Bettina Ravnborg Thude, Andreas Granhof Juhl, Egon Stenager, Christian von Plessen and Erik Hollnagel
The purpose of this paper is to understand how the hospital staff (nurses and physicians) at two hospital wards have coped with everyday work having leaders in conflict or longer…
Abstract
Purpose
The purpose of this paper is to understand how the hospital staff (nurses and physicians) at two hospital wards have coped with everyday work having leaders in conflict or longer periods without one or the other leader and whether the way the staff handled the challenges was resilient.
Design/methodology/approach
Through semi-structured interviews with the staff at the two wards, the authors analysed how the staff were working, if they had cooperation and interdisciplinary cooperation, how they would handle uncertainties and how they coped with the absence of their leaders.
Findings
The staff at both wards were handling the everyday work in a resilient way. The authors argue that to increase the resilience in an organisation, leaders should acknowledge the need to establish strong emotional ties among staff and at the same time ensure role structures that make sense in the everyday work.
Originality/value
This study reports on original work and shows what decision makers could do to increase resilience in an organisation. This paper shows that the organisational context is important for the staff to act resiliently. As leaders come and go, it can be important for the stability of the organisation to promote the staff in acting resiliently independent of the leader situation.
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Bettina Ravnborg Thude, Svend Erik Thomsen, Egon Stenager and Erik Hollnagel
Despite the practice of dual leadership in many organizations, there is relatively little research on the topic. Dual leadership means two leaders share the leadership task and…
Abstract
Purpose
Despite the practice of dual leadership in many organizations, there is relatively little research on the topic. Dual leadership means two leaders share the leadership task and are held jointly accountable for the results of the unit. To better understand how dual leadership works, this study aims to analyse three different dual leadership pairs at a Danish hospital. Furthermore, this study develops a tool to characterize dual leadership teams from each other.
Design/methodology/approach
This is a qualitative study using semi-structured interviews. Six leaders were interviewed to clarify how dual leadership works in a hospital context. All interviews were transcribed and coded. During coding, focus was on the nine principles found in the literature and another principle was found by looking at the themes that were generic for all six interviews.
Findings
Results indicate that power balance, personal relations and decision processes are important factors for creating efficient dual leaderships. The study develops a categorizing tool to use for further research or for organizations, to describe and analyse dual leaderships.
Originality/value
The study describes dual leadership in the hospital context and develops a categorizing tool for being able to distinguish dual leadership teams from each other. It is important to reveal if there are any indicators that can be used for optimising dual leadership teams in the health-care sector and in other organisations.
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Abstract
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Søren Bie Bogh, Ane Blom, Ditte Caroline Raben, Jeffrey Braithwaite, Bettina Thude, Erik Hollnagel and Christian von Plessen
The purpose of this paper is to understand how staff at various levels perceive and understand hospital accreditation generally and in relation to quality improvement (QI…
Abstract
Purpose
The purpose of this paper is to understand how staff at various levels perceive and understand hospital accreditation generally and in relation to quality improvement (QI) specifically.
Design/methodology/approach
In a newly accredited Danish hospital, the authors conducted semi-structured interviews to capture broad ranging experiences. Medical doctors, nurses, a quality coordinator and a quality department employee participated. Interviews were audio recorded and subjected to framework analysis.
Findings
Staff reported that The Danish Healthcare Quality Programme affected management priorities: office time and working on documentation, which reduced time with patients and on improvement activities. Organisational structures were improved during preparation for accreditation. Staff perceived that the hospital was better prepared for new QI initiatives after accreditation; staff found disease specific requirements unnecessary. Other areas benefited from accreditation. Interviewees expected that organisational changes, owing to accreditation, would be sustained and that the QI focus would continue.
Practical implications
Accreditation is a critical and complete hospital review, including areas that often are neglected. Accreditation dominates hospital agendas during preparation and surveyor visits, potentially reducing patient care and other QI initiatives. Improvements are less likely to occur in areas that other QI initiatives addressed. Yet, accreditation creates organisational foundations for future QI initiatives.
Originality/value
The authors study contributes new insights into how hospital staff at different organisational levels perceive and understand accreditation.
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Bettina Ravnborg Thude, Egon Stenager, Christian von Plessen and Erik Hollnagel
The purpose of the study is to determine whether one leader set-up is better than the others according to interdisciplinary cooperation and leader legitimacy.
Abstract
Purpose
The purpose of the study is to determine whether one leader set-up is better than the others according to interdisciplinary cooperation and leader legitimacy.
Design/methodology/approach
The study is a qualitative study based on semi-structured interviews at three Danish hospitals.
Findings
The study found that the leadership set-up did not have any clear influence on interdisciplinary cooperation, as all wards had a high degree of interdisciplinary cooperation independent of which leadership set-up they had. Instead, the authors found a relation between leadership set-up and leader legitimacy. In cases where staff only referred to a leader from their own profession, that leader had legitimacy within the staff group. When there were two leaders from different professions, they only had legitimacy within the staff group from their own profession. Furthermore, clinical specialty also could influence legitimacy.
Originality/value
The study shows that leadership set-up is not the predominant factor that creates interdisciplinary cooperation; but rather, leader legitimacy also should be considered. Additionally, the study shows that leader legitimacy can be difficult to establish and that it cannot be taken for granted. This is something chief executive officers should bear in mind when they plan and implement new leadership structures. Therefore, it would also be useful to look more closely at how to achieve legitimacy in cases where the leader is from a different profession to the staff.
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Abstract
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Jason Martin, Per-Erik Ellström, Andreas Wallo and Mattias Elg
This paper aims to further our understanding of policy–practice gaps in organizations from an organizational learning perspective. The authors conceptualize and analyze…
Abstract
Purpose
This paper aims to further our understanding of policy–practice gaps in organizations from an organizational learning perspective. The authors conceptualize and analyze policy–practice gaps in terms of what they label the dual challenge of organizational learning, i.e. the organizational tasks of both adapting ongoing practices to prescribed policy demands and adapting the policy itself to the needs of practice. Specifically, the authors address how this dual challenge can be understood in terms of organizational learning and how an organization can be managed to successfully resolve the dual learning challenge and, thereby, bridge policy–practice gaps in organizations.
Design/methodology/approach
This paper draws on existing literature to explore the gap between policy and practice. Through a synthesis of theories and an illustrative practical example, this paper highlights key conceptual underpinnings.
Findings
In the analysis of the dual challenge of organizational learning, this study provides a conceptual framework that emphasizes the important role of tensions and contradictions between policy and practice and their role as drivers of organizational learning. To bridge policy–practice gaps in organizations, this paper proposes five key principles that aim to resolve the dual challenge and accommodate both deployment and discovery in organizations.
Research limitations/implications
Because this is a conceptual study, empirical research is called for to explore further and test the findings and conclusions of the study. Several avenues of possible future research are proposed.
Originality/value
This paper primarily contributes by introducing and elaborating on a conceptual framework that offers novel perspectives on the dual challenges of facilitating both discovery and deployment processes within organizations.
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The purpose of this paper is to explore the idea of practice‐based innovation and to propose a framework that can be used to conceptualize and analyze practice‐based innovation…
Abstract
Purpose
The purpose of this paper is to explore the idea of practice‐based innovation and to propose a framework that can be used to conceptualize and analyze practice‐based innovation processes in organizations.
Design/methodology/approach
The argument is driven by conceptual analysis and theoretical synthesis based on theory and research on innovation, organizational change, individual and organizational learning.
Findings
The proposed framework portrays practice‐based innovation as a cyclical process of adaptive and developmental learning driven by contradictions and tensions between explicit and implicit dimensions of work processes.
Originality/value
The paper adds to previous research through its focus on practice‐based innovation and the conceptualization of this notion in terms of learning in and through everyday work. It thus creates connections between innovation research and research on workplace learning.