Roy Liff

Multiprofessional Cooperation and Accountability Pressures

Abstract This article examines how multiprofessional healthcare teams, working as a post-New Public Management (post-NPM) reform, respond to accountability pressure resulting from the implementation of NPM reforms. The team members use three strategies to respond to this pressure: responsibility avoiding that results in conflict; responsibility ignoring that results in parallel work and responsibility sharing that results in cooperation. Depending on how the professionals respond to different contextual factors, the choice of strategies can either foster or inhibit cooperation in multiprofessional teams. Achieving holistic patient care is threatened when accountability pressure increases for teams that have not yet developed their internal routines of cooperation.

Unintended Consequences of NPM Drive the “Bureaucracy”

This article examines the unintended consequences following implementation of a new public management (NPM) reform—a performance-based salary system—in two Swedish public schools. Headmasters and central office personnel were interviewed. The expected reform results at last appeared a decade after implementation when salary-setting procedures adopted the bureaucratic framework. Despite the common view that NPM reforms, owing to unintended consequences, fail because they adapt poorly to the Weberian control regime at public organizations, this article argues that the unintended consequences of an NPM reform can drive the “bureaucratic” organization even when there is no evidence of debureaucratization.

Does patient‐centred care mean risk aversion and risk ignoring?: Unintended consequences of NPM reforms

Purpose – This article aims to describe and analyze the results of efforts to improve patient-centered care (PCC) in psychiatric healthcare.Design/methodology/approach – Using the methodology of a ...

Systematic and serendipitous discoveries: a shift in sensemaking

Purpose – The purpose of this paper is to enrich the theoretical understanding of the phenomenon of sensemaking where a conceptual shift was provoked by a serendipitous encounter. Design/methodology/approach – A theoretical framework consisting of three elements of reflexivity: the cognitive, the social, and the normative, all of which support the study. Semi-structured interviews were conducted in the investigation of a serendipitous Episode that occurred in a larger research project. This Episode took place at a meeting between a social welfare officer and a psychologist in which they discussed the treatment of a psychiatric patient. When the psychologist left the meeting for a brief period, the researchers, unexpectedly, were able to interview the social welfare officer alone. Findings – This interview revealed a deviation from the institutionalized patient treatment procedure that was explained to the researchers in earlier interviews. The study shows that shifts in sensemaking are possible when resea...

Book review: Ageing, organisations and management: Constructive discourses and critical perspectivesAaltioIirisMillsAlbert JMillsJean Helms (eds), Ageing, organisations and management: Constructive discourses and critical perspectives, Palgrave Macmillan: Cham, 2017. 370 pp.: £87.40, ISBN: 9783319588131

and think we know about leadership. They also, a bit more gingerly, lead the reader into the still not fully delineated and paved path of what are termed here as “Critical Issues” such as the impact of gender and diversity, ethical thinking, and language on how leadership can—or should—be best understood. It is the comprehensiveness of the text that is, perhaps, its strongest point. The use of the terms “Traditional Approaches” and “Current Issues” led this reader to sense that the former were held to have more weight or import. This may or may not have been the intention of the authors. It seems that some of these “Current Issues” have already become part and parcel of the field and have been shown to be important factors both in the study and practice of leadership. This matter can—perhaps—be more clearly articulated as these matters can be seen as much more than “Current Issues” that can serve as commentaries on “Traditional Approaches.” The authors make fairly frequent reference to the fact that an overwhelming portion of what is known about leadership is from what Henrich et al. (2010) termed “WEIRD” countries (Western, Educated, Industrial, Rich, and Developed)—and specifically English-speaking societies. The authors, rightly, note the limitations of the above in general and in the contemporary globalized era in which we live. With that said, one might have expected that more of an effort would be made to bring to bear the research and reality of leadership in these “other countries” that make up most of humanity. One example of the above that was particularly disappointing to this reader can be found in the Epilogue in which the authors feature the thoughts of other leadership scholars regarding the future of leadership studies. I think the above is a great idea and was very intrigued to hear the thoughts of the scholars from the field. However, almost all of these scholars were “Anglos”—most from the United Kingdom, supplemented by two Scandinavian scholars. This would have been a good opportunity to actually address the very myopia of the leadership field about which the authors spoke, by including comments from non-“WEIRD” scholars. I urge them to do so in future editions. Like many “Anglo”-based texts, this work typically focuses to the type and size of organizations that are common to the United States or Europe—but less so in many other countries. This reviewer lives in a country in which “large” organizations would qualify as “small and medium-sized enterprises” (SMEs) in the minds of most scholars. One way to make the work more relevant to international students may be to increase its focus on SMEs—the type of organizations in which many students, particularly in non-Anglo countries, may very well find themselves. However, overall, Studying Leadership is clearly a very welcome addition to the crowded leadership field. It will be a welcome professional companion not only to graduate students but also to the more seasoned researcher and instructor. Fougère and Moulettes (2012) suggested that textbooks should be invitations to dialogue, rather than a means of closing conversation. Doris Schedlitzki and Gareth Edwards have succeeded in accomplishing the above in a very satisfactory manner in this text. It is no easy task and kudos to them for that.

Political board’s contribution to strategic management: a case study

ABSTRACT This study examines the support, control and strategic functions of an executive hospital political board from the perspective of how institutionalised internal procedures influence board functions. Board members and leading hospital managers were interviewed about politicians’ ways of working, managers’ preparation of decision issues and board work under the presidency model. The politicians strengthened the decision-making processes by requesting additional supporting documents, and by defending the hospital from public criticism. However, the board exercises weak strategic and control functions; it absorbs the responsibilities of the hospital managers and the upper political levels as it reaffirms its executive authority. Nonetheless, the study suggests that abolishing or replacing the board with a non-political board may not improve organisational governance. The study gives insights in politicians’ contribution to strategic public management, an aspect lacking in existing literature.

Promoting cooperation in health care: creating endogenous institutions

Purpose – The purpose of this paper is to investigate if a rational perspective can be used to interpret cooperation problems in a health care organisation. This perspective is proposed as a complementary perspective to the cultural perspective that dominates as an explanation of cooperation problems. The focus of the research is multiprofessional teamwork in contemporary Swedish health care.Design/methodology/approach – Four cases studies, in which the cooperation in daily work is described, are used to test the two perspectives. The cases concern the cooperative methods health care professionals use when work conditions depend upon an internal norm of mutual cooperation. Although the research is not designed to evaluate the two perspectives, it permits the rational explanations of cooperation problems to be compared with possibly cultural explanations.Findings – The investigation concludes that health care cooperation problems may be primarily explained by the rational perspective, and only secondarily ...