Digital health and citizen engagement : changing the face of health service delivery

We highlight two contemporary trends that would benefit from more focused research as they have the capacity to significantly reshape health system delivery in the coming decade. The first is digital health and big data science. The second potential landslide is the growing phenomenon of patient and citizen engagement. This paper outlines the key features and rationale for how digital health and increased engagement can reshape health services, pointing to key areas that warrant careful research by healthcare management scholars. We further point to the relationship and overlap of these two areas and suggest that examining the synergy between these two related trends is a third area of priority in health research

Place and Organizing for Emerging Technologies:Challenges of Scaling 3DPrinting Across a UK Hospital

This paper examines how the role of place shapes the way emerging technologies scale across hospital organizations. Through a five-year ethnographic field study on organizing 3D printing across a major UK National Health Service (NHS) hospital, we extend theory on how places influence the attempted scaling of this emerging technology. Informed by a practice lens and a process research approach, we develop a model that theorizes the constitutive role of place in terms of its resources, materiality and location meaning, which taken together, explain how and why the scaling of 3D printing failed in three different situated places remained rather limited. Moreover, we unpack the idea of place dynamics, which entail processes of place bending, place extending and place framing to theorize the role of place in scaling an emerging technology. We conclude by discussing the implications for the organizing of emerging technologies and highlight the ways in which place is integral to shaping the process of scaling

Developing collaborative professionalism : an investigation of status differentiation in academic organizations in knowledge transfer partnerships

In recent years there has been a significant growth in knowledge transfer partnerships to improve the quality and timeliness of healthcare. These activities require an increasing level of interdependence between academic and healthcare professionals, with important implications for human resource management. To understand these knowledge transfer partnerships, we conducted an in-depth longitudinal study based on 99 interviews and 5 focus-group workshops across academic and healthcare professionals in nine university-based knowledge transfer partnerships in England. We explore how academic professionals of lower and higher status organizations develop a new form of professional work, based on the principles of collaborative professionalism, during their involvement in partnerships with healthcare professionals. We illuminate how the interdependent work between academic professionals and healthcare professionals in the development of a new academic specialization is shaped by the status of their organization

Creating Value in Online Communities: The Sociomaterial Configuring of Strategy, Platform, and Stakeholder Engagement

How is value created in an online community (OC) over time? We explored this question through a longitudinal field study of an OC in the healthcare arena. We found that multiple kinds of value were produced and changed over time as different participants engaged with the OC and its evolving technology in various ways. To explain our findings, we theorize OC value as performed through the ongoing sociomaterial configuring of strategies, digital platforms, and stakeholder engagement. We develop a process perspective to explain these dynamics and identify multiple different kinds of value being created by an OC over time: financial, epistemic, ethical, service, reputational, and platform. Our research points to the importance of expanding the notion of OC users to encompass a broader understanding of stakeholders. It further suggests that creating OC value increasingly requires going beyond a dyadic relationship between the OC and the firm to encompassing a more complex relationship involving a wider ecosystem of stakeholders

Leadership of healthcare commissioning networks in England : a mixed-methods study on clinical commissioning groups

Objective: To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation. Design: Mixed-method, multisite and case study research. Setting: Six clinical commissioning groups and local clusters in the East of England area, covering in total 208 GPs and 1 662 000 population. Methods: Semistructured interviews with 56 lead GPs, practice managers and staff from the local health authorities (primary care trusts, PCT) as well as various healthcare professionals; 21 observations of clinical commissioning group (CCG) board and executive meetings; electronic survey of 58 CCG board members (these included GPs, practice managers, PCT employees, nurses and patient representatives) and subsequent social network analysis. Main outcome measures: Collaborative relationships between CCG board members and stakeholders from their healthcare network; clarifying the role of GPs as network leaders; strengths and areas for development of CCGs. Results: Drawing upon innovation network theory provides unique insights of the CCG leaders’ activities in establishing best practices and introducing new clinical pathways. In this context we identified three network leadership roles: managing knowledge flows, managing network coherence and managing network stability. Knowledge sharing and effective collaboration among GPs enable network stability and the alignment of CCG objectives with those of the wider health system (network coherence). Even though activities varied between commissioning groups, collaborative initiatives were common. However, there was significant variation among CCGs around the level of engagement with providers, patients and local authorities. Locality (sub) groups played an important role because they linked commissioning decisions with patient needs and brought the leaders closer to frontline stakeholders. Conclusions: With the new commissioning arrangements, the leaders should seek to move away from dyadic and transactional relationships to a network structure, thereby emphasising on the emerging relational focus of their roles. Managing knowledge mobility, healthcare network coherence and network stability are the three clinical leadership processes that CCG leaders need to consider in coordinating their network and facilitating the development of good clinical commissioning decisions, best practices and innovative services. To successfully manage these processes, CCG leaders need to leverage the relational capabilities of their network as well as their clinical expertise to establish appropriate collaborations that may improve the healthcare services in England. Lack of local GP engagement adds uncertainty to the system and increases the risk of commissioning decisions being irrelevant and inefficient from patient and provider perspectives

Policy translation through localisation : implementing national policy in the UK

This paper builds on policy implementation studies, which seek to explain how policies undergo some form of ‘translation’ from general policy guidelines to implementation in practice at the local level. The paper makes two contributions to the policy implementation literature. First, it draws on the concept of ‘local universality’ to suggest that the translation of policy by central actors is not simply transmitted but is iteratively transformed through multiple distributed agencies including local actors, infrastructure, data sets and organisational practices. Second, empirical findings show how structural policy design features influence implementation and (re)shape policy content by incorporating knowledge from practice

Finding your sea-legs : exploring newcomer embodied learning in an extreme context

Embodied learning involves developing not only socio-technical know-how but also the bodily capacity to execute practices competently. In extreme contexts, newcomers encounter threatening experiences that may incapacitate their ability to participate. How newcomers develop the bodily capacity to participate in such situations is a research area that requires further attention. Using ethnographic data from a study of novices working in the risky context of seafaring, we show that newcomers encounter threat experiences (imagined, immediate, and attenuated) that trigger them to engage in three types of body work: priming, battling, and enduring, from which they develop the capacity to participate. Our analysis suggests a model of newcomer embodied learning in practices in an extreme context and contributes to embodied learning literature by showing: (1) body work directed at capacity to participate, (2) the mutually constitutive relationship between body work and threat experiences, and (3) the temporal complexity of embodied learning anchored in the body work and threat experiences

Navigating turbulent waters : crafting learning trajectories in a changing work context

How do newcomers gain access to learning opportunities when they are denied opportunities to practice? Changes in the nature of work, such as labour outsourcing and technological advancements, have created challenges for newcomers to learn. They may be more easily relegated to low-level repetitive tasks, such as scutwork. In these situations, newcomers’ ambiguous position as learners can limit access to participation in practices needed to progress their learning trajectories. Using field-study data, we explore the situated learning of merchant-navy cadets. We show that, when newcomers are not permitted access to participation, the structural arrangements of practice – temporal structures, spatial territories and hierarchical arrangements – hinder learning opportunities. We show, further, that some newcomers leverage these same structural arrangements surreptitiously as resources to access participation, which we conceptualise as stealth work. Consequently, we unveil the soft forms of power at play in crafting access to learning trajectories, making three contributions. First, we show how structural arrangements of a practice can be leveraged to enable learning. Second, we show that gaining access stealthily, requires both normative and counter-normative performances. Third, we show the importance of access in crafting learning trajectories and unpack how such access is navigated by newcomers