Behavioural operations in healthcare : knowledge sharing perspective

Purpose The purpose of this paper is to provide arguments and empirical evidence that different knowledge sharing behaviours – i.e. sharing best practices, sharing mistakes, seeking feedbacks – are promoted and enabled by different types of knowledge assets, and differently affect employees’ innovative work behaviours. Design/methodology/approach The research framework includes four sets of constructs: employees’ innovative work behaviour, knowledge sharing, knowledge assets, psychological safety. The literature-grounded hypotheses were tested collecting data from healthcare professionals from three hospice and palliative care organisations in Italy. In all, 195 questionnaires were analysed using structural equations modelling technique. Findings First, findings show that the linkage between knowledge assets and knowledge sharing is both direct and indirect with psychological safety as relevant mediating construct. The linkage between relational and structural social capital and seeking feedbacks and sharing mistakes is fully mediated by psychological safety. Second, findings show that each dimension of knowledge sharing affects the different dimensions of employees’ innovative work behaviour – i.e. idea generation, idea promotion, idea implementation – in a distinct manner. While sharing of best practices influences all of them, seeking feedbacks affects idea promotion and sharing mistakes influences idea implementation. Practical implications The results provide operations managers with a clearer picture of how to pursue improvements of current operations by leveraging on knowledge sharing among employees through the creation of numerous, high-quality interpersonal relationships among employees, based on rich and cohesive network ties. Originality/value This study, by adopting a micro-level perspective, offers an original perspective on how knowledge assets and knowledge sharing initiatives may contribute to the engagement of innovative work behaviour by employees

The role of managers in enacting two-step institutional work for radical innovation in professional organizations.

Radical innovation in professional settings faces an institutional challenge. Professionals enjoy autonomy predicated on jurisdictional knowledge and can resist radical innovation if their interests are threatened. Our study examines if and how managers mediate professional resistance and ensure that radical innovation can take hold. A comparative case study of 12 Italian hospitals introducing integrated service configurations shows that managers may hold back from introducing radical innovation where they judge professional resistance as insurmountable. Executives reinforce, rather than challenge, the status quo, and discourage middle managers from further actions. Where the professional context is more receptive because of micro-institutional affordances, then, managers enact different tactics. Managers may centralize decision-making through political work, which however increases professional resistance and hinder radical innovation. Managers may adopt project management approaches, which facilitate local experiments, but struggle to scale-up the radical innovation. Most successful cases are characterized by executive and middle managers enacting a two-step institutional work, which reconfigures the regulative, normative and cognitive foundations of professional boundaries and practice. The comparative study shows how managers can support radical innovation in collaboration with professionals. In the two-step institutional work, executive and middle managers develop stable alliances with local professional groups to provide cognitive/normative foundations of radical innovation; second, they allow professionals to inhabit nascent institutional arrangements to make sense of how these fit with their prevailing interests, norms, and beliefs; third, they co-develop new structures/rules that encourage professionals to pursue radical innovation; finally, they perform maintenance work to preserve professionals’ attachment to new institutions

Empirical insights on the nature of synergies among HRM policies - an analysis of an ethics-oriented HRM system

In the last years, several HRM scholars have theoretically support the idea that the policies bundled in an HRM system present synergistic effects. Surprisingly, empirical studies about those synergistic effects are scarce, and their results unstable. As a result, some critical voices in the HR field are questioning the idea of synergies among HR policies, and calling for more research which does not take them for granted. Addressing this gap, this study tests the existence and nature of synergies in HRM systems targeted at improving the employees' perception of benevolent and principled ethical climates. Results from a probabilistic sample of 6000 employees from 6 European countries highlight that synergies occur both for benevolent and principled ethical climates, even if the specific components of the HRM system presenting synergistic effects are different in the two cases. Implications of the findings for HRM practice are presented and discussed

How are professionals recruited by external agents in misconduct projects? The infiltration of organized crime in a university

Private firms, crime organizations or states may successfully recruit professionals in misconduct projects. How they do so remains however under investigated. Past studies mostly take professionals’ perspective, or limit the organizational initiative of external agents to perverse incentives and threats. Our study shows instead how external agents may penetrate governance bodies and professional events to recruit and control professionals, who are both aware of and reluctant toward misconduct. Our longitudinal case study used judicial and non-judicial sources to analyse how a mafia clan infiltrated Troy University, and controlled the trade of exams and admissions for decades. The clan selected Troy University because of the presence of professors predisposed toward misconduct. The clan infiltrated the predisposed professors inside governance bodies and students inside academic events to recruit the reluctant professors with peer pressures, situated threats and administrative controls. It then exploited a generalized code of silence to control professionals for years. Overall, the study highlights the combination of perverse and pervasive mechanisms to recruit professionals; the role of corrupt professionals as lynchpin between external agents and reluctant peers; and the perverse exploitation of normal professional practices of autonomy, trusteeship and multiple embeddedness

Users’ search mechanisms and risks of inappropriateness in healthcare innovations : the role of literacy and trust in professional contexts

In the context of professional service organizations, user engagement with knowledge search might generate significant risks of inappropriateness to innovation processes. Previous research suggests that professionals would then keep users at arms' length, controlling the design and implementation of innovations internally. This study overcomes this view investigating how professional service organizations can enable users' knowledge search while controlling for the risks of inappropriateness. Combining a qualitative research on 5 innovation processes in healthcare organizations with quantitative research on 110 service users, our findings highlight that professional providers, such as senior clinicians, shaped their tactics according to the ‘threats’ of laggards, i.e. users searching knowledge outside of professional logics of appropriateness; more than to the opportunities of lead-user communities. Professional providers sought to “activate” users' engagement with knowledge search by investing on their literacy, i.e. showing the basics of the logic of appropriateness informing their decision; and on trust relationships, i.e. becoming transparent on the criteria of knowledge selection during the innovation processes

Nutritional value of a rice-hydrolysate formula in infants with cows' milk protein allergy: a randomized pilot study.

This study was designed to assess whether a rice-hydrolysate formula allows normal growth and adequate metabolic balance in infants with cows' milk protein allergy. Infants (seven females, nine males; aged 6–14 months) were randomly assigned to receive a rice-hydrolysate formula ( n = 8) or a soy formula (control group, n = 8). Standardized growth indices ( Z scores) and biochemical parameters were evaluated during a 6-month treatment period. Infants in both groups showed normal growth patterns during the study, and no adverse reactions were seen. Mean plasma biochemical parameters were within the normal ranges, and did not differ between groups. In conclusion, rice-hydrolysate formula may be a nutritionally suitable alternative for infants with cows' milk protein allergy. Larger studies, with satisfactory power, should be undertaken to confirm these findings

Implementation of eunethta core model (R) in lombardia: the VTS Framework

Objectives: This study describes the health technology assessment (HTA) framework introduced by Regione Lombardia to regulate the introduction of new technologies. The study outlines the process and dimensions adopted to prioritize, assess and appraise the requests of new technologies. Methods: The HTA framework incorporates and adapts elements from the EUnetHTA Core Model and the EVIDEM framework. It includes dimensions, topics, and issues provided by EUnetHTA Core Model to collect data and process the assessment. Decision making is instead supported by the criteria and Multi-Criteria Decision Analysis technique from the EVIDEM consortium. Results: The HTA framework moves along three process stages: (i) prioritization of requests, (ii) assessment of prioritized technology, (iii) appraisal of technology in support of decision making. Requests received by Regione Lombardia are first prioritized according to their relevance along eight dimensions (e.g., costs, efficiency and efficacy, organizational impact, safety). Evidence about the impacts of the prioritized technologies is then collected following the issues and topics provided by EUnetHTA Core Model. Finally, the Multi-Criteria Decision Analysis technique is used to appraise the novel technology and support Regione Lombardia decision making. Conclusions: The VTS (Valutazione delle Tecnologie Sanitarie) framework has been successfully implemented at the end of 2011. From its inception, twenty-six technologies have been processed