Stable Leadership Research Articles

Wikimedia movement governance: the limits of a-hierarchical organization

Purpose– The purpose of this paper is to show the limits of a-hierarchical organization in the Wikimedia movement governance model. Wikimedia governance, as well as the dynamic transformations it is currently undergoing, remains to be covered by the literature on organization and management studies; yet, they exemplify the problems with the “organization of the future,” which is highly idealized throughout the management literature.Design/methodology/approach– The research design relies on an ethnographic, long-term, participative study of the Wikipedia community at large. The methods used rely mainly on discourse analysis and interviews. The study benefits from the unique participant immersion of the researcher (who spent six years participating in the studied community, making over five edits each day on average, and being elected to several positions of highest trust within the organization).Findings– The findings show that the open, participative, and democratic character of the organization, which in theory is oriented toward sustainable solidarity, as well as the semi-anonymous character of some of the members’ identities, makes the community more empowered yet more belligerent. Also, the entirely open and flat governance model makes it more difficult to establish a stable leadership consensus.Research limitations/implications– Research is limited due to its methodological design, as it relies on in-depth qualitative case studies, rather than wider analysis. Further quantitative research is needed to confirm the findings on a bigger scale and in other open collaboration organizations.Practical implications– The findings show that participative organizational design, especially in open collaboration projects, have adverse effects in leading to overly confrontational and quarrelsome organizational culture, which not only makes decision making more difficult, but also deters people less used to debating and conflict.Social implications– The social implications of the findings suggest that even in highly democratized structures, some minimal forms of leadership, and governance are useful to facilitate the decision-making processes.Originality/value– This paper extends the understanding of organizational dynamics and governance in open collaboration organizations, and exposes the shortcomings of this model, which are an inevitable trade-off for its indisputable benefits.

Book Review of "Transforming a College: The Story of a Little-Known College’s Climb to National Distinction"

Keller, George (2014). Transforming college: The story of little-known college's climb to national distinction. Baltimore: Johns Hopkins University Press. Pages: 146. C$ 32.86 (paper).Conceived first as journal article in Planning for Higher Education (25(3), 1997), George Keller (1928-2007) published Transforming college (2004, Johns Hopkins) at the urging of then (and still) President of Elon University, Leo Lambert. Re-published in 2014 to mark Elon's 125th anniversary, Transforming college is with little change an account of how a small, unattractive, parochial bottom-feeder (p. XVII) liberal arts college in Elon, N.C. transformed itself into much larger institution of national stature in the decades before 2000 (changing its name from Elon College to Elon University in 2001). Given the number of reviews already published of the virtually identical 2004 edition, what I offer here is brief comment on changes to the book and the landscape of American higher education as seen through the lens of American higher education.As Keller had hoped, Transforming college became popular monograph. No doubt its popularity was based on the search, perhaps most intense in America's heavily privatised higher education ecosystem, for recipe for success. As both Keller and Lambert recognise, however, copy-and-paste approach from case study is less likely to bear fruit than high-above-the-cloud (p. XIV) read for inspired institutional planning. In both editions alike, the reader finds case study treatment of: stable leadership; strategic planning; personnel (including faculty) selection, training and recognition, particularly for teaching quality; institutional advancement/development and marketing. All of this and more, it is argued (originally by Keller and parenthetically in 2014 by Lambert), has spurred the University's success.To any student of higher education this list is neither unfamiliar nor exhaustive. What is different about the 2014 edition is, first, the new 28 page afterword by Leo Lambert. In it we read what continues to define and shape success or failure at Elon University (and American higher education generally). All of it, he says, is couched in context-relevant strategic planning (the theme that distinguished Keller's career as scholar of higher education though he, of course, was not involved in this republication). Thus we read about: the stable cast of characters in the original book that continue to play role at Elon including long-retired but engaged ex-president (indeed Lambert himself is only the 8th president in the institution's history); an emphasis on service to the institution; enrolment growth (by more than 50%) and diversification, including out-of-state registrants (reaching 80% of the University) from such places as Massachusetts, California, Texas and Illinois; supportive Board, alumni and parents; effective management and use of its growing endowment. We also read about ambitious campus construction that continues to expand Elon (including residential halls), the growth and development of professional schools (e. …

Micro examination of museum workplace culture: how institutional changes influence the culture of a real-world art museum

ABSTRACTThis paper explores how the art museum's leadership, management structure, and internal communications influence its workplace culture. Using ethnographic inquiry and grounded theory, the paper demonstrates how a specific museum's organizational culture is constructed and how it can be changed through various structural and value-driven changes based on an emerging theory of an organization as an open system. At the museum, an unstable organizational structure caused by frequent leadership turnover factored heavily in creating a non-collaborative workplace with ongoing personal conflicts. The institutional and internal changes called for a more flexible management system than the traditional hierarchical structure. However, by adopting qualities of a learning organization that constantly evolves and grows, this art museum can become a more effective and efficient organization with a stable management structure, sustainable and collective leadership, an effective communicational system, and therefore a positive, cohesive, and vision-driven workplace.

Establishing and implementing best practice to reduce unplanned admissions in those aged 85 years and over through system change [Establishing System Change for Admissions of People 85+ (ESCAPE 85+)]: a mixed-methods case study approach

BackgroundIn England, between 2007/8 and 2009/10, the rate of unplanned hospital admissions of people aged 85 years and above rose from 48 to 52 per 100. There was substantial variation, with some areas showing a much faster rate of increase and others showing a decline.ObjectivesTo identify system characteristics associated with higher and lower increases in unplanned admission rates in those aged 85 years and over; to develop recommendations to inform providers and commissioners; and to investigate the challenges of starting to implement these recommendations.DesignMixed-methods study using routinely collected data, in-depth interviews and focus groups. Data were analysed using the framework approach, with themes following McKinsey’s 7S model. Recommendations derived from our findings were refined and prioritised through respondent validation and consultation with the project steering group. The process of beginning to implement these recommendations was examined in one ‘implementation site’.ParticipantsSix study sites were selected based on admission data for patients aged 85 years and above from primary care trusts: three where rates of increase were among the most rapid and three where they had slowed down or declined. Each ‘improving’ or ‘deteriorating’ site comprised an acute hospital trust, its linked primary care trust/clinical commissioning group, the provider of community health services, and adult social care. At each site, representatives from these organisations at strategic and operational levels, as well as representatives of patient groups, were interviewed to understand how policies had been developed and implemented. A total of 142 respondents were interviewed.ResultsBetween 2007/8 and 2009/10, average admission rates for people aged 85 years and over rose by 5.5% annually in deteriorating sites and fell by 1% annually in improving sites. During the period under examination, the population aged 85 years and over in deteriorating sites increased by 3.4%, compared with 1.3% in improving sites. In deteriorating sites, there were problems with general practitioner access, pressures on emergency departments and a lack of community-based alternatives to admission. However, the most striking difference between improving and deteriorating sites was not the presence or absence of specific services, but the extent to which integration within and between types of service had been achieved. There were also overwhelming differences in leadership, culture and strategic development at the system level. The final list of recommendations emphasises the importance of issues such as maximising integration of services, strategic leadership and adopting a system-wide approach to reconfiguration.ConclusionsRising admission rates for older people were seen in places where several parts of the system were under strain. Places which had stemmed the rising tide of admissions had done so through strong, stable leadership, a shared vision and strategy, and common values across the system.Future workResearch on individual components of care for older people needs to take account of their impact on the system as a whole. Areas where more evidence is needed include the impact of improving access and continuity in primary care, the optimal capacity for intermediate care and how the frail elderly can best be managed in emergency departments.Study registrationUK Clinical Reasearch Network 12960.Funding detailsThe National Institute for Health Research Health Services and Delivery Research programme.

Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration when programs are funded and implemented in the community.

The International Rehabilitation Forum: an academic consortium that builds medical rehabilitation in low resource regions through participation, mentoring, and disruptive innovation

Program/Project Purpose: The economic consequences of noncommunicable diseases may relate more to a lifetime of disability than either death or health care expenitures. Medical rehabilitation and Physiatry are proven to alter disability, save lives, decrease cost, and improve contribution to society. However the vast majority of persons with disability in low resource countries receive no rehabilitation whatsoever. It must be concluded that past academic, philanthropic, and socio-political efforts have failed. The solution may come from non-traditional strategies. Program: The International Rehabilitation Forum (IRF, www.rehabforum.org) is a not-for-profit organization built by American and international academics to advance medical rehabilitation by purposefully working outside of traditional mechanisms. Structure/Method/Design: IRF principles include: 1) Participation: Stable executive leadership, but informal membership without dues or obligation in order to encourage low-resource participation and bypass universities’ bylaws. 2) Mentoring: Identifying and mentoring rising leaders in low-resource countries and bi-cultural high-resource professional. 3) Disruptive innovation: Researching absurdities in policy and presenting these in the most politically advantageous ways. Holding inexpensive ‘world congresses’ in lowresource countries so the organization’s local partnership can leverage the prestige. Bypassing academics to work with the famous, rich, and influential. Outcomes & Evaluation: The nature of the strategy precludes accurate assessment of impact, however some specifics are illustrative; 1) participation: ‘supporters’ include 50 academic and aid organizations and at least 321 professionals from around the world. 2) Mentoring: IRF mentored the Pakistani 2014 global AuthorAID Mentor of the Year from residency through global prominence; two bicultural Americans from medical school through MD, FAAPMR, and MPH to faculty appointments; and the national leaders of rehabilitation medicine of three countries. Low-resource professionals have coauthored at least 12 publications initiated by high-resource IRF mentors. 3) Disruptive innovation: An ironic IRF expose on Physiatry in Africa and Antarctica was published simultaneously in 5 global journals and changed WHO policy. Sham ‘American’ physiatry consultations in an African trauma ward proved a profound deficit in care. An IRF-commissioned video game, ‘Language Independent Functional Evaluation’ has outperformed traditional functional assessments and is used on 4 continents. IRF’s ‘Captain Crip’ videos have gained global attention. World congresses have caused promises from three universities to build rehabilitation units. An IRF meeting launched the ISPRM/WHO committee on disaster rehabilitation. Four ministries of health have now commissioned the IRF to design their medical rehabilitation policies. Going Forward: Next steps include a ‘global on-line synchronous residency training program’ for isolated Physiatrist faculty, 24-7 coverage of an African rehab unit and research center, and an on-line magazine/journal with mentoring peer-reviewers. Financial sustainability, volunteer management, and succession planning are organizational challenges. The IRF’s success in disruptive innovation illustrates weak points in traditional global health strategies and may encourage others to look for non-traditional change strategies. Funding: No funding listed. Abstract #: 01NCD010

The Relationship Between Stressors and Intent to Leave Nursing Homes Among Directors of Nursing

According to the Centers for Medicare and Medicaid Services, some nursing homes have been ranked worst in the nation when rating the quality of resident care. The purpose of this study was to determine the relative strength of workplace stress, job satisfaction, organizational support, and personal data (number of years employed, age, highest education level) in predicting director of nursing (DON) intentions to leave the position. This information contributes to social change because it is important to know that DONs need to experience general satisfaction in order to maintain stable leadership that positively contributes to the quality of care in Tennessee nursing homes and ensures that the factors decreasing the stability in the DON position in nursing homes can be addressed.

Emerging Lessons From Regional and State Innovation in Value‐Based Payment Reform: Balancing Collaboration and Disruptive Innovation

In recent decades, practitioners and policymakers have turned to value-based payment initiatives to help contain spending on health care and to improve the quality of care. The Robert Wood Johnson Foundation funded 7 grantees across the country to design and implement value-based, multistakeholder payment reform projects in 6 states and 3 regions of the United States. As the external evaluator of these projects, we reviewed documents, conducted Internet searches, interviewed key stakeholders, cross-validated factual and narrative interpretation, and performed qualitative analyses to derive cross-site themes and implications for policy and practice. The nature of payment reform and its momentum closely reflects the environmental context of each project. Federal legislation such as the Patient Protection and Affordable Care Act and federal and state support for the development of the patient-centered medical home and accountable care organizations encourage value-based payment innovation, as do local market conditions for payers and providers that combine a history of collaboration with independent innovation and experimentation by individual organizations. Multistakeholder coalitions offer a useful facilitating structure for galvanizing payment reform. But to achieve the objectives of reduced cost and improved quality, multistakeholder payment innovation must overcome such barriers as incompatible information systems, the technical difficulties and transaction costs of altering existing billing and payment systems, competing stakeholder priorities, insufficient scale to bear population health risk, providers' limited experience with risk-bearing payment models, and the failure to align care delivery models with the form of payment. From the evidence adduced in this article, multistakeholder, value-based payment reform requires a trusted, widely respected "honest broker" that can convene and maintain the ongoing commitment of health plans, providers, and purchasers. Change management is complex and challenging, and coalition governance requires flexibility and stable leadership, as market conditions and stakeholder engagement and priorities shift over time. Another significant facilitator of value-based payment reform is outside investment that enables increased investment in human resources, information infrastructure, and care management by provider organizations and their collaborators. Supportive community and social service networks that enhance population health management also are important enablers of value-based payment reform. External pressure from public and private payers is fueling a "burning bridge" between the past of fee-for-service payment models and the future of payments based on value. Robust competition in local health plan and provider markets, coupled with an appropriate mix of multistakeholder governance, pressure from organized purchasers, and regulatory oversight, has the potential to spur value-based payment innovation that combines elements of "reformed" fee-for-service with bundled payments and global payments.

ASPA’s Section on Transportation Policy and Administration

The Section on Transportation Policy and Administration (STPA) of the American Society for Public Administration was chartered in 1992 as an organization dedicated to bringing together scholars, practitioners, and students interested in the role played by transportation in society. Although transportation policy and administration is somewhat specialized as a subject matter area in public administration, STPA grew rapidly in the 1990s due in large part to a stable group of founding members who provided both intellectual and organizational leadership. This article reviews the growth and development of STPA from its early years to the present. Attention is given to section activities, including publications, newsletters, awards, and conference presentations. Two themes are prevalent throughout the review: the importance of committed, diverse, and stable leadership and the high level of intellectual and professional discourse that has characterized the work of the section.

What a Decade for ASHA

What a Decade for ASHA

Between Aspiration and Reality: Indonesian Foreign Policy After the 2014 Elections

On October 20, 2014, Indonesia—the world's fourth-largest nation, third-largest democracy, and largest Muslim-majority country—after a decade of stable leadership under Susilo Bambang Yudhoyono, in...

Leader Turnover, Volatility, and Political Risk

On average, democracy reduces political risk for foreign investors, yet this emphasis on regime type obscures the tremendous variation within autocracies. Moreover, conventional explanations emphasizing the role of checks and balances are ill‐suited to explain why some autocracies, which typically lack these features, are associated with such low‐risk environments. This article explains variations in political risk by emphasizing the role of autocratic leader replacement. Autocrats select from a heterogeneous mixture of private goods to appease narrow‐winning coalitions. Leader replacement in such regimes is, therefore, associated with new winning coalitions and new private goods. When turnover is frequent, the policy environment becomes more volatile and political risk increases relative to autocracies with more stable leadership. Importantly, the risk‐increasing effect of turnover holds for both irregular and rule‐bound leader transitions in autocracies. These predictions are strongly supported through cross‐national quantitative analysis employing a new measure of leaders’ risk of political replacement.

Building institutional capacity: from pervasive individualism to sustained coordination in small firm sectors

The small-business sector faces a persistent dilemma: small firms often lack the human skills and financial resources to modernize and compete. How, then, can small firms overcome collective action problems to forge sector-wide modernization? This paper examines the political dynamics and the process of institutional change that underpin successful industrial upgrading through a comparative, longitudinal analysis of two policy experiments aiming at the modernization of small firm sectors in Portugal. Relying on comparative-historical analysis and process tracing, this study shows that successful industrial upgrading relies on intense and sustained political action, led by strong and stable interest leadership, in the pursuit of well-defined developmental benchmarks, and relying on the implementation of political, organizational and financial strategy according to a specific logic and sequence.

Context-dependent hierarchies in pigeons

Hierarchical organization is widespread in the societies of humans and other animals, both in social structure and in decision-making contexts. In the case of collective motion, the majority of case studies report that dominant individuals lead group movements, in agreement with the common conflation of the terms "dominance" and "leadership." From a theoretical perspective, if social relationships influence interactions during collective motion, then social structure could also affect leadership in large, swarm-like groups, such as fish shoals and bird flocks. Here we use computer-vision-based methods and miniature GPS tracking to study, respectively, social dominance and in-flight leader-follower relations in pigeons. In both types of behavior we find hierarchically structured networks of directed interactions. However, instead of being conflated, dominance and leadership hierarchies are completely independent of each other. Although dominance is an important aspect of variation among pigeons, correlated with aggression and access to food, our results imply that the stable leadership hierarchies in the air must be based on a different set of individual competences. In addition to confirming the existence of independent and context-specific hierarchies in pigeons, we succeed in setting out a robust, scalable method for the automated analysis of dominance relationships, and thus of social structure, applicable to many species. Our results, as well as our methods, will help to incorporate the broader context of animal social organization into the study of collective behavior.

Contrasting Trajectories of Change in Primary Care Clinics: Lessons From New Orleans Safety Net

We sought to compare and contrast patterns of change toward patient-centered medical homes (PCMHs) in 5 New Orleans primary care safety net clinics in the aftermath of Hurricane Katrina. We assessed the general direction of change in practice to discover possible reasons for differences in patterns of change, and to identify impediments to change. Data collection consisted of 5 semiannual telephone interviews with clinic leadership over 2.5 years supplemented by administrative audits. We used standard survey indexes of PCMH to monitor practice change. We conducted site visits and unstructured in-person interviews with clinicians and staff of the 5 clinics. PCMH index scores improved during the observation period with variations in rates of change and initial levels of PCMH. Qualitative analysis suggested possible explanations for this differential success: (1) early vs later starts in practice change, (2) funding based on patient outcomes, (3) demands that compete with practice change, (4) qualities of clinic leadership, and (5) relations with the communities where patients live. Barriers to practice change included high demand for services, deficient linkages between hospital and specialty care, lack of staff resources, and a need to focus on clinic finances. The PCMH model can successfully address the needs of safety net populations. Stable leadership committed to serving safety net patients via the PCMH model is important for successful practice transformation. Beyond clinic walls, cultivating deep ties to the communities that clinics serve also supports the PCMH model.

Leadership and transformational change in healthcare organisations: a qualitative analysis of the North East Transformation System.

The research project 'An Evaluation of Transformational Change in NHS North East' examines the progress and success of National Health Service (NHS) organisations in north east England in implementing and embedding the North East Transformation System (NETS), a region-wide programme to improve healthcare quality and safety, and to reduce waste, using a combination of Vision, Compact, and Lean-based Method. This paper concentrates on findings concerning the role of leadership in enabling tranformational change, based on semi-structured interviews with a mix of senior NHS managers and quality improvement staff in 14 study sites. Most interviewees felt that implementing the NETS requires committed, stable leadership, attention to team-building across disciplines and leadership development at many levels. We conclude that without senior leader commitment to continuous improvement over a long time scale and serious efforts to distribute leadership tasks to all levels, healthcare organisations are less likely to achieve positive changes in managerial-clinical relations, sustainable improvements to organisational culture and, ultimately, the region-wide step change in quality, safety and efficiency that the NETS was designed to deliver.

Employee benefits, stable leadership improve nurse retention in homes

Employee benefits, stable leadership improve nurse retention in homes

Information, Commitment, and Intra-War Bargaining: The Effect of Governmental Constraints on Civil War Duration1

Thyne, Clayton L. (2012) Information, Commitment, and Intra-War Bargaining: The Effect of Governmental Constraints on Civil War Duration. International Studies Quarterly, doi: 10.1111/j.1468-2478.2012.00719.x © 2012 International Studies Association This article considers how governmental variations affect the duration of civil conflicts. Recent work suggests that war termination is likely when competing actors gain information about the power balance and are able to credibly commit to war-ending agreements. I focus on how the strength and stability of executives impact these factors. Regarding information, power consolidation within the government reduces the number of people who must agree on a settlement, which should shorten civil conflicts. Stable leadership should likewise shorten conflicts by making it harder for potential spoilers to derail war-ending agreements, helping minimize credibility problems. This argument is tested by examining how variations in institutional design (executive constitutional and legislative power), political strength (ideological fragmentation and polarization), and stability (leadership tenure) affect the duration of civil conflicts from 1946 to 2004. The results suggest that powerful and stable executives are indeed well equipped to end civil conflicts.

Extending primary care: potential learning from Italy

Health systems across Europe are under increasing pressure to shift care outside hospitals and into community settings. The emphasis is on providing high-quality, coordinated care for a growing population of older patients and those with long-term conditions. Extended primary care is regarded as the key means of achieving such a shift. We report learning following exploratory visits to two sites in Italy, each providing an example of a primary care organisation with extended general practices, community health and local resource utilisation responsibilities. We draw out three areas of potential interest--shifting care from hospital to community settings, facilitating localism and enabling stable leadership--all of which appear to provide a means for local clinicians, managers and their communities to commission care according to local needs. We conclude by recommending that primary care researchers consider undertaking further work in Italy, building on this exploratory work and more systematically exploring the effects of such programmes.

Medicare Agency, Providers Face Challenges This Year

Medicare Agency, Providers Face Challenges This Year