To protect themselves against deskilling and obsolescence, professionals must periodically revise their claims to authority and expertise. Although we understand these dynamics in the broader system of professions, we have a less complete understanding of how this process unfolds in specific organizational contexts. Yet given the ubiquity of embedded professionals, this context is where jurisdictional shifts increasingly take place. Drawing on a comparative ethnographic study of human resources (HR) professionals in two engineering firms, we introduce the concept of jurisdictional entrenchment to explain the challenges embedded professionals face when they attempt to redefine their jurisdiction. Jurisdictional entrenchment describes a condition in which embedded professionals have accumulated tasks, tactics, and expertise that enable them to make jurisdictional claims in an organization. We show how such entrenchment is a double-edged sword: instrumental to the ability of professionals to withstand challenges to their authority but detrimental when expertise and skills devalued by the professionals remain in high demand by clients, thus preventing the professionals' shift to their aspirational jurisdiction. Overall, our study contributes to a better understanding of how embedded professionals renegotiate jurisdictional claims within the constraints of organizational employment.
This is the accepted version of the paper.This version of the publication may differ from the final published version. Acknowledgements: We would like to thank Lisa Cohen, Santi Furnari, Stefan Haefliger, Paula Jarzabkowski, Sebastien Mena, Amit Nigam, Gerardo Okhuysen, Mark Zbaracki, and participants in the Cass internal research workshop for their helpful comments and suggestions. We also appreciate the thoughtful guidance of Mauro Guillen, and our three anonymous reviewers. The field work for the film project was generously supported by the Reginald Jones Center at the Wharton School. Permanent repository link 2 ABSTRACTIn this article, we examine how occupational communities that are embedded in organizations exercise control processes to achieve emergent coordination. We compare two types of organizations, equipment manufacturing and film production, and find that while occupational control was important for emergent coordination in both settings, this relationship varied according to two aspects of occupational embeddedness: organizational acknowledgement and occupational interdependence. In the equipment manufacturing setting, occupational control was latent: the communities visibly conformed to organizational control processes while exercising occupational control behind the scenes to coordinate emergently. In the film setting, the organization granted the occupational community significant latitude over its tasks, which enabled members to coordinate emergently the majority of the time. We propose that these two aspects of occupational embeddedness must be analyzed together with occupational control processes to explain how integration unfolds in knowledge-based settings. 3The post-industrial economy is increasingly made up of organizations that rely on skilled occupations to accomplish knowledge-based activities (Alvesson 1995;Vallas 1999; Barley 1996;Powell and Snellman 2004;Gorman andSandefur 2011). As Gorman and Sandefur (2011: 291) note, "the world of work is increasingly divided into two hemispheres: one which requires expert knowledge accessible only through higher education, and one which does not." Indicative of this shift, in the United States, professional and related services are the largest and fastest growing category of workers as of 2010 (Bureau of Labor Statistics 2010). However, the growing prominence of knowledge work in the economy has not been reflected in the literature on coordination, which has largely focused on documenting the impact of changes in the organizational environment.The presence of multiple groups with expert knowledge in organizational settings has made the accomplishment of collective tasks more challenging (Stark 1999). These challenges have reinvigorated interest in the study of coordination in organizations, albeit with a change in focus. While early organizational design research attended primarily to the role of structures and planning in coordination, recent scholarship conceptualizes coordination as emergent: workers achieve collective outcomes through ongo...
The emergence of an evidence-based medicine logic represents a major change in the large and complex field of American healthcare. In this analytical case study, we show that the intellectual school of evidence-based medicine became an important meso-structure that facilitated the growth of the new logic in American healthcare. The new intellectual school was a community of scholars who generated shared rules and resources through intergenerational mentoring. The school engaged in advocacy to advance new intellectual paradigms for conceptualizing healthcare quality that, when connected with material practices in the field of American healthcare, came to form a new institutional logic.
BackgroundHealthcare providers and systems globally are increasingly recognising the benefits of adopting continuous improvement methods to transform hospital services. Creating a continuous improvement culture relies on giving frontline staff the support and freedom to identify opportunities for positive, sustainable, change and the skills to enable action. This paper analyses the leadership behaviours and practices that support or inhibit the adoption of a continuous improvement culture, drawing on a qualitative evaluation within the outpatient directorate at one National Health Service (NHS) trust.ObjectiveIdentify key leadership behaviours and practices that enable and inhibit a continuous improvement culture in healthcare settings.MethodsResults from the 2020 NHS staff engagement survey informed the development of an original survey and interview protocol aimed at uncovering factors that enable or inhibit a continuous improvement culture in this directorate. All staff within the outpatient directorate at all NHS banding levels were invited to take part.Results44 members of staff took part: 13 members of staff were interviewed, and 31 members of staff completed a survey. Of the factors that are perceived to inhibit a continuous improvement culture, ‘Not feeling listened to or supported to find the right solution’ was the most frequently occurring theme. Conversely, the most common enabling factors were ‘leaders and staff solving problems together’ and ‘leaders making time to understand the challenges of their staff’. The findings suggest that the most important behavioural changes leaders can make are: proactively taking the time to listen to and understand the challenges staff face; and supporting them to find the root cause of problems.ConclusionContinuous improvement cultures depend on high staff engagement; leaders who show curiosity, invest time in listening, and act as partners in problem solving are more likely to elicit engagement and thereby enable a continuous improvement culture.
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