Susan Miller

Planned or Prioritized? Two Options in Managing the Implementation of Strategic Decisions*

This paper presents findings from a study of 55 cases of decision implementation. The research identifies a number of features that characterize the way implementation is managed which appear to enhance the chance of success. Analysis reveals patterns in the data indicating that these features fall into two groupings, giving rise to two distinct approaches to implementation management. These are termed the Experience-based approach and the Readiness-based approach from the initial conditions which give rise to each. Although following either approach may enhance decision performance, the greatest success is associated with a dual approach. Implementations that follow neither are generally less successful. A theory of implementation management is postulated, comprising a Planned Option and a Prioritized Option. Copyright Blackwell Publishing Ltd 2003.

The Contribution of Clinical Directors to the Strategic Capability of the Organization

This paper attempts to define the role of the clinical director (CD) with reference to the strategic contribution they can make to health service organizations. Drawing on reflections and evidence gained from developing, running and evaluating a three-year, regionally based, management development programme for CDs, three ways of potentially enhancing strategic capability are identified. These are to do with promoting knowledge connectivity, challenging the dominant managerial logic and acting as a link-pin in inter- and intra-organizational learning networks. Ways in which planned managerial learning and development can help promote this capability are explored.

Divergent Identities? Professions, Management and Gender

This article critically examines issues of gender in relation to the ‘professionalization’ of management, with particular reference to the National Health Service (NHS). It focuses on the Master of Business Administration (MBA) qualification and the role this plays in professional development of managers and clinicians. One MBA course, which has included a number of participants from the NHS and has attempted to include some recognition of gender issues, is used for illustrative purposes. The article raises important concerns about the implications of gender for NHS and other public sector professionals, and draws some conclusions about the ways in which management education might incorporate gender into the curriculum.

How Organizations Can Overbalance Decision Overreach as a Reason for Failure

A special case of the big bad decision is identified. It is called decision overreach. Two separate elements constitute overreach, namely, disproportionality and irreversibility. Four conditions seem to dispose managers to take decisions that are disproportionate and irreversible. These are small size of firm, relatively short duration of decision process, a lack of foresight, and overfamiliarity with products and markets. The data are drawn from U.K. manufacturing organizations.

Doctors in Management – Part II: Getting into Action

The second part of a two‐part article, the first part of which described the clinical directors′ management devel‐opment programme designed and run during 1991‐93 by the Northern Health Authority and Durham University Business School. Focuses on the second, action learning, period of the course. Describes the action learning model used in the programme, includes a member′s description of his set′s experiences, and draws conclusions about the programme′s reception and achievements.

Doctors in Management: Two into One Won’t Go – Or Will It? Part I

Describes a three‐year collaborative initiative between Northern Regional Health Authority and Durham University Business School which seeks to help 24 clinical directors, already heavily burdened with professional responsibilities, to assume quickly and perform effectively in new strategic management roles. The programme, one of half‐a‐dozen such joint projects across the UK, all different in design, won substantial funding from the NHS Management Executive and is being nationally evaluated by Middlesex Business School.

Getting into the Act: Who Decides about Corporate Strategy

Discusses the nature of strategic decision making in organizations. Explores the process of implementation and poses questions about how to evaluate decision success. Discusses links between decisions and corporate strategies and emphasizes the importance for organizational members of being party to the more covert political activity in organizations. “Who decides corporate strategy?” – concludes that women may be excluded from this most critical of activities, by being placed too low in the hierarchy to sanction strategic decisions, and by not making use of the more subtle ways of influencing strategy.