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This study investigated operating room teams confronted with learning a radically new technology for performing cardiac surgery. Implementing new technology in hospitals is challenging because of the perceived risk to human life of trying something new when current approaches meet widely accepted standards of care. Understanding the learning and adoption process is therefore critical, both for innovators introducing new technologies and for hospitals seeking to adopt them. Past research in medicine has found that cumulative experience using new techniques leads to improvement but has not investigated organizational and group characteristics that may facilitate obtaining the right kinds of experience and ultimately facilitate successful adoption of new approaches. This paper begins to address this gap by examining organizational and group characteristics that vary across operating room teams learning a new technology. A specific barrier to learning that these teams faced was the highly precise routines characterizing the conventional surgical procedure; the new technology disrupted these routines, requiring the operating room teams to relearn how to work together. We report on data collected in 165 interviews with members of the operating room and others associated with the cardiac surgery process at 16 hospitals.

Mergers have increased at a fast rate in the last 10 years. Nevertheless, practitioners and consultants point out the low rate of success for mergers. Considering this paradoxical situation, it would appear opportune to question the possibility of developing a specific competence within an organization for carrying out mergers and acquisitions. This research aims to propose a model for analyzing the development of such a competence. This paper presents a study of competence-building according to two aspects: level of recognition by the organization and level of use. The study model defines four forms that competence may take: ad hoc responses, capitalization, institutionalization, and dynamic competence. This model is used for the study of the development by the Lafarge Group of a competence in managing cultural integration after international mergers and acquisitions.

This paper presents the results of a qualitative study of ethical decision making by managers employed in two major companies in the U.K. Forty managers from these large commercial organizations were interviewed about how ethical issues arise and are dealt with at work. This interview data was transcribed and a thematic content analysis was conducted in order to explore the various influences upon managerial ethical decision making. The analysis framework includes analysis at both an individual level, in terms of the role of individual characteristics such as personal value systems, and at an organizational level, in terms of the influence of organizational characteristics such as organizational culture. The paper then goes on to examine the extent to which this empirically-based account of ethical decision making is congruent with, or runs contrary to, some of the main theoretical propositions contained in the ethical decision-making literature. This provided only limited empirical support for the theoretical propositions described in the literature. In particular, the findings of the empirical work reported here suggest that while personal values may play a part in organizational ethics, the ethical decision-making process itself is subject to a much greater influence from the everyday demands and commercial pressures which managers perceived as being placed upon them in the types of organizations examined in this study. Thus, while supportive of the notion that values may be important in some respects, the study suggests that they are not necessarily that closely involved with the actual decision-making process. Rather the evidence gathered in this study indicates that they can exert an affectively-mediated retrospective effect. This possibility would suggest a reformulation of the role of values in the ethical decision-making process, while also calling for a greater emphasis upon the role of emotions. These are, however, only tentative findings and must therefore be subject to further empirical work before the precise way in which ethical issues arise, unfold and are dealt with in the workplace can be understood.