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Article

Tracy H. Porter, James K. Stoller and Scott J. Allen

Since 1990, the Cleveland Clinic has trained physicians in team skills through various iterations of a program called Leading in Healthcare (LHC). In the present study…

Abstract

Purpose

Since 1990, the Cleveland Clinic has trained physicians in team skills through various iterations of a program called Leading in Healthcare (LHC). In the present study, the authors utilize a case study approach to gain insight into the LHC curriculum, and more specifically, the team project. The purpose of this paper is to better understand the Cleveland Clinic’s position on the issue and its approach to education – specifically among physicians.

Design/methodology/approach

The authors utilized a case study approach with four key program architects.

Findings

The results of this exploratory research yielded three themes: There is a lack of formal physician education in teamwork, there is a growing trend of inter-disciplinary teams and the team project was an important component of teambuilding in LHC.

Research limitations/implications

A breakdown in team function adversely impacts patient care. While formal and informal participation in teams is imbedded in the role, physicians are rarely trained in leadership or teambuilding in their formal medical education – much of it is learned on the job in hidden curricula. In addition to the adverse effects of dysfunctional teams on patient care, the authors have explored another area that will be affected by a lack of education – the team experience at the administrative level. As more and more physicians take on leadership roles in healthcare, there is an additional need to build competencies around teams (e.g. team theory, cross-functional team participation and leading teams) from an administrative perspective.

Originality/value

This is one of only a few studies which have specifically examined the impact of a teamwork education for physicians.

Details

Leadership in Health Services, vol. 31 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Content available
Article

Michele Heath and Tracy H. Porter

The purpose of this paper is to gain understanding into the human factors which might impede the change process. Change is inevitable in contemporary organizations and…

Abstract

Purpose

The purpose of this paper is to gain understanding into the human factors which might impede the change process. Change is inevitable in contemporary organizations and particularly within the healthcare field with respect to information technology (IT). Regardless of the amount of literature surrounding change management process organizational leaders will often ignore the human factors associated with the introduction of new IT.

Design/methodology/approach

This study sought to examine physician resistance surrounding the Electronic health record (EHR) change process through the lens of each of these three aspects of the Bovey and Hede (2001a) model through semi-structured interviews with physicians. Semi-structured interviews were conducted with physicians from hospitals within the Midwest.

Findings

The findings suggest that physicians have been impacted by the EHR change management system within their hospitals. Though each of the participants experienced different issues; it was clear from the data the change to an EHR system was disruptive to their day-to-day routines and caused various challenges. EHR change management research demonstrates physicians are resisting the change despite recognizing its potential benefits.

Originality/value

This paper contributes to the change management literature by examining how physician resistance can have a negative impact on healthcare organizations during a precipitous technology change. The study also provides a unique understanding of how technology resistance can disrupt an organizational change process.

Details

American Journal of Business, vol. 34 no. 1
Type: Research Article
ISSN: 1935-5181

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Article

Michele Heath and Tracy Porter

Drawing from the extant literature on sensemaking theory, the purpose of this paper is to understand how physicians view health information exchange (HIE) implementation…

Abstract

Purpose

Drawing from the extant literature on sensemaking theory, the purpose of this paper is to understand how physicians view health information exchange (HIE) implementation and how their stories frame the situation.

Design/methodology/approach

This paper utilizes content analysis with sensemaking theory as a theoretical lens to analyze physicians’ interviews.

Findings

The stories within this study draw attention to how sensemaking might impact the HIE implementation process. The findings demonstrated four well-defined manifest themes specific to sensemaking: bracketing, enactment, social and identity construction. There were sub-themes that cut across major themes: financial implications, practice changes and impact on professional reputation. The data demonstrated that each participant singled out items or events specific to the HIE change process in order to make sense of the change as an entirety.

Originality/value

No other study has applied sensemaking in an effort to gain insight into the ways physicians view the HIE process. Therefore, this study offers a unique perspective which might provide a framework through which to understand the possible barriers to successful implementation of HIE from a physician.

Details

Qualitative Research in Organizations and Management: An International Journal, vol. 14 no. 4
Type: Research Article
ISSN: 1746-5648

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Article

Vickie Coleman Gallagher, Tracy H. Porter and Kevin P. Gallagher

Sustainability initiatives are important considerations for twenty-first century institutions. Employees, customers and other stakeholders expect responsible business…

Abstract

Purpose

Sustainability initiatives are important considerations for twenty-first century institutions. Employees, customers and other stakeholders expect responsible business practices that focus on people, profit and planet in unison. Sustainability efforts require a strong advocate who can champion relevant business practices and embed new practices within the culture and across the entire organization. The purpose of this paper is to explain the tangible actions described as necessary by change agents in order to move sustainability initiatives forward in their organizations. This research employs the narrative provided by these agents in interviews – to inform the activities outlined in an established model of political skill and reputation building. This analysis enables the model to illustrate the sequential patterns and process of events, i.e. antecedents and consequences that are simply assumed in the existing variance models.

Design/methodology/approach

This research is based on in-depth qualitative interviews with the sustainability managers from a variety of organization and industry contexts (e.g. building products, hospitals, banking, energy, environmental and manufacturing).

Findings

The exploration of sustainability initiatives reveals the importance of the change agent’s reputation for building trust in their organizations. Reputation is fostered through political skill and persuasion, while leveraging social capital.

Research limitations/implications

The research is rich in the depth of individual-level phenomena, thereby highlighting the skills necessary to enact change within a variety of industries. However, given the limited sample size, macro-level issues cannot be addressed.

Practical implications

Political skill is a teachable skill that is enhanced through mentoring and coaching. Sustainability initiatives and their organizations can benefit from leveraging persons with strong reputations to facilitate change. When lacking, persons with content knowledge can be groomed to grow their reputation, network, persuasion and political skills.

Social implications

Sustainability is vital to the future of our earth and humanity. Business and society would benefit from the growth of this phenomenon.

Originality/value

The authors aim to help change agents achieve their objectives through consideration of not just the goals, but the process as well.

Details

Journal of Organizational Change Management, vol. 33 no. 1
Type: Research Article
ISSN: 0953-4814

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Article

Tracy H. Porter, Vickie Coleman Gallagher and Diane Lawong

Organizations have viewed sustainability as a societal problem and unrelated to business. To recognize sustainability as an organizational issue requires companies to deal…

Abstract

Purpose

Organizations have viewed sustainability as a societal problem and unrelated to business. To recognize sustainability as an organizational issue requires companies to deal with the challenge of transforming into environmentally sustainable enterprises. This requires institutions to align mission statements with values. The purpose of this paper is to replicate previous research in sustainability and the cultural facets which impact the process.

Design/methodology/approach

A qualitative case study method was used to analyze 25 organizations within the US Midwest with various contexts to determine how their respective cultures impacted their change initiatives. Specifically, the authors spoke to sustainability change agents with regard to their leadership and culture, and the factors that are conducive to (or barriers to) implementing sustainability initiatives.

Findings

The original study demonstrated the presence of seven contextual conditions which are important in the process of imbedding sustainability within the institution. This research found the same dimensions to be present; however, they manifested differently 15 years later.

Practical implications

The original research offered a somewhat dark picture of the sustainability change initiatives within organizations. The current study however; offers a much more positive perspective which demonstrates organizations appear to have progressed with regard to sustainability.

Originality/value

This is a replication study whereby we discovered similar themes as to the nature of contextual factors that can hinder or advance sustainability initiatives; however, the findings 15 years later show a marked difference in the current state of affairs and the ability to implement sustainability initiatives.

Details

American Journal of Business, vol. 31 no. 4
Type: Research Article
ISSN: 1935-5181

Keywords

Abstract

Details

American Journal of Business, vol. 29 no. 3/4
Type: Research Article
ISSN: 1935-5181

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Book part

Jennifer A. Reich

Public health programs facilitate access to resources that not only provide individuals’ options but also often foreclose individual preference through prescriptive…

Abstract

Public health programs facilitate access to resources that not only provide individuals’ options but also often foreclose individual preference through prescriptive requirements. This chapter takes two disparate cases from public health – vaccines and family planning –that reveal patterns of inequality in who has access to individual choice and who requires state support to exercise choice. Looking specifically at dynamics of funding and compulsion, this chapter elucidates how reliance on the rhetoric of individual choice as an expression of freedom rewards those with the greatest access to resources and fails to make sure that all members of the community have the resources to shape their own outcomes or to make sure collective health is protected.

Details

Studies in Law, Politics, and Society
Type: Book
ISBN: 978-1-78714-811-6

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Book part

Ashley F. Kim

This chapter draws on qualitative interviews to examine how Bhutanese refugees interact with norms around mothering and childbirth. Since these women have birthed and…

Abstract

This chapter draws on qualitative interviews to examine how Bhutanese refugees interact with norms around mothering and childbirth. Since these women have birthed and reared children in Bhutan and/or Nepal, as well as in the United States, their stories help to explore how the implications of medicalization differ for individuals by race, class, and nation, with a unique cross-comparative lens. In particular, the respondents uniquely identify epidurals as an important medical intervention, simultaneously increasing their autonomy while subscribing to neoliberal mothering. This research furthers our understanding of neoliberal mothering and medicalization by showing a nuanced script that illuminates social processes, resistance, and internalization through an intersectional and cross-cultural lens.

Details

Reproduction, Health, and Medicine
Type: Book
ISBN: 978-1-78756-172-4

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Article

Tracy H Porter, Kelly Diane Riesenmy and Dail Fields

A key challenge for organizations is identification of candidates for development as organizational leaders. While selection criteria may vary, one important consideration…

Abstract

Purpose

A key challenge for organizations is identification of candidates for development as organizational leaders. While selection criteria may vary, one important consideration is the extent to which an employee is motivated to lead. Previous studies have restricted investigation of the antecedents of these motivations to individual differences such as personality, self-efficacy, and previous leadership experiences, suggesting that leadership capacity may depend largely on employee selection. However, employee assessments of numerous aspects of the work environment may also have a substantial role in determining an employee’s motivation to lead (MTL), suggesting that an organization’s leadership capacity may depend on many other human resource practices. The paper aims to discuss these issues.

Design/methodology/approach

In this study, the authors explored the role of employee assessments of work experiences as determinants of three types of MTL. This paper investigates the impact of a value-oriented organizational culture and the employee’s assessment of the work environment (pay satisfaction, promotion possibilities, recognition, job design, internal communication, and employee’s relationship with his/her current leader). Hierarchical multiple regression analysis was used to test the hypotheses.

Findings

Based upon the results of 210 respondents the strength of relationship varies among the three alternative types of leadership motivation. The results suggest that besides individual differences, the perceived work environment may be a significant determinant of motivation to become an organizational leader. Employee assessments of pay, promotion opportunities, recognition, job design, quality of organizational communications, and workplace spirituality all play a role in determining employee MTL.

Originality/value

This paper offers a number of implications for human resource management practices, hiring, and leadership development.

Details

American Journal of Business, vol. 31 no. 2
Type: Research Article
ISSN: 1935-5181

Keywords

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Abstract

Details

International Best Practices in Health Care Management
Type: Book
ISBN: 978-1-78441-278-4

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