Giuseppe Scaratti

Reflexivity in practice : tools and conditions for developing organizational authorship

In this article, we build on the results of a participatory action research project in healthcare to discuss a number of methods that can strengthen the link between reflexive work and authoring in organizational contexts. We argue that, from an organizational point of view, the challenge is to devise new ways to configure (and consider) people as the authors of their work. This means assuming responsibility for, and constructively contributing to, the goals of the organizations to which they belong. Combining insights from theoretical reflection and experience from the field, the article discusses the tools, process and material conditions for fostering practical reflexivity and organizational authorship. We conclude that much is to be gained if we distinguish between authorship and authoring. Authorship is the general process whereby managers and organizational members contribute to the reproduction of organizational realities. Authoring is constituted by the special circumstances whereby authorship is brought to critical consciousness and becomes open to deliberate reorientation.

Pushing Action Research Toward Reflexive Practice

Managers today increasingly find themselves facing unexpected problems, needing to learn how to cope with complex environments and to take action in an often chaotic flow of events. This article discusses how researchers can engage managers in a form of dialogical action research, capable of nurturing knowledge and change. This is achieved by creating space for collaborative dialogue between managers and researchers, and supplementing it with the integration of a reflexive writing practice. We first present methodological reflections related to the challenges of sustaining management practice through action research. Second, we explicate dialogical action research and illustrate the reflexive writing practice through two vignettes which provide opportunities to reflexively explore “how things work” in managers’ organizational contexts. This forms the basis for sustaining participation and learning at individual and collective levels. Finally, we identify and discuss the specific conditions and limits of such an approach.

Barriers and facilitators to the uptake of computerized clinical decision support systems in specialty hospitals: protocol for a qualitative cross-sectional study

BackgroundComputerized clinical decision support systems (CDSSs) have been shown to improve the efficiency and quality of patient care by connecting healthcare professionals with high quality, evidence-based information at the point-of-care. The mere provision of CDSSs, however, does not guarantee their uptake. Rather, individual and institutional perceptions can foster or inhibit the integration of CDSSs into routine clinical workflow. Current studies exploring health professionals’ perceptions of CDSSs focus primarily on technical and usability issues, overlooking the social or cultural variables as well as broader administrative or organizational roles that may influence CDSS adoption. Moreover, there is a lack of data on the evolution of perceived barriers or facilitators to CDSS uptake across different stages of implementation.MethodsWe will conduct a qualitative, cross-sectional study in three Italian specialty hospitals involving frontline physicians, nurses, information technology staff, and members of the hospital board of directors. We will use semi-structured interviews following the Grounded Theory framework, progressively recruiting participants until no new information is gained from the interviews.DiscussionCDSSs are likely to become an integral and diffuse part of clinical practice. Various factors must be considered when planning their introduction in healthcare settings. The findings of this study will guide the development of strategies to facilitate the successful integration of CDSSs into the regular clinical workflow. The evaluation of diverse health professionals across multiple hospital settings in different stages of CDSS uptake will better capture the complexity of roles and contextual factors affecting CDSS uptake.

The power of professionally situated practice analysis in redesigning organisations: A psychosociological approach

Purpose – This paper seeks to provoke thoughts around the possibility of using the lever of practices and situated knowledge to trigger organisational change and to redesign it with the involvement of the whole organisation.Design/methodology/approach – The paper presents connections between a psychosociological approach and a practice‐based approach. The use of ethnomethodology is offered as a way to detect situated practice and meaning at works.Findings – This contribution underlines how change and learning in organisations can find support in investing in local knowledge and in detecting and reflecting around the living practices of daily activities. Knowing in practice requires the involvement and continuous work of connecting among individuals, groups, organisations and institutions in situated contexts. The paper shows how strategic a process this is, presenting a way to work on situated data.Practical implications – The paper represents a way to work on organisational change grounded on action rese...

Embedding Impact in Engaged Research: Developing Socially Useful Knowledge through Dialogical Sensemaking

This paper explores how we can embed impact in research to generate socially useful knowledge. Our contribution lies in proposing a form of engaged research that draws upon situated knowledge and encompasses dialogical sensemaking as a way of making experience sensible in collaborative researcher−practitioner conversations. We draw attention to the intricacies of doing socially useful research and illustrate how five conversational resources can be used within dialogical sensemaking through an example of a research project in which impact and relevance were embedded and where researchers and practitioners worked together to resolve an important social and organizational issue.

Building social sustainability: multi-stakeholder processes and conflict management

Purpose - – The aim of the paper is to investigate social sustainability by focussing on the stakeholder theory and by presenting specific levers and capabilities for building more socially sustainable organizations. Design/methodology/approach - – The paper is based on the analysis of recent academic and managerial literature. Through comparing theoretical and methodological perspectives from multiple authors, a specific theoretical and methodological viewpoint based on the stakeholder theory is proposed. Findings - – The paper discusses the idea that building socially sustainable organisations requires the management of multi-stakeholder processes that are physiologically conflicting and that often create paradoxical tensions. Participative settings of action and reflection and capabilities as reflexivity and “paradoxical thinking” are proposed as key levers for dealing with multi-stakeholders processes towards a more socially sustainable organizing. Research limitations/implications - – This paper raises reflections focussed on the “social pillar” of sustainability and does not consider different types of organizations in different multi-stakeholders processes. Such a perspective does not exhaust the variety of cases and research studies that could be considered in the field and further developed. Originality/value - – The value of the paper is in its construction of a framework for both research and practical purposes in the domain of management and sustainability. The work also attempts to link the concepts of reflexivity and paradox to a methodological proposal for leading the organizational journey towards social sustainability.

Knowing, learning and acting in health care organizations and services : Challenges and opportunities for qualitative research

Purpose – The purpose of this paper is to discuss the value of post‐modern psychosocial approaches to studying knowledge and practice construction in health care organizations and settings (HCO&S) and the increasing ability of qualitative research to furnish a deeper, more ecological, and more usable understanding of the social construction of health knowledge and practices.Design/methodology/approach – The argument proposed in the paper is based on a critical literature review conducted on the Psychinfo, Scopus, PubMed and Web of Science databases.Findings – Recent years have seen cultural changes in the values and goals of healthcare interventions that are deeply reconfiguring HCO&S. These changes are reframing HCO&S action and are highlighting the importance of understanding and managing not only the “expert context” but also the “lay contexts” of healthcare interventions. In an attempt to deal with these emergent changes (and challenges), HCO&S are taking advantage of new insights matured in the post‐...

Weak knowledge for strengthening competences: a practice-based approach in assessment management

The aim of this article is to demonstrate the importance of local knowledge for the design of assessment tools intended to develop and enhance human resources in organizations. With respect to the standardization of assessment procedures brought about by the application of universal and global reference models, the article uses a case study to illustrate the potentialities and shortcomings of using a local approach. After a brief survey of the main theoretical frames of reference, the article describes how local knowledge was used at an assessment centre set up at a multinational operating in the maritime transport sector, with a view to developing the competences required by the company. The article describes and discusses the ways in which certain classic knowledge management situations were adapted at the assessment centre to local needs and conditions, and the main results obtained. Finally discussed are the practical and social implications, as well as the limitations and the transferability, of a local approach to assessment.

A multi‐method approach for looking inside healthcare practices

Purpose – The purpose of this paper is to explore a specific multi‐method approach with which to detect and analyze professional practices in order to support organizational reflection and change.Design/methodology/approach – Based on a case study, the paper describes the methodological choices made during the research process. The qualitative potentials of narrative and ethnographic orientations, and a package of data gathering tools, are analyzed in depth.Findings – The paper presents the advantages and drawbacks of tools to articulate practices and to develop hypotheses for change. It emphasizes the approachs innovative value and potential in contributing to knowledge sharing in organizations, and the implications for researchers and participants.Practical implications – The paper furnishes concrete suggestions on how practitioners and researchers/consultants can be induced to pay particular attention to aspects of the operational knowledge that should accompany change processes. This appears even mor...

The practice of evaluation as an evaluation of practices

This article describes the theoretical basis and characteristics of a process-based, negotiated and generative approach to the evaluation of organizations. Illustrated by a case study, it highlights the inappropriateness of standardized instruments in the face of complexity and uncertainty, suggesting ways to improve the practice of evaluating dynamic complex systems. It underlines how conducting an evaluation within an organization is an opportunity to produce knowledge that reflects on and can potentially transform existing systems. Using an action-research method, ‘instructions to the double’, the implications for data collection and analysis suited to complex interventions and complex environments, are presented and discussed. In particular, the article describes the monitoring and evaluation of practices as unfolding processes, in which evaluative methods and tools are context dependent and subject to social, dynamic and contested mobilization of knowledge. The collective negotiation and production of knowledge in collaboration with practitioners working within the organization, is considered as the necessary condition for enhancing the formative and transformative role of evaluation and supporting reflexivity in professional practices.