HealthCare Excellence
Type
applied research project
Start Date
March 1, 2003
End Date
December 31, 2022
Status
ongoing
Keywords
Organisation
Management
Gesundheitswesen
Spital
Krankenhaus
Systemtheorie
Prozessforschung
Description
"HealthCare Excellence" ist ein langjähriges Forschungsprogramm, zum Management von Organisationen des Gesundheitswesens. Im Vordergrund steht dabei die Untersuchung von routinisierten Praktiken des Organisierens und Führens sowie deren Wirkung für eine erfolgreiche Zukunftssicherung. In Zusammenarbeit mit öffentlichen Schweizer Spitälern werden mit Hilfe feldnaher, qualitativer Methoden in Längsschnittstudien vier Themenfelder untersucht:
1. Veränderungsfähigkeit: Gestaltung von Veränderungsinitiativen zur Stärkgung der Veränderungsfähigkeit von Organisationen
2. Führungsfähigkeit: Weiterentwicklung der kollektiven Entscheidungs-, Handlungs- und Führungsfähigkeit
3. Vernetzungsfähigkeit: Herausforderungen und Möglichkeiten für die Gestaltung nachhaltiger Entwicklungsprozesse zu integrativen Versorgungsmodellen
4. Management in der Fachausbildung: Untersuchung von Management und Organisationeverständnissen von Ärztinnen und Ärzten und deren Entstehung in ihrer fachlichen Ausbildung
Durch die Bearbeitung dieser Themenfelder erarbeiten wir wissenschaftlich fundiertes und praktisch relevantes Orientierungswissen für Entscheidungsträger im Gesundheitswesen.
Wissenschaftlich leistet HealthCare Excellence einen Beitrag zu einer systemischen, prozessorientierten Forschung von Organisation und Management, was sich in unterschiedlichen Dissertationen, Publikationen und Konferenzbeiträgen niederschlägt.
1. Veränderungsfähigkeit: Gestaltung von Veränderungsinitiativen zur Stärkgung der Veränderungsfähigkeit von Organisationen
2. Führungsfähigkeit: Weiterentwicklung der kollektiven Entscheidungs-, Handlungs- und Führungsfähigkeit
3. Vernetzungsfähigkeit: Herausforderungen und Möglichkeiten für die Gestaltung nachhaltiger Entwicklungsprozesse zu integrativen Versorgungsmodellen
4. Management in der Fachausbildung: Untersuchung von Management und Organisationeverständnissen von Ärztinnen und Ärzten und deren Entstehung in ihrer fachlichen Ausbildung
Durch die Bearbeitung dieser Themenfelder erarbeiten wir wissenschaftlich fundiertes und praktisch relevantes Orientierungswissen für Entscheidungsträger im Gesundheitswesen.
Wissenschaftlich leistet HealthCare Excellence einen Beitrag zu einer systemischen, prozessorientierten Forschung von Organisation und Management, was sich in unterschiedlichen Dissertationen, Publikationen und Konferenzbeiträgen niederschlägt.
Leader contributor(s)
Member contributor(s)
Partner(s)
Center da sandà Engiadina Bassa(CSEB), Kantonsspital Aarau, Zürcher Höhenkliniken Davos (ZHD), Spitalregion St. Gallen, Kinderspital Zürich, Spitalregion Affoltern, Davoser Höhenkliniken, Universitätsspital Basel, Kantonsspital Graubünden
Funder
Topic(s)
Organisations- und Wandelprozesse in Spitälern
Führungs- und Managemententwicklung in Spitälern
Method(s)
qualitative Sozialforschung
systemische Reflexionsforschung
Range
Institute/School
Range (De)
Institut/School
Eprints ID
30510
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Item type:Publication, Accomplishing paradox latency with a coordinating routine : a process perspective on accomplishing stability in a pluralistic organization(2015-06-24)This paper investigates how the paradox of differentiation and integration becomes latent through a routine by which the relatively autonomous actors move forward organization wide issues. The paradox lens provides a promising perspective to explore pluralistic organizations. While it argues that paradoxes are integral to organizations it assumes that they remain latent without addressing how paradox latency is assomplished. By using routine dynamics, this study investigates the routinely and situative enactment of the paradox of differentiation and integration. The single research setting of a qualitative longitudinal case study shows how paradox latency is accomplished within the executive board during an initiative of integrating two hospitals. Accomplishment of paradox latency reveals different patterns which are integral to a coordinating routine by which this hospital moves forward organization wide issues despite its plurality. This coordinating routine and the paradox of differentiation and integration form a duality which explains how a pluralistic organization achieves stability. The proposed duality further advances the paradox lens by attending to paradox latency. In addition, the proposed duality addresses the current interest in routine dynamics on relating groups of routines.Type:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Managing the Catch-22 of Organizational Change Processes - A system theoretical perspective on communicative practices(2008-06-05); The paper explores how complex organizational change processes can be succesfully handled. The fundamental challenge is to unfold the operative paradox which systematically emerges in the contradiction of current and future organizing. The paper is based on a longitudinal, single case study in a Swiss acute hospital over a period of eight years. Taking a system theoretical perspective, we identified six interrelated communicative practices to handle the paradox within the organization. These practices point to "structuring communication" as the relating principle to handle the two opposing poles involved in paradoxes of changing.Type:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Stabilizing Patterns Of Decisions In Pluralistic Organizations As "Bootstrapping"(2011-06-16); Mitterlechner, MatthiasType:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Stabilizing patterns of decisions in pluralistic organizations as "bootstrapping"(EGOS European Group for Organizational Studies, 2011-07-06); Mitterlechner, MatthiasType:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Multiple Ways of Decision-Making in a Hospital : A Process View on Decision-making in Pluralistic Organizations(2012-06-21); ; Decision-making in pluralistic organizations, like hospitals, is a fragile process, particularly when they span professional boundaries, as in change or merger projects. The fragility is often explained by divergent goals, knowledge-intensive work processes and dispersed power structures. Due to the high autonomy of different actors decisions need to be made collectively and to a certain degree the consent of those affected by the decisions is required. In addition, decision-making is a cyclical process as decision effects feedback on the decision-makers. However, the question of how actors carry out decisions over time has not been widely explored in management and organization theory. Traditional theories of rational choice do not incorporate the social and cyclical nature of nature of decision-making. We turn to literature of the process perspective that suggests understanding decision-making as a pattern of action unfolding over time. Emphasizing the role of time decisions emerge from the temporal proximity of challenge, solutions and decision maker. This paper uses a process lens to examine how different actors enact different decisions practices in order to enable collective strategic actions. Although various scholars have established decision-making as a central concern of organizational science, less attention has been paid to the actual decision practices/processes in pluralistic organizations. Apparently, it is assumed that the ways of decision-making do not vary across a pluralistic organization. This paper addresses this gap by analyzing the diverse decision practices of different professions within a hospital. This paper extends existing understandings of how distinct decision practices shape the process of strategic actions. We elaborate on the role of the professional background in making decisions, based on analysis of a longitudinal case study of a merger process between two hospitals. Our data show distinctly different decision-practices within a hospital: fast and personalized decision-making by surgeons, collaborative decision-making that appeals to the nurses' notion of caring, consensus-seeking understanding of emerging patterns that fits to the routines of internists and bureaucratically pre-planned project management by administrators. Our study makes two contributions: first, reaching a strategic decision and generating organization action around strategic goals is not only difficult because different interest groups pursue their own goals. But also, it is because the decisions practices within a pluralistic organization differ significantly; second, decision-making is heavily shaped and legitimized by the way actors perform their daily work. Such referencing stabilizes a specific decision-practice inside a professional domain. At the same time, organization-wide decisions during which different ways of decision-making join, making decisions becomes ambiguous.Type:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, How organizational practices act as a strategy generating principle: an empirical case from a university hospital(2006-05-08); Investigation into the practices involved when conducting a strategic change project in a Swiss University Hospital to explore the interrelated network of practices to stabelize daily organizing within a complex organizationType:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Das Unwahrscheinliche managen : Voraussetzungen einer intergrierten Gesundheitsversorgung(Schweizerische Ärzteverlag EMH, 2013-07-03); ; Type:journal articleJournal:SÄZ - Schweizerische ÄrztezeitungVolume:2013Issue:27/28 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Changing Change : An empirical study towards a recursive understanding of change processesThis paper explores the recursivity of change processes. As episodic approaches exclude this dimension and continuous approaches do not explore it in depth, the research question is: how and why does recursivity of change processes unfold? Based on a longitudinal, interpretative single case study of a change process in the nursing departments to integrate two hospitals, we detect four different change theories in use over time. Triggered externally, they emerge from internal challenges within the process. The research first provides the insight that the recursivity of change can be understood as change of the change process itself. Secondly, we explain this dynamic with a recursive model, rooted in social systems theory. It gives rise to reconsider the question of stability in change for future development of continuous change theories as well as for practice to organize change mindfully to neither risk change, nor ongoing daily organizing.Type:conference paper
