Suchergebnisse

This study examines the impact of bureaucratic structure on morale among hospital staff. Hypotheses are drawn from Hage's axiomatic theory of organizations, including the predicted negative impact on morale of formalization, centralization and stratification, and the positive impact on morale of task complexity. Contingency hypotheses involving structure and task complexity are also examined. Results indicate morale is either positively affected or unaffected by structure, and negatively affected by process. Some evidence of contingent effects are found. The findings are discussed within the broader context of Weber's theory of bureaucracy. This paper addresses the relationship between several structural features of bureaucracy and workers' morale in a hospital setting. It examines these relationships from broadly defined theoretical perspectives. In this connection, Weber's theory of bureaucracy is treated, as was the case in his original, as part of his general theory of rationalization in modern western society. The study considers the relationship between: 1) Formalization and morale, 2) Centralization and morale, 3) Stratification and morale, 4) Complexity and morale. These structural features of bureaucracy—formalization, centralization, stratification and complexity‐are treated as the means at the command of management for attaining organizational objectives. Worker morale is often referred to as the "level of feeling" about themselves among workers or about the work they perform (Revans, 1964; Veninga, 1982; Simendinger and Moore, 1985; Zucker, 1988). In effect, the term is used in stating that morale is high or low to suggest that something is right or wrong about the organization. Surprisingly, many of these studies do not explain why they are suggesting a particular state of morale, but only that the state of morale is crucial to the performance of the organization. In essence, morale is the level of confidence of the employees. It can vary from one department to the other due to specific or overall structural conditions of the organizations; without giving it routine consideration, performance will degenerate (Nelson, 1989).

Cet article examine la relation entre différents aspects de la stratification et la performance des départements d'un système multi‐hospitalier. Précisément, l'impact de la stratification sur la coordination, le climat d'adaptation au changement, la qualité des soins et le morale sont discuté. Nos prédictions sont basées sur le modèle axiomatique de Hage, qui fût baséà l'origine sur la théorie de la bureaucratie de Max Weber. A l'encontre de cette théorie, la stratification, en pratique, n'est qu'un détriment à la performance organisationnelle, surtout lorsque celle‐ci est opérationalise en terme de pathologie de communication.This paper examines the relationships between aspects of stratification and performance in departments of a multihospital system. Specifically, impacts of stratification on co‐ordination, climate for change, quality of care and morale are addressed. The predicted impacts are based on Hage's axiomatic model, which was originally based on Max Weber's theory of bureaucracy. Contrary to this theory, stratification in practice is found to be a detriment to organizational performance, particularly where it is operationalized in terms of communications pathologies.

La theorie du localisme‐cosmopolitanisme est appliquee a l'identification des types de medecin. L'analyse factorielle, le coefficient de concordance de Kendall ainsi que les gamma et chi‐carres sont utilises selon diverses combinaisons pour identifier des constellations de variables. On identifie deux types de medecins qui sont statistiquement bien differencies: le professionnel de la medecine (cosmopolitain) et le politicien de la medecine (local). Une demonstration empirique s'ensuit laquelle etablit que les cosmopolitains ont une attitude plus liberate que les locaux vis‐a‐vis les problemes sociaux et medicaux et une attitude plus critique vis‐a‐vis les regimes d'assurance maladie.The theory of localism‐cosmopolitanism is applied to the identification of physician‐types. Factor analysis, Kendall's coefficient of concordance, gamma and chi‐square are used in combination to identify variable clusters. Two statistically distinct types were found, the professional (cosmopolitan) and the medical politician (local). Empirical evidence is presented which indicates that cosmopolitans tend to be more liberal than locals in attitudes toward certain medical‐social issues, and more critical of health insurance plans.