Understanding middle managers' influence in implementing patient safety culture.
Jennifer Gutberg,Whitney Berta +1 more
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A novel conceptual model based on Organizational Learning Theory is offered to explain the ability of middle managers in healthcare organizations to influence patient safety culture change and proposes that middle managers can capitalize on their unique position between upper and lower levels in the organization and engage in ‘ambidextrous’ learning.Abstract:
The past fifteen years have been marked by large-scale change efforts undertaken by healthcare organizations to improve patient safety and patient-centered care. Despite substantial investment of effort and resources, many of these large-scale or “radical change” initiatives, like those in other industries, have enjoyed limited success – with practice and behavioural changes neither fully adopted nor ultimately sustained – which has in large part been ascribed to inadequate implementation efforts. Culture change to “patient safety culture” (PSC) is among these radical change initiatives, where results to date have been mixed at best. This paper responds to calls for research that focus on explicating factors that affect efforts to implement radical change in healthcare contexts, and focuses on PSC as the radical change implementation. Specifically, this paper offers a novel conceptual model based on Organizational Learning Theory to explain the ability of middle managers in healthcare organizations to influence patient safety culture change. We propose that middle managers can capitalize on their unique position between upper and lower levels in the organization and engage in ‘ambidextrous’ learning that is critical to implementing and sustaining radical change. This organizational learning perspective offers an innovative way of framing the mid-level managers’ role, through both explorative and exploitative activities, which further considers the necessary organizational context in which they operate.read more
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Researching Complex Interventions in Health: The State of the Art (vol 16, 101, 2016)
Peter Craig,Ingalill Rahm-Hallberg,Nicky Britten,Gunilla Borglin,Gabriele Meyer,S. Koepke,Jane Noyes,Jackie Chandler,Sara Levati,Anne E. Sales,Lehana Thabane,Lora Giangregorio,Nancy Feeley,Sylvie Cossette,Rod S Taylor,Jacqueline J Hill,David Richards,Willem Kuyken,L. von Essen,Andrew James Williams,Karla Hemming,Richard J. Lilford,Alan Girling,Monica Taljaard,Munyaradzi Dimairo,Mark Petticrew,Janis Baird,Graham Moore,Willem Odendaal,Salla Atkins,Elizabeth Lutge,Natalie Leon,Simon Lewin,Katherine Payne,T. vanAchterberg,Walter Sermeus,Martin Pitt,Thomas Monks +37 more
Abstract: Table of contentsKEYNOTE PRESENTATIONSK1 Researching complex interventions: the need for robust approachesPeter CraigK2 Complex intervention studies: an important step in developing knowledge for practiceIngalill Rahm-HallbergK3 Public and patient involvement in research: what, why and how?Nicky BrittenK4 Mixed methods in health service research – where do we go from here?Gunilla BorglinSPEAKER PRESENTATIONSS1 Exploring complexity in systematic reviews of complex interventionsGabriele Meyer, Sascha Köpke, Jane Noyes, Jackie ChandlerS2 Can complex health interventions be optimised before moving to a definitive RCT? Strategies and methods currently in useSara LevatiS3 A systematic approach to develop theory based implementation interventionsAnne SalesS4 Pilot studies and feasibility studies for complex interventions: an introductionLehana Thabane, Lora GiangregorioS5 What can be done to pilot complex interventions?Nancy Feeley, Sylvie CossetteS6 Using feasibility and pilot trials to test alternative methodologies and methodological procedures prior to full scale trialsRod TaylorS7 A mixed methods feasibility study in practiceJacqueline Hill, David A Richards, Willem KuykenS8 Non-standard experimental designs and preference designsLouise von EssenS9 Evaluation gone wild: using natural experimental approaches to evaluate complex interventionsAndrew WilliamsS10 The stepped wedge cluster randomised trial: an opportunity to increase the quality of evaluations of service delivery and public policy interventionsKarla Hemming, Richard Lilford, Alan Girling, Monica TaljaardS11 Adaptive designs in confirmatory clinical trials: opportunities in investigating complex interventionsMunyaradzi DimairoS12 Processes, contexts and outcomes in complex interventions, and the implications for evaluationMark PetticrewS13 Processes, contexts and outcomes in complex interventions, and the implications for evaluationJanis Baird, Graham MooreS14 Qualitative evaluation alongside RCTs: what to consider to get relevant and valuable resultsWillem Odendaal, Salla Atkins, Elizabeth Lutge, Natalie Leon, Simon LewinS15 Using economic evaluations to understand the value of complex interventions: when maximising health status is not sufficientKatherine PayneS16 How to arrive at an implementation planTheo van AchterbergS17 Modelling process and outcomes in complex interventionsWalter SermeusS18 Systems modelling for improving health careMartin Pitt, Thomas Monks
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References
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Journal ArticleDOI
A Dynamic Theory of Organizational Knowledge Creation
TL;DR: In this paper, the authors propose a paradigm for managing the dynamic aspects of organizational knowledge creating processes, arguing that organizational knowledge is created through a continuous dialogue between tacit and explicit knowledge.
Journal ArticleDOI
Exploration and Exploitation in Organizational Learning
TL;DR: In this paper, the authors consider the relation between the exploration of new possibilities and the exploitation of old certainties in organizational learning and examine some complications in allocating resources between the two, particularly those introduced by the distribution of costs and benefits across time and space.
Book
Organizational Learning: A Theory Of Action Perspective
Chris Argyris,Donald A. Schön +1 more
TL;DR: Aguilar et al. as discussed by the authors define intervencion as "entrar en un conjunto de relaciones en desarrollo con el proposito de ser util".
Journal ArticleDOI
Social Capital: Prospects for a New Concept
Paul S. Adler,Seok-Woo Kwon +1 more
TL;DR: A growing number of sociologists, political scientists, economists, and organizational theorists have invoked the concept of social capital in the search for answers to a broadening range of questions being confronted in their own fields as mentioned in this paper.
Journal ArticleDOI
Organizational Learning and Communities-of-Practice: Toward a Unified View of Working, Learning, and Innovation
John Seely Brown,Paul Duguid +1 more
TL;DR: Work, learning, and innovation in the context of actual communities and actual practices are discussed in this paper, where it is argued that the conventional descriptions of jobs mask not only the ways people work, but also significant learning and innovation generated in the informal communities-of-practice in which they work.