Laura Galuppo

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.

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.

The social relevance and social impact of knowledge and knowing

The concept of the relevance of knowledge and the relationship between theory and practice has been widely addressed and discussed, for example, in a number of journal Special Issues including Organization Studies (2009 and 2010), the Journal of Management Studies (2009), and the British Journal of Management (2011). In the search to balance “scientific rigour” with “practical relevance” (Eikeland and Nicolini, 2011), various modes of knowledge have been proposed: Mode 1 scientific, Mode 2 contextual (Gibbons et al., 1994), Mode 3 diverse stakeholders (Huff and Huff, 2001), and Mode 0 patronage (Bresnen and Burrell, 2012). The question lying at the heart of this debate seems to be whether organization studies has anything meaningful and relevant to say (Alvesson, 2012).

Work transformation following the implementation of an ERP system: an activity-theoretical perspective

Purpose The purpose of this study is to introduce the Human Resources (HR) module of the SAP suite in the Italian branch of a leading multinational pharmaceutical company. This study can be re-conducted within the interpretive tradition of information technology studies focusing on the attempt to understand and describe how software users in the HR department interpreted the enterprise resource planning (ERP) technology, how they changed their work practices and the changes that occurred in organizational discourses and meanings alongside the process. Design/methodology/approach The case study/intervention took start with the impulse of the Italian HR department manager, who was struck by the way that the ERP system technology implementation was affecting work life of the employees in the department. This research/intervention used interviews, focus groups and internal documents as sources of data. The authors conducted and analyzed 20 narrative interviews and 3 focus groups with middle managers, and they analyzed about 120 pages of internal memos. Findings The implementation of ERP systems is almost invariably accompanied by great expectations of increased process rationalization, efficiency and cost-effectiveness, and upper managers’ discourses make large use of what Engestrom et al., 2010 have called process efficiency rhetoric. But the ERP technology, most likely, will neither revolutionize management nor will it become a “complete calculation machine” that runs an entire work organization (Quattrone and Hopper, 2005, p. 731). Originality/value The implementation of the ERP system has caused conflicts and disturbances, aggravating contradictions that already existed between activity systems and introducing new types of contradictions. Pre-existent contradictions become clearer; there is a stronger interconnection between activity systems. The individual agents could experiment an expansion in their activities if only they will initiate a movement of expansive learning and if they are not prevented from doing so by coercive control. The natural expansion of the subjects’ scope of activity and horizons of possibilities could be sustained by the ERP technology if it is not used as a tool for domination and if the upper management does not try and separate what cannot in actuality be separated: The actors’ capabilities of improvised learning, which makes the institution of a new mode of the activity possible, and their capacity to assume collective control of the meaning and direction of the transformation of the activity. ERPs are technologies that can naturally bring transformations in the activity system and networks where they are introduced, but in some cases, they can easily and in a non reflective manner be intended as tools for oppression by the upper management.

Reconstructing the internship program as a critical reflexive practice: the role of tutorship

ABSTRACT Critical reflexivity has been acknowledged as fundamental in higher education. For facing complex situations in turbulent environments, students nowadays need not only to be taught technical knowledge, but also to be helped develop “relevant” learning for their future professional practice. In recent years, scholars have concentrated on what makes the internship experience a successful opportunity for the parties involved, and have also discussed the crucial role of a mentor/tutor in sustaining relevant and effective learning. However, the specific conditions that make tutorship successful in promoting critical reflexivity in such a boundary crossing experience need to be further explored. Aim of this paper is therefore to analyze what tutorship conditions sustain the development of critical reflexivity in internship. For this purpose, we will present the case study of an internship program run by one of the largest universities in northern Italy.

Innovating Health care through Multi-Stakeholder Partnership: The Welfare Italia Servizi Case

Abstract Purpose This chapter focuses on an innovative effort in the Italian context in which a complex web of partnerships was created as the foundation of an alternative model of health care. More specifically, the start-up of a health-care organization – Welfare Italia Servizi (WIS) – is analyzed and discussed with respect to its sustainability. Design/methodology/approach The process of organizing a sustainable health care is analyzed through the theoretical lenses of multi-stakeholders management and partnership perspectives. The possibility of developing dense knowledge about the WIS’s case has stemmed from our collaboration with the organization board with regard to a research process intended to monitor the organizational start-up and its sustainability challenges. Findings The case provides new insights into the dynamic nature of building multi-stakeholder partnership in a complex environment; the developmental life-cycle challenge of multi-stakeholder partnership, and the meaning of sustainability. The case suggests a tapestry of issues such as how sustainability may be “paradoxical,” dynamic, led by different and sometimes conflicting logics, and changeable over time like a growing tree in an intricate forest. Originality/value The case can stimulate learning and discussions both within the community of practitioners and the community of academics with respect to which promising conditions could help address the challenge of starting-up a sustainable organization in the health-care field.

Change and Management of Complex Services: The Ethno-narrative Form to Support Good Living and Working Together

Nowadays, managing change in complex services requires that middle management re-designs its objects and professional practices, in order to cope with new needs. It seems therefore crucial to activate training settings that allow managers to: (1) develop research and analytical skills on their own work practices and professional objects; (2) face and manage conflict, related to every change, that represents an opportunity to reflect and review ones own practices; and (3) build new and shared repertories of managerial practices, able to support a better form of living and working together within the management community. Moving from these hypotheses, inside the setting of a training intervention conducted in an educational service, the article discusses a specific tool used to generate opportunity of exchange, and reflection, within a challenging framework of change.