Redefining managerial effectiveness in a multilevel organization : a structurationist account

Many organization theories consist of an interpretation frame and an idea about the ideal equilibrium state. This article explains how the equilibrium concept is used in four organization theories: the theories of Fayol, Mintzberg, Morgan, and Volberda. Equilibrium can be defined as balance, fit or requisite variety. Equilibrium is related to observables dependent on the definition of organization as work organization, formal organization or artifact organization. Equilibrium can be explicitly related to performance in the theory used, enabling cross-sectional research. The discussed theories can be mapped on a state space model in a way that clarifies the equilibrium concept, namely a mu-space (Fayol and Morgan), or a gamma-space (Mintzberg and Volberda). 1 Prof.dr. Henk W.M. Gazendam is professor of Information Systems in the Public Sector at the Faculty of Public Administration at Twente University and associate professor of Information Strategy at the Faculty of Management and Organization at Groningen University (P.O.Box 800, NL-9700-AV Groningen, The Netherlands, tel +31-50-3637078, email [email protected]). 2 Contribution to the Computational and Mathematical Organization Theory Workshop, May 3 and 4, 1996, Washington Hilton & Towers. 3 The author wishes to thank Vincent Homburg for his valuable comments.

Changing dominance in mixed profession groups:Putting theory into practice

An extended professional identity theory is proposed to enhance interprofessional collaboration. The purpose of this study is to investigate whether comparative feedback on interprofessional interaction can decrease the degree of profession-based dominance and general dominance in mixed profession groups. This observational study comprised a randomized double-blind pretest-posttest control group design with 19 mixed profession groups (10 intervention and nine control groups, each with three dental and three dental hygiene students). All groups received reflective feedback during two consecutive two hour team development meetings. Intervention groups also received comparative feedback. Profession-based dominance concerned the sum of three observation items (conversational turn-taking, dominance and contributing ideas) with a three-point scale: -1 = dental dominance, 0 = no dominance, +1 = dental hygiene dominance. Polychoric correlations confirmed positive associations with the latent trait and an unidimensional underlying structure. Observation items were internally consistent (alpha > .70). General dominance concerned the sum of absolute values of observation items with a minimum value of zero (no dominance) and the maximum value of three (strong dominance). A two-way factorial ANOVA was performed. The results revealed a significant interaction effect with regard to general dominance, F(1,17) = 6.630, p = 0.20 and large effect size (partial eta squared = 0.28). Comparative feedback on interprofessional interaction decreases general dominance in mixed profession groups

The Joint Influence of Intra- and Inter-Team Learning Processes on Team Performance: A Constructive or Destructive Combination?

In order for teams to build a shared conception of their task, team learning is crucial. Benefits of intra-team learning have been demonstrated in numerous studies. However, teams do not operate in a vacuum, and interact with their environment to execute their tasks. Our knowledge of the added value of inter-team learning (team learning with external parties) is limited. Do both types of team learning compete over limited resources, or do they form a synergistic combination? We aim to shed light on the interplay between intra- and inter-team learning in relation to team performance, by including adaptive and transformative sub-processes of intra-team learning. A quantitative field study was conducted among 108 university teacher teams. The joint influence of intra- and inter-team learning as well as structural (task interdependence) and cultural (team efficacy) team characteristics on self-perceived and externally rated team performance were explored in a path model. The results showed that adaptive intra-team learning positively influenced self-perceived team performance, while transformative intra-team learning positively influenced externally rated team performance. Moreover, intra-team and inter-team learning were found to be both a constructive and a destructive combination. Adaptive intra-team learning combined with inter-team learning led to increased team performance, while transformative intra-team learning combined with inter-team learning hurt team performance. The findings demonstrate the importance of distinguishing between both the scope (intra- vs. inter-team) and the level (adaptive vs. transformative) of team learning in understanding team performance

The organizational and performance effects of nurse practitioner roles

Background. Most studies evaluating the roles of Nurse Practitioners have compared the care delivered by individual Nurse Practitioners with that provided by other professionals. These studies should be complemented by research focusing on a higher unit of analysis, namely the organization of the care process for a specific patient group. The most important reason is that Nurse Practitioners are increasingly involved in direct, multiprofessional care in complex health care organizations and networks. In these work settings, their roles may, in both positive and negative ways, lead to changes in the organization of the entire care delivery system. Aim. The aim of this paper is to stimulate awareness and evaluation of these organizational changes and their potential impact on the effectiveness of the care process. Approach. A conceptual model based on patterned systems contingency theory is proposed. With the help of this model, attention is drawn to issues at the level of the organization and the effectiveness of the care processes that merit attention when Nurse Practitioner positions are being introduced. These issues are derived from case studies in Dutch hospitals. Results. According to the model, a Nurse Practitioner position will change the work structure of the care process involved. Therefore, the effectiveness of a Nurse Practitioner position will be dependent on the changes realized in the work structure. The resulting structure should fit the task characteristics of the care services demanded by the specific patient group. On the basis of this model and the examples presented, questions for further study are formulated. Conclusions. Nurse Practitioner roles can only enhance the effectiveness of care processes when embedded in a work structure that is internally consistent and adjusted to the task environment and available skill-mix. A structural contingency framework may be helpful in identifying relevant organizational issues. To determine the effects of Nurse Practitioner roles, cross-sectional as well as longitudinal studies are needed

The organizational and performance effects of nurse practitioner roles

Background. Most studies evaluating the roles of Nurse Practitioners have compared the care delivered by individual Nurse Practitioners with that provided by other professionals. These studies should be complemented by research focusing on a higher unit of analysis, namely the organization of the care process for a specific patient group. The most important reason is that Nurse Practitioners are increasingly involved in direct, multiprofessional care in complex health care organizations and networks. In these work settings, their roles may, in both positive and negative ways, lead to changes in the organization of the entire care delivery system. Aim. The aim of this paper is to stimulate awareness and evaluation of these organizational changes and their potential impact on the effectiveness of the care process. Approach. A conceptual model based on patterned systems contingency theory is proposed. With the help of this model, attention is drawn to issues at the level of the organization and the effectiveness of the care processes that merit attention when Nurse Practitioner positions are being introduced. These issues are derived from case studies in Dutch hospitals. Results. According to the model, a Nurse Practitioner position will change the work structure of the care process involved. Therefore, the effectiveness of a Nurse Practitioner position will be dependent on the changes realized in the work structure. The resulting structure should fit the task characteristics of the care services demanded by the specific patient group. On the basis of this model and the examples presented, questions for further study are formulated. Conclusions. Nurse Practitioner roles can only enhance the effectiveness of care processes when embedded in a work structure that is internally consistent and adjusted to the task environment and available skill-mix. A structural contingency framework may be helpful in identifying relevant organizational issues. To determine the effects of Nurse Practitioner roles, cross-sectional as well as longitudinal studies are needed