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, the…
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.
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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.
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Gina Phelps Thoebes, Tracy H. Porter and Jessica A. Peck
The purpose of this paper is to provide a systematic review of the current state of physician leadership. Theory of expert leadership (TEL) was applied to explore the effects of…
Abstract
Purpose
The purpose of this paper is to provide a systematic review of the current state of physician leadership. Theory of expert leadership (TEL) was applied to explore the effects of physician inherent knowledge, industry experience and leadership capabilities on leader behaviors and outcomes.
Design/methodology/approach
This review (August 2011–February 2022) applied the preferred reporting items for systematic review and meta-analysis strategy. Our search began with 3,537 studies and a final sample of 12 articles.
Findings
The findings offer a number of studies that note the relationship between physician leadership and the three dimensions of TEL. How influential these are on leadership behaviors and health-related outcomes varies. We also found a number of studies that described general physician leadership behaviors that were not directly linked to factors of TEL, as well as two additional themes: leader identity and trust.
Originality/value
To the best of the authors’ knowledge, this is the first systematic review that has applied a highly cited theory (i.e. TEL) to the data and the first that has focused solely on a U.S. population. These findings offer healthcare organizations insight into the potential strengths and challenges of physician leadership.
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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 with…
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.
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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 practices…
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.
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Tracy Porter, Michele Heath, Nicholas Messina and Scott C. Bible
Leaders influence individuals to understand and agree upon goals and methods to accomplish shared objectives. However, how leaders motivate others to assume a leadership role is…
Abstract
Purpose
Leaders influence individuals to understand and agree upon goals and methods to accomplish shared objectives. However, how leaders motivate others to assume a leadership role is an open question. This paper aims to examine how employee perceptions of their supervisors’ transformational leadership behaviors might affect a millennial and their motivation toward leadership. This paper also investigated the relationship within a spiritually based organizational context since workplace spirituality has become increasingly popular within contemporary corporate cultures.
Design/methodology/approach
This conceptual paper offers propositions, which examine two areas: first, the impact of a spiritual work context on a millennial’s motivation to lead and, second, the proposed moderating impact of a transformational leader on these relationships.
Findings
These linkages are important for organizational leaders to examine, as millennials will be the largest portion of the workforce by 2025. In addition, the influence of a transformational leader may not be as powerful as previous research has demonstrated. This difference is based on aspects of millennials, which are different from previous generations. Organizations spend thousands of dollars on the development of transformational leaders and spiritual (meaningful) workplaces; however, this may not be useful in the future.
Originality/value
To the best of the authors’ knowledge, to date no research has examined the impact of a transformational leader on a millennial’s motivation toward leadership in a spiritual work context.
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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 and how…
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.
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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 is the…
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.