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The authors contribute to scholarly understanding of the interplay between macro-level institutions and micro-level action by focusing attention on the ways the power of institutions works through mundane organizational spaces to constrain individuals as they interact with organizations. The authors explore these macro- and micro-connections between institutions and organizational spaces through a qualitative inductive study of an emergency department in a public hospital in Australia. Analyzing observational and interview data related to a waiting room and a corridor, their findings show how the systemic power of the state and the medical profession impacts micro-level action through organizational spaces. The authors find that the medical profession exerted power in a system of domination over marginalized patients through the waiting room as an exclusion space. At the same time, the state exerted discipline power over professional subjects through the corridor as a surveillance space. Individual resistance to institutional power over the ED was controlled by policing deviance in the surveillance space and ejecting resisters to the exclusion space. Their findings contribute to the literature by opening up new insight into how mundane organizational spaces convey institutional power by dominating and disciplining micro-level actions.

In this chapter the authors focus on the role of power associated with microfoundations of organizational hybridity. They develop a framework that illuminates how key sources of power based on Buchanan and Badham (2008) and French and Raven (1959) manifest at the level of everyday work practices. Using this framework, they draw on existing studies concerning hybridity in professional organizations to illustrate how different forms of power come into play when actors guided by different logics engage in day-to-day professional work. Overall, the authors suggest that more attention to how micro-level actors use different forms of power to support, hamper, or alter different mechanisms to manage tensions among competing logics in everyday work is critical to improving our understanding about the microfoundations of institutionalism.

Purpose: The current study aims to cast light on the divide between academic research in management accounting and its applicability to practice by examining, from the standpoint of nursing, how this gap is perceived and what challenges may be involved in bridging it.

Design/Methodology/Approach: The current study compares the findings of Tucker and Parker (2014) with both quantitative as well as qualitative evidence from an international sample of nursing academics.

Findings: The findings of this study point to the differing tradition and historical development in framing and addressing the research–practice gap between management accounting and nursing contexts and the rationale for practice engagement as instrumental in explaining disciplinary differences in addressing the research–practice gap.

Research Implications Despite disciplinary differences, we suggest that a closer engagement of academic research in management accounting with practice “can work,” “will work,” and “is worth it.” Central to a closer relationship with practice, however, is the need for management accounting academics to follow their nursing counterparts and understand the incentives that exist in undertaking research of relevance.

Originality/value: The current study is one of the few that has sought to look to the experience of other disciplines in bridging the gap. Moreover, to our knowledge, it is the first study in management accounting to attempt this comparison. In so doing, our findings provide a platform for further considering how management accounting researchers, and management accounting as a discipline might, in the spirit of this study’s title, “Learn from the Experience of Others.”

This article examines how a profit-centered restructuring of labor relations in an academic medical center undermined team-based care practices in its intensive care unit. The Institute of Medicine has promoted team-based care to improve patient outcomes, and the staff in the intensive care unit researched for this paper had established a set of practices they defined as teamwork. After hospital executives rolled out a public relations campaign to promote its culture of teamwork, they restructured its workforce to enhance numerical and functional flexibility in three key ways: implementing a “service line” managerial structure; cutting a range of staff positions while combining others; and doubling the capacity of its profitable and highly regarded intensive care unit. Hospital executives said the restructuring was necessitated by changes to payment models brought forth by the Affordable Care Act. Based on 300 hours of participant-observation and 35 interviews with hospital staff, findings show that the restructuring lowered staff resources and intensified work, which limited their ability to practice care they defined as teamwork and undermined the unit’s collective identity as a team. Findings also show how staff members used teamwork as a sensitizing concept to make sense of what they did at work. The meanings attached to teamwork were anchored to positions in the hospitals’ organizational hierarchy. This paper advances our understanding of he flexible work arrangements in the health care industry and their effects on workers.

Research with vulnerable groups is crucial to get their input into public policy design that will directly impact on them. However, there are many methodological and ethical challenges involved in encouraging participation from groups with a wide range of intellectual, cognitive and physical capacities while ensuring that the rights and well-being of participants are protected. Rather than exploring ethical theories, this chapter is a case study describing the practical ethical considerations that were involved in designing and holding a series of focus groups with adult health and social care service users from vulnerable cohorts. It is based on a series of focus groups which the Institute of Public Health (IPH) held with specified cohorts as part of a policy development process on adult safeguarding for the Department of Health (DOH) in Ireland. The four cohorts were people with intellectual disability, cognitive impairments, significant mental health challenges and nursing home residents. This chapter does not describe the findings of the focus groups but outlines the ethical and methodological considerations that arose in designing and conducting this research, and the practical ethical safeguards employed to mitigate risk and comply with Irish and EU General Data Protection Regulation (GDPR) legislation governing health research. It outlines the ethical issues around protecting confidentiality and using incentives to encourage participation, how individuals' capacity to give informed consent was maximized, the risk-assessment and mitigation procedures used to prevent harms arising and the measures put in place to provide follow-up emotional support to participants.

To explain job hours in four health-care occupations – physicians, nurses, emergency medical technicians (EMTs), and nursing assistants, this paper focuses on three sets of factors: class and gender, job conditions and commitment, and family situation. We find that class counts, whether understood in terms of occupation or earnings. Gender shapes hours, but more as a characteristic of occupations than of individuals. Job conditions that explain hours vary, depending on occupational grouping. Families also matter – children, but not spouses, shape the work hours of nurses; spouses, but not children, shape work hours for the other three occupations.

Over 3 million intermittently employed and socially disadvantaged workers receive low wages and limited benefits in diverse long-term care settings and employment arrangements as they try to become a positively valued unified occupation: “direct care workers.” Before this occurs, these workers must overcome negative definitions imposed by three powerful institutions: professional guilds, employers, and states. Care workers’ legitimacy is challenged as nursing labels them “unlicensed, assistive personnel,” defining them in terms of their task relationship to nurses rather than their social relationship to clients. Care workers’ identity is obscured as corporate rationalization nullifies their unique contributions with task unbundling, part-time work, short staffing, and turnover undermining bonding with colleagues and clients. State regulation impedes care workers’ integration, segmenting similar workers under different regulatory regimes, defining workers negatively rather than by their educational attainments and competencies. Overcoming this triple negation will require not just cultural change, but also real structural changes, and can occur only through concerted actions involving coalitions. Labor market intermediaries, public authorities, labor unions, workforce investment boards, philanthropic organizations, and government interagency groups are among those supporting direct care workers’ advancement by strategically coordinating licensing, purchasing, and developing the workforce. Recent federal policy changes and health reform legislation have enhanced recognition of this occupation and are providing new resources for its development.

The COVID-19 pandemic and its related economic meltdown and social unrest severely challenged most countries, their societies, economies, organizations, and individual citizens. Focusing on both more and less successful country-specific initiatives to fight the pandemic and its multitude of related consequences, this chapter explores implications for leadership and effective action at the individual, organizational, and societal levels. As international management scholars and consultants, the authors document actions taken and their wide-ranging consequences in a diverse set of countries, including countries that have been more or less successful in fighting the pandemic, are geographically larger and smaller, are located in each region of the world, are economically advanced and economically developing, and that chose unique strategies versus strategies more similar to those of their neighbors. Cultural influences on leadership, strategy, and outcomes are described for 19 countries. Informed by a cross-cultural lens, the authors explore such urgent questions as: What is most important for leaders, scholars, and organizations to learn from critical, life-threatening, society-encompassing crises and grand challenges? How do leaders build and maintain trust? What types of communication are most effective at various stages of a crisis? How can we accelerate learning processes globally? How does cultural resilience emerge within rapidly changing environments of fear, shifting cultural norms, and profound challenges to core identity and meaning? This chapter invites readers and authors alike to learn from each other and to begin to discover novel and more successful approaches to tackling grand challenges. It is not definitive; we are all still learning.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.