Search

Organizations are widely using teams as a way to successfully solve urgent and complex problems maximizing the value of their human capital. Teams engage in boundary-spanning strategies to seek information from outside experts to improve their performance, epitomizing a process of search. Scholars have linked search processes to two motives: problemistic search and slack search which are both dependent on team goals and performance-aspiration levels. Reaching beyond previous studies, this article focuses on team members' social status -- as related to their embeddedness in a social network of external ties - and on their perception of team performance. We also argue that the two factors interact at individual level to determine search strategies, so that social status moderates the relationship between individual perception of team performance and boundary-spanning search. Our research relies on a sample of 174 professionals working within 23 multidisciplinary teams in the healthcare context. The study provides novel insights to team and performance feedback literature contributing to this stream of research in three ways: firstly, we found that when performance is below the aspirational level of team members, they engage in boundary spanning ties as a strategy to search for knowledge to meet team objectives; secondly, based on the social exchange theory we theorized and we found evidence on the impact that status has on boundary spanning activities. Finally, we reveal that the status moderates the relationship between performance and boundary spanning activities. [ABSTRACT FROM AUTHOR]

The article presents a study conducted to analyze the effect of hospital referral networks on hospitalization decisions. To conduct the study, techniques of social network analysis were applied to investigate the inter-organizational networks formed by patient transfers across hospitals. Topics discussed include institutional setting of the study, data collection, and use of dependent variables and measures. The results showed that a patient's transfer may obstruct a hospital's ability to decide whether the patient should be hospitalized or treated in an outpatient regime, or transferred to another hospital.

Although much scholarly work has investigated how organizations learn from past failures, we still lack knowledge about whether and how different types of failure experiences interact and jointly help firms prevent future failure events. This article develops a novel comparative-contingent theoretical framework that considers firms' experience with both small and large failures, as well as experiential and vicarious learning mechanisms through firms' both direct and indirect failure experience. We test our hypotheses on an original dataset comprising all companies that have issued high-severity and low-severity medical device recalls in the decade 2009-2018. We provide evidence of a strong experiential learning effect from both small and large failures, which however is salient only to prevent the same type of failure but not the other. We also find that firms' learning from small failures is contingent on two experiential factors. Firms directly experiencing a high number of large failures prove unable to learn from their own small failures, while exposure to a high number of peers' small failures reduces firms' learning rate from small failures. This article contributes to the scholarship addressing organizational learning by demonstrating a differential salience of small vs large failure events in stimulating learning and a detrimental interaction of experiential and vicarious learning mechanisms. [ABSTRACT FROM AUTHOR]

Despite the increasing calls for embedding complexity theory and system thinking in business and management research and education, scholarly work and educational curricula adopting complex reasoning are still very sparse. This conceptual article aims to propel this line of research and education by developing an integrated framework for teaching and learning of complex reasoning. The model highlights several cognitive challenges underpinning the adoption of complexity thinking, such as the tendency to simplify reductionist thinking, the counterintuitivenss of complex systems' behavior, the continuous evolution of complex systems, and the difficulty of updating cognitive frames, and the tendency towards immediate decision-making. Given such challenges, we argue for the need for dynamic preparedness as a core competence for embedding complex reasoning in research and practice. Based on complexity's threshold concepts, namely non-linearity, feedback loops, system delays, systems' dependency on initial conditions, and multiple interactions, we argue how dynamic preparedness can be developed through an inductive, situated educational approach, which trains intuition to sensemaking and towards the recognition of boundary conditions of simplified models. The proposed framework provides a timely contribution to complexity research and complex reasoning education in management and policy, particularly crucial to prevent and mitigate future systemic shocks. [ABSTRACT FROM AUTHOR]

Base-of-the-pyramid (BOP) scholarship and practice have traditionally focused on poverty alleviation efforts, while concerns for environmental degradation within BOP business models have received far less attention. We bridge this gap by proposing a socio-ecological perspective to understand whether a product's low environmental impact enhances BOP users' product adoption, thereby reinforcing the poverty alleviation goals of BOP projects. Owing to the relevance of apt menstrual hygiene management to both socio-economic outcomes of BOP women and to environmental conservation, this study examines the case of sanitary napkins uptake. Results from a discrete-choice experiment involving 164 BOP women (n = 1148) in two Indian slums show that sanitary products' biodegradability is the most important attribute affecting women's preferences towards menstrual hygiene management solutions, which also significantly interacts with socio-economic and socio-cultural characteristics of women and their community. Our findings highlight the possibility for BOP business models to establish positive synergies between the apparently competing goals of environmental protection and poverty alleviation, renew the call for co-creation approaches in designing BOP solutions that are situated in a socio-ecological framework. [ABSTRACT FROM AUTHOR]

Organizational resilience can be viewed as the capability of organizations and systems to absorb and adapt to environmental shocks, by either bouncing back to their initial status, or achieving a new, more advantageous equilibrium. Limited research has been conducted on the antecedents to organizational and systemic resilience, and particularly in the context of radical, sudden changes. Particularly understudied is the analysis of relational dynamics in situations of sudden change, when social relationships, their structure and their evolution during environmental shocks or turbulences may be an important antecedent of organizational and systemic resilience. This paper explores how organizations within an open, complex adaptive system modify their social capital to achieve performance resilience, by investigating the modifications of patient referral networks among hospitals in the Abruzzo region as a consequence of the 2009 L'Aquila earthquake. Our findings reveal that the earthquake has an important, although highly-differentiated, effect on the network structure as a whole and on the ego-network structure of regional hospitals. While network structure indicators seem not to be significantly modified by the earthquake and exhibit a substantial stability of the system's performance, social capital structure of the collapsed hospital changes profoundly in the disaster aftermath and these changes are more radical and profound than the those observed in other hospitals in the network. Moreover, our findings highlight that both geographical and social proximity are significant factors underpinning nodes' heterogenous reaction to changes. A discussion of the main theoretical contributions of our findings concludes the paper. [ABSTRACT FROM AUTHOR]

Background Emphasizing the gatekeeper role of primary care organizations is a strategy to reduce healthcare costs in several systems. Performance of primary care organizations can consequently be operationalized in terms of their effectiveness as gatekeepers and primary care organizations receive performance feedback regarding their performance as gatekeepers. Even though it is crucial for a well-functioning primary care system, it is unclear how primary care organizations respond to this type of benchmarking, Purpose To explore the attention for- and response of primary care organizations to performance feedback information of their gatekeeping performance. Methodology/Approach We conducted a survey, including closed questions, open questions, and vignettes, among all primary care practices that utilized performance feedback information of their gatekeeping performance between 2015 and 2018 in the Netherlands. Results The results indicate that the majority of general practitioners consider and comprehend performance feedback information regarding their gatekeeping performance. Although a practice's performance relative to the aspiration level determines an organization's response to the feedback information, respondents consider the performance feedback information untimely, and not sufficiently aligned with their organizational goals. Conclusion The performance'response relationship of performance feedback information regarding gatekeeping performance follows existing theory on organizational learning. Furthermore, responses to performance below aspiration levels are undertaken on a longer term. However, primary care organizations emphasize goals within their own domain of primary care rather than those associated to their gatekeeping role. Organizational learning from performance feedback information regarding gatekeeping performance thus seems to be limited. Practice Implications Benchmarking the gatekeeping performance of primary care organizations seems to have limited effects. Primary care organizations should be made more aware of their goals as gatekeepers in order to improve organizational learning from such performance feedback information. [ABSTRACT FROM AUTHOR]

In the context of increasing public demand on high-quality and accessible care, and predictions of unmanageable costs in healthcare provision, social entrepreneurship holds the promise of making a cost-effective, social impact in healthcare. Although research in the field is rapidly increasing, the process of social entrepreneurial action is poorly understood. This paper hopes to contribute to our understanding of the emergence of social entrepreneurial action in healthcare by conducting an exploratory study of the antecedents of social entrepreneurial action by Ashoka Fellows. Build upon a qualitative paradigm, we used Gioia's two-step methodology to analyze the online available profiles of 57 Ashoka Fellows active in healthcare. We were able to reveal fourteen antecedents grouped into four interlinked aggregate dimensions. Our study suggests the dimensions of multi-disciplinarity, exposure, connectedness and pro-social orientation synergize antecedents into a social entrepreneurial pathway, composed out of combinations of antecedents accumulated into a portfolio of tangible and intangible resources available to individuals. Although our study has focused only on the profiles of highly successful social entrepreneurs, we argue our research holds enough robust evidence to warrant further exploration of our suggested model in order to gain a deeper understanding on the emergence of social entrepreneurial action. [ABSTRACT FROM AUTHOR]

Organizational culture is considered critical for improving health system outcomes. Yet, empirical evidence confirming this relationship is limited. This may be due to the prevailing way that studies conceptualize culture using a consensus perspective, which assumes that more agreement among members is better. However, to meet multiple healthcare needs of patients with complex conditions, diverse providers with various disciplinary backgrounds increasingly must work together. Given the need for multidisciplinary collaboration, using what Chan (1998) calls a dispersion model may be more suitable to explain variations in team performance. A dispersion model conceptualizes organizational culture through heterogeneity among groups instead of within group agreement. To recognize the heterogeneity in values and skills that different healthcare professionals introduce to multidisciplinary teams, we assess whether heterogeneity in team cultures is associated with the degree to which patients perceive care to be more or less integrated. We analyze a sample of 2,911 patient responses and 17 healthcare teams. Results from two-level ordered logistic regression analyses suggest that intermediate levels of heterogeneity in perceived culture among healthcare team members is significantly, positively related to integrated care. These findings contribute to better understanding how culture can facilitate multidisciplinary team performance. [ABSTRACT FROM AUTHOR]

Pro-competitive reforms have been enacted throughout Western healthcare systems despite mixed evidence of their effect. Although healthcare organizations competing under non-price competition have been shown to cooperate using patient transfers, little is known about cooperative strategies of healthcare organizations in price-competitive healthcare markets. This paper investigates a novel and understudied form of inter-hospital cooperation described as potentially hazardous to well-functioning healthcare markets, namely the act of sharing medical specialists between hospitals. In particular, it investigates the influence of price-competition on cooperative hospital strategies. We use a stochastic actor-oriented model to analyze the cooperative dynamics amongst 94 general and academic hospitals in the Netherlands between 2010 and 2015. Our results show that, in a price-competitive healthcare sector, hospitals predominantly cooperate with their direct competitors. However, the ratio of price-competitive to non-price competitive services offered by a hospital does not significantly influence their cooperative strategies. The practical implications of this form of inter-organizational cooperation for effective managed-care and anti-trust enforcement are discussed. [ABSTRACT FROM AUTHOR]

Although market-based reforms have introduced incentives for healthcare organizations to compete in many countries, cooperative inter-organizational arrangements remain salient to the delivery of health care. This paper investigates shared medical specialists as a novel form of cooperation between healthcare organizations. We construct a two-level logistic random intercept model to explore how the characteristics of medical specialists and healthcare organizations influence the probability of a specialist to be shared across specialized care organizations. Our analysis is based on a sample of 616 healthcare organizations and 18,142 medical specialists in the price competitive specialized care sector of the Netherlands. It reveals that male and more experienced specialists, as well as those who are affiliated to larger organizations are more likely to be shared. While this could suggests that specialized care organizations share complementary resources, specialists affiliated to tertiary centers are significantly less likely to be shared. We furthermore find that the likelihood of a specialist to be shared differs significant across medical specialties, warranting further research at the specialty level. The potential implications of specialist sharing for inter-organizational learning and effective managed competition are discussed, as well as its use as an indicator of inter-organizational cooperation in healthcare. [ABSTRACT FROM AUTHOR]