Exploring the Role of Job Crafting in Managing the Tensions of Standardized Work in Healthcare Opera

Abstract

Combining both HOM and organizational research, this paper examined how a bottom-up approach to job design termed job crafting, manifests in standardized work procedures and how it affects the performance of standardized operations. The research is built upon an in-depth longitudinal case study that investigated the adoption of national standardized stroke care process in a UK general hospital. This study identified many multi-level tensions of standardized work in healthcare operations previously discussed in the HOM literature, reinforcing the idea that and any implementation mechanism must be multi-faceted and dynamic. Detailed observation of pathway implementation confirms the vital influence of professional autonomy on the pathway performance by crafting their work. The study found that all the different forms of the initial model of job crafting i.e. task, relational and cognitive were present among different groups of staff during standardized work operations at the hospital. Positive and negative consequences of job crafting to both the staff and the operational procedures were clearly observed. Drawing on organizational and HRM literature interventions to facilitate positive job crafting to improve the performance in standardized operations were discussed. Directions for further studies are also suggested. Keywords: standardized work, healthcare operations, implementation tensions, autonomous professionals, job crafting