Stefano Tasselli

Social Network Analysis: Foundations and Frontiers on Advantage

We provide an overview of social network analysis focusing on network advantage as a lens that touches on much of the area. For reasons of good data and abundant research, we draw heavily on studies of people in organizations. Advantage is traced to network structure as a proxy for the distribution of variably sticky information in a population. The network around a person indicates the persons access and control in the distribution. Advantage is a function of information breadth, timing, and arbitrage. Advantage is manifest in higher odds of proposing good ideas, more positive evaluations and recognition, higher compensation, and faster promotions. We discuss frontiers of advantage contingent on personality, cognition, embeddedness, and dynamics.

The Microfoundations of Organizational Social Networks A Review and an Agenda for Future Research

This paper focuses on an emergent debate about the microfoundations of organizational social networks. We consider three theoretical positions: an individual agency perspective suggesting that people, through their individual characteristics and cognitions, shape networks; a network patterning perspective suggesting that networks, through their structural configuration, form people; and a coevolution perspective suggesting that people, in their idiosyncrasies, and networks, in their differentiated structures, coevolve. We conclude that individual attitudes, behaviors, and outcomes cannot be fully understood without considering the structuring of organizational contexts in which people are embedded, and that social network structuring and change in organizations cannot be fully understood without considering the psychology of purposive individuals. To guide future research, we identify key questions from each of the three theoretical perspectives and, particularly, encourage more research on how individual actions and network structure coevolve in a dynamic process of reciprocal influence.

Social Networks and Inter-professional Knowledge Transfer: The Case of Healthcare Professionals:

This study examines the relationship between the structure of professional networks and patterns of inter-professional knowledge transfer in the healthcare setting. Collecting survey data and qualitative evidence from 118 professionals in a hospital department, we used theory on the sociology of professions and social networks to investigate patterns of knowledge transfer between doctors and nurses. First we found that members of different professions tend to be embedded in distinctive professional cliques, which in turn inhibit effective inter-professional knowledge transfer. Network structure, however, combines with individual characteristics in predicting knowledge transfer patterns. By occupying central positions in closely knit networks, clinical directors can facilitate knowledge transfer patterns between doctors and nurses. And actors who are legitimated both intra-professionally and inter-professionally to occupy brokerage positions in social networks, namely junior doctors and nurse managers, are more likely to gain access to non-redundant, valuable knowledge. The overall picture is one of network structure interplaying with the characteristics of individual actors in shaping the dynamics of professional interactions.

Social Networks of Professionals in Health Care Organizations A Review

In this article, we provide an overview of social network research in health care, with a focus on social interactions between professionals in organizations. We begin by introducing key concepts defining the social network approach, including network density, centrality, and brokerage. We then review past and current research on the antecedents of health care professionals’ social networks—including demographic attributes, professional groups, and organizational arrangements—and their consequences—including satisfaction at work, leadership, behaviors, knowledge transfer, diffusion of innovation, and performance. Finally, we examine future directions for social network research in health care, focusing on micro–macro linkages and network dynamics.

The growth and composition of primary and community-based care services. Metrics and evidence from the Italian National Health Service.

BackgroundOver the past few decades, in OECD countries there has been a general growing trend in the prevalence of out-of-hospital healthcare services, but there is a general lack of data on the use of these services.MethodsWe defined a list of 303 indicators related to primary and community healthcare services in collaboration with 13 Italian Local Health Authorities (LHAs). Then, for each LHA, we collected and analyzed these indicators for two different years (2003 and 2007).ResultsOut-of-hospital care absorbs 56% of all costs in our sample of LHAs. Expenditure on outpatients’ visits to specialists and on diagnostic examinations accounts for 13% of the costs, while spending on primary care (including prevention and public health) accounts for 9%, and for intermediate structures (including those related to rehabilitation, elderly people, disabled people, and mental health) the figure is 11%. Different Italian LHAs have made different strategic choices with respect to primary and community-based care (PCC).ConclusionsTwo distinct strategic orientations in the adoption of PCC services by LHAs has emerged from our study. The first has been an investment mainly in ambulatory and home-based primary care services in order to increase the number of low-complexity settings. A second strategy has prioritized the allocation of resources to intermediate inpatient structures for specific types of patients, namely elderly and disabled people, post-acute patients in need of rehabilitation and long-term care, and patients in hospices.

Are public health authorities able to “steer” rather than “row”? An empirical analysis in the Italian National Health Service

The nature of the local health authorities (LHAs) in the Italian National Health Service has been deeply reformed during the 1990s by new public management (NPM) reforms that introduced decentralization, quasi-market and managerialism. These reforms implied that the main role of LHA is to govern the production of health services in their area (steer) rather than to only directly produce services (row). After more than 15 years from these reforms of Italian healthcare, we describe how much the steering versus rowing dichotomy made an impact on LHA activity, through an analysis of the management control systems they set up for themselves and the subsequent qualitative analysis of the opinions that a diverse group of managers expressed during 8 days of group discussion. Results show that managers of Italian LHAs, when only a small part of services is produced, tend to perceive their steering role as impossible to play and focus on production, leaving therefore ungoverned a significant part of the services offered to residents. NPM, therefore, was able to influence the reform of Italian healthcare but, as suggested by a postmodernist interpretation, left managers with a rhetoric change based on inconsistent assumptions instead of actionable ideas to manage the change process.

The Network Structure of Organizational Vocabularies

Abstract We study organizational vocabularies as complex social structures emerging from the association between organizational participants and words they use to describe and make sense of their experiences at work. Using data that we have collected on the association between managers in a multi-unit international company and words they use to describe their organizational units and the overall company, we examine the relational micro-mechanisms underlying the observed network structure of organizational vocabularies. We find that members of the same subsidiary tend to become more similar in terms of the words they use to describe their units. Members of the same subsidiary, however, do not use the same words to describe the corporate group. Consequently, the structure of organizational vocabularies tends to support consistent local interpretations, but reveals the presence of divergent meanings that organizational participants associate with the superordinate corporate group.

Organizational correlates of continuity of care: A pendulum swing between differentiation and integration:

Introduction Continuity of care is among the foundations of primary care and has long been identified as a critical determinant of healthcare outcomes. This article aims to assess through an empirical study the relationships between distinct organizational features (namely, the use of clinical pathways and clinical databases, and the centralization of healthcare setting or provider) and types of patient-perceived continuity of care. Methods A multilevel regression model was performed, analyzing survey data on patient-perceived continuity of care and on the organization of care for three specific chronic conditions (chronic obstructive pulmonary disease, diabetes and late-stage cancer). A total of 497 healthcare professional responses (79% response rate) and 323 patient responses were collected in 13 Italian Local Health Authorities. Results Clinical pathways have a statistically significant and positive effect on relational continuity (p ≤ 0.01), while centralization of care in one professional improves the perceived quality of the relationship from a longitudinal perspective. A small, but statistically significant, improvement in continuity of care was detected when services are taken out of the hospital. No statistical significant effect of the use of clinical databases by professionals was found. Conclusions Although largely neglected, organizational features can impact the continuity of care experienced by patients. The higher prevalence of chronic conditions should push modern health systems for more extensive attention towards organizational strategies aimed at enhancing continuity of care.

Love and Organization Studies: Moving beyond the Perspective of Avoidance

Despite its undoubted centrality in modern society, Love has not received the attention it deserves in the study of organizations. Among the reasons for this avoidance is the fact that love is passionate and not authoritative; personal and subjective but not public. To understand the way organizational research can incorporate love, I explore and discuss three interweaving constructs. Eros (or a tale of the self) calls for an expression of the individuality in organizations, in terms of creativity, sense making and experience. Philia (or a tale of trust) contributes to explore trustworthy relationships, welcoming the other and enabling individuals to flourish in the workplace. Agape (or a tale of compassion) refers to generalized love for humanity and opens to the understanding of compassionate leadership. In the discussion, I call for new directions in the study of love as the organization and the organization as love.

Are public health authorities able to “steer” rather than “row”? An empirical analysis in the Italian National Health Service: ARE PUBLIC HEALTH AUTHORITIES ABLE TO “STEER” RATHER THAN “ROW”?

The nature of the local health authorities (LHAs) in the Italian National Health Service has been deeply reformed during the 1990s by new public management (NPM) reforms that introduced decentralization, quasi-market and managerialism. These reforms implied that the main role of LHA is to govern the production of health services in their area (steer) rather than to only directly produce services (row). After more than 15 years from these reforms of Italian healthcare, we describe how much the steering versus rowing dichotomy made an impact on LHA activity, through an analysis of the management control systems they set up for themselves and the subsequent qualitative analysis of the opinions that a diverse group of managers expressed during 8 days of group discussion. Results show that managers of Italian LHAs, when only a small part of services is produced, tend to perceive their steering role as impossible to play and focus on production, leaving therefore ungoverned a significant part of the services offered to residents. NPM, therefore, was able to influence the reform of Italian healthcare but, as suggested by a postmodernist interpretation, left managers with a rhetoric change based on inconsistent assumptions instead of actionable ideas to manage the change process.