How managers learn when their organisations go through change

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.A review of the learning literature reveals the current lack of a viable theory of how people learn when they encounter change in the workplace. This thesis presents a new model of learning that describes how people learn in response to changes in their environment. The research tracked the learning of twenty-one managers and staff from two organisations implementing change programmes. Participants recorded their learning in monthly diaries whilst interviews were conducted at the beginning and end of the year. Learning as an outcome was defined as any change in behaviour, cognition or emotional orientation towards a cue. Learning outcomes for each participant were identified and the learning process was then tracked through the interviews and monthly diaries. The research identifies four core learning processes that appear in all instances of learning: paying attention, responding emotionally, making sense of 'cues' and taking action. Learning is said to have taken place when these four processes are engaged in such a way as to lead to emotional, behavioural or cognitive change. We then ask the question - what motivates people to engage these processes in ways that lead to learning and change? We noted that learning is both driven and inhibited by four important needs - the desire to achieve important goals, achieve psychological well-being, fulfil personal values and establish self-esteem. Finally, we identify five different learning states, showing how the underlying dynamic driving these processes differs according to the degree of control exercised over the learning process. The research goes on to describe the detailed dynamics that illustrate this theory. We conclude that learning, particularly in response to change, is a far more complex process than many current models suggest. We attempt to encapsulate this complexity in our own learning model and then suggest possible area for future research

Manager’s and citizen’s perspective of positive and negative risks for small probabilities

So far „risk‟ has been mostly defined as the expected value of a loss, mathematically PL, being P the probability of an adverse event and L the loss incurred as a consequence of the event. The so called risk matrix is based on this definition. Also for favorable events one usually refers to the expected gain PG, being G the gain incurred as a consequence of the positive event. These “measures” are generally violated in practice. The case of insurances (on the side of losses, negative risk) and the case of lotteries (on the side of gains, positive risk) are the most obvious. In these cases a single person is available to pay a higher price than that stated by the mathematical expected value, according to (more or less theoretically justified) measures. The higher the risk, the higher the unfair accepted price. The definition of risk as expected value is justified in a long term “manager‟s” perspective, in which it is conceivable to distribute the effects of an adverse event on a large number of subjects or a large number of recurrences. In other words, this definition is mostly justified on frequentist terms. Moreover, according to this definition, in two extreme situations (high-probability/low-consequence and low-probability/high-consequence), the estimated risk is low. This logic is against the principles of sustainability and continuous improvement, which should impose instead both a continuous search for lower probabilities of adverse events (higher and higher reliability) and a continuous search for lower impact of adverse events (in accordance with the fail-safe principle). In this work a different definition of risk is proposed, which stems from the idea of safeguard: (1Risk)=(1P)(1L). According to this definition, the risk levels can be considered low only when both the probability of the adverse event and the loss are small. Such perspective, in which the calculation of safeguard is privileged to the calculation of risk, would possibly avoid exposing the Society to catastrophic consequences, sometimes due to wrong or oversimplified use of probabilistic models. Therefore, it can be seen as the citizen‟s perspective to the definition of risk

An Integrative Review of the Literature on Technology Transformation in Healthcare

Healthcare transformation through technology is a core objective of health reform. It is important for decision makers to understand the likelihood that reform policies will in fact transform. This study evaluates evidence of technology transformation in healthcare through an integrative review of the healthcare and business literature, guided by the theory of punctuated equilibrium (TPE). TPE describes the process of transformation within organizations, markets, and groups. The theory explains transformation as a pattern of long periods of incremental change (equilibrium) punctuated by short periods of dramatic change (revolution). An underlying deep structure defines the environment of the organization, market, or group. Radical change in the deep structure of the environment is necessary for transformational change. This integrative review covered the period January 2004 through April 2012. The inclusion criteria required that the article or study address both the implementation of health information technology in the United States and describe one of the three components of TPE. Five hundred twenty articles focusing on transformational change were identified through structured database searches of MedLine/PubMed, Business Source Complete, Social Science Research Network, and others. The articles were reviewed, and coded using the three elements of TPE. A directed content analysis of the coded data produced 10 themes describing the three TPE elements: variations in the environment, market complexity, regulation, flawed risk and reward, theories of technology acceptance, barriers, ethical considerations, competition and sustainability, environmental elements of revolution, and internal elements of revolution. The results describe a healthcare market exhibiting strong equilibrium and substantial resistance to change from HIT. Minimal descriptions of the revolutionary element of TPE were evident. The deep structure of healthcare indicates that the historical provider and hospital-centered market prevails. Conditions that might encourage alteration of this deep structure were: empowering and engaging patients; updating care delivery models; and reducing market uncertainty. The revolutionary changes seen in other complex markets from banking to travel to manufacturing relied heavily on the power of the consumer to alter deep structure. Although the concept of patient centeredness was present in the literature there was little clarity regarding the patient as an agent of structural change. To our knowledge this is the first application of TPE to investigate technology transformation in healthcare. Others have demonstrated TPE as a viable model for explaining transformational change in other markets. The study is limited by the study timeframe and the absence of newer literature reflecting the impact of recent policy changes. Despite this limitation the findings suggest that TPE presents a potentially valuable framework to guide evaluation of the progress of policies that encourage transformation from technology. Some propose that altering the complex deep structure of healthcare may require a complete destruction of existing processes before new processes, innovations, and technologies can emerge. The Affordable Care Act (2010) and the meaningful use provisions of the HITECH Act (2009) are moving healthcare toward new patient centered models of care. Uncertainty around the future of reform policies from possible repeal or amendment likely contributes to resistance to transformational change. This may perpetuate the historical rational and incremental pattern of HIT advancement. Patients as consumers have the potential to influence change given the appropriate tools. The importance of consumers to the transformation process suggests that policies fostering technologies that integrate patients into new care delivery models are likely paramount to realizing technological transformation

The Dialectic Process of Firm Growth: An Empirical Study of Growth of HR service SMEs in Guangzhou City, the People’s Republic of China

How to best understand and facilitate growth of SMEs has been an important and long-standing subject for academics and management practitioners in China and abroad. This dissertation joins this effort, reporting an empirical study on the growth of HR service firms (SMEs) in Guangzhou City, China, which have been playing an increasingly important role in fast economic development of the country. The study aims to gain a better understanding on how and why these service firms were able to grow so as to identify ways to facilitate their growth. To achieve the objectives, this study first reviewed the theories of the growth of the firm, in particular, theory of Penrose (1959), from which research gaps were identified and research questions were raised. Next, using multiple-case (embedded) design, the researcher of the study carried out two phases of empirical research on growth of the HR service SMEs in Guangzhou City. Findings from the research were then thoroughly discussed in view of extant literature on firm growth and conclusions were drawn on the research questions as to how and why these firms in the city were able to grow. Based on the findings, it is concluded in this dissertation that HR service SMEs studied were in dialectical relation with their market (mainly their customers and competitors), with market constantly challenging these SMEs which in turn, continuously taking up and quite often overcoming these market challenges; it is this dialectical process of continuous forming and resolving conflicts between firm capabilities and market demands that led to spiral growth of these SMEs; thus, it could be said that causes of growth were the increase in market demands and the development of firm capabilities; 3 both forces interacted constantly in a dialectical manner to produce forces driving firm growth.EThOS - Electronic Theses Online ServiceGBUnited Kingdo