A Visual Turn for Organizational Research: Embodying the Real Subject in Video-Based Ethnography

For organizational ethnography we argue that traditional philosophies of onto-epistemological realism be supplanted by interpretive and reflexive thinking to provide fresh theoretical assumptions and new methodological proposals for film- and video-based research. The argument is developed in three phases: First, to establish analytical context, we explore the historical evolution of the ethnographic organizational documentary and discuss habitual problems – methodological, philosophical and technical – filmmakers have faced when claiming qualities of directness and objectivity in their work; that is, through the style of ‘film-truth’. Second, to advance new conceptual logic for video-based organizational research, we supplant the objectivist and realist philosophy underpinning traditional documentary filmmaking with sociologically interpretive and reflexive arguments for undertaking ethnography in organizations, a subjective process which importantly yields greater understanding of affect and embodiment. Finally, to define new methodological opportunities, these interpretive and reflexive arguments are marshalled to underpin a strategy of participatory thinking in video-based organizational ethnography – a ‘withness’ approach facilitating a greater sense of affect and embodiment as well as polyvocal interpretation of visual data; a practice which sees filmmakers, social theorists, participants, and viewers alike united in analytical space

"You can't do both- something will give" : limitations of the targets culture in managing UK healthcare workforces

Based on a three-year ethnographic study of four UK National Health Service (NHS) organizations, we explore the everyday cultural experience of managing clinical and administrative workforces. Although NHS organizations claim to function as enlightened HRM employers, we argue that the inflexible application of metrics-based target systems to clinical and administrative tasks, including HRM operations, can result in dysfunctional outcomes for patient care and workforce morale. Reminiscent of the recent Mid Staffordshire health care scandal, the priorities attached to NHS personnel meeting the demands of performance management systems can prove incompatible with them also meeting the fundamental “human” needs of patients. The everyday experience of health care organization becomes one of employees reconciling competing logics of business efficiency and integrity of care. Trapped metaphorically between shrinking resources and expanding targets, the inclination—on the frontline and at mid-management level—is to extend the integrity of care, although this is sometimes impossible and can prove problematic in terms of system accountability. In response to such organizational tensions the behavior of many frontline and mid-management staffs ultimately reflects a form of “street-level bureaucracy”—a situation in which traditional professional norms are reasserted informally in ways that often transgress prescribed performance systems

The cost of work-related stress to society: a systematic review

Objective. A global and systematic review of the available evidence examining the cost of work-related stress would yield important insights into the magnitude and nature of this social phenomenon. The objective of this systematic review was to collate, extract, review, and synthesize economic evaluations of the cost of work-related stress to society. Method. A research protocol was developed outlining the search strategy. Included cost-of-illness (COI) studies estimated the cost of work-related stress at a societal level, and were published in English, French or German. Searches were carried out in ingenta connect, EBSCO, JSTOR, Science Direct, Web of Knowledge, Google and Google scholar. Included studies were assessed against ten COI quality assessment criteria. Results. Fifteen COI studies met the inclusion criteria and were reviewed. These originated from Australia, Canada, Denmark, France, Sweden, Switzerland, the United Kingdom, the United States, and the EU-15. At a national and pan-European level, the total estimated cost of work-related stress in 2014 was observed to be considerable and ranged substantially from US $221.13 million to$187 billion. Productivity related losses were observed to proportionally contribute the majority of the total cost of work-related stress (between 70 to 90%), with healthcare and medical costs constituting the remaining 10% to 30%. Conclusion. The evidence reviewed here suggests a sizeable financial burden imposed by work-related stress on society. The observed range of cost estimates across studies was understood to be attributable to variations in definitions of work-related stress; the number and type of costs estimated; and, in how production loss was estimated. It is postulated that the cost estimates identified by this review are likely conservative due to narrow definitions of work - related stress (WRS) and the exclusion of diverse range of cost components

Noise induced oscillations in non-equilibrium steady state systems

We consider effect of stochastic sources upon self-organization process being initiated with creation of the limit cycle. General expressions obtained are applied to the stochastic Lorenz system to show that departure from equilibrium steady state can destroy the limit cycle at certain relation between characteristic scales of temporal variation of principle variables. Noise induced resonance related to the limit cycle is found to appear if the fastest variations displays a principle variable, which is coupled with two different degrees of freedom or more.Comment: 11 pages, 4 figures. Submitted to Physica Script

Being a manager, becoming a professional? A case study and interview-based exploration of the use of management knowledge across communities of practice in health-care organisations

Background: Understanding how managers in the NHS access and use management knowledge to help improve organisational processes and promote better service delivery is of pressing importance in health-care research. While past research has examined in some depth how managers in the NHS perform their roles, we have only limited understanding of how they access management knowledge, interpret it and adapt and apply it to their own health-care settings. Objectives: This study aims to investigate how NHS middle managers encounter, adapt and apply management knowledge in their working practices and to examine the factors [particularly organisational context, career background and networks of practice (NoPs)/communities of practice (CoPs)] which may facilitate or impede the acceptance of new management knowledge and its integration with practice in health-care settings. Our research was structured around three questions: (1) How do occupational background and careers influence knowledge receptivity, knowledge sharing and learning among health-care managers? (2) How do relevant CoPs enable/obstruct knowledge sharing and learning? (3) What mechanisms are effective in supporting knowledge receptivity, knowledge sharing and learning/unlearning within and across such communities? Design and setting: Three types of NHS trust were selected to provide variation in organisational context and the diversity of services provided: acute, care and specialist foundation trusts (FTs). It was expected that this variation would affect the knowledge requirements faced by managers and the networks likely to be available to them. To capture variation amongst managerial groups in each trust, a selection framework was developed that differentiated between three main cohorts of managers: clinical, general and functional. Participants: After initial interviews with selected key informants and Advisory Group members, the main empirical phase consisted of semistructured interviews combined with ethnographic observation methods. A purposive, non-random sample of managers (68 in total) was generated for interview, drawn from across the three trusts and representing the three cohorts of managers. Interviews were semistructured and data was collated and analysed using NVivo 9 software (QSR International, Warrington, UK). Main outcome measures: The analysis was structured around four thematic areas: context (institutional and trust), management (including leadership), knowledge and networks. The research underlines the challenges of overcoming fragmentation across a diffuse managerial CoP in health care, exacerbated by the effects of organisational complexity and differentiation. The research highlights the importance of specific training and development initiatives, and also the value of NoPs for knowledge sharing and support of managers. Results: The main findings of the research stress the heterogeneity of management and the highly diverse sources of knowledge, learning, experience and networks drawn upon by distinct management groups (clinical, general and functional); the particular challenges facing general managers in establishing a distinct professional identity based around a coherent managerial knowledge base; the strong tendency for managerial knowledge – particularly that harnessed by general managers – to be more ‘home grown’ (localised) and experiential (as opposed to abstract and codified); and the tendency for this to be reinforced through the difficulties facing general managers in accessing and being actively engaged in wider networks of professionals for knowledge sharing, learning and support. Conclusions: Management in health care is a complex and variegated activity that does not map onto a clear, unitary and distinct CoP. Improving flows of knowledge and learning among health-care managers involves taking account not just of the distinctiveness of managerial groups, but also of a number of other features. These include the complex relationship between management and leadership, alternative ways of bridging the clinical–managerial interface, the importance of opportunities for managers to learn through reflection and not mainly through experience and the need to support managers – especially general managers – in developing their networks for knowledge sharing and support. Building on the model developed in this research to select managerial cohorts, future work might usefully extend the research to other types of trust and health-care organisation and to larger samples of health-care managers, which can be further stratified according to their distinct occupational groups and CoPs. There is also scope for further ethnographic research that broadens and deepens the investigation of management using a range of observation methods. Funding: The National Institute for Health Research Health Service and Delivery Research programme

The Body Dances: Carnival Dance and Organization

Building on the work of Pierre Bourdieu and Maurice Merleau-Ponty we seek to open up traditional categories of thought surrounding the relation `body-organization' and elicit a thought experiment: What happens if we move the body from the periphery to the centre? We pass the interlocking theoretical concepts of object-body/subject-body and habitus through the theoretically constructed empirical case of `carnival dance' in order to re-evaluate such key organizational concepts as knowledge and learning. In doing so, we connect with an emerging body of literature on `sensible knowledge'; knowledge that is produced and preserved within bodily practices. The investigation of habitual appropriation in carnival dance also allows us to make links between repetition and experimentation, and reflect on the mechanism through which the principles of social organization, whilst internalized and experienced as natural, are embodied so that humans are capable of spontaneously generating an infinite array of appropriate actions. This perspective on social and organizational life, where change and permanence are intricately interwoven, contrasts sharply with the dominant view in organization studies which juxtaposes change/ creativity and stability

Identification of surgeon burnout via a single-item measure

Background Burnout is endemic in surgeons in the UK and linked with poor patient safety and quality of care, mental health problems, and workforce sustainability. Mechanisms are required to facilitate the efficient identification of burnout in this population. Multi-item measures of burnout may be unsuitable for this purpose owing to assessment burden, expertise required for analysis, and cost. Aims To determine whether surgeons in the UK reporting burnout on the 22-item Maslach Burnout Inventory (MBI) can be reliably identified by a single-item measure of burnout. Methods Consultant (n = 333) and trainee (n = 217) surgeons completed the MBI and a single-item measure of burnout. We applied tests of discriminatory power to assess whether a report of high burnout on the single-item measure correctly classified MBI cases and non-cases. Results The single-item measure demonstrated high discriminatory power on the emotional exhaustion burnout domain: the area under the curve was excellent for consultants and trainees (0.86 and 0.80), indicating high sensitivity and specificity. On the depersonalisation domain, discrimination was acceptable for consultants (0.76) and poor for trainees (0.69). In contrast, discrimination was acceptable for trainees (0.71) and poor for consultants (0.62) on the personal accomplishment domain. Conclusions A single-item measure of burnout is suitable for the efficient assessment of emotional exhaustion in consultant and trainee surgeons in the UK. Administered regularly, such a measure would facilitate the early identification of at-risk surgeons and swift intervention, as well as the monitoring of group-level temporal trends to inform resource allocation to coincide with peak periods

Three-dimensional coherent X-ray diffraction imaging of a ceramic nanofoam: determination of structural deformation mechanisms

Ultra-low density polymers, metals, and ceramic nanofoams are valued for their high strength-to-weight ratio, high surface area and insulating properties ascribed to their structural geometry. We obtain the labrynthine internal structure of a tantalum oxide nanofoam by X-ray diffractive imaging. Finite element analysis from the structure reveals mechanical properties consistent with bulk samples and with a diffusion limited cluster aggregation model, while excess mass on the nodes discounts the dangling fragments hypothesis of percolation theory.Comment: 8 pages, 5 figures, 30 reference

Comparison of gene targets and sampling regimes for SARS-CoV-2 quantification for wastewater epidemiology in UK prisons

Prisons are high-risk settings for infectious disease transmission, due to their enclosed and semi-enclosed environments. The proximity between prisoners and staff, and the diversity of prisons reduces the effectiveness of non-pharmaceutical interventions, such as social distancing. Therefore, alternative health monitoring methods, such as wastewater-based epidemiology (WBE), are needed to track pathogens, including SARS-CoV-2. This pilot study assessed WBE to quantify SARS-CoV-2 prevalence in prison wastewater to determine its utility within a health protection system for residents. The study analysed 266 samples from six prisons in England over a 12-week period for nucleoprotein 1 (N1 gene) and envelope protein (E gene) using quantitative reverse transcriptase-polymerase chain reaction. Both gene assays successfully detected SARS-CoV-2 fragments in wastewater samples, with both genes significantly correlating with COVID-19 case numbers across the prisons (p < 0.01). However, in 25% of the SARS-positive samples, only one gene target was detected, suggesting that both genes be used to reduce false-negative results. No significant differences were observed between 14- and 2-h composite samples, although 2-h samples showed greater signal variance. Population normalisation did not improve correlations between the N1 and E genes and COVID-19 case data. Overall, WBE shows considerable promise for health protection in prison settings