Search results

The purpose of this paper of inter-professional networks is to analyze the evolution of relationships between professional groups enacting new forms of collaboration to address clinical imperatives.

This paper uses a case study based on semi-structured interviews with physicians and nurses, document analysis and informal discussions.

This study documents how two inter-professional networks were developed through professional agency. The findings show that the means by which networks are developed influence the form of collaboration therein. One of the networks developed from day-to-day, immediately relevant, exchange, for patient care. The other one developed from more formal and infrequent research and training exchanges that were seen as less decisive in facilitating patient care. The latter resulted in a loosely knit network based on a small number of ad hoc referrals while the other resulted in a tightly knit network based on frequent referrals and advice seeking.

Developing inter-professional networks likely require a sustained phase of interpersonal contacts characterized by persuasion, knowledge sharing, skill demonstration and trust building from less powerful professional groups to obtain buy-in from more powerful professional groups. The nature of the collaboration in any resulting network depends largely on the nature of these initial contacts.

The literature on inter-professional healthcare networks focusses on mandated networks such as NHS managed care networks. There is a lack of research on inter-professional networks that emerged from the bottom up at the initiative of healthcare professionals in response to clinical imperatives. This study looks at some forms of collaboration that these “grass-root” initiatives engender and how they are consolidated.

On 10 September 2007 the world was stunned by the news that Anita Roddick – the founder of The Body Shop – was dead at the age of 64. Everyone recognizes the success of The Body Shop, but it is not easily explained using traditional strategic thinking. This paper aims to shed new light on Anita Roddick's entrepreneurial and managerial flair, as well as on her legacy to the field of management.

Configuration as a quality is an intriguing and intuitively appealing new idea. The main innovation is the premise that organizational elements form common gestalts such that each can be best understood in relation to the other elements in the configuration. This paper probed the conceptual notion of configuration as a quality in an empirical sense by revisiting one of the classic Harvard Business School (HBS) case studies: The Body Shop International.

The paper shows The Body Shop as a good example of a comprehensive configuration that allows immediate intuitive apprehension of the new idea of configuration as a quality.

The main issue is the limited depth of analysis that has been achieved through the single HBS case as the main source of evidence. As such, although the propositions put forward seem highly plausible, the supplementary explanation still remains incomplete, opening opportunities for further research.

Re‐visiting classic case studies such as the HBS Body Shop International can stimulate the debate and fuel the process of theory building through the amalgamation of diversified old and new perspectives of the same phenomenon.

There has been considerable effort in recent years to link and integrate professional services more closely for patients with comorbidities. However, difficulties persist, especially at the clinical level. This study aims to shed light on these difficulties by examining the process of sensemaking in professionals directly involved in this integration.

The authors conducted an eight‐year longitudinal case study of an organization specializing in mental health and substance abuse. Different data collection methods were used, including 34 interviews conducted between 2003 and 2009, observations and document analysis. The authors performed a qualitative analysis of the data using a processual perspective.

This paper provides empirical insights about the nature of the sensemaking process in which professionals collectively participate and the effects of this process on the evolution of integrated services. It suggests that the development of integrated practices results from an evolutional and collective process of constructing meanings that is rooted in the work activities of the professionals involved.

By drawing attention to the capacity of professionals to shape the projects they are implementing, this study questions the capacity of managers to actually manage such a process. In order to obtain the expected benefits of integration projects, such emergent dynamics must first be recognized and then supported. Only then can thought be given to mastering them.

The fact that this is a single case study is not a limitation per se, although it does raise the issue of the transferability of results. Replicating the study in other contexts would verify the applicability of the authors' conclusions.

This study offers a fresh perspective on the difficulties generally encountered at the clinical level when trying to integrate services. It makes a significant contribution to work on the dynamics of sensemaking in organizational life.

The aim of this paper is to illustrate and discuss how healthcare organisations can act as institutional entrepreneurs in a context of change.

The authors conducted an in-depth longitudinal case study (2005-2008) of a healthcare organisation in the province of Quebec, Canada. Data collection consisted of real-time observations of senior managers (n=87), interviews (n=24) with decision-makers and secondary data analysis of documents.

The paper reports on the extent to which entrepreneurial healthcare organisations can be a driving force in the creation of a new practice. The authors analyse the development of a diabetes reference centre by a healthcare organisation acting as an institutional entrepreneur that illustrates the conceptualisation of an innovation and the mobilisation of resources to implement it and to influence other actors in the field. The authors discuss the case in reference to three stages of change: emergence, implementation and diffusion. The results illustrate the different strategies used by managers to advance their proposed projects.

This study helps to better understand the dynamics of mandated change in a mature field such as healthcare and the roles played by organisations in this process. By adopting a proactive strategy, a healthcare organisation can play an active role and strongly influence the evolution of its field.

This paper is one of only a few to analyse strategies used by healthcare organisations in the context of mandated change.

Governments everywhere are implementing reform to improve primary care. However, the existence of a high degree of professional autonomy makes large-scale change difficult to achieve. The purpose of this paper is to elucidate the change dynamics and the involvement of professionals in a primary healthcare reform initiative carried out in the Canadian province of Quebec.

An empirical approach was used to investigate change processes from the inception of a public policy to the execution of changes in professional practices. The data were analysed from a multi-level, combined contextualist-processual perspective. Results are based on a longitudinal multiple-case study of five family medicine groups, which was informed by over 100 interviews, questionnaires, and documentary analysis.

The results illustrate the multiple processes observed with the introduction of planned large-scale change in primary care services. The analysis of change content revealed that similar post-change states concealed variations between groups in the scale of their respective changes. The analysis also demonstrated more precisely how change evolved through the introduction of “intermediate change” and how cycles of prescribed and emergent mechanisms distinctively drove change process and change content, from the emergence of the public policy to the change in primary care service delivery.

This research was conducted among a limited number of early policy adopters. However, given the international interest in turning to the medical profession to improve primary care, the results offer avenues for both policy development and implementation.

The findings offer practical insights for those studying and managing large-scale transformations. They provide a better understanding of how deliberate reforms coexist with professional autonomy through an intertwining of change content and processes.

This research is one of few studies to examine a primary care reform from emergence to implementation using a longitudinal multi-level design.

The purpose of this study is to explore the influence of hospitals’ organisational characteristics on telehealth adoption by health‐care centres involved in the extended telehealth network of Quebec (French acronym RQTE)

The article is based on a review of the literature and a questionnaire, which was administered via telephone interviews to the 32 hospitals involved in the Extended Telehealth Network of Quebec. Contingency analyses were performed to determine which organisational factors have influenced telehealth adoption. Subsequently, a multiple case study was conducted among nine hospitals representative of different categories of telehealth adopters. In‐depth interviews with various actors involved in telehealth activities have permitted a deepening of one's understanding of the impact of clinical and administrative contexts on telehealth adoption.

The results from both the questionnaire and interviews support the observation made by Whitten and Adams in 2003 that telehealth programs are not isolated, but located within larger health organisations. Moreover, health‐care organisations are also positioned in a larger geographical, economical and socio‐political environment. Therefore, it is important to investigate the context in which telehealth projects are taking place prior to experimentation.

This study has highlighted the relevance of considering the characteristics and the dynamics of health‐care organisations at each stage of telehealth implementation in order to take their specific needs into account.

In this essay, I draw on the chapters by Fisher et al., Keller and Tian, and Zundel et al. that deal with the role of paradox in the context of jazz, linguistics, mathematics and poetry respectively to reflect on the nature of paradox, also considering examples from my own and other research. I argue specifically, that in everyday language, the notion of paradox is used mostly to refer not so much to persistent tensions between interdependent elements, but to describe an outcome as irony where action intended to achieve one goal actually results in its opposite or in something contrary to it. I suggest that while there may be a relation between the formal definition of paradox in the academic literature and the everyday understanding of paradox as irony, this has not been fully elucidated and would deserve further analysis and research. Doing so might perhaps bring back some of the feeling of discomfort and intractability that the notion of paradox naturally inspires, acting as a possible counterpoint to the optimism of both-and.