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Article
Publication date: 4 July 2016

Stanley J. Smits, Dawn E. Bowden and James O. Wells

The healthcare system in the USA is undergoing unprecedented change and its share of unintended consequences. This paper explores the leadership role of the physician in…

1297

Abstract

Purpose

The healthcare system in the USA is undergoing unprecedented change and its share of unintended consequences. This paper explores the leadership role of the physician in transforming the present culture of healthcare to restore, refine and preserve its traditional care components.

Design/methodology/approach

The literature on change, organizational culture and leadership is leveraged to describe the structural interdependencies and dynamic complexity of the present healthcare system and to suggest how physicians can strengthen the care components of the healthcare culture.

Findings

When an organization’s culture does not support internal integration and external adaptation, it is the responsibility of leadership to transform it. Leaders can influence culture to strengthen the care components of the healthcare system. The centrality of professionalism in the delivery of patient services places a moral, societal and ethical responsibility on physicians to lead a revitalization of the care culture.

Practical implications

This paper focuses on cultural issues in healthcare and provides options and guidance for physicians as they attempt to lead and manage the context in which services are delivered.

Originality/value

The Competing Values Framework, the major interdependent domains and five principal mechanisms for leaders to embed and fine tune culture serve as the main tenets for describing the ongoing changes in healthcare and defining the role of the physician as leaders and advocates for the Patient Care Culture.

Details

Leadership in Health Services, vol. 29 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

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Article
Publication date: 6 October 2014

Stanley J. Smits, Dawn Bowden, Judith A. Falconer and Dale C. Strasser

– This paper aims to present a two-decade effort to improve team functioning and patient outcomes in inpatient stroke rehabilitation settings.

1758

Abstract

Purpose

This paper aims to present a two-decade effort to improve team functioning and patient outcomes in inpatient stroke rehabilitation settings.

Design/methodology/approach

The principal improvement effort was conducted over a nine-year period in 50 Veterans Administration Hospitals in the USA. A comprehensive team-based model was developed and tested in a series of empirical studies. A leadership development intervention was used to improve team functioning, and a follow-up cluster-randomized trial documented patient outcome improvements associated with the leadership training.

Findings

Iterative team and leadership improvements are presented in summary form, and a set of practice-proven development observations are derived from the results. Details are also provided on the leadership training intervention that improved teamwork processes and resulted in improvements in patient outcomes that could be linked to the intervention itself.

Research limitations/implications

The practice-proven development observations are connected to leadership development theory and applied in the form of suggestions to improve leadership development and teamwork in a broad array of medical treatment settings.

Practical implications

This paper includes suggestions for leadership improvement in medical treatment settings using interdisciplinary teams to meet the customized needs of the patient populations they serve.

Originality/value

The success of the team effectiveness model and the team-functioning domains provides a framework and best practice for other health care organizations seeking to improve teamwork effectiveness.

Details

Leadership in Health Services, vol. 27 no. 4
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 18 May 2012

Dawn E. Bowden and Stanley J. Smits

As healthcare has become more scientifically based and far more sophisticated in terms of technology, it has become more fragmented in terms of care‐giving, and less personal. The…

1485

Abstract

Purpose

As healthcare has become more scientifically based and far more sophisticated in terms of technology, it has become more fragmented in terms of care‐giving, and less personal. The purpose of this paper is to discuss the challenging task of leading and managing in the gap between the existing and emerging cultures of healthcare.

Design/methodology/approach

This paper considers the literature on culture, how it exists at many levels and in multiple forms, and the impacts it has on the US healthcare system. Further, the paper explores foundations of the current healthcare culture and attempts to forecast features of the emerging culture, incorporating examples of advances in scientific knowledge and technology.

Findings

System change will continue to be problematic until leaders and change agents find ways to operate effectively in the gap between the existing cultural tenets and those emerging as the result of scientific and technological advancements.

Originality/value

Punctuated equilibrium theory serves as a main tenet for describing how changes will continue to push the USA towards a cultural tipping point. This paper contends that leaders and managers can succeed only by understanding and respecting both cultures and calls for improved theory development and research to help find creative ways to advance the new culture without trampling the old.

Details

Journal of Health Organization and Management, vol. 26 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Available. Content available
Article
Publication date: 11 March 2014

97

Abstract

Details

Journal of Health Organization and Management, vol. 28 no. 1
Type: Research Article
ISSN: 1477-7266

Available. Content available
Article
Publication date: 4 July 2016

Graham Dickson and Karen Owen

419

Abstract

Details

Leadership in Health Services, vol. 29 no. 3
Type: Research Article
ISSN: 1751-1879

Available. Content available
Article
Publication date: 9 March 2022

Bradley Bowden and Jeff Muldoon

233

Abstract

Details

Journal of Management History, vol. 28 no. 2
Type: Research Article
ISSN: 1751-1348

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Article
Publication date: 12 June 2017

Bradley Bowden

Are business outcomes due primarily to entrepreneurial and managerial ability or are they mainly the result of business content? The purpose of this study is to explore this…

245

Abstract

Purpose

Are business outcomes due primarily to entrepreneurial and managerial ability or are they mainly the result of business content? The purpose of this study is to explore this question by comparing the railroads of Victoria and Queensland (Australia) and the South-West and Northern Plains of America between 1881 and 1900. Given the commonalities of the four railway systems in terms of their economic orientation towards rural custom, and their marked difference in terms of ownership, one would expect similarities in their financial circumstances if outcomes were primarily determined by fluctuations in global commodity markets. Conversely, marked differences would be expected if outcomes primarily resulted from managerial initiative.

Design/methodology/approach

Conceptually, this study is informed by the idea that social and economic outcomes are shaped by long historical movements, with meaningful structural change occurring rarely but to great effect. In exploring this concept through a comparison of the railways of Australia and the American West, the study draws on two forms of archival evidence. One source of evidence relates to railroad management, operations and finances. Figures cited come primarily from Australian railway commissioners’ reports and Poor’s Manual of the Railroads of the USA. The other source of evidence relates to agricultural statistics. These are drawn from official reports.

Findings

This study argues that effective strategic decision-making can only occur if we understand the structural changes that alter our world. In the late nineteenth century, the Australian and American railroads servicing newly settled rural regions were financial failures because management failed to appreciate the structural changes that the revolution in steam-powered transport had initiated; a revolution which resulted in commodity prices – and hence, the railway rates for farm produce – being determined by global demand and supply balances rather than by local factors. As a result, they continued a policy of expansion that was no longer financially justified.

Originality/value

This study seeks to contribute to a fundamental debate in historical studies and management about the drivers of social and economic change. Increasingly, there is acceptance of the view that historical circumstances are inherently unstable and what counts is the particular change cascading through a myriad of “events”. This study points in a contrary direction, suggesting that business outcomes are primarily determined by deep structural shifts that can be understood and steered but seldom opposed.

Details

Journal of Management History, vol. 23 no. 3
Type: Research Article
ISSN: 1751-1348

Keywords

Available. Content available
Article
Publication date: 9 January 2017

Bradley Bowden

521

Abstract

Details

Journal of Management History, vol. 23 no. 1
Type: Research Article
ISSN: 1751-1348

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Article
Publication date: 14 May 2020

Elyria Kemp, Elten Briggs and Nwamaka A. Anaza

Researchers and practitioners have traditionally maintained that organizational buying requires rational decision-making. However, individuals at organizations make decisions…

2470

Abstract

Purpose

Researchers and practitioners have traditionally maintained that organizational buying requires rational decision-making. However, individuals at organizations make decisions daily applying a confluence of rationalizations and emotions. This study aims to address the roles of personal feelings, facts and emotional advertising content in the organizational decision-making process.

Design/methodology/approach

In two studies, the authors apply both qualitative and quantitative methods to explore emotional and cognitive reactions to advertising. In Study 1, depth interviews were conducted with marketing and advertising content developers from a Fortune 100 technology company. In Study 2, a web-based survey was sent out to a Fortune 100 company’s buyer panel.

Findings

Results suggest that advertising using emotion-based themes helps to foster brand engagement tendencies and advocacy for a brand. Findings also demonstrate that organizational status (C-level executive’s vs non-C-level employees) moderates the relationship between buyers’ reliance on facts and their receptivity to advertising using emotion-based themes, such that reliance on facts increases the appeal of emotional advertising.

Research limitations/implications

This research contributes to the organizational buying literature by addressing the dearth of research on the role of emotions in organizational decision-making and providing insight into the role of advertising in business-to-business (B2B) decision-making.

Practical implications

These results imply that advertising incorporating emotion-based themes provide meaningful information to B2B buyers and is especially effective when targeted at buyers at higher levels in an organization.

Originality/value

B2B buying behavior has traditionally been considered a rational undertaking. This research explores how decision-making orientation and the presence of advertising using emotion-based themes help to foster engagement and advocacy for the brand.

Details

European Journal of Marketing, vol. 54 no. 7
Type: Research Article
ISSN: 0309-0566

Keywords

Available. Content available
Article
Publication date: 12 September 2016

Bradley Bowden

405

Abstract

Details

Journal of Management History, vol. 22 no. 4
Type: Research Article
ISSN: 1751-1348

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