affecting the usage of mHealth apps based on user usage data collected from an mHealth app.

Design/methodology/approach

Using a dataset collected from an mHealth app named mPower, developed for patients with Parkinson's disease (PD), this paper investigated the effects of disease diagnosis, disease progression and mHealth app difficulty level on app usage, while controlling for user information. App usage is measured by five different activity counts of the app.

Findings

The results across five measures of mHealth app usage vary slightly. On average, previous professional diagnosis and high user performance scores encourage user participation and engagement, while disease progression hinders app usage.

Research limitations/implications

The findings potentially provide insights into better design and promotion of mHealth products and improve the capability of health management of patients with chronic diseases.

Originality/value

Studies on the mHealth app usage are critical but sparse because large-scale and reliable mHealth app usage data are limited. Unlike earlier works based solely on survey data, this research used a large user usage data collected from an mHealth app to study key factors affecting app usage. The methods presented in this study can serve as a pioneering work for the design and promotion of mHealth technologies.

Details

Information Technology & People, vol. 34 no. 1
Type: Research Article
ISSN: 0959-3845

Keywords

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