Ulrica von Thiele Schwarz, Kin Andersson and Carina Loeb
The purpose is explore an approach to acquire, analyze and report data concerning an organizational change initiative that combines knowledge generation and knowledge use, and…
Abstract
Purpose
The purpose is explore an approach to acquire, analyze and report data concerning an organizational change initiative that combines knowledge generation and knowledge use, and contrast that with a method where knowledge generation and use is separated. More specifically, the authors contrast a participatory group workshop with individual interviews analyzed with thematic analysis, focusing on information about the change process and its perceived practical relevance and usefulness.
Design/methodology/approach
Participants were managers responsible for implementing a broad organizational change aiming to improve service quality (e.g. access and equity) and reduce costs in a mental health service organization in Sweden. Individual interviews were conducted at two points, six months apart (i1: n = 15; i2: n = 18). Between the interviews, a 3.5-h participatory group workshop was conducted, during which participants (n = 15) both generated and analyzed data through a structured process that mixed individual-, small- and whole-group activities.
Findings
Both approaches elicited substantive information about the content, purpose and process of change. While the content and purpose findings were similar across the two data sources, the interviews described how to lead a change process, whereas the workshop yielded concrete information about what to do. Benefits of interviews included personal insights about leading change while the workshop provided an opportunity for collective sense-making.
Originality/value
When organizational stakeholders work through the change process through a participatory workshop, they may get on the same page, but require additional support to take action.
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Mandus Frykman, Robert Lundmark, Ulrica von Thiele Schwarz, Karin Villaume and Henna Hasson
The purpose of this paper is to investigate line managers’ influence on employee usage of a web-based system for occupational health management.
Abstract
Purpose
The purpose of this paper is to investigate line managers’ influence on employee usage of a web-based system for occupational health management.
Design/methodology/approach
Questionnaires were used to measure line managers’ transformational leadership at baseline and their change-supportive managerial activities during weeks 16–52. Employee initial (weeks 16–52) and sustained (weeks 53–144) use of the web-based system was measured by extracting their frequency of logins to the system from electronic records. Data were collected from six white-collar organizations from 2011 through 2013. Mixed Poisson regressions were used to analyze the influence of transformational leadership and change-supportive managerial activities on employee usage.
Findings
As predicted, line managers’ change-supportive activities influenced the employees’ initial and sustained use of the system. Line managers’ transformational leadership had no direct effect on employees’ use of the system, however transformational leadership was indirectly associated with employees’ initial and sustained use of the system through line managers’ change-supportive activities.
Originality/value
The study adds to the understanding of the role line managers’ play during the implementation of occupational health interventions. The findings suggest that the line managers’ change-supportive activities directed toward the intervention are important for employees’ initial and sustained use of the system. The influence of transformational leadership was indirect, suggesting that line managers may need to direct their leadership behaviors toward the intervention to facilitate implementation.
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Robert Lundmark, Karina Nielsen, Henna Hasson, Ulrica von Thiele Schwarz and Susanne Tafvelin
Line managers can make or break organizational interventions, yet little is known about what makes them turn in either direction. As leadership does not occur in a vacuum, it has…
Abstract
Purpose
Line managers can make or break organizational interventions, yet little is known about what makes them turn in either direction. As leadership does not occur in a vacuum, it has been suggested that the organizational context plays an important role. Building on the intervention and leadership literature, we examine if span of control and employee readiness for change are related to line managers' leadership during an organizational intervention.
Design/methodology/approach
Leadership is studied in terms of intervention-specific constructive, as well as passive and active forms of destructive, leadership behaviors. As a sample, we use employees (N = 172) from 37 groups working at a process industry plant. Multilevel analyses over two time points, with both survey and organizational register data were used to analyze the data.
Findings
The results revealed that span of control was negatively related to constructive leadership and positively related to passive destructive leadership during the intervention. Employee readiness for change was positively related to constructive leadership, and negatively related to both passive and active destructive leadership.
Practical implications
Our findings suggest that contextual factors need to be assessed and considered if we want line managers to engage in constructive rather than destructive leadership during interventions.
Originality/value
The present study is the first to address line managers' making or breaking of organizational interventions by examining the influence of context on both their destructive and constructive leadership.
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Sara Korlén, Anna Essén, Peter Lindgren, Isis Amer-Wahlin and Ulrica von Thiele Schwarz
Policy makers are applying market-inspired competition and financial incentives to drive efficiency in healthcare. However, a lack of knowledge exists about the process whereby…
Abstract
Purpose
Policy makers are applying market-inspired competition and financial incentives to drive efficiency in healthcare. However, a lack of knowledge exists about the process whereby incentives are filtered through organizations to influence staff motivation, and the key role of managers is often overlooked. The purpose of this paper is to explore the strategies managers use as intermediaries between financial incentives and the individual motivation of staff. The authors use empirical data from a local case in Swedish specialized care.
Design/methodology/approach
The authors conducted an exploratory qualitative case study of a patient-choice reform, including financial incentives, in specialized orthopedics in Sweden. In total, 17 interviews were conducted with professionals in managerial positions, representing six healthcare providers. A hypo-deductive, thematic approach was used to analyze the data.
Findings
The results show that managers applied alignment strategies to make the incentive model motivating for staff. The managers’ strategies are characterized by attempts to align external rewards with professional values based on their contextual and practical knowledge. Managers occasionally overruled the financial logic of the model to safeguard patient needs and expressed an interest in having a closer dialogue with policy makers about improvements.
Originality/value
Externally imposed incentives do not automatically motivate healthcare staff. Managers in healthcare play key roles as intermediaries by aligning external rewards with professional values. Managers’ multiple perspectives on healthcare practices and professional culture can also be utilized to improve policy and as a source of knowledge in partnership with policy makers.
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Karin Strömqvist Bååthe, Osman Aytar, Ulrica von Thiele Schwarz and Marina Arkkukangas
To gain a deeper understanding of the development of a joint vision for Close Care, its obstacles and opportunities, in the region of Sörmland based on national health and social…
Abstract
Purpose
To gain a deeper understanding of the development of a joint vision for Close Care, its obstacles and opportunities, in the region of Sörmland based on national health and social services reforms.
Design/methodology/approach
Seven semi-structured interviews were conducted with thirteen stakeholders. Documentation from the process was used to enhance the findings. A qualitative content analysis was performed.
Findings
Stakeholders described Close Care as entailing “person centeredness, cooperation, and resource sharing” but found it “too abstract”. Participation in developing the vision varied, with experiences of “external pressure” and low “readiness for organisational change”. Views on a regional vision’s “relevance and usability” differed. Participants highlighted several opportunities for the Close Care vision, such as: “a stepping-stone for implementation”, “harmonises with other health care visions” and “forming a cross municipal and regional network”. They also noted obstacles like “symbolic alienation”, “cognitive complexity”, “short-term economic reality” and “uncertainty around implementation”.
Practical implications
Opportunities and obstacles for the vision of Close Care can inform complex healthcare reforms that require stakeholder cooperation.
Social implications
Understanding Close Care may enable health system stakeholders to more effectively cooperate around the citizens’ needs.
Originality/value
Research on common ground has mainly focused on national or international policy levels and individual hospitals, professionals or patients. This study offers insights on regional and municipal cooperation in health care driven by a common vision.
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Susanne Tafvelin, Henna Hasson, Karina Nielsen and Ulrica von Thiele Schwarz
In previous studies, outcomes of leadership training have varied, with some studies suggesting large effects and others small. Although the transfer of training literature…
Abstract
Purpose
In previous studies, outcomes of leadership training have varied, with some studies suggesting large effects and others small. Although the transfer of training literature suggests a number of factors that influence training outcomes, this knowledge has seldom been used when evaluating the outcomes of leadership training. The purpose of the present study is therefore to examine how factors related to transfer of training influence outcomes of leadership training.
Design/methodology/approach
In the present research, follower-rated outcomes of a leadership training program in Denmark (N = 298) was examined from a transfer of training perspective.
Findings
Using Baldwin and Ford's transfer of training model as a framework, analyses revealed that leaders' utility reactions (i.e. perception of usefulness) and learning were linked to transfer of training. In addition, leaders' perceptions of transfer were associated with post-intervention follower-rated transformational leadership and collective self-efficacy.
Practical implications
Making sure that leaders find the training useful for their everyday activities (i.e. positive utility reactions) and that they have time to learn the training content is important to enable transfer and for leaders to use trained skills back at work.
Originality/value
The findings indicate the importance of understanding how leaders' perception of training content influences leadership training outcomes and that these perceptions need to be a part of the evaluation of leadership training. In addition, the findings suggest that factors predicting transfer of leadership training differ from other types of training.
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Mandus Frykman, Ulrica von Thiele Schwarz, Åsa Muntlin Athlin, Henna Hasson and Pamela Mazzocato
The purpose of this paper is to uncover the mechanisms influencing the sustainability of behavior changes following the implementation of teamwork.
Abstract
Purpose
The purpose of this paper is to uncover the mechanisms influencing the sustainability of behavior changes following the implementation of teamwork.
Design/methodology/approach
Realistic evaluation was combined with a framework (DCOM®) based on applied behavior analysis to study the sustainability of behavior changes two and a half years after the initial implementation of teamwork at an emergency department. The DCOM® framework was used to categorize the mechanisms of behavior change interventions (BCIs) into the four categories of direction, competence, opportunity, and motivation. Non-participant observation and interview data were used.
Findings
The teamwork behaviors were not sustained. A substantial fallback in managerial activities in combination with a complex context contributed to reduced direction, opportunity, and motivation. Reduced direction made staff members unclear about how and why they should work in teams. Deterioration of opportunity was evident from the lack of problem-solving resources resulting in accumulated barriers to teamwork. Motivation in terms of management support and feedback was reduced.
Practical implications
The implementation of complex organizational changes in complex healthcare contexts requires continuous adaption and managerial activities well beyond the initial implementation period.
Originality/value
By integrating the DCOM® framework with realistic evaluation, this study responds to the call for theoretically based research on behavioral mechanisms that can explain how BCIs interact with context and how this interaction influences sustainability.
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Henna Hasson, Ulrica von Thiele Schwarz and Susanne Tafvelin
The purpose of this paper is to explore the consequences of self–other agreement (SOA) between leaders and subordinates on constructive and passive leadership behaviors for…
Abstract
Purpose
The purpose of this paper is to explore the consequences of self–other agreement (SOA) between leaders and subordinates on constructive and passive leadership behaviors for employee well-being, performance and perception of learning climate.
Design/methodology/approach
Questionnaire ratings of 76 leaders and 211 subordinates in a forest industrial company on full-range leadership and subordinate ratings of well-being, work performance and learning climate have been used in this paper. The data were analyzed using polynomial regression with response surface analysis.
Findings
SOA on constructive leadership (transformational leadership and contingent reward) was related to subordinates’ perception of a positive learning climate. SOA on passive leadership (management-by-exception passive) reduced subordinates’ performance, while disagreement reduced their well-being.
Practical implications
It is important to give leaders feedback on their own and their subordinates’ ratings of not only constructive leadership behaviors but also passive behaviors.
Originality/value
The study demonstrates how SOA on leaders’ constructive and passive leadership behaviors impacts employees’ well-being, performance and work climate.
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Rebecca Mosson, Henna Hasson, Ulrica von Thiele Schwarz and Anne Richter
A common component in leadership interventions is the provision of feedback on leadership behaviors. The assumption is that, when there is a discrepancy in this feedback between…
Abstract
Purpose
A common component in leadership interventions is the provision of feedback on leadership behaviors. The assumption is that, when there is a discrepancy in this feedback between managers’ and others’ ratings of leadership, this will increase managers’ self-awareness and motivate them to close this gap. The purpose of this paper is to investigate how agreement between managers and their subordinates changes over time as a result of a leadership intervention.
Design/methodology/approach
Questionnaire data were collected from line managers (N=18) and their subordinates (N=640) at pre-intervention, post-intervention and at a six-month follow-up. The managers participated in a leadership intervention that aimed to increase their knowledge and skills related to the leadership behaviors described in the Full-Range Leadership Model. Inter-rater agreement and reliability were calculated to justify aggregating the subordinates’ ratings. The managers and their subordinates were grouped according to three agreement categories: in agreement, managers’ over-rating and managers’ under-rating based on the managers’ views of their leader behaviors in relation to their subordinates’.
Findings
Manager-subordinate agreement on the managers’ leadership increased between pre-intervention and post-intervention but then decreased at the six-month follow-up (17, 61 and 44 percent, respectively). Most managers (n=15) changed agreement categories over time, and only three managers remained in the same agreement category throughout. The subordinates’ mean leadership ratings changed more than the managers’ mean ratings.
Originality/value
This is the first study to explore how manager-subordinate agreement changes when managers participate in a leadership intervention in a health care context. It shows that an intervention that includes upward feedback, by which managers self-rating of their leadership is compared with their subordinates’ ratings, can be an effective way to increase agreement.
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David Ebbevi, Ulrica Von Thiele Schwarz, Henna Hasson, Carl Johan Sundberg and Mandus Frykman
To review the literature and identify research gaps in the role and influence boards of directors of companies have in occupational health and safety (OHS).
Abstract
Purpose
To review the literature and identify research gaps in the role and influence boards of directors of companies have in occupational health and safety (OHS).
Design/methodology/approach
This was done in a scoping review built on a structured search in MEDLINE (PubMed), EMBASE, PsycINFO, Sociological Abstracts, CCInfoWeb, EconLit, Web of Science, CINAHL and gray literature. Citations and reference lists were tracked. Inclusion criteria were publication in English. Exclusion criteria were studies covering companies using subcontractors to arrange OHS, or with <250 employees.
Findings
Forty-nine studies were included. The majority contained empirical data (n = 28; 57%), some were entirely normative (n = 16; 33%), and a few contained normative claims far beyond empirical data (n = 5; 10%). Empirical studies gave no insight into the scope of impact of board activities on OHS, and no studies assess the causal mechanisms by which board activities influence OHS outcomes. Most studies focused on both health and safety (n = 20; 41%) or only safety (n = 15; 31%). Context might explain the focus on safety rather than health, but is not clearly elucidated by the studies. Several studies are describing leadership behavior, although not framed as such. A narrative summary is presented to facilitate future research.
Research limitations/implications
Future research should include: (1) which board activities influence OHS, (2) how board activities influence OHS, (3) the influence of context and (4) the leadership role of boards of directors.
Originality/value
This study identifies a total lack of research on the basic mechanics of the relationship between boards and OHS.