Latitude or Latent Control? How Occupational Embeddedness and Control Shape Emergent Coordination

We examine how different occupational communities that are embedded in organizations exercise control processes to achieve emergent coordination as they create complex products together. We compare two types of organizations, equipment manufacturing and film production, and find that although occupational control was important for emergent coordination in both settings, this relationship varied according to two aspects of occupational embeddedness: organizational acknowledgment of occupational control and occupational interdependence. In the equipment manufacturing setting, occupational control was latent: the communities visibly conformed to organizational control processes while exercising occupational control behind the scenes to coordinate emergently. In the film setting, the organization granted the occupational community significant latitude over its tasks, which enabled members to coordinate emergently to solve problems the majority of the time. We propose that these two aspects of occupational embeddedness must be analyzed together with occupational control processes to explain how integration unfolds in knowledge-based settings in ways that organizational control processes are ill-equipped to manage

Multidisciplinary teams, and parents, negotiating common ground in shared-care of children with long-term conditions: A mixed methods study

Background: Limited negotiation around care decisions is believed to undermine collaborative working between parents of children with long-term conditions and professionals, but there is little evidence of how they actually negotiate their respective roles. Using chronic kidney disease as an exemplar this paper reports on a multi-method study of social interaction between multidisciplinary teams and parents as they shared clinical care. Methods. Phases 1 and 2: a telephone survey mapping multidisciplinary teams' parent-educative activities, and qualitative interviews with 112 professionals (Clinical-psychologists, Dietitians, Doctors, Nurses, Play-specialists, Pharmacists, Therapists and Social-workers) exploring their accounts of parent-teaching in the 12 British children's kidney units. Phase 3: six ethnographic case studies in two units involving observations of professional/parent interactions during shared-care, and individual interviews. We used an analytical framework based on concepts drawn from Communities of Practice and Activity Theory. Results: Professionals spoke of the challenge of explaining to each other how they are aware of parents' understanding of clinical knowledge, and described three patterns of parent-educative activity that were common across MDTs: Engaging parents in shared practice; Knowledge exchange and role negotiation, and Promoting common ground. Over time, professionals had developed a shared repertoire of tools to support their negotiations with parents that helped them accomplish common ground during the practice of shared-care. We observed mutual engagement between professionals and parents where a common understanding of the joint enterprise of clinical caring was negotiated. Conclusions: For professionals, making implicit knowledge explicit is important as it can provide them with a language through which to articulate more clearly to each other what is the basis of their intuition-based hunches about parents' support needs, and may help them to negotiate with parents and accelerate parents' learning about shared caring. Our methodology and results are potentially transferrable to shared management of other conditions. © 2013 Swallow et al.; licensee BioMed Central Ltd

Districts, multinationals and global/digital networks

This paper reflects on what remains of Becattini’s utopia in the new context of a globalized and digital economy. Can one still foresee a global world populated with local societies able to produce value by following their own inspirations and chorally participating in a world-wide division of cognitive labor? It is suggested that the interpretive value of Becattini’s theorizing remains, to the extent that one moves away from the consideration of the classical district model, and adopts his more general way of thinking about the economy, which is only exemplified by the historical circumstance of industrial districts. His view may well apply to a variety of circumstances, not only to industrial districts and it is flexible enough to encompass economic change under different environmental conditions

More than a method? Organisational ethnography as a way of imagining the social

© 2016 Informa UK Limited, trading as Taylor & Francis Group. The authors–two anthropologists and an organisational theorist, all organisational ethnographers–discuss their understanding and practices of organisational ethnography (OE) as a way of imagining and reflect on how similar this understanding may be for young organisational researchers and students in particular. The discussion leads to the conclusion that OE may be regarded as a methodology but that it has a much greater potential when it is reclaiming its roots: to become a mode of doing social science on the meso-level. The discussion is based on an analysis of both historical material and the contemporary learning experiences of teaching OE as more than a method to our students

Towards successful coordination of electronic health record based-referrals: a qualitative analysis

<p>Abstract</p> <p>Background</p> <p>Successful subspecialty referrals require considerable coordination and interactive communication among the primary care provider (PCP), the subspecialist, and the patient, which may be challenging in the outpatient setting. Even when referrals are facilitated by electronic health records (EHRs) (<it>i.e</it>., e-referrals), lapses in patient follow-up might occur. Although compelling reasons exist why referral coordination <it>should </it>be improved, little is known about which elements of the complex referral coordination process should be targeted for improvement. Using Okhuysen & Bechky's coordination framework, this paper aims to understand the barriers, facilitators, and suggestions for improving communication and coordination of EHR-based referrals in an integrated healthcare system.</p> <p>Methods</p> <p>We conducted a qualitative study to understand coordination breakdowns related to e-referrals in an integrated healthcare system and examined work-system factors that affect the timely receipt of subspecialty care. We conducted interviews with seven subject matter experts and six focus groups with a total of 30 PCPs and subspecialists at two tertiary care Department of Veterans Affairs (VA) medical centers. Using techniques from grounded theory and content analysis, we identified organizational themes that affected the referral process.</p> <p>Results</p> <p>Four themes emerged: lack of an institutional referral policy, lack of standardization in certain referral procedures, ambiguity in roles and responsibilities, and inadequate resources to adapt and respond to referral requests effectively. Marked differences in PCPs' and subspecialists' communication styles and individual mental models of the referral processes likely precluded the development of a <it>shared </it>mental model to facilitate coordination and successful referral completion. Notably, very few barriers related to the EHR were reported.</p> <p>Conclusions</p> <p>Despite facilitating information transfer between PCPs and subspecialists, e-referrals remain prone to coordination breakdowns. Clear referral policies, well-defined roles and responsibilities for key personnel, standardized procedures and communication protocols, and adequate human resources must be in place before implementing an EHR to facilitate referrals.</p

Swimming in a Sea of Shame: Incorporating Emotions into Explanations of Institutional Reproduction and Change

We theorize the role in institutional processes of what we call the shame nexus, a set of shame-related constructs: felt shame, systemic shame, sense of shame, and episodic shaming. As a discrete emotion, felt shame signals to a person that a social bond is at risk and catalyzes a fundamental motivation to preserve valued bonds. We conceptualize systemic shame as a form of disciplinary power, animated by persons’ sense of shame, a mechanism of ongoing intersubjective surveillance and self-regulation. We theorize how the duo of the sense of shame and systemic shame drives the self-regulation that underpins persons’ conformity to institutional prescriptions and institutional reproduction. We conceptualize episodic shaming as a form of juridical power used by institutional guardians to elicit renewed conformity and reassert institutional prescriptions. We also explain how episodic shaming may have unintended effects, including institutional disruption and recreation, when it triggers sensemaking among targets and observers that can lead to the reassessment of the appropriateness of institutional prescriptions or the value of social bonds. We link the shame nexus to three broad categories of institutional work

Knowledge Exchange Processes in Multicultural Teams: Linking Organizational Diversity Climates to Teams’ Effectiveness

We developed an evidence-based model illuminating team knowledge exchange processes as a key link between organizational diversity climate and the effectiveness of multicultural teams (MCTs). Our analysis is based on 143 in-depth interviews and extensive observations of team interactions that occurred in 48 teams from 11 companies. Our findings revealed that teams that oscillated between assertive and cooperative knowledge exchange processes were more effective. We also found such dual processes were more prevalent in organizations that had an engagement-focused diversity climate characterized by utilization of diversity to inform and enhance work processes based on the assumption that cultural differences give rise to different knowledge, insights, and alternative views. Based on our findings we developed specific propositions about optimizing MCT knowledge-exchange processes to guide future research and practice

Interstitial Spaces: Microinteraction Settings and the Genesis of New Practices Between Institutional Fields

I develop a model linking specific microinteraction dynamics between members of different institutional fields and the genesis of new practices. The model centers on the concept of interstitial spaces—that is, small-scale settings where individuals from different fields interact occasionally and informally around common activities to which they devote limited time (e.g., hobbyist clubs, hangouts, workshops, meet-ups). I argue that the features of interstitial spaces (e.g., their institutional diversity and their occasional and informal nature) facilitate the individuals interacting in these settings to temporarily break free from existing institutions and experiment collectively with new activities and ideas. However, these very same features hinder the constitution of such new activities and ideas into new practices. I identify two microlevel conditions that enable the new activities and ideas developed in interstitial spaces to be constituted into new practices: the emergence of successful interaction rituals, and the presence of catalysts sustaining others' interactions and assisting the construction of shared meanings