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Health care delivery is experiencing a multi-faceted epidemic of suffering among patients and care providers. Compassion is defined as noticing, feeling and responding to suffering. However, compassion is typically seen as an individual rather than a more systemic response to suffering and cannot match the scale of the problem as a result. The authors develop a model of a compassion system and details its antecedents (leader behaviors and a compassionate human resource (HR) bundle), its climate or the extent that the organization values, supports and rewards expression of compassion and the behaviors and practices through which it is enacted (standardization and customization) and its effects on efficiently reducing suffering and delivering high quality care.

This paper uses a conceptual approach that synthesizes the literature in health services, HR management, organizational behavior and service operations to develop a new conceptual model.

The paper makes three key contributions. First, the authors theorize the central importance of compassion and a collective commitment to compassion (compassion system) to reducing pervasive patient and care provider suffering in health care. Second, the authors develop a model of an organizational compassion system that details its antecedents of leader behaviors and values as well as a compassionate HR bundle. Third, the authors theorize how compassion climate enhances collective employee well-being and increases standardization and customization behaviors that reduce suffering through more efficient and higher quality care, respectively.

This paper develops a novel model of how health care organizations can simultaneously achieve efficiency and quality through a compassion system. Specific leader behaviors and practices that enable compassion climate and the processes through which it achieves efficiency and quality are detailed. Future directions for how other service organizations can replicate a compassion system are discussed.

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.

The purpose of this paper to review the latest management developments across the globe and pinpoint practical implications from cutting‐edge research and case studies.

This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.

The English novelist, physicist and chemist C.P. Snow, who died in 1980, once lamented the gulf that had grown between the arts and sciences. Snow is best remembered now for his phrase “the two cultures” coined for a lecture to illustrate that the world is the poorer for this state of affairs.

The paper provides strategic insights and practical thinking that have influenced some of the world's leading organizations.

The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy‐to‐digest format.

Entrepreneurship evolves in and around fields, particularly around the creation of opportunities. A central problem remains that entrepreneurial opportunities are both distributed among and co-created by embedded actors. We propose framing this in cultural terms as a “multiverse problem,” whereby entrepreneurial possibilities are understood within the bounds of a field, but also through traversing adjacent topographies. We argue that a focus on entrepreneurial moments captures important dynamics that bring together adjacent possibles, leading to drastically different pathways. The usefulness of this argument is illustrated in this paper through the articulation of a cultural cartographic approach to mapping and realizing entrepreneurial possibilities. We develop four principles of cultural cartography, apply them to several examples, and demonstrate implications to cultural entrepreneurship and adjacent theoretical traditions.

Since Weick’s (1993) seminal Mann Gulch paper articulated a collapse of sensemaking, scholars have repeatedly investigated sensemaking downstream of enactment. Motivated by another wildland firefighting tragedy, the tragic loss of 19 firefighters in Arizona in 2013, this study aims to look at enactment itself and reveals that the endogenous creation and re-creation of the wildland fire caused a fatal feedback loop of “trigger traps” leading to perpetual enactment that short-circuited sensemaking. Wildland fires can have unpredictable consequences, which triggers in individual sensemakers a fatal and continuous return to the beginning of the sensemaking process.

This paper’s approach is a case study based on a textual analysis of sources investigating the 2013 Yarnell Hill fire. The authors also carefully compared the Yarnell Hill and Mann Gulch disasters in search of breakdowns in sensemaking that could help us understand why we continue to lose firefighters in the line of duty.

The simultaneously volatile and complex environment at Yarnell illustrates sensemaking antecedents to the study of enactment. The findings suggest ways that organizations – those fighting wildfire or those fighting a global pandemic – can avoid getting trapped in the early stages of enactment and can retain resilience in their sensemaking.

This paper introduces the concept of “trigger traps” to help explain the fatal feedback loop of repeated environmental triggers in the early stages of sensemaking in volatile environments.

This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

This chapter examines the role of political skill in relation to employee psychological and physiological health and well-being. First, we begin by providing a review of the current research on the relationship of political skill to stress and strain; additionally, areas in this literature that are in need of greater theoretical specification are identified. A multi-mediation organizing framework is proposed, which suggests that political skill impacts intrapsychic (i.e., constructs residing within an individual such as control, self-esteem) and interpersonal processes (i.e., authenticity, trustworthiness, affability, and humility), which subsequently influence the development and maintenance of work relationships, networks, and coalitions, and ultimately affects individual psychological and physiological health and well-being. The implications of this framework, and directions for future research, are discussed.

The purpose of this paper is to explore the relationship between hospitals’ electronic health record (EHR) adoption characteristics and their patient safety cultures. The “Meaningful Use” (MU) program is designed to increase hospitals’ adoption of EHR, which will lead to better care quality, reduce medical errors, avoid unnecessary cost, and promote a patient safety culture. To reduce medical errors, hospital leaders have been encouraged to promote safety cultures common to high-reliability organizations. Expecting a positive relationship between EHR adoption and improved patient safety cultures appears sound in theory, but it has yet to be empirically demonstrated.

Providers’ perceptions of patient safety culture and counts of patient safety incidents are explored in relationship to hospital EHR adoption patterns. Multi-level modeling is employed to data drawn from the Agency for Healthcare Research and Quality’s surveys on patient safety culture (level 1) and the American Hospital Association’s survey and healthcare information technology supplement (level 2).

The findings suggest that the early adoption of EHR capabilities hold a negative association to the number of patient safety events reported. However, this relationship was not present in providers’ perceptions of overall patient safety cultures. These mixed results suggest that the understanding of the EHR-patient safety culture relationship needs further research.

Relating EHR MU and providers’ care quality attitudes is an important leading indicator for improved patient safety cultures. For healthcare facility managers and providers, the ability to effectively quantify the impact of new technologies on efforts to change organizational cultures is important for pinpointing clinical areas for process improvements.