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Article
Publication date: 30 October 2009

Louise Kippist and Anneke Fitzgerald

This article aims to examine tensions between hybrid clinician managers' professional values and health care organisations' management objectives.

4925

Abstract

Purpose

This article aims to examine tensions between hybrid clinician managers' professional values and health care organisations' management objectives.

Design/methodology/approach

Data are from interviews conducted with, and observation of, 14 managerial participants in a Cancer Therapy Unit set in a large teaching hospital in New South Wales, Australia, who participated in a Clinical Leadership Development Program.

Findings

The data indicate that there are tensions experienced by members of the health care organisation when a hybrid clinician manager appears to abandon the managerial role for the clinical role. The data also indicate that when a hybrid clinician manager takes on a managerial role other members of the health care organisation are required concomitantly to increase their clinical roles.

Research limitations/implications

Although the research was represented by a small sample and was limited to one department of a health care organisation, it is possible that other members of health care organisations experience similar situations when they work with hybrid clinician managers. Other research supports the findings. Also, this paper reports on data that emerged from a research project that was evaluating a Clinical Leadership Development Program. The research was not specifically focused on organisational professional conflict in health care organisations.

Practical implications

This paper shows that the role of the hybrid clinician manager may not bring with it the organisational effectiveness that the role was perceived to have. Hybrid clinician managers abandoning their managerial role for their clinical role may mean that some managerial work is not done. Increasing the workload of other clinical members of the health care organisation may not be optimal for the health care organisation.

Originality/value

Organisational professional conflict, as a result of hybridity and divergent managerial and clinical objectives, can cause conflict which affects other organisational members and this conflict may have implications for the efficiency of the health care organisation. The extension or duality of organisational professional conflict that causes interpersonal or group conflict in other members of the organisation, to the authors' knowledge, has not yet been researched.

Details

Journal of Health Organization and Management, vol. 23 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 11 February 2019

Jacinta Nzinga, Gerry McGivern and Mike English

The purpose of this paper is to explore the way “hybrid” clinical managers in Kenyan public hospitals interpret and enact hybrid clinical managerial roles in complex healthcare…

1974

Abstract

Purpose

The purpose of this paper is to explore the way “hybrid” clinical managers in Kenyan public hospitals interpret and enact hybrid clinical managerial roles in complex healthcare settings affected by professional, managerial and practical norms.

Design/methodology/approach

The authors conducted a case study of two Kenyan district hospitals, involving repeated interviews with eight mid-level clinical managers complemented by interviews with 51 frontline workers and 6 senior managers, and 480 h of ethnographic field observations. The authors analysed and theorised data by combining inductive and deductive approaches in an iterative cycle.

Findings

Kenyan hybrid clinical managers were unprepared for managerial roles and mostly reluctant to do them. Therefore, hybrids’ understandings and enactment of their roles was determined by strong professional norms, official hospital management norms (perceived to be dysfunctional and unsupportive) and local practical norms developed in response to this context. To navigate the tensions between managerial and clinical roles in the absence of management skills and effective structures, hybrids drew meaning from clinical roles, navigating tensions using prevailing routines and unofficial practical norms.

Practical implications

Understanding hybrids’ interpretation and enactment of their roles is shaped by context and social norms and this is vital in determining the future development of health system’s leadership and governance. Thus, healthcare reforms or efforts aimed towards increasing compliance of public servants have little influence on behaviour of key actors because they fail to address or acknowledge the norms affecting behaviours in practice. The authors suggest that a key skill for clinical managers in managers in low- and middle-income country (LMIC) is learning how to read, navigate and when opportune use local practical norms to improve service delivery when possible and to help them operate in these new roles.

Originality/value

The authors believe that this paper is the first to empirically examine and discuss hybrid clinical healthcare in the LMICs context. The authors make a novel theoretical contribution by describing the important role of practical norms in LMIC healthcare contexts, alongside managerial and professional norms, and ways in which these provide hybrids with considerable agency which has not been previously discussed in the relevant literature.

Details

Journal of Health Organization and Management, vol. 33 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 19 October 2015

Graeme Currie, Penelope Tuck and Kevin Morrell

The purpose of this paper is to analyse role transition for professionals moving towards hybrid managerial roles. Specifically, the authors examine reforms to the national tax…

Abstract

Purpose

The purpose of this paper is to analyse role transition for professionals moving towards hybrid managerial roles. Specifically, the authors examine reforms to the national tax agency in the UK, focusing on attempts to shift hybrid managers away from a focus on tax compliance, to a greater customer focus. This extends understanding of the relationship between New Public Management (NPM) and the public professions, by offering greater insight into the dynamic between regulators and regulatees, as professionals are co-opted into management roles that encompass greater customer orientation.

Design/methodology/approach

The authors draw on documentary data relating to reform from 2003 to 2012 and 43 semi-structured interviews with senior tax inspectors co-opted into hybrid manager roles.

Findings

The findings support established accounts of the effect of NPM reform to public professions, as these professionals are co-opted into hybrid management roles. Some hybrid managers resist, others embrace the demands of the new role. Linked to a hitherto neglected aspect of analysis (the extent to which hybrid managers embrace a greater customer orientation) the findings also show a more novel third response: some hybrid managers leave the national tax agency for opportunities in the private sector. These public-to-private professionals the authors call “canny customers”. Canny customers are ideally placed to exploit aspects of NPM reform, and thereby accelerate changes in the governance of public agencies, but in a way that might undermine the function of the tax agency and tax professions.

Practical implications

In regulatory settings, policy reform to co-opt professionals into hybrid managerial roles may have mixed effects. In settings where a focal dynamic is the regulator-regulatee relationship, effective governance will require understanding of the labour market to temper excess influence by those hybrid managers who become canny customers, otherwise, in settings where it is easy for individuals to move from regulator to regulatee, the pace and consequences of reform will be harder to govern. This runs the danger of eroding professional values. The specific case of tax professionals reflects themes in the literature examining hybridisation for accountants, and provides novel insight into the dynamics of professionalism that extend to the case of accountants.

Originality/value

The contribution is to extend the literature on role transition of professionals. The authors focus on hybrid managers in the context of a regulatory agency: the UK national tax agency. Policy reforms associated with hybridisation emphasised customer orientation. The authors highlight labour market characteristics impacting the regulator-regulatee dynamic, and an as yet unexplored, unintended consequence of reform. The public professional who leaves for the private sector becomes a “canny customer” who can exploit and accelerate reform.

Details

Accounting, Auditing & Accountability Journal, vol. 28 no. 8
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 11 May 2020

Sally Smith, Thomas N. Garavan, Anne Munro, Elaine Ramsey, Colin F. Smith and Alison Varey

The purpose of this study is to explore the role of professional and leader identity and the maintenance of identity, through identity work as IT professionals transitioned to a…

Abstract

Purpose

The purpose of this study is to explore the role of professional and leader identity and the maintenance of identity, through identity work as IT professionals transitioned to a permanent hybrid role. This study therefore contributes to the under-researched area of permanent transition to a hybrid role in the context of IT, where there is a requirement to enact both the professional and leader roles together.

Design/methodology/approach

The study utilised a longitudinal design and two qualitative methods (interviews and reflective diaries) to gather data from 17 IT professionals transitioning to hybrid roles.

Findings

The study findings reveal that IT professionals engage in an ongoing process of reconciliation of professional and leader identity as they transition to a permanent hybrid role, and they construct hybrid professional–leader identities while continuing to value their professional identity. They experience professional–leader identity conflict resulting from reluctance to reconcile both professional and leader identities. They used both integration and differentiation identity work tactics to ameliorate these tensions.

Originality/value

The longitudinal study design, the qualitative approaches used and the unique context of the participants provide a dynamic and deep understanding of the challenges involved in performing hybrid roles in the context of IT.

Details

Information Technology & People, vol. 34 no. 2
Type: Research Article
ISSN: 0959-3845

Keywords

Article
Publication date: 7 July 2014

Haldor Byrkjeflot and Peter Kragh Jespersen

The purpose of this paper is to bring the discussion on the relationship between management and medicine a step forward by focussing on: first, how the notion of hybrid and…

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Abstract

Purpose

The purpose of this paper is to bring the discussion on the relationship between management and medicine a step forward by focussing on: first, how the notion of hybrid and hybridity has been used in the literature on healthcare management. Second, the authors have mapped the alternative ways that the concept have been used in order to conceptualize a more specific set of possible combinations of managerial and professional roles in healthcare management. Hybrid management is a topic that ought to be important for training, communication among researchers and for identifying areas of future research: in management, in healthcare reforms, in sociology of professions and in theory of organizations.

Design/methodology/approach

The authors provide a systematic literature review in order to map the various conceptualizations of hybrid management. The authors have searched for “hybrid leadership,” “hybrid management” combined with hospitals and health care in a whole range of journals, identified in Google scholar, Academic Search Premier, Academic Research Library and Sage Publication. The authors have also used already existing literature reviews. The search has resulted in more than 60 articles and book titles that have been classified according to whether they make a fit with three alternative ways of conceptualizing hybrid management. The authors are aware that they might have missed some relevant literature but the literature included is quite comprehensive.

Findings

In the literature the authors have found three conceptualizations of management. The clinical manager who combines professional self-governance with a general management logic. The commercialized manager who combines professional self-governance with an enterprise logic. The neo-bureaucratic manager who combines self-governance with a neo-bureaucratic logic.

Originality/value

In most analyses of hybridity in management and organization the notion of hybrid has been used in a rather superficial way. By mapping the various uses of hybrid in the literature and suggest how a professional logic may be combined with a set of alternative logics of management the authors provide a platform for developing the concept of hybrid management into a more useful tool for analyses of changes in healthcare management.

Details

International Journal of Public Sector Management, vol. 27 no. 5
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 7 September 2023

Syed Mudasser Abbas, Zhiqiang Liu and Muhammad Khushnood

This study aims at investigating how hybrid intelligence might enhance employee engagement in breakthrough innovation. Specifically, it empirically examines the mediating role of…

Abstract

Purpose

This study aims at investigating how hybrid intelligence might enhance employee engagement in breakthrough innovation. Specifically, it empirically examines the mediating role of self-extinction and moderating role of social intelligence.

Design/methodology/approach

This study, using the lens of socio-technical system (STS) theory, collected data from 317 employees through cross-sectional survey. The hypotheses were tested using MPlus 8.3 by applying Structural Equation Modelling (SEM).

Findings

The results support the proposed model, suggesting that hybrid intelligence fosters employees' breakthrough innovation engagement and such a relationship is fully mediated by self-extinction. Besides, the findings provide support for the positive moderating impact of social intelligence on such indirect relationships in a way that high social intelligence will further strengthen the relationship.

Originality/value

As a pioneering contribution, the study uncovers the social mechanism that underlies hybrid intelligence–breakthrough innovation engagement relationship via self-extinction. The research suggests managers leveraging employees' social intelligence for playing a critical role in countering the negative impact of self-extinction by enhancing the employees' engagement in the breakthrough innovation process.

Details

International Journal of Emerging Markets, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1746-8809

Keywords

Open Access
Article
Publication date: 10 March 2023

Huda Khan, Ahmad Arslan, Lauri Haapanen, Peter Rodgers and Shlomo Yedidia Tarba

Applying both the dynamic capability and configuration theoretical perspectives, the paper showcases the role of network configuration and dynamics of hybrid offerings in both…

Abstract

Purpose

Applying both the dynamic capability and configuration theoretical perspectives, the paper showcases the role of network configuration and dynamics of hybrid offerings in both developed and emerging markets by high-tech firms.

Design/methodology/approach

The current paper uses an exploratory qualitative research methodology based on in-depth case studies of three Finnish high-tech firms operating in the medical technology industry globally.

Findings

The findings from the study showed that dynamic capabilities such as sensing and customer engagement along with internal coordination and adaptation capabilities are critical to the success of hybrid market offerings. Moreover, dynamic capabilities were found to be influential in those emerging and advanced international markets where case firms were less familiar with market dynamics. Moreover, the configuration of these capabilities within functional units and coordination of marketing and R&D activities can be effective for creating hybrid offerings in international markets. Ultimately, this was found to be the case even though target market selection for hybrid offerings was influenced by the level of convergence and fragmentation of the market.

Originality/value

Applying the configuration theory, this is one of the first studies to specifically analyze the differences in organizational network configuration changes in relation to hybrid market offerings in both developed economies and emerging economies. The findings contribute to hybrid market offering literature by pointing out that not only internal capabilities are important for enacting hybrid offerings, but the roles of ecosystems and knowledge centers are also extremely important to develop hybrid offerings. This paper also highlights the criticality of under-studied dynamic capabilities such as market sensing and customer engagement in the context of hybrid offerings in international markets. This showcases the wider role of ecosystems in enabling technology firms to develop hybrid offerings.

Details

International Marketing Review, vol. 40 no. 4
Type: Research Article
ISSN: 0265-1335

Keywords

Article
Publication date: 8 December 2021

Petra Kokko and Harri Laihonen

The article seeks to explain whether and how value-based healthcare principles lead to hybridization. The public management literature has been increasingly interested in hybrid

Abstract

Purpose

The article seeks to explain whether and how value-based healthcare principles lead to hybridization. The public management literature has been increasingly interested in hybrid forms of governance and hybrid performance management, but empirical studies are still rare. Further, the article studies the design of performance management and accounting systems as healthcare organizations reorganize their care processes applying value-based healthcare principles.

Design/methodology/approach

This article first connects the theoretical discussions on value-based healthcare and performance management for hybrids. The conceptual understanding of performance management in hybrid healthcare uses a case study of a Finnish healthcare organization with documentary data and transcribed interviews with healthcare professionals from both the strategic and operative levels of healthcare.

Findings

The article illustrates and analyses how new policy-level objectives and principles of value-based healthcare led to hybridity in healthcare, manifest in mixed ownership of a particular care path and new forms of social and financial control. Further, the article provides empirical evidence of how increased hybridity necessitated new organizational modes and roles, new managerial tools for performance management and created a need to develop the capability to account and measure entire integrated care processes. Important enabling factors for the integration of care and hybrid performance management were commitment created in dialogue, voluntary-based trust and technology to generate factual shared information.

Practical implications

The study is informative for stakeholders, funders and managers of healthcare organizations, namely new knowledge for the discussion of hybrid governance in healthcare, including a critical account of the applicability and impact of a hybrid service model in healthcare management. Moreover, the article illustrates what needs to be reconsidered in performance management and accounting practices when reorganizing care processes according to the principles of value-based healthcare.

Originality/value

The article extends the analysis of performance management in hybrids and sheds new light on hybridization in healthcare. It also provides much-needed empirical evidence on the processes and practices of accounting and performance management after implementing a value-based healthcare strategy.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. 34 no. 3
Type: Research Article
ISSN: 1096-3367

Keywords

Open Access
Article
Publication date: 16 March 2021

Tomi Rajala and Petra Kokko

This study examines unexplored horizontal accountability types between public, private and third sector actors within a hybrid organization. The case organization was applying a…

2876

Abstract

Purpose

This study examines unexplored horizontal accountability types between public, private and third sector actors within a hybrid organization. The case organization was applying a novel alliance model to generate service paths for heterogeneous clientele consuming cultural, educational, health and social services. It was first to do so in Finland.

Design/methodology/approach

This research is on a case study that used documents and interviews to examine the design of the horizontal accountability. The descriptive analysis focused on identifying what type of formal accountability system was designed (i.e. who is the account holder, and who is accountable and for what and why).

Findings

An imbalanced accountability system was identified because accountability obligations were unevenly distributed between public, private and third sector actors. The private sector was the most accountable for performance, and the third sector (i.e. voluntary sector) was the least accountable. As account holders, the public, private and third sector actors were judging their conduct as account providers. This created a biased horizontal accountability system. The hybrid's accountability system was dynamic because the contracts made to establish the hybrid included opportunities to change horizontal accountability if future changes to the external environment affect too drastically the potential to achieve the hybrid's goals.

Originality/value

Three new concepts are proposed for studying dysfunctional accountability systems: dynamic, biased and horizontally imbalanced accountability.

Details

Accounting, Auditing & Accountability Journal, vol. 35 no. 3
Type: Research Article
ISSN: 0951-3574

Keywords

Open Access
Article
Publication date: 15 December 2021

Giuseppe Grossi, Jarmo Vakkuri and Massimo Sargiacomo

Drawing upon theoretical insights on value creation perspectives, the authors aim to advance the understanding of performance and accountability in different hybrid organisations.

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Abstract

Purpose

Drawing upon theoretical insights on value creation perspectives, the authors aim to advance the understanding of performance and accountability in different hybrid organisations.

Design/methodology/approach

The authors conceptualise common theoretical origins of hybrid organisations and how they create and enact value, by reflecting on the Accounting, Auditing and Accountability Journal (AAAJ) special issue articles. Furthermore, the authors propose an agenda for future research into accounting, performance and accountability for hybrid organisations.

Findings

Hybrid organisations can be conceptualised through their approaches to value creation (mixing, compromising and legitimising). This article provides a more detailed understanding of accounting, performance and accountability changes in hybrid organisations.

Practical implications

This contribution also has relevant practical implications for actors, such as politicians, managers, professionals, auditors, controllers and accountants, encased in various hybrid organisations, policy contexts and multi-faceted interfaces between public, private and civil society.

Originality/value

Hybridity lenses reveal novel connections between different types of hybrid organisations and how they create and enact multiple values.

Details

Accounting, Auditing & Accountability Journal, vol. 35 no. 3
Type: Research Article
ISSN: 0951-3574

Keywords

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