Suchergebnisse

1. Deconstructing the welfare state : undoing 'one of the greatest achievements in history'? -- 2. Deconstructing the NHS : the changing roles of junior and middle managers -- 3. Exploring NHS work : a critical-action perspective -- 4. Ready to do business : management and organizational change in an acute trust -- 5. Contested culture : managerial work in an ambulance trust -- 6. Staying afloat : negotiating change at a mental health trust -- 7. When organizations disappear : deconstructing management at a primary care trust -- 8. Managing the impossible : the challenges of organizational change in the NHS.

The article examines the escalation of commitment to failing strategies from a psychodynamic perspective as an affective process connecting organizational, systemic and individual levels. We propose a theory of organizational blind spots to explain how such escalation of commitment occurs. Blind spots develop as an organizational defence mechanism for coping with problems resulting from attempts to implement unrealistic strategy or policy goals. Unrealistic strategic aims mobilize and reinforce blind spots through processes of splitting, blame and idealization, thus enabling organizations to persist with unsuccessful courses of action. Organizational blind spots arise when leadership and/or operational members in organizations are unable to acknowledge unworkable strategies. Vignettes from the National Health Service in England (the NHS) are used to illustrate how blind spots sustain an illusory possibility of success while commitment to a failing strategy escalates. The theory of blind spots offers a novel social-psychological approach to understanding how these dysfunctions of strategy develop and become institutionalized, putting organizations in jeopardy and threatening their survival.

While there is emerging evidence to suggest that (organizational) culture can affect the performance and quality of health services, little attention has been directed at how these relationships might be mediated, facilitated or attenuated by aspects of service design (i.e. those arrangements that combine facilities, staff and service users in the co-production of care). Using two case studies set in mental health services, this article explores how both culture and performance may be viewed as emergent properties of service design configurations. Thus central to ideas of service re-design should be notions of service users as the co-producers (with staff) of both organizational culture and organizational performance, as well as a clearer understanding of how such co-production processes are modulated by specific design configurations.

The reactions of followers after losing a leader are an important and neglected area of study. In fact, little is known about reactions to changes of leadership in organizational settings, generally. The effects of loss and specifically of bereavement within the family are well known. Whilst organizational life differs from family life, some relationships and reactions to loss may be comparable. One way of illuminating reactions to the loss of a leader is to look empirically at cases of leadership loss. This article presents one example taken from the health service of a team whose leader died after a short illness. Members of this team reacted differently according to their previous attachment to the leader and their reactions ranged from grief to indifference. The death of a leader is an extraordinary occurrence that may illuminate reactions to loss more generally within organizations.

It has been suggested that localised attempts at change may fail because of organisational defences that are sustained through bureaucratic systems. Mental health workers face specific threats arising from the nature and context of their work. The resulting anxieties lead to defensiveness in the workers that may be supported by organisational structures and procedures. Attempts at changing existing patterns of work can increase anxiety and lead to more (rather than less) entrenched resistance in the form of organisational defences. As a result, the service received by patients may barely change. Four health service contexts are introduced here and psychodynamic processes operating therein are explored and contrasted.

Critical approaches to leadership studies have sought to challenge the normative position of leadership as residing solely within the formal leader and have gone as far as to undermine the traditionally held assumption of leadership as a ""real"" phenomenon. The book offers a critical account of the nature of leadership and management in modern organizations. Specifically it examines the forces that affect the influence relationships between leaders and followers in public sector organizational settings and thus, how these relationships inform social influence processes. Although the.

This book showcases international research on health care organizations. It presents diverse and multidisciplinary approaches to studying differing health care settings, in international context. These approaches range from in depth observation to questionnaire based measures, investigating a spectrum of health care professionals.

Austerity measures and neoliberal policies have deeply affected the UK cultural sector. In particular they have been central to cementing the idea that contemporary cultural institutions should henceforth be regarded as commercial operations. As the language of business and management (B&M language) increasingly frames how organisations of the cultural sector are described, this paper defines the main discursive practices motivating this performative repositioning. Drawing theoretically from the concept of performativity, and building empirically on in-depth interviews with senior staff across the UK museum sector, we argue that the incursion of B&M language has reshaped the 'reality' of the sector by materialising new relations. Signally, we advance a concept of performative hegemonic language to describe a range of manifestations of linguistic re-labelling in the world of the museum. Our paper illustrates what happens when an organisation starts to classify activities through B&M language, considering the implications of framing this etymology as transcendent to its cultural counterpart. Relabelling, we contend, re-orients meaning, and this translates into the ascent of what we call the 'neoliberal museum'. Overall, our paper unpacks the linguistic-material processes underpinning the ideological transformations affecting the cultural sector.

Despite the increasing deployment of formalized boundary spanning roles and practices, the mechanisms and dynamics of their legitimation remain under-explored. Using the Bourdieusian lens, we theorize legitimation of boundary spanning as accumulation, mobilization and conversion of several forms of capital unfolding in a configuration of intersecting fields. Drawing on a qualitative longitudinal case study of a collaborative partnership between a university and healthcare organizations, we describe changes in the structure, sources and mutual convertibility of capital assets over time. We also analyse the implications of this evolution for the relationships between the intersecting fields and the social trajectory of boundary spanners. We argue that legitimation of boundary spanning roles and practices is a highly transformative, collective and political process that increases the capital endowments and authority of individual boundary spanning agents but may lead to the erosion of the very same roles and practices that were being legitimized.

Based on fieldwork in residential homes, arrangements for the care of older people are examined with reference, primarily, to Deetz's theory of 'corporate colonization'. Extending this theory, it is argued that grouping such people in care homes can result in a form of social segregation, one that reflects the management of the aged body in relation to normative constructions of dependence. Focusing on the experiences of residents, the everyday effects of narratives of decline on disciplining the lives of older people are assessed, with this analysis taking recourse to the work of Foucault (1979). The result is the identification of three related concepts at work in the colonizing process of the aged body: (i) appropriation of the body – the physical and social practices involved in placing older people in care homes; (ii) separation from previous identities – how a range of new subjectivities are produced in the process of becoming a 'resident'; and (iii) contesting colonized identities – the ways in which residents can attempt to challenge normative concepts of managed physical and mental decline. Overall the disciplining of the body is theorized not only as an adjunct to the notion of corporate colonization but also, more generally, as a prominent and powerful organizing principle of later life.