This article analyses a process improvement project based on Lean Six Sigma (LSS) techniques in the emergency department (ED) of a large Australian hospital. We consider perspectives of the clinical and managerial staff involved in the project implementation, its implications for empowerment and work intensification. We find that the project appeared to improve patient flow from the ED to the wards and to have positive implications for some staff. However, these achievements tended to be the result of senior staff using the project to leverage resources and create desirable outcomes, rather than the result of the use of LSS, in particular. We found some evidence of work intensification, but this was attributable to wider systemic issues and budget constraints, rather than being a direct consequence of the use of LSS. We argue that translating LSS from a manufacturing context into the politicised and professionalised context of healthcare changes the usual questions about empowerment or work intensification to questions about the influences of powerful stakeholders.

Recently, Haggerty and Wright suggested that HR could be reconceptualised as signals sent to employees rather than practices. We examine this novel approach and consider how it fits in the practice. In hospitals, ward managers are intermediaries in relation to signals that are passed between upper managers and their staff. We discuss to what extent ward managers have the analytical and functional skills required to interpret and convey complex signals to the staff under their jurisdiction. We draw conclusions about the role of ward managers in the HR function of hospitals. There are theoretical and practical implications for the role of line managers more generally, beyond the hospital context.

To what extent have hospitals developed their skilled clinicians to perform the administrative and human resources (HR) manager role of the ward manager? We consider this research question through an analysis of an acute hospital called 'The Hospital' where the executive team is aiming to adopt a form of high-performance work system (HPWS). We focus primarily on explanations in terms of conditions, rather than the personalities of individual managers, which are most powerful in shaping their behaviour. There has long been a failure of hospitals (and other employing organisations) to develop fully the skills required by employees before they become line managers. Line managers are a critical link in the high-performance chain and this study illustrates that, despite their rhetoric, hospitals may still have much potential for implementing schemes to develop nurses further to prepare them for linemanager positions and to support them after they move into such roles. We infer from this study that such hospitals may not yet have completed the journey to having HPWS. Hence, there is still much scope for such hospitals to progress and enjoy the benefits that proponents claim for HPWS.

This article introduces a special issue on Situating Human Resource Management (HRM) Practices in their Political and Economic Contexts. We develop a novel multilevel framework for exploring the political economy of HRM and use this to position the articles in this special issue. We argue that the study of HRM is often too narrowly constructed within a psychological, positivistic paradigm and at an organisationlevel, and that situating HRM in its political and economic context requires a more inclusive, interdisciplinary approach that includes the use of kaleidoscopic imagination and meta-theoretical bricolage. By embracing a theoretically pluralist approach to studying HRM, researchers are better able to analyse how different levels of the political economy interact with specific HRM practices to impact value creation. We conclude by discussing the contribution of this article and the special issue, as well as highlighting avenues for future research.