Is the doctor in? A relational approach to job design and the coordination of work

Gittell, Jody Hoffer; Weinberg, Dana Beth; Bennett, Adrienne L.; Miller, Joseph A.

doi:10.1002/hrm.20242

Cited by 71 publications

(83 citation statements)

References 60 publications

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“…For example, nurse participants were asked, "How much does the physician in this clinic respect the role you play in caring for patients?" The internal reliability for the relational coordination scale (Cronbach's a ¼ 0.89) in the present study compare favourably with previous reports (a ¼ 0.86 and 0.87) (Hagigi, 2008;Gittell et al, 2008). Construct validity of the study instrument was assessed using confirmatory factor analysis (CFA).…”

Section: Instrumentationsupporting

confidence: 56%

Perceived quality of interprofessional interactions between physicians and nurses in oncology outpatient clinics

Lee

Doran

Tourangeau

et al. 2014

European Journal of Oncology Nursing

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Section: Instrumentationsupporting

confidence: 56%

Perceived quality of interprofessional interactions between physicians and nurses in oncology outpatient clinics

Lee

Doran

Tourangeau

et al. 2014

European Journal of Oncology Nursing

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“…Nevertheless, this should not discour- analysis. By conducting research at the unit (e.g., Eisenhardt & Brown, 1999;Karim, 2006;2009) or work level (e.g., Garg & Rastogi, 2005;Gittell, et al, 2008;Grant, Fried, & Juillerat, 2010;Humphrey et al, 2007), deeper insights into desirable and "competitive" organizational design practice will be achieved.…”

Section: Discussionmentioning

confidence: 99%

Organizing for Competitiveness – Structural and Process Characteristics of Organizational Design

Hernaus¹,

Aleksić²,

Klindžić³

2013

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Vizja Press&IT www.ce.vizja.pl 25An emerging multidimensional approach to organizational design outlines the need for the alignment of relevant structural and process characteristics of organizations. However, neither the interaction of these characteristics nor their role and importance for organizational competitiveness is properly examined in the literature. Therefore, the main goal of this paper is to investigate the relationship between the structural and process characteristics of organizational design to determine how and to what extent these characteristics contribute to achieving a competitive advantage. The field survey was conducted on a cross-sectional sample of 134 Croatian companies. The research findings outlined the need for a new organizational design approach that emphasizes both the vertical and horizontal dimensions of design solutions. This paper contributes to previous research by showing that organizational design represents a source of competitive advantage only if structural and process characteristics are commonly designed. In addition, we confirmed that although structural characteristics are usually more often addressed, it is process characteristics that make a difference. IntroductionOrganizational design has become an important and relevant topic both in theory and in practice. A turbulent and highly competitive business environment accompanied by a constant interplay of rising complexity and interdependence creates an ongoing demand for organizational designs that can respond to new and more powerful coordination mechanisms (Galbraith, 2012). Additionally, contemporary organizations must be efficient, effective, flexible, agile, innovative, fast-cycled, responsive, and aligned.They must focus on increasing the capacity of existing resources as an additional strategy for meeting the resource demands of the business (Steinmetz, Bennet, & Hakonsson, 2012). Although such organizational goals require very broad systemic efforts and call for numerous organizational interventions, differentiation and integration of activities can be recognized as one of the most relevant design issues (e.g., Dougherty, 2001;Lawrence & Lorsch, 1967;Raisch et al., 2009

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“…Existing evidence around care coordination predicts that comanagement designs improve provider coordination through stage-based and site-based specialization. 12 However, the mechanisms that mediate coordination and patient outcomes are not clear. Moreover, the mechanisms of coordinating multi-disciplinary teams may be specific to each clinical setting.…”

Section: Discussionmentioning

confidence: 99%

“…20 This instrument was chosen because it has already been validated in various clinical contexts 8,12,21 and the theoretical assumptions about the independent relational and communication components of coordination are applicable to our context. RC is characterized by the 7 domains of frequent, timely, accurate, and problem-solving communications; shared goals, shared knowledge, and mutual respect.…”

Section: Relational Care Coordinationmentioning

confidence: 99%

“…11 The use of hospitalists, for example, is shown to capitalize on this advantage by improving coordination through physician availability that facilitates communication and relational interactions among hospital-based staff. 12 While system-level interventions such as this have received significant attention from experts in organizations, empirical studies that explore the contribution of team member characteristics to overall coordination are lacking. 13 Inpatient comanagement services offer a unique model for studying teamwork.…”

mentioning

confidence: 99%

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Effects of provider characteristics on care coordination under comanagement

Hinami

Whelan

Konetzka

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Care coordination is critical in settings characterized by high levels of uncertainty, time constraints, and interdependent work processes. The effects of provider characteristics on coordination in comanaged teams has never been examined.OBJECTIVE:To characterize individual providers based on their contribution to team coordination.PARTICIPANTS:Hospitalists, nonphysician providers, hepatologists, and fellows on a comanaged liver service of an academic hospital.DESIGN:Between April 2008 and October 2008, participants were surveyed at baseline and repeatedly at the completion of physician rotations to assess their preferred and actual comanagement structures. In addition, they repeatedly rated their comanagers' contributions to overall coordination using an instrument that assessed relational coordination (RC). Providers were categorized into tertiles of RC. Their management preferences and the frequency of a “composite bad outcome” (intensive care unit [ICU] transfer or inpatient death) in each tertile were evaluated.RESULTS:All (100%) Baseline Surveys and 177/224 (79%) Repeated Surveys were completed by 32 providers. RC was shown to be a stable attribute of providers and not of adverse patient outcomes. Higher coordinators were characterized by their “ownership of patients” (higher 86% vs. lowest 20%, P < 0.01). High compared to low coordinator hepatologists demonstrated leadership through a broader delegation of tasks as well as self‐assignment of responsibilities. A trend toward more frequent “composite bad outcomes” was seen for low tertile physicians: hospitalists (low 8.6% vs. high 1.1%, P < 0.01), hepatologists (low 5.2% vs. high 2.0%, P = 0.22), fellows (low 5.8% vs. high 1.8%, P = 0.08).CONCLUSION:Individual provider's teamwork‐related disposition affects perceived coordination on comanaged team and may influence patient outcomes. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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Is the doctor in? A relational approach to job design and the coordination of work

Cited by 71 publications

References 60 publications

Perceived quality of interprofessional interactions between physicians and nurses in oncology outpatient clinics

Perceived quality of interprofessional interactions between physicians and nurses in oncology outpatient clinics

Organizing for Competitiveness – Structural and Process Characteristics of Organizational Design

Effects of provider characteristics on care coordination under comanagement

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