Organizational Culture and Physician Satisfaction with Dimensions of Group Practice

To assess the extent to which the organizational culture of physician group practices is associated with individual physician satisfaction with the managerial and organizational capabilities of the groups. Study Design and Methods . Physician surveys from 1997 to 1998 assessing the culture of their medical groups and their satisfaction with six aspects of group practice. Organizational culture was conceptualized using the Competing Values framework, yielding four distinct cultural types. Physician-level data were aggregated to the group level to attain measures of organizational culture. Using hierarchical linear modeling, individual physician satisfaction with six dimensions of group practice was predicted using physician-level variables and group-level variables. Separate models for each of the four cultural types were estimated for each of the six satisfaction measures, yielding a total of 24 models. Sample Studied . Fifty-two medical groups affiliated with 12 integrated health systems from across the U.S., involving 1,593 physician respondents (38.3 percent response rate). Larger medical groups and multispecialty groups were over-represented compared with the U.S. as a whole. Principal Findings . Our models explain up to 31 percent of the variance in individual physician satisfaction with group practice, with individual organizational culture scales explaining up to 5 percent of the variance. Group-level predictors: group (i.e., participatory) culture was positively associated with satisfaction with staff and human resources, technological sophistication, and price competition. Hierarchical (i.e., bureaucratic) culture was negatively associated with satisfaction with managerial decision making, practice level competitiveness, price competition, and financial capabilities. Rational (i.e., task-oriented) culture was negatively associated with satisfaction with staff and human resources, and price competition. Developmental (i.e., risk-taking) culture was not significantly associated with any of the satisfaction measures. In some of the models, being a single-specialty group (compared with a primary care group) and a group having a higher percent of male physicians were positively associated with satisfaction with financial capabilities. Physician-level predictors: individual physicians' ratings of organizational culture were significantly related to many of the satisfaction measures. In general, older physicians were more satisfied than younger physicians with many of the satisfaction measures. Male physicians were less satisfied with data capabilities. Primary care physicians (versus specialists) were less satisfied with price competition. Conclusion . Some dimensions of physician organizational culture are significantly associated with various aspects of individual physician satisfaction with group practice.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72696/1/j.1475-6773.2006.00648.x.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/72696/2/HESR+648+Appendix+A.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/72696/3/HESR+648+Appendix+C.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/72696/4/HESR+648+Appendix+B.pd

Effects of heavy ion particle irradiation on spore germination of bacillus spp. From extremely hot and cold environments

Extremophiles are optimal models in experimentally addressing questions about the effects of cosmic radiation on biological systems. The resistance to high charge energy (HZE) particles, and helium (He) ions and iron (Fe) ions (LET at 2.2 and 200 keV/µm, respectively, until 1000 Gy), of spores from two thermophiles, Bacillus horneckiae SBP3 and Bacillus licheniformis T14, and two psychrotolerants, Bacillus sp. A34 and A43, was investigated. Spores survived He irradiation better, whereas they were more sensitive to Fe irradiation (until 500 Gy), with spores from thermophiles being more resistant to irradiations than psychrotolerants. The survived spores showed different germination kinetics, depending on the type/dose of irradiation and the germinant used. After exposure to He 1000 Gy, D-glucose increased the lag time of thermophilic spores and induced germination of psychrotolerants, whereas L-alanine and L-valine increased the germination efficiency, except alanine for A43. FTIR spectra showed important modifications to the structural components of spores after Fe irradiation at 250 Gy, which could explain the block in spore germination, whereas minor changes were observed after He radiation that could be related to the increased permeability of the inner membranes and alterations of receptor complex structures. Our results give new insights on HZE resistance of extremophiles that are useful in different contexts, including astrobiology

A bibliometric study of the literature on technological innovation: an analysis of 60 international academic journals

This paper aims to contribute to the debate on technological innovation, organization and work. Although technological innovation remained a debated topic in the academic literature during the past years, its implications for organizational processes seem still not sufficiently theorized and empirically investigated. By using two complementary journals’ rankings a search in the ISI Web of Science platform from 1985 through 2013 was performed. To analyze the 998 scientific retrieved contributions a bibliometric analysis has been conducted, adopting also Social Network Analysis tools. Our results reveal a significant growth of the technological innovation literature over the investigated period, the multidisciplinarity of the field and, particularly, the relevance of management and business & economics contributions. Overall, this study offers a broad overview of the literature on technological innovation and emphasizes the opportunity to investigate the role of technological innovation within the organizational life.This paper aims to contribute to the debate on technological innovation, organization and work. Although technological innovation remained a debated topic in the academic literature during the past years, its implications for organizational processes seem still not sufficiently theorized and empirically investigated. By using two complementary journals’ rankings a search in the ISI Web of Science platform from 1985 through 2013 was performed. To analyze the 998 scientific retrieved contributions a bibliometric analysis has been conducted, adopting also Social Network Analysis tools. Our results reveal a significant growth of the technological innovation literature over the investigated period, the multidisciplinarity of the field and, particularly, the relevance of management and business & economics contributions. Overall, this study offers a broad overview of the literature on technological innovation and emphasizes the opportunity to investigate the role of technological innovation within the organizational life.Monograph's chapter

Technology and Sociomaterial Performation

Part 1: IS/IT Implementation and AppropriationInternational audienceOrganizational researchers have acknowledged that understanding the relationship between technology and organization is crucial to understanding modern organizing and organizational change [1]. There has been a significant amount of debate concerning the theoretical foundation of this relationship. Our research draws and extends Deleuze and DeLanda’s work on assemblages and Callon’s concept of performation to investigate how different sociomaterial practices are changed and stabilized after the implementation of new technology. Our findings from an in-depth study of two ambulatory clinics within a hospital system indicate that “perform-ing” of constituting, counter-performing, calibrating, and stratifying explained the process of sociomaterial change and that this process is governed by an overarching principle of “performative exigency”. Future studies on sociomateriality and change may benefit from a deeper understanding of how sociomaterial assemblages are rendered performative

Understanding the context of balanced scorecard implementation: a hospital-based case study in pakistan

Background: As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods: Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp\u27s context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation.Results: Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing infrastructures and data networks. Conclusion: Variable levels of the BSC implementation were observed in this study. Those intending to apply the BSC in other hospital settings need to ensure a participatory culture, clear institutional mandate, appropriate leadership support, proper reward and recognition system, and sensitization to BSC benefits