The Community General Hospital

Georgopoulos, Basil S.; Mann, Floyd C.

doi:10.1097/00000441-196306000-00015

Cited by 80 publications

(20 citation statements)

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“…For example, various typologies identify both structural and enacted dimensions of coordinating mechanisms. This includes programmed versus nonprogrammed means of coordinating, which examines the extent to which activities can be specified in advance (Argote 1982, Georgopoulos and Mann 1962, Georgopoulos and Cooke 1979, and bureaucratic versus less bureaucratic task assignment, in which less bureaucracy requires greater flexibility in coordinating mechanisms (Ching et al 1992). This suggests tension between the standardized nature of tasks with rules to govern each activity and the mutual adjustment, informal communication, and improvisation that occurs between actors to achieve tasks (Adler 1995, Malone and Crowston 1994, Orlikowski 1996, Thompson 1967.…”

Section: Dynamic Nature Of Coordinating Mechanismsmentioning

confidence: 99%

Toward a Theory of Coordinating: Creating Coordinating Mechanisms in Practice

Jarzabkowski

Lê

Feldman

2012

Organization Science

248

217

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T his paper uses a practice perspective to study coordinating as dynamic activities that are continuously created and modified in order to enact organizational relationships and activities. It is based on the case of Servico, an organization undergoing a major restructuring of its value chain in response to a change in government regulation. In our case, the actors iterate between the abstract concept of a coordinating mechanism referred to as end-to-end management and its performance in practice. They do this via five performative-ostensive cycles: (1) enacting disruption, (2) orienting to absence, (3) creating elements, (4) forming new patterns, and (5) stabilizing new patterns. These cycles and the relationships between them constitute a process model of coordinating. This model highlights the importance of absence in the coordinating process and demonstrates how experiencing absence shapes subsequent coordinating activity. IntroductionThis paper is about the process of coordinating. We show that coordinating mechanisms are dynamic social practices that are under continuous construction. Despite some preoccupation in the literature with specifying the standards, rules, and schedules that comprise coordinating mechanisms, organization theorists have long noted that these mechanisms are not stable entities (e.g., Galbraith 1977, Lawrence and Lorsch 1967, March and Simon 1958, Thompson 1967. Indeed, scholars have shown that mechanisms fluctuate to adapt to conditions of uncertainty, novelty, and change when existing ways of organizing activities are disrupted and must be accomplished in new ways (Adler 1995;Argote 1982;Crowston 1997;Feldman 2000Feldman , 2003Pentland 1992). There are thus increasing calls for research to examine the dynamic nature of coordinating mechanisms as they are constructed within the activities of interdependent actors as they perform organizational tasks over time (Adler 1995, Ching et al. 1992, Jarzabkowski 2004, Malone and Crowston 1994, Okhuysen and Bechky 2009. By shifting the analytic focus from coordinating mechanisms as reified standards, rules, and procedures to coordinating as a dynamic social practice, our research provides insight into the microprocesses involved in coordinating.We study the coordinating of a major structural change at Servico, a Financial Times Stock Exchange (FTSE) 100 company, through the performance of a specific coordinating mechanism, end-to-end management (E2E). Drawing on performative and ostensive concepts as developed in the literature on organizational routines (e.g., Feldman 2000, Feldman and Pentland 2003, Pentland and Feldman 2005, Howard-Grenville 2005, Levinthal and Rerup 2006, Rerup and Feldman 2011, Zbaracki and Bergen 2010, we examine how actors iterate between the abstract concept of end-to-end management and their performance of it in practice. We explain how these performances enact what the actors come to identify as end-to-end management and how they use it as part of accomplishing a major coordinating task: restructuring the core who...

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Section: Dynamic Nature Of Coordinating Mechanismsmentioning

confidence: 99%

Toward a Theory of Coordinating: Creating Coordinating Mechanisms in Practice

Jarzabkowski

Lê

Feldman

2012

Organization Science

248

217

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“…To be sure, coordination is not a new concept to the health services research community. Studies of coordination and quality of care date back more than 30 years (Georgopoulos and Mann 1962). The existing literature, however, is limited in two important ways.…”

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confidence: 99%

Patterns of Coordination and Clinical Outcomes: A Study of Surgical Services.

Young¹,

Charns²,

Desai³

et al. 1997

AMPROC

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Objective. To test the hypothesis that surgical services combining relatively high levels of feedback and programming approaches to the coordination of surgical staff would have better quality of care than surgical services using low levels of both coordination approaches as well as those surgical service using low levels of either coordination approach. Study Setting. A study sample of 44 academically affiliated surgical services that are part of the Department of Veterans Affairs. Study Design. In a cross-sectional analysis, surgical services were assigned to one of three groups based on their scores on feedback and programming coordination measures: high on both measures; high on one measure, low on the other; and low on both. Univariate and multivariate analyses were used to assess differences among these groups with respect to three quality indicators: risk-adjusted mortality, risk-adjusted morbidity, and staff perceptions of quality. Data Collection/Extraction Methods. Risk-adjusted mortality and morbidity came from an outcomes reporting program within the Department of Veterans Affairs that entails the prospective collection of clinical data from patient charts. Data on coordination practices and perceived quality came from a survey of surgical staff at each of the 44 participating surgical services. Principal Findings. The group of surgical services using high feedback and high programming had the best perceived quality. This group also had the lowest morbidity, but the difference was statistically significant with respect to only one of the two other groups: the group with low feedback and low programming. No significant group differences were found for mortality. Conclusions. Study results provide partial support for the hypothesis that high levels of feedback and programming should be combined for optimal quality of care. Study results also suggest that staff coordination is more important for improving morbidity than mortality in surgical services.

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“…Aside from the technical difficulties that arise when allocating to specialists, sharing resources might invoke resistance. As in most professional organizations, such as hospitals, professionals are organized in groups that are typically outside the control of the organization (Georgopoulos and Mann 1962). This leads to distrust between specialists and managers regarding each other's intentions Mintzberg 2001a, 2001b).…”

Section: Capacity Planningmentioning

confidence: 99%

“…Hospitals consist of organizational units that use both bureaucratic and professional forms of control (Georgopoulos and Mann 1962;Lawrence and Dyer 1983). The organizational culture and focus of these units influence many aspects of MSS implementation.…”

Section: Dealing With Implementation Problems: An Organizational Apprmentioning

confidence: 99%

Suitability and managerial implications of a Master Surgical Scheduling approach

2009

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Operating room (OR) planning and scheduling is a popular and challenging subject within the operational research applied to health services research (ORAHS). However, the impact in practice is very limited. The organization and culture of a hospital and the inherent characteristics of its processes impose specific implementation issues that affect the success of planning approaches. Current tactical OR planning approaches often fail to account for these issues. Master surgical scheduling (MSS) is a promising approach for hospitals to optimize resource utilization and patient flows. We discuss the pros and cons of MSS and compare MSS with centralized and decentralized planning approaches. Finally, we address various implementation issues of MSS and discuss its suitability for hospitals with different organizational foci and culture.Keywords Master surgical scheduling · Organizational issues · Operating room management · Organizational focus and culture · Health care operations planning and scheduling

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The Community General Hospital

Cited by 80 publications

References 0 publications

Toward a Theory of Coordinating: Creating Coordinating Mechanisms in Practice

Toward a Theory of Coordinating: Creating Coordinating Mechanisms in Practice

Patterns of Coordination and Clinical Outcomes: A Study of Surgical Services.

Suitability and managerial implications of a Master Surgical Scheduling approach

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