PurposeThis paper aims to fill gaps in one’s knowledge of the impact of organizational change on two outcomes relevant to hospital service quality (performance obstacles and physician job satisfaction) and in one’s knowledge of the role of middle manager change-oriented leadership in relation to the same outcomes. Further, the authors aim to identify how physician participation in decision-making is impacted by organizational change and change-oriented leadership, as well as how it mediates the relationships between these two variables, performance obstacles and job satisfaction.Design/methodology/approachThe study adopted a cross-sectional survey design including data from Norwegian hospital physicians (N = 556). A hypothetical model was developed based on existing theory, confirmatory factor analysis was carried out in order to ensure the validity of measurement concepts, and the structural model was estimated using structural equation modelling.FindingsThe organizational changes in question were positively related to performance obstacles both directly and indirectly through participation in decision-making. Organizational change was also negatively related to job satisfaction, both directly and indirectly. Change-oriented leadership was negatively related to performance obstacles, but only indirectly through participation in decision-making, whereas it was positively related to job satisfaction both directly and indirectly.Originality/valueThe authors developed a theoretical model based on existing theory, but to their knowledge no other studies have tested these exact relationships within one model. These findings offer insights relevant to current and ongoing developments in the healthcare field and to the question of how hospitals may deal with continuous changes in ways that could contribute positively towards outcomes relevant to service quality.

Translation studies have shown that management ideas and practices change as they travel between contexts, and that there are regularities in how they are translated through editing. We, however, know less about what facilitates good translations, i.e. the translation of new ideas and practices into working practices or routines that contribute to the attainment of organizational goals. This study investigates how the concept of readiness for change can increase our understanding of translation processes and translation outcomes through following an intra-organizational translation of a new management idea and practice in a hospital. The aim is to identify how the use of editing rules in a strategic translation process impacts readiness for change. It is also to identify how readiness influences the use of editing rules and translation practices in an operative translation process and the resulting differences in the quality of translation outcomes. This study finds that strategic translations may foster readiness for change. Readiness furthermore enables inclusive operative translation processes in which editing practices and translation rules are used to thoroughly rework a new management idea and practice into a good translation. MAD-StatementManagement ideas and practices change as they travel to new organizational settingsthey are translated. Not all translation outcomes contribute to the attainment of organizational goals. This paper argues that readiness for change is a key concept in understanding translation processes and the quality of translation outcomes. Change initiators may foster readiness for change among operative level employees through strategic translations. When readiness is high, a further operative translation process including a wide range of participants as translators may thoroughly rework the new idea and practice into new, constructive work practices that enable the organization to attain important goals.

Knowledge is lacking regarding how organizational factors are associated with uncertainty in patient treatment. Thus, the aim of the current study was to investigate how competence development and collaborative climate relates to job performance and job commitment, and further whether job performance and job commitment relate to uncertainty. Additionally, we examined whether these associations differed between four different hospitals. We applied data from 6445 hospital workers who provided care to patients. Basic statistics and structural equation modelling (SEM) were used to test the validity of the theoretical model developed in the study and the hypothesized associations. All hypothesized paths between the latent variables were significant and in accordance with the model across the four hospitals. The current study has implications for practical human resource management and indicates that competence development should be strengthened at the individual level and collaborative climate should be strengthened at the ward level. Strengthening competence development and collaborative climate can increase job performance and job commitment of individual workers and reduce uncertainty during care in hospital settings.

Background Distributed Leadership (DL) has been suggested as being helpful when different health care professionals and patients need to work together across professional and organizational boundaries to provide integrated care (IC). This study explores whether General Practitioners (GPs) adopt leadership actions that transcend organizational boundaries to provide IC for patients and discusses whether the GPs’ leadership actions in collaboration with patients and health care professionals contribute to DL. Methods We interviewed GPs (n = 20) of elderly multimorbid patients in a municipality in Norway. A qualitative interpretive case design and Gioia methodology was applied to the collection and analysis of data from semi-structured interviews. Results GPs are involved in three processes when contributing to IC for elderly multimorbidity patients; the process of creating an integrated patient experience, the workflow process and the process of maneuvering organizational structures and medical culture. GPs take part in processes comparable to configurations of DL described in the literature. Patient micro-context and health care macro-context are related to observed configurations of DL. Conclusion Initiating or moving between different configurations of DL in IC requires awareness of patient context and the health care macro-context, of ways of working, capacity of digital tools and use of health care personnel.

Over the past four decades, a large number of public health care reforms and policies internationally and nationally have been aimed at solving these challenges. At the outset of 2018, the Norwegian Minister of Health Services restated that reduction in waiting times and quality improvement are strategic goals for the Norwegian hospital sector. The policy vision is to create "The Patients' Health Service". He pointed to the development of new ways of planning and organizing services as means to reach those goals 1. Internationally, hospitals are introducing integrated, patient-centred organizational structures in order to achieve more patient-centred care, cost reductions and quality improvements. The new structures organize the delivery of services around the need of the patient instead of along the traditional lines of professional specialization (Vera & Kuntz, 2007). With regard to the planning of health service delivery work, the Minister announced that hospitals will be required to establish national planning indicators. These should describe the number of patients who do not turn up for their hospital appointments, the share of hospital consultations that are rescheduled, and the extent of time for which the hospitals are currently planning consultations ahead. The intent is to establish a national best practice for planning. These practices could ensure that patients more consistently receive the treatments they are entitled to within mandated guarantee deadlines, and enable hospitals to utilize their resources more efficiently as a result of a more coherent, long term matching of tasks and staff, instead of increasing efficiency by making health service professionals work faster and harder. Reforms, new policies and the continuous large-and/or small-scale changes aiming for service quality improvement that they manifest in within hospital organizations have been identified as a move away from 1