Looking Good or Doing Better? Patterns of Decoupling in the Implementation of Clinical Directorates

Mascia, Daniele; Morandi, Federica; Cicchetti, Americo

doi:10.5465/ambpp.2011.65869728

Cited by 8 publications

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“…Very important tasks have been delegated to middle managers who are considered to connect the strategic and the operational levels of an organization [2]. In hospitals, middle managerial roles are occupied by doctor-managers who have to deal with dual roles (managerial and clinical) [46]. These professionals are experiencing dramatic changes in their working conditions [1,7], and empirical evidence suggests that the effectiveness of such changes strongly depends on their abilities [8][9].…”

Section: Discussionmentioning

confidence: 99%

The Microfoundations of Physicians’ Managerial Attitude

Vincenzo

Angelozzi

Morandi

2020

Preprint

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Background. Accountable care has profoundly changed the organizational models adopted by health care organizations and, consequently, the skill set required for doctor-managers who have become middle managers and must deal with the operational management of their units. The aim of this study was to identify the psychological microfoundations (i.e., traits) of physicians’ managerial attitude. Specifically, we analysed the roles played by narcissism, specialization choices and identification with the organization. Methods. We collected primary data on a population of ward unit heads in the Italian National Health Service. A logistic regression model predicting the levels of managerial attitude was employed. Results. The results indicate that high levels of narcissism and identification with the organization are related with higher managerial attitude (instead of clinical attitude). Additionally, we found that physicians with a technique-oriented specialization present a higher probability of manifesting managerial attitude (in comparison to clinical attitude). Conclusions. Hospital managers can benefit from the use of these findings by developing a strategic approach to human resource management that allows them to identify, train and select the right mix of technical knowledge and managerial skills for middle management roles.

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Section: Discussionmentioning

confidence: 99%

The Microfoundations of Physicians’ Managerial Attitude

Vincenzo

Angelozzi

Morandi

2020

Preprint

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“…Indeed, previous studies, with larger representative samples, tend to confirm the percentage distributions among institutional typologies and geographical locations detecting, for example, the presence of more organizations in the North, if compared to Central and Southern Italy. 3 Each healthcare organization autonomously selected two CDs (with the exception of one organization, which selected only one CD) to be involved in the study.…”

Section: Methodsmentioning

confidence: 99%

“…This organizational model, introduced at first in the United States during the 1980s, quickly became the most frequent response European healthcare systems provided to the new managerial challenges the NPM approach implied, being considered the most suitable to balance the need for greater efficiency with quality improvement. 3 CDs are semiautonomous hospital divisional units in which several clinical wards are integrated or merged. 49,50 Although wards may be aggregated on the basis of different criteria, the main intent of the law is clearly to assign responsibility to organizations by creating subunits that are accountable for their own activities.…”

Section: From a Local To An International Contextmentioning

confidence: 99%

“…However, although the model has been introduced in the system over 15 years ago, its concrete success is still widely debated. 3 Indeed, a number of studies suggest that institutional and/or legislative changes are not sufficient to enact (or, at least, are not the sole determinants of) change in an organization's identity. It is argued that such change requires a deep cultural one, able to overcome all those resistances that may hinder effective change.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Overcoming factors such as a lack of capacity of action and the presence of consolidated routines, therefore, seems to be the only way to enhance fully implemented CDs. 3,6,7 This work wants to spread light on to the still poorly explored issue about whether CDs have really fostered change in line with their objectives. To do this we explored the extent of adoption and actual implementation of Human Resource Management (HRM) practices in CDs, by using an innovative framework of analysis.…”

Section: Introductionmentioning

confidence: 99%

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HRM practices and organizational change: Evidence from Italian clinical directorates

Gabutti

Morandi

2018

Health Serv Manage Res

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The general degree of implementation of HRM practices is still somewhat distant from a theoretically excellent and full implementation, especially if we consider the important lag of time since the reforms affected the sector. Nevertheless, results open the way to important considerations about the effectiveness of the CD model. Original value: The original methodology and scoring system suggested in this work produce a concise evaluation of the development of an effective HRM system within CDs. Our framework of analysis allows interesting benchmarking activities among different CDs of an organization and, ultimately, among different organizations. Moreover, the methodology presented may constitute a valid source of information in order to carry out future research on the items able to affect the implementation of such tools.

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The need for management education of healthcare management employees

Jankelová

Joniaková

Romanová

2021

Health Planning & Management

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SummaryGiven the wide professional discussion on the dominating professional focus of healthcare managers at the expense of management knowledge, the main goal of this paper is to verify the extent, to which management education of healthcare workers affects the level of their management skills.MethodologyThe Descriptive statistics methods have been used to answer research questions regarding the differences in the perception of the managerial skills and their disposition importance between managers with a completed management education and without it. Emphasis was placed on people management skills and communication skills. The research sample consisted of 253 healthcare managers.ResultsManagers with a completed specialized management study are characterized by higher values of entrepreneurial competences and communication skills. They also have exceptional skills in the area of initiator of change. Another significant difference is the higher adaptation of roles and low critique of their subordinates. They are oriented at workers and relationships with them.ConclusionOur results show that management education of healthcare managers significantly contributes to the implementation of newer approaches to people management and the use of the necessary management skills, which are a source of higher efficiency in the context of the present world of work and its challenges.

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Looking Good or Doing Better? Patterns of Decoupling in the Implementation of Clinical Directorates

Cited by 8 publications

References 0 publications

The Microfoundations of Physicians’ Managerial Attitude

The Microfoundations of Physicians’ Managerial Attitude

HRM practices and organizational change: Evidence from Italian clinical directorates

The need for management education of healthcare management employees

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