Hospital management from a high reliability organizational change perspective

2017 ◽  
Vol 30 (1) ◽  
pp. 67-84 ◽  
Author(s):  
Nomie Eriksson
Keyword(s):  
Six Sigma ◽  
Expert Knowledge ◽  
High Reliability ◽  
Leadership Roles ◽  
Structured Interviews ◽  
Bottom Up ◽  
Content Type ◽  
Theoretical Concepts ◽  
Nurses Perceptions ◽  
Continuous Work

Purpose The purpose of this paper is to describe and analyze nurses’ perceptions and evaluations of healthcare developmental work after the introduction of Lean and Six Sigma and, how nurses aspire to maintain a high reliability organization (HRO). Design/methodology/approach Nurses’ roles and the way they respond to new efficiency and quality working methods are crucial. Underlying themes were analyzed from in-depth, semi-structured interviews with (n=17) nurses at two Swedish hospitals. Findings The nurses perceived that Lean worked better than Six Sigma, because of its bottom-up approach, and its similarities with nurses’ well-known work qualities. Nurses coordinate patients care, collaborate in teams and take leadership roles. To maintain high reliability and to become quality developers, nurses need stable resources. However, professional’s logic collides with management’s logic. Expert knowledge (top-down approach) without nurses’ local knowledge (bottom-up approach) can lead to problems. Healthcare quality methods are standardized but must be used with flexibility. However, HROs ensue not only from method quality but also from work attitudes, commitment and continuous work-improvement. Practical implications Management can support personnel in developmental work with: continuous education, training, teamwork, knowledge sharing and cooperation. Authoritarian method structures that limit the healthcare professionals’ autonomy should be softened or abandoned. Originality/value The study uses theoretical concepts from HROs, which were developed for unexpected events, to explain the consequences of implementing Lean and Six Sigma in healthcare.

Barriers and enablers to women in fire and emergency leadership roles

2019 ◽  
Vol 34 (2) ◽  
pp. 78-93 ◽  
Author(s):  
Debra Parkinson ◽  
Alyssa Duncan ◽  
Frank Archer
Keyword(s):  
Role Models ◽  
Online Survey ◽  
Leadership Roles ◽  
Structured Interviews ◽  
Family Responsibilities ◽  
Content Type ◽  
Management Leadership ◽  
Senior Women ◽  
Qualitative Component ◽  
In Fire

Purpose The purpose of this paper is to understand what (if any) actual and perceived barriers exist for women to take on fire and emergency management leadership roles within the Department of Environment, Land, Water and Planning, Victoria, Australia. Design/methodology/approach An anonymous quantitative online survey was used to collect data about opinions and thoughts of staff. This informed the qualitative component of the research – in-depth, semi-structured interviews and a focus group. The combination of these techniques provides deeper insight into the nature of the barriers for women. Findings Respondents identified real barriers for women accessing leadership roles in fire and emergency. Reflecting the wider literature on barriers to women in executive roles, those identified related to sexism, career penalties not faced by men for family responsibilities, and assumptions of women helping other women’s careers. There were more men in senior roles, leaving senior women isolated and often overlooked. Women had fewer role models and sponsors than men and less developed networks, finding it harder to access training and deployments. The context was described by most as “a boys’ club”, where men were seen to dominate meetings and stereotype the abilities of women. Originality/value This paper analyses the barriers to women in fire and emergency leadership roles within a masculine workplace and is rare in including a qualitative aspect to the issue in the Australian context.

Exploring destination brand disengagement in a top-down policy context

2020 ◽  
Vol 13 (3) ◽  
pp. 347-363 ◽  
Author(s):  
Narcís Bassols ◽  
Thomas Leicht
Keyword(s):  
Place Branding ◽  
Field Work ◽  
Local Context ◽  
Brand Strategy ◽  
Structured Interviews ◽  
Top Down ◽  
Online Questionnaire ◽  
Bottom Up ◽  
Content Type ◽  
Depth Study

Purpose This paper aims to analyze the case of Cartagena, Colombia, as a case of a failed destination branding. It also broadens the findings by connecting them to the extant literature about place branding, thus making this paper more explanatory. It tries to fit the fieldwork’s findings into the two main streams of branding research (bottom-up vs top-down). This paper also gives practical insights into the destination’s network of stakeholders and discusses ways to improve the destination’s management and branding. Design/methodology/approach This paper uses a mixed methodology approach. Field work consisted of online questionnaire to hospitality employees in the city plus semi-structured interviews conducted with 18 “expert” stakeholders in the destination. This paper is of empirical nature. Findings The main cause of the destination’s brand failure is found to be the top-down approach to the place brand strategy. The literature shows that cases such as this one are more common than assumed, and a possible way out of the problem is the application of bottom-up or “mixed” approaches, as these may circumvent the problems found. Research limitations/implications Cases like this one illustrate very well a local context but might be difficult to transfer to other contexts, so the generalization power of this paper is limited to similar places in the sociopolitical sense of the term. Practical implications For place branding practitioners and destination management organizations , this paper is a call for participative approaches which include all of the stakeholders of a place. Originality/value This paper offers an in-depth study of a branding case in Latin America, a part of the world relatively unexplored in the branding literature. On the basis of the presented case, this paper pitches top-down versus bottom-up approaches. Finally, it explains the findings by connecting the place to its broad geographical context.

Leadership in crisis situations: merging the interdisciplinary silos

2018 ◽  
Vol 31 (1) ◽  
pp. 110-128 ◽  
Author(s):  
Hugo Paquin ◽  
Ilana Bank ◽  
Meredith Young ◽  
Lily H.P. Nguyen ◽  
Rachel Fisher ◽  
...  
Keyword(s):  
Crisis Management ◽  
Pediatric Emergency ◽  
Leadership Roles ◽  
Structured Interviews ◽  
Content Type ◽  
Team Members ◽  
Relative Independence ◽  
The Relationship ◽  
Medical Simulation Training

Purpose Complex clinical situations, involving multiple medical specialists, create potential for tension or lack of clarity over leadership roles and may result in miscommunication, errors and poor patient outcomes. Even though copresence has been shown to overcome some differences among team members, the coordination literature provides little guidance on the relationship between coordination and leadership in highly specialized health settings. The purpose of this paper is to determine how different specialties involved in critical medical situations perceive the role of a leader and its contribution to effective crisis management, to better define leadership and improve interdisciplinary leadership and education. Design/methodology/approach A qualitative study was conducted featuring purposively sampled, semi-structured interviews with 27 physicians, from three different specialties involved in crisis resource management in pediatric centers across Canada: Pediatric Emergency Medicine, Otolaryngology and Anesthesia. A total of three researchers independently organized participant responses into categories. The categories were further refined into conceptual themes through iterative negotiation among the researchers. Findings Relatively “structured” (predictable) cases were amenable to concrete distributed leadership – the performance by micro-teams of specialized tasks with relative independence from each other. In contrast, relatively “unstructured” (unpredictable) cases required higher-level coordinative leadership – the overall management of the context and allocations of priorities by a designated individual. Originality/value Crisis medicine relies on designated leadership over highly differentiated personnel and unpredictable events. This challenges the notion of organic coordination and upholds the validity of a concept of leadership for crisis medicine that is not reducible to simple coordination. The intersection of predictability of cases with types of leadership can be incorporated into medical simulation training to develop non-technical skills crisis management and adaptive leaderships skills.

Implementation of Lean Six Sigma in Saudi Arabian organisations

2017 ◽  
Vol 34 (4) ◽  
pp. 508-529 ◽  
Author(s):  
Saja Ahmed Albliwi ◽  
Jiju Antony ◽  
Norin Arshed ◽  
Abhijeet Ghadge
Keyword(s):  
Saudi Arabia ◽  
Six Sigma ◽  
Best Practice ◽  
Online Survey ◽  
Saudi Arabian ◽  
Lean Six Sigma ◽  
Current Status ◽  
Future Research ◽  
Structured Interviews ◽  
Content Type

Purpose Although the popularity of the Lean Six Sigma (LSS) methodology has illustrated many benefits over the years for those organisations who have implemented it, this strategy has received less attention in developing countries. The purpose of this paper is to critically assess the current status of LSS implementation in Saudi Arabian organisations. Design/methodology/approach This research is based on a descriptive survey questionnaire which has been derived from two systematic literature reviews. The survey was distributed to 400 organisations in Saudi Arabia using Qualtrics online software. In total, 146 responses were received where 102 responses were completed and analysed. Findings The findings of the survey highlighted that the implementation of LSS is still in the early stages in organisations within Saudi Arabia. This was clearly shown by many factors such as years of deploying LSS, LSS infrastructure, level of awareness of LSS, impact of LSS on business functions and so on. Research limitations/implications The primary limitation of this study is that data has been collected from an online survey and therefore no deeper insights could have been captured from the survey. This calls for future research to be undertaken by executing semi-structured interviews in selective organisations within Saudi Arabia. Originality/value This paper contributes to the current status of LSS in Saudi Arabian organisations. It also gives recommendations to guide the future of LSS in Saudi organisations by comparing LSS literature with best practice.

Barriers to implementing waste-to-energy projects in Sri Lanka: a PESTEL analysis

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Binashi Kumarasiri ◽  
Piumi Dissanayake
Keyword(s):  
Sri Lanka ◽  
Expert Knowledge ◽  
Research Strategy ◽  
Waste To Energy ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Content Type ◽  
The Government ◽  
Under Construction

PurposeIt is no surprise that garbage is not garbage for some. It is money. This is why garbage has been overestimated to a point that money allocated for waste-to-energy (WtE) projects feed individual pockets. Many countries have already adapted WtE as a successful solution for both energy and waste crisis. Although in Sri Lanka six WtE projects were promised, the government abruptly decided that it would not have any more projects other than the two plants that were under construction. The purpose of this paper is to analyse barriers to the implementation of WtE projects in Sri Lanka.Design/methodology/approachAn exploratory case study was selected as the research strategy to achieve the research aim. In total, two WtE megaprojects, which have been initiated implementation in Sri Lanka, were used as cases. A total of 12 semi-structured interviews with four personnel from each case and four government officials were used as the data collection technique. Data analysis was carried out using code-based content analysis. The barriers were extracted through analysis of case findings using an abductive analysis. The strategies to mitigate identified barriers were formulated based on attributes highlighted through case study findings and further validated through the opinions of three experts.FindingsBarriers were analysed using the PESTEL framework to get ample insight into barriers that impact on the implementation of WtE projects in Sri Lanka. Less support from the government due to their less awareness on WtE, high investment and operational cost, lack of expert knowledge on WtE technologies in Sri Lanka, absence of a proper regulatory framework for implementation WtE technologies, lengthy process and delay in getting approvals from government process, poor attitudes of public and their protests due to the less awareness on WtE are the foremost barriers identified in this study. Further, strategies were proposed based on the empirical research findings to overcome barriers to facilitate the successful implementation of WtE projects in Sri Lanka.Research limitations/implicationsSo far only two WtE megaprojects have been initiated the implementation in Sri Lanka. Therefore, the scope of the study was limited only to those projects. Moreover, the type of waste considered in this study is municipal solid waste (MSW), which has become a bigger problem in Sri Lanka.Originality/valueThe current study unveils an analysis of barriers for implementation of WtE projects in Sri Lanka, including strategies for mitigating identified barriers. The findings would enable relevant stakeholders, i.e. policymakers, industry practitioners, investors, government bodies and researchers to make informed decisions on implementation of WtE projects and thereby promote successful implementation of WtE projects in Sri Lanka.

Benchmarking Six Sigma implementation in services companies operating in an emerging economy

2014 ◽  
Vol 21 (1) ◽  
pp. 62-76 ◽  
Author(s):  
Paulo Augusto Cauchick Miguel ◽  
Marly Monteiro de Carvalho
Keyword(s):  
Six Sigma ◽  
Methodological Approach ◽  
Emerging Economy ◽  
Full Time ◽  
Structured Interviews ◽  
Content Type ◽  
Service Companies ◽  
Management Leadership ◽  
Management Approaches ◽  
Strategic Project

Purpose – The paper reports case studies conducted in services organizations that apply Six Sigma in an emerging economy. Aspects of human resources and full-time specialist, infra-structure, top management leadership, customer requirements, focus on financial and non-financial results, structured method and strategic project selection are investigated. The paper aims to discuss these issues. Design/methodology/approach – Case-based research is employed as methodological approach. Data were mostly gathered through semi-structured interviews with managers involved with Six Sigma implementation. When available, archival data were also used to achieve more evidence towards triangulation. Then, the aggregation of the results was done a posteriori. Findings – It was verified that Six Sigma was successfully implemented in those companies, however with some drawbacks. The studied companies adopt Six Sigma in association with other quality management approaches, mainly ISO 9000: 2008 and lean production. Research limitations/implications – The study was limited to three service companies. Therefore, the study findings are not subject to generalisation for other similar firms. Practical implications – The research shows the importance of Six Sigma implementation in service companies in addition to its contribution to practical application by identifying the relevant aspects of its introduction. It enables practitioners to use the findings on factors that should be taken into consideration when applying Six Sigma. Originality/value – It is one of the few studies on Six Sigma analysis in emerging economies. In addition, the empirical results found support in existing theory to some extent.

scholarly journals Forging a collective entrepreneurial identity within existing organizations through corporate venturing

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ying Zhang ◽  
Marina G. Biniari
Keyword(s):  
Secondary Data ◽  
Corporate Entrepreneurship ◽  
Role Identity ◽  
Structured Interviews ◽  
Bottom Up ◽  
Content Type ◽  
Corporate Context ◽  
Management Literature ◽  
Parent Companies

PurposeThis study unpacks how organizational members construct a collective entrepreneurial identity within an organization and attempt to instill entrepreneurial features in the organization's existing identity.Design/methodology/approachThe study draws on the cases of two venturing units, perceived as entrepreneurial groups within their respective parent companies. Semi-structured interviews and secondary data were collected and analyzed inductively and abductively.FindingsThe data revealed that organizational members co-constructed a “corporate entrepreneur” role identity to form a collective shared belief and communities of practice around what it meant to act as an entrepreneurial group within their local corporate context and how it differentiated them from others. Members also clustered around the emergent collective entrepreneurial identity through sensegiving efforts to instill entrepreneurial features in the organization's identity, despite the tensions this caused.Originality/valuePrevious studies in corporate entrepreneurship have theorized on the top-down dynamics instilling entrepreneurial features in an organization's identity, but have neglected the role of bottom-up dynamics. This study reveals two bottom-up dynamics that involve organizational members' agentic role in co-constructing and clustering around a collective entrepreneurial identity. This study contributes to the middle-management literature, uncovering champions' identity work in constructing a “corporate entrepreneur” role identity, with implications for followers' engagement in constructing a collective entrepreneurial identity. This study also contributes to the organizational identity literature, showing how tensions around the entrepreneurial group's distinctiveness may hinder the process of instilling entrepreneurial features in an organization's identity.

Mastering continuous improvement (CI): the roles and competences of mid-level management and their impact on the organisation's CI capability

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steven Robert Fannon ◽  
Jose Eduardo Munive-Hernandez ◽  
Felician Campean
Keyword(s):  
Causal Relationship ◽  
Continuous Improvement ◽  
Reference Model ◽  
Reference Value ◽  
Leadership Roles ◽  
Structured Interviews ◽  
Content Type ◽  
Environment Model ◽  
Comprehensive Framework

PurposeThis paper establishes a comprehensive basis for understanding the roles and competences of mid-level management and their influence on the effectiveness of continuous improvement (CI) capability within an organisation.Design/methodology/approachThis research builds upon the hypothesis that methods alone do not lead to successful CI capability development. It focuses on the role of mid-level management in driving a CI environment that underpins the effectiveness of CI capability. A reference model for the CI environment is synthesised based on critical literature review, integrating CI culture, CI enablers and CI leadership elements. A comprehensive framework is introduced to define CI leadership roles and competence indicators. A quantitative benchmarking study involving structured interviews with 15 UK organisations was undertaken to collect evidence for a causal relationship between CI leadership competences and CI capability.FindingsAnalysis of the benchmarking data provides clear evidence of the causal relationship between the CI leadership competences of mid-level management and CI capability of the organisation. Given that the empirical study was structured on the basis of the CI leadership roles and competences framework introduced in this paper, this also provides validation for the proposed framework and the CI environment model.Practical implicationsThe evidence-based knowledge of the positive relationship between the mid-management CI leadership competences and the effectiveness of the CI capability informs strategic organisational development interventions towards enhancing CI capability and effectiveness, ultimately underpinning productivity enhancement and sustainability. The framework for mid-level management CI leadership roles, responsibilities and competences introduced in this paper and grounded in underpinning work undertaken within a large automotive Original Equipment Manufacturer (OEM), can be adapted by any organisation. The CI environment reference model should provide a comprehensive support for strategists to communicate the framework for CI capability improvement within an organisation, to enhance acceptability and adherence to improvement actions.Originality/valueThis research proves for the first time the significance of the causal relationship between the CI leadership competences and the effectiveness of the CI capability within an organisation, thus filling an important gap between established previous work, focussing on the role of mid-level management on one side and practitioner and team level roles, methodologies and tools. The proposed CI environment model is a theoretical contribution with reference value for both practice and further studies. The comprehensive framework for mid-level management CI leadership roles, responsibilities and competences introduced in this paper provides sound foundation to deliver CI leadership in the workplace.

Evaluating the supply chain information flow in Egyptian SMEs using six sigma

2018 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Omneya Kandil ◽  
Rasha Abd El Aziz
Keyword(s):  
Supply Chain ◽  
Business Process ◽  
Radio Frequency Identification ◽  
Six Sigma ◽  
Measurement Tool ◽  
Rfid Technology ◽  
Structured Interviews ◽  
Content Type ◽  
The Cost ◽  
The Impact

Purpose There is a great deal of concern among the Egyptian economy that small- and medium-sized enterprises’ (SMEs’) potentials are not fully used although they dominate it and contribute to its success. The question is what challenges are preventing those SMEs from performing efficiently. This research aims to focus on examining the issues regarding the supply chain of Egyptian SMEs, exploring the areas that need improvement and assessing the impact of technology in enhancing their performance and whether they afford applying it. Design/methodology/approach In this research, semi-structured interviews were conducted at 14 Egyptian SMEs. Then, the business process at six of the fourteen SMEs was observed. After that, a representative sampling was applied and a company was chosen as a representative case company. Moreover, the selected company’s documents were analyzed to capture the full image of the current supply chain performance in Egyptian SMEs. Finally, the Six Sigma DMAIC approach was used to assess the effectiveness of the current supply chain and identify the problems faced and how to deal with these deficiencies. Findings The current process of the supply chain was analyzed and the result shows the obstacles and constrains facing SMEs in Egypt. Despite the clear benefits of radio frequency identification (RFID) technology, Egyptian SMEs still do not use it to solve their problems due to its high cost and their low budgets. However, the investigation concludes that SMEs in particular can benefit from the RFID technology and will be able to pay back the cost of the system applied after a certain period of time that is measured by calculating the breakeven point of having the RFID system against the current situation. As a result, improvements were realized and recommended for the organization. Originality/value This research develops a model that suits SMEs in the Egyptian market. The use of a case study approach with a quality measurement tool, namely, the Six Sigma DMAIC approach, especially after surveying several SMEs, and observing the business process at some of them, makes this a thorough investigation which proves that even SMEs can use the RFID technology despite its high cost that hinders its utilization. Thus, this research helps decision-makers in Egyptian SMEs make better informed decisions and guides them to when will they be able to pay back the cost of the system applied.

The generic-discipline dilemma: learning advising in quantitative literacy

2015 ◽  
Vol 6 (1) ◽  
pp. 24-39
Author(s):  
Marion Blumenstein
Keyword(s):  
Data Analysis ◽  
Learning Strategies ◽  
Teaching And Learning ◽  
Expert Knowledge ◽  
Real Life ◽  
Student Experience ◽  
Quantitative Literacy ◽  
Learning Support ◽  
Structured Interviews ◽  
Content Type

Purpose – This paper aims to provide insights into the experiences of and challenges confronting higher degree research students and learning advisors (LAs) regarding data analysis support. The ability to handle data and use numerical evidence systematically is an important transferable skill and essential for the successful completion of a quantitative research thesis. Design/methodology/approach – A combination of qualitative and quantitative data was used, enabling a convergence of findings: the questionnaire and one-on-one advisory sessions feedback gathered information on the student experience, while semi-structured interviews provided data on the LAs’ perspective. Findings – Phenomenographic analysis of interviews revealed many challenges associated with centralised learning support provision. Learning advisors recognised not only different disciplinary needs but also the tensions associated with working centrally and cross-disciplinary. Students identified a need for more practice-orientated training opportunities in data analysis during their postgraduate and doctoral research. Practical implications – Understanding gained from students’ and LAs’ experiences are essential for changes of university-wide teaching and learning strategies. The collection of “bottom-up” data on the student experience combined with data on learning thresholds provided by faculty and student learning support units would allow a coordinated, institution-wide approach to identified learning needs. Originality/value – Developing a community of practice concerned with quantitative literacy means that staff with expert knowledge, regardless of discipline affiliation, can provide an environment in which students are able to develop their analytical skills further and can participate in ongoing discussions on real-life research and data analysis issues.

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