Search results

Organizational change is a key mechanism to ensure the sustainability of healthcare systems. However, healthcare organizations are persistently difficult to change, and literature is riddled with examples of failed change endeavors. In this chapter, we attempt to unravel the underlying causes for failed organizational change. We distinguish three types of change with different levels of depth that require different change approaches. Transformations are the deepest forms of change where beliefs and principles need to be modified to successfully influence routines. Renewals are deep forms of change where principles need to be modified to successfully influence routines. Improvements are shallow forms of change where only modifications at the level of routines are needed. Using deoxyribonucleic acid (DNA) as our metaphor, we propose a theory of “organizational DNA” to understand organizations and these three types of organizational changes. We posit that organizations are made up of a double helix consisting of a so-called “social string,” which contains the “soft” interaction or communication among the organization's members, and a so-called “technical string,” which contains “hard” organizational aspects such as structure and technology. Ladders of organizational nucleotides (i.e., Routines, Principles, and Beliefs) connect this double helix in various combinations. Together, the double helix and accompanying nucleotides make up the DNA of an organization. Without knowledge of the architecture of organizational DNA and whether a change addresses beliefs, principles, and/or routines, we believe that organizational change is constrained and based on luck rather than change management expertise. Following this metaphor, we show that organizational change fails when it attempts to change one part of the DNA (e.g., routines) in a way that renders it incompatible with the connecting components (e.g., principles and beliefs). We discuss how the theory can be applied in practice using an exemplar case.

This chapter explores the extent to which female public relations (PR) practitioners perform professionalism in the workplace by interrogating and examining their professional behaviours. Using an ethnographic approach, where the researcher is immersed in the field, it uncovers the lived experiences and behavioural responses of women working in PR agency environments in the United Kingdom and enables a rich description of professional behaviours to emerge.

Fawkes argues that research into roles in PR ‘has tended to assess roles using management rather than sociological theory’ (2014, p. 2). That is not to say that all PR research adopts the same paradigmatic stance. Several scholars have encouraged the development of a research agenda rooted in social theory. Holtzhausen called for a move away from what she termed the ‘modernist approach to organizations’ (2002, p. 251), which focuses on management discourse, and encouraged instead a focus on the postmodern concept of discourse, where meaning is constructed and conveyed through social and institutional practices.

In seeking to discover the ‘lived experience’ of female practitioners, this chapter locates professionalism in the context of their behaviours and enables individuals to articulate their understandings of the relationship between performance and professionalism. Using Goffman's (1959) work on social encounters as performances in conjunction with Foucauldian discourse and Feminist theory, this chapter explores the three stages of performing professionalism – preparation, performance and reception – through the eyes of women working in PR agencies in the United Kingdom to explore their lived experience and determine how gender affects their performance of professional behaviour.

Although educators would likely agree that values and ethics are important in all disciplines, they have particular importance for practice-oriented fields. These applied professionals need to solve complex social problems that require the application of ethical standards and value perspectives. While the importance of value-engaged practice is known to the applied field, there is little research and conversation about how values can be integrated into teaching. This chapter synthesizes values-education approaches in various practice-based disciplines such as public administration (PA), program evaluation, social work, and public health. This chapter draws from empirical and theoretical works as well as the authors' experiences developing, participating in, and conducting values-based research on professionals and professional education.

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.