Organizational Responses Research Articles

Leading Organizational Change in the Post-COVID Pandemic Era.

Leading Organizational Change in the Post-COVID Pandemic Era.

Great debates in trauma biomechanics.

At the 2021 annual meeting of the Orthopaedic Trauma Association, the Basic Science Focus Forum hosted its first ever debate-style symposium focused on biomechanics and fracture repair. The 3 subjects of debate were "Mechanics versus Biology-Which is 'More Important' to Consider?" "Locked Plate versus Forward Dynamization versus Reverse Dynamization-Which Way Should I Go?" and "Sawbones versus Cadaver Models-What Should I Believe Most?" These debates were held because fracture healing is a highly organized synergistic response between biological factors and the local mechanical environment. Multiple studies have demonstrated that both factors play roles in governing bone healing responses, and the causal relationships between the 2 remain unclear. The lack of clarity in this space has led to a spectrum of research with the common goal of helping surgeons make good decisions. Before reading further, the reader should understand that the questions posed in the debate titles are unanswerable and might represent a false choice. Instead, the reader should appreciate that the debates were held to gain a more thorough understanding of these topics based on the current state of the art of experimental and clinical studies, by using an engaging and thought-provoking format.

Observational study of organisational responses of 17 US hospitals over the first year of the COVID-19 pandemic

ObjectivesThe COVID-19 pandemic has required significant modifications of hospital care. The objective of this study was to examine the operational approaches taken by US hospitals over time in response to...

National Amoxicillin-Clavulanate Formulation Use Pattern: A Survey.

Five commercially available amoxicillin-clavulanate (AMC) ratio formulations contribute to ratio selection variability with efficacy and toxicity implications. The objective of this survey was to determine AMC formulation use patterns across the United States. A multicenter practitioner survey was distributed to multiple listservs (American College of Clinical Pharmacy pediatrics, infectious diseases, ambulatory care, pharmacy administration; American Society of Health-System Pharmacists; Pediatric Pharmacy Association members), and selected pediatric Vizient members in June 2019. Responses were screened for multiples within institutions. Repeated organization responses were identified (n = 37) and excluded if the duplicate matched another response from the same organization exactly (n = 0). One hundred ninety independent responses were received. Nearly 62% of respondents represented a children's hospital within an acute care hospital; remainder being from stand-alone children's hospitals. Around 55% of respondents indicated prescribers were responsible for choosing the patient-specific formulation for inpatients. Nearly 70% of respondents indicated multiple formulations were available due to clinical need (efficacy, toxicity, measurable volume), whereas over 40% responded that the number of liquid formulations were limited to decrease the potential for error. Variability was demonstrated among institutions using ≥ 2 different formulations for acute otitis media (AOM), sinusitis, lower respiratory tract infection, skin and soft tissue infection, and urinary tract infection (33.6%, 37.3%, 41.5%, 35.8%, and 35.8%, respectively). The 14:1 formulation was the most common, but not exclusive, for AOM, sinusitis, and lower respiratory tract infections with 2.1%, 2.1%, and 2.6% of respondents indicating use of the 2:1 formulation and 10.9%, 15%, and 16.6% of respondents indicating use of the 4:1 formulation. Significant AMC formulation selection variability exists across the United States.

Disruptive market shift: Conceptualization, antecedents, and response mechanisms

Although prior research has examined the effects of different forms of disruptive market shift on organizational practice, structure, and performance, knowledge is lacking on its conceptual domain, antecedents, and organizational response outcomes. This study draws insights from an in-depth analysis of 23 organizations to conceptualize disruptive market shift and explore its antecedents and consequences. We find that digitization, technological advancements, political uncertainty and government regulations, competitive pressures, the media, and customer dynamism are major drivers of disruptive market shifts. Furthermore, evidence suggests that organizations establish collaborative relationships, initiate internal transformational processes, and develop innovative metrics and patterns to respond to disruptive market shifts. We discuss the theoretical and managerial implications of the findings.

Mitigating anxiety: The role of strategic leadership groups during radical organisational change

This article examines the role of strategic leadership groups in radical organisational change. Previous research has focused on how ‘heroic’ individual leaders guide change. In contrast, we argue that strategic leadership groups are indispensable to understanding and supporting radical organisational change. Building on a longitudinal study in a global European company, our research identifies four phases of ‘negotiated order’ that shape group and organisational responses to change. Our findings reveal that strategic leadership groups help manage emotions and understand the shifting authority relations that inevitably arise during periods of change. Drawing upon the psychoanalytic concept of ‘projective identification’, we develop a theoretical framework for understanding the tensions of change. The model shows how emotional coalitions that develop in strategic leadership groups afford a source of political and psychological containment against the anxieties of radical organisational change. These formations offer transitional spaces for change, providing opportunities for progress. The advantage of this new perspective on radical change is that it helps to move the organisation beyond periods of ambivalence and conflict, with positive implications for leadership practice.

Professional bodies

AbstractOrganization structures and processes of UK-based professional associations and regulatory bodies (professional bodies) are analyzed across all professions and over the long term. These are successful, long lived, and important organizations which have been neglected in the sociological and organizational literatures. Numbers have been growing and on average these organizations have enjoyed consistent financial success. They have been changing, reacting in part to external challenges, but also in response to internal challenges arising from growth and strains due to reactions to changes from their primary stakeholders, their members. We trace substantial changes in their staffing, governance, and education activities. We evaluate whether these changes amount to corporatization, as has been found in other public and third-sector organizations. We evaluate whether the changes confirm the charge that these organizations demonstrate the iron law of oligarchy. We find corporatization has been substantial but limited and that the changes represent shifting toward strategy rather than oligarchy, though democratic weakening has occurred. We find organization responses to member confusion, concerns, and criticisms to be influential in driving these changes and contributing to the sustainability of these organizations.

Rising Every Time We Fall: Organizational Fortitude and Response to Adversities

The role of organizational resilience enabling firms to respond to adversity and survive has become ever more critical in the wake of an increasingly unpredictable external environment. Yet, while we understand the importance of resilience in responding to a major adversity, we have little appreciation for how firms are affected and react when facing multiple adversities over time, or how multilevel factors might impose on this process. These are crucial issues given that adversities are not necessarily single, isolated, or infrequent episodes. By studying a long-established family firm in the United Kingdom that experienced four major adversities, we identify the process that enabled it not only to survive but also to thrive. In this qualitative study, we introduce the notion of organizational fortitude to describe the approach that a firm develops to cope with the challenges of multiple unexpected adversities and highlight how multilevel factors combine to foster organizational fortitude.

Navigating the uncharted: A crisis response mix to creeping ‘unknowns’

Creeping crises have received limited attention in crisis management. With a backdrop of COVID-19, we explore how tourism organisations can address unprecedented creeping crises. We propose and test a creeping crisis response matrix qualitatively and quantitatively by analysing 108 earnings calls from 22 hotel groups covering the first 16 months of the pandemic. Some cannot detect creeping crises during the incubation periods or the later re-emergence, whereas early exposure gives an advantage in crisis response. Contrary to conventional wisdom, organisational responses to unknown crises are not always reactive, with organisations deploying a varied mix of responses (reactive, adaptive, protective and proactive) even in the early stages of a crisis. As the framing of the crisis improves, crisis responses shift from survival to full-on experimentation, to response by design and then to response by protocol. The proposed matrix can be used as a response roadmap for navigating future, unknown, creeping crises.

Friends, peers and safeguarding

Friends, peers and safeguarding

Is it just me? The organizational implications of individual and collective burnout in schools

PurposeThis paper explores how individual and collective burnout has become an organizational concern for school leaders, why burnout matters and what might be done to address the problems individual and organizational burnout generates.Design/methodology/approachThis paper presents an analysis of the current literature regarding individual and collective burnout, identifies contributing factors and explores the impacts of each. Following a discussion and synthesis of the research literature, implications for practice are presented.FindingsHighlighting exhaustion as a factor in burnout and as a significant consequence of stress, the paper proposes specific individual teacher and leader actions focused on addressing broad organizational responses with the potential to address the consequences of burnout including depersonalization, cynicism, emotional and compassion fatigue, and a loss of individual and collective efficacy. The authors argue that for burnout to be successfully mitigated, urgent strategic and focused organizational responses are essential to identify, track, and counter individual and collective burnout.Originality/valueMuch of the existing burnout literature focuses on the individual as the locus of experience and inquiry. The authors contend that this predominant focus on individual experience is insufficient to address systemic organizational issues, problems and concerns facing educational organizations that perpetuates and accelerates the experience of individuals. This paper contribution elevates conceptions of and discussions about burnout to the organizational level and reframes the conversation by focusing on organizational responses.

Steering the Direction of Research through Organizational Identity Formation

Public research organizations respond to external pressures from national research evaluation systems, performance-based funding systems and university rankings by translating them into internal goals, rules and regulations and by developing organizational identities, profiles and missions. Organizational responses have primarily been studied at the central organizational level, and research on the steering of research has primarily focused on the impacts of performance-based funding systems. However, research evaluation exercises may also have a formative impact, especially below the central organizational level. This paper uses a case study of a research unit of a biomedical research school in the Netherlands to explore the organizational response to a relatively critical external assessment report. It shows that the participation in the Dutch research evaluation cycle legitimated the formation of a new organizational identity for the research unit, which functions as a frame that suggests to staff members a new interpretation of the type of research that is at the core of what the research unit does. We identify three additional steering mechanisms that support the enactment of the organizational identity: steering by resource allocation, by suggesting and by re-organizing. We, furthermore, explore the epistemic effects – the direction and conduct of research – of the organizational response, through interview data in combination with a bibliometric analysis.

How Temporary/Permanent Employment Status and Mindfulness Redraw Employee Organizational Citizenship Responses to Person-Organization Fit

This paper analyzes the role of temporary/permanent employment in the way employees respond to person-organization fit (P-O Fit) with organizational citizenship behaviors (OCBs), and whether mindfulness redraws this relationship. Compared to permanent employees, temporary employees may have fewer future prospects in their organization, thus leading them to engage less in this type of behavior, the potential returns of which are typically unspecified in time and are likely beyond their temporary reach. However, the self-regulatory, present-moment awareness and non-judgmental acceptance functions of mindfulness could reverse this relationship. Structural equation modeling using data from 280 employees of 10 Spanish hotels revealed that temporary (permanent) employees reacted to P-O Fit with lower (higher) OCBs, unless they were mindful, in which case their OCBs increased (decreased). The findings show that employment status and mindfulness redraw the P-O Fit - OCB relationship and that mindfulness makes temporary (permanent) employees respond to P-O Fit with increased (decreased) OCBs.

Organisational learning, or organised irresponsibility? Risk, opacity and lesson learning about mental health related deaths

This article examines how deaths related to mental health in England and Wales are investigated and the extent to which lessons are learned in their aftermath. It uses two concepts from academic literature to discuss organisational responses to these deaths: organisational learning, and organised irresponsibility. Organisational learning stresses the importance of learning lessons from data; in contrast, Beck’s concept of organised irresponsibility states that organisational lesson learning is impeded by the fragmented and risk-averse nature of public institutions. The article considers 210 organisational responses to Reports to Prevent Future Deaths (PFDs) issued by Coroners. PFDs are sent to any organisation Coroners believe could act to prevent future deaths. The article identifies three findings: Firstly, organisations tend to produce generic responses rather than addressing specific issues raised by Coroners. Second, organisations tend to cite existing policies as responses to Coroners despite those policies not preventing specific deaths. Third, institutions seek to displace blame onto other organisations in attempting to avoid accepting responsibility for the death. The article adds to the canon of knowledge on deaths in healthcare, and in the care of the state by identifying significant structural weaknesses that impede organisational lesson learning about preventable deaths.

The 2020s Global Crises: A Discussion of How International Institutions are Responding to the Russia-Ukraine Crisis and Climate Change Crisis

Humanity in the early 2020s has been endangered by several global crises like poverty, geopolitical unrest, inflation, pandemics, deepening inequality, supply-chain disruptions, climate change, and the Russia-Ukraine War; just to mention a few. The need for a social construct through the intervention of international institutions and non-state actors than individual state actors as postulated by Constructivists is essential. The purpose of this study is to review the response of various international organizations (IMF, World Bank, EU, UN, OECD, and NATO) to the global crises plaguing our world; specifically, Russia-Ukraine and Climate Change. We review the varied responses to the global impacts of the Russia-Ukraine war and Climate Change through the lens of Social Constructivism, an International Relations Theory. This theory emphasizes the impact of our actions on the world we live in and hence, the need for ‘rules’ that can guide our actions as well as reward those who follow the rules and punish those who do not. It also postulates the importance of international organizations/non-state actors in inducing our behaviors by lobbying or coaxing rather than individual state actors. Borrowing from the tenets of this theory, it is evident that our world needs the collaborative action of states through international relations and not individual state responses to combat these current global crises. This collaborative strategy is evident via the various responses (sanctions, emotional, material, weaponry) from the different international institutions listed in this study to the Russia-Ukraine war. Moreso, there continue to be diverse progressive collaborative conferences and policy reviews by member states of each of the international institutions listed in this study in response to the overwhelming impact of climate change. Even though this study focuses on international institutions' responses to just two of the global crises, there is an avenue for further review-research on the other crises.

Health and social care workers experiences of coping while working in the frontline during the COVID-19 pandemic: One year on.

The unprecedented pressure of working on the frontline during the Covid-19 pandemic had a demonstrable impact on the mental health and wellbeing of health and social care workers in the early stages of the pandemic, however, less research has focused on workers' experiences over the longer course of the pandemic. We set out to develop an explanatory model of the processes that helped and hindered the coping of HSCWs working over the course of the Covid-19 pandemic. Twenty HSCWs based in the UK took part in the study. They completed semi-structured interviews 12-18 months after the peak of the first wave in the UK. Interviews were transcribed and analysed using grounded theory methodology. The analysis identified eleven theoretical codes: personal context, organisational resources, organisational response, management, colleagues, decision-making and responsibilities, internal impacts, external impactors, safety, barriers to accessing support and temporal factors. The findings suggest that factors related to the individual themselves, their personal context, the organisation they work in, their managers, the support structures around them and their sense of safety impacted on HSCWs; ability to cope. Some factors changed over time throughout the first year of the pandemic, such as workload and staff illness, which further impacted HSCWs' coping. There were many barriers to accessing support that also impacted coping, including availability, awareness and time. The relationship between the factors that impacted coping are represented in an explanatory model. The findings extend previous studies on the mental health impact on frontline HSCWs working during Covid-19, providing novel insight by developing an explanatory model illustrating the underlying factors that impacted their coping experiences over the course of the pandemic in the UK. The findings from this study may assist in the development of improved and more effective support for HSCWs going forwards.

Veterans Health Administration response to 2021 recall of Philips Respironics devices: A case study.

This case study describes, for the time frame of June 2021 through August 2022, the U.S. Veterans Health Administration (VHA) organizational response to a manufacturer's recall of positive airway pressure devices used in the treatment of sleep disordered breathing. VHA estimated it could take over a year for Veterans to receive replacement devices. Veterans awaiting a replacement faced a dilemma. They could continue using the recalled devices and bear the product safety risks that led to the recall, or they could stop using them and bear the risks of untreated sleep disordered breathing. Using a program monitoring approach, we report on the processes VHA put in place to respond to the recall. Specifically, we report on the strategic, service, and operational plans associated with VHA's response to the recall for Veterans needing replacement devices. In program monitoring, the strategic plan reflects the internal process objectives for the program. The service plan articulates how the delivery of services will intersect the customer journey. The operational plan describes how the program's resources and actions must support the service delivery plan. VHA's strategic plan featured a clinician-led, as opposed to primarily legal or administrative response to the recall. The recall response team also engaged with VHA's medical ethics service to articulate an ethical framework guiding the allocation of replacement devices under conditions of scarcity. This framework proposed allocating scarce devices to Veterans according to their clinical need. The service plan invited Veterans to schedule visits with sleep providers who could assess their clinical need and counsel them accordingly. The operational plan distributed devices according to clinical need as they became available. Monitoring our program processes in real time helped VHA launch and adapt its response to a recall affecting more than 700,000 Veterans.

Translating quality criteria in university accreditation

PurposeThe purpose of this paper is to explore how Danish higher education institutions (HEIs) navigate the demands and expectations of accreditation procedures, and how the limited freedom posed by accreditation schemes is used by HEIs by way of translation.Design/methodology/approachThrough document studies of policy documents and the institutional self-assessment reports, the paper follows the concept of quality from the international level to the Danish national level, and onwards into the individual HEIs, where the authors examine how notions of quality are constructed through the translation of national regulation, guidelines and procedures of accreditation into the self-narratives of the self-assessment reports.FindingsThe authors find that the national guidelines for accreditation represents a complex translation of supranational guidelines by minimizing certain aspects and enhancing others. This national translation is then analyzed as the frame for the institutional translations where the analysis reveals how HEIs exercise a great deal of agency, within a quite narrow frame constituted by regulations and guidelines.Originality/valueBy using the Olivers (1991) typology of organizational responses, the authors discuss how the HEIs not only imitate and abide to institutionalized norms and concepts of quality but also reformulate, edit, omit and enhance certain elements of quality. The authors demonstrate that when accreditation meets the HEIs, it is clearly the national agendas that are most pervasive and offer the most relevant vocabulary for the HEIs.

Sexual Boundary Violations: Exploring How the Interplay Between Violations, Retributive, and Restorative Responses Affects Teams

Studying and discussing boundary violations between people is important for potentially averting future harm. Organizations typically respond to boundary violations in retributive ways, by punishing the perpetrator. Interestingly, prior research has largely ignored the impact of sexual boundary violations and retributive dynamics on teams. This is problematic as teams provide an obvious setting not only to detect and discuss troubling behavior by peers, but also for learning how to prevent future harm. Therefore, in this study we explore team-level experiences regarding sexual boundary violations and organizational responses to these incidents. Drawing on an in-depth case study, our findings shed light on the profound negative consequences of a retributive organizational response to sexual boundary violations. Additionally, our findings show how a restorative approach, inviting teams to reflect on the violations and their impact, can help teams to recover. Our main contribution involves a model that demonstrates how the interplay between sexual boundary violations, retributive, and restorative organizational responses affects teams. This model shows how combining these responses can acknowledge distress within teams, heal relationships between team members through dialogue, and open up the possibility to learn from these events. This model extends prior research focusing on individual actions and outcomes regarding violations. Additionally, by combining retributive and restorative organizational responses in one model, we extend the literature on restorative organizational responses to boundary violations.

Using the Pan American Health Organization Digital Conversational Agent to Educate the Public on Alcohol Use and Health: Preliminary Analysis.

There is widespread misinformation about the effects of alcohol consumption on health, which was amplified during the COVID-19 pandemic through social media and internet channels. Chatbots and conversational agents became an important piece of the World Health Organization (WHO) response during the COVID-19 pandemic to quickly disseminate evidence-based information related to COVID-19 and tobacco to the public. The Pan American Health Organization (PAHO) seized the opportunity to develop a conversational agent to talk about alcohol-related topics and therefore complement traditional forms of health education that have been promoted in the past. This study aimed to develop and deploy a digital conversational agent to interact with an unlimited number of users anonymously, 24 hours a day, about alcohol topics, including ways to reduce risks from drinking, that is accessible in several languages, at no cost, and through various devices. The content development was based on the latest scientific evidence on the impacts of alcohol on health, social norms about drinking, and data from the WHO and PAHO. The agent itself was developed through a nonexclusive license agreement with a private company (Soul Machines) and included Google Digital Flow ES as the natural language processing software and Amazon Web Services for cloud services. Another company was contracted to program all the conversations, following the technical advice of PAHO staff. The conversational agent was named Pahola, and it was deployed on November 19, 2021, through the PAHO website after a launch event with high publicity. No identifiable data were used and all interactions were anonymous, and therefore, this was not considered research with human subjects. Pahola speaks in English, Spanish, and Portuguese and interacts anonymously with a potentially infinite number of users through various digital devices. Users were required to accept the terms and conditions to enable access to their camera and microphone to interact with Pahola. Pahola attracted good attention from the media and reached 1.6 million people, leading to 236,000 clicks on its landing page, mostly through mobile devices. Only 1532 users had a conversation after clicking to talk to Pahola. The average time users spent talking to Pahola was 5 minutes. Major dropouts were observed in different steps of the conversation flow. Some questions asked by users were not anticipated during programming and could not be answered. Our findings showed several limitations to using a conversational agent for alcohol education to the general public. Improvements are needed to expand the content to make it more meaningful and engaging to the public. The potential of chatbots to educate the public on alcohol-related topics seems enormous but requires a long-term investment of resources and research to be useful and reach many more people.