his.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Organising Healthcare with Multi-Professional Teams: Activity Coordination as a Logistical Flow
University of Skövde, School of Business. University of Skövde, Enterprises for the Future. (Medarbetarskap och Organisatorisk resiliens, Followership and Organizational Resilience (FORE))ORCID iD: 0000-0003-2476-4411
School of Business, Economics and Law, University of Gothenburg, Gothenburg, Sweden.
2016 (English)In: Offentlig Förvaltning. Scandinavian Journal of Public Administration, ISSN 2000-8058, E-ISSN 2001-3310, Vol. 20, no 4, 53-72 p.Article in journal (Refereed) Published
Abstract [en]

Multi-professional teams are now common when organising healthcare. Such teams areconsidered to resolve fragmentation issues amongst units and their functions, facilitateefficient and high quality care and are also deemed to enable different professions to meetand exchange experience and knowledge. The expected consequence is superior decisionsand improved care. However, research suggests that the deployment of multi-professionalteams within healthcare organisations is problematic with regard to knowledge sharingand integration between different professional groups. While often recognised, the reasonfor this shortcoming has rarely been explored in depth. This study consequently elaborateson the factors hindering knowledge sharing through illustrating and discussing thelogics of different professional groups and the ensuing consequences when multiprofessionalteams interact. The finding is that the teams are being utilised by the medicalprofessions in accordance with their professional logic. This results in the coordination ofactivities, incorporating the patient flow logistics amongst the different professions; makingthe impact of multi-professional teams concrete in practice and illustrating their potentialpositive outcomes for professionals and patients, even though they are not operatingas forums for overt knowledge integration for the different professions.

Place, publisher, year, edition, pages
Göteborgs universitet, 2016. Vol. 20, no 4, 53-72 p.
Keyword [en]
Multi-professional teams, Organising healthcare, Coordination of activities, Logistical flow, Professional logics
National Category
Business Administration
Research subject
Humanities and Social sciences
Identifiers
URN: urn:nbn:se:his:diva-12441OAI: oai:DiVA.org:his-12441DiVA: diva2:936413
Available from: 2016-06-13 Created: 2016-06-13 Last updated: 2017-04-12Bibliographically approved
In thesis
1. The Logics of Healthcare - In Quality Improvement Work
Open this publication in new window or tab >>The Logics of Healthcare - In Quality Improvement Work
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Quality improvement (QI) has become a cornerstone in contemporary healthcare organizations with the aim of enabling management that facilitates efficiency and effectiveness, while providing a consistent correlation between health spending and indicators of access to and quality of care. However, despite years of reform which have attempted to change healthcare professionals’ practice, traditional professional modes of working remain relatively stable and entrenched. Previous research has highlighted the fact that healthcare professionals’ active involvement in quality improvement work (QIW) is often lacking. Such a lack is often explained by professionals’ scepticism towards management, managers, and organizationally related improvement initiatives.  Yet, there is a shortage of studies which focus on analysis at the level of the actor when studying healthcare professionals’ involvement in QIW.

This dissertation presents a qualitative case study of the QIW undertaken by a multi-professional diabetes care team. It enables a description and analysis of healthcare professionals’ involvement in QIW at the actor level of analysis. A theoretical framework, consisting of the combination of institutional logics and institutional work, is applied in order to focus on varied and complementary aspects of institutional dynamics while simultaneously emphasizing the embeddedness of actors’ actions and interactions.

The study shows that healthcare professionals’ identification with and adherence to the professional logic in general impairs their involvement in QIW. Adherence entails perceiving professional judgments and discretion as legitimate in guiding practice and work. However, the study emphasizes that adherence to the professional logic varies amongst professionals representing different professions. This means that healthcare professionals’ acceptance of the bureaucratic control of work as legitimate differs - enabling diverse approaches and practices in QIW. Furthermore, the study illustrates that the physicians’ relative dominance hinders the utilization of multiple perspectives in the multi-professional team. This finding elucidates how dominance and hierarchization of logics enable healthcare professionals’ practice to remain relatively stable, despite managerial attempts to change and alter it. Finally, the study delineates the interactions needed in order to bridge institutional logics at the actor level of analysis. Such interactions are characterized by reciprocal acts of claiming and granting influence that constitute creative/disruptive institutional work, enabling actors to find new approaches to each other and further facilitate healthcare professionals’ involvement in QIW.

Place, publisher, year, edition, pages
Göteborgs universitet, 2017
Keyword
quality improvement, quality improvement work, healthcare organizations, healthcare professionals, institutional logics, institutional work
National Category
Business Administration
Research subject
Followership and Organizational Resilience
Identifiers
urn:nbn:se:his:diva-13418 (URN)978-91-628-9953-0 (ISBN)978-91-628-9954-7 (ISBN)
Note

Paper I Gadolin, C. & Andersson, T. Healthcare Quality Improvement Work: A Professional Employee Perspective, Accepted for publication in International Journal of Health Care Quality Assurance. Paper II Gadolin, C. Professional Employees’ Strategic Employment of the Managerial Logic in Healthcare, Conditionally accepted for publication in Qualitative Research in Organizations and Management: An International Journal. Paper III Gadolin, C. & Wikström, E. (2016) Organising Healthcare with Multi-professional Teams: Activity Coordination as a Logistical Flow, Scandinavian Journal of Public Administration, 20(4), pp. 53-72. Paper IV Andersson, T. & Gadolin, C. Institutional Work Through Interaction in Highly Institutionalized Settings: Quality Improvement Work in Healthcare, In review for Organization Studies.

Available from: 2017-04-12 Created: 2017-03-21 Last updated: 2017-06-05Bibliographically approved

Open Access in DiVA

Gadolin & Wikström (2016)(276 kB)82 downloads
File information
File name FULLTEXT01.pdfFile size 276 kBChecksum SHA-512
dbbe9b5bb333e35ba98b9eeeb4e5cf0e77fa3ede301c8b7b0e9c47b20e7c5b028b7abb249bdb1ed7d50d06000b4566fdc635ea9847eb69dc792d9f0fe5bbac82
Type fulltextMimetype application/pdf

Other links

Fulltext

Search in DiVA

By author/editor
Gadolin, Christian
By organisation
School of BusinessEnterprises for the Future
In the same journal
Offentlig Förvaltning. Scandinavian Journal of Public Administration
Business Administration

Search outside of DiVA

GoogleGoogle Scholar
Total: 82 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Total: 539 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf