AOM symposium presentation - Danielle Tucker

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It is now generally accepted that strategies are rarely implemented as planned (Mintzberg, 1978). Strategies usually evolve over time as a result of many people interacting and utilizing a range of incremental processes to understand what should realistically be implemented as part of the strategy, essentially adjusting the strategy as required (Burgelman, 1983). However, despite learning much about how change outcomes are achieved, academics and managers are yet to agree on how successful strategic change outcomes are achieved (Stouten, 2018). It can be very difficult to achieve the benefits that a strategic project was designed to achieve (Zwikael & Smyrk, 2019).

Business

Exploring Street-level Bureaucrats’ Discretion in
Strategic Implementation of Policy in UK Tele-
healthcare
Transforming the Organization:
The Implications of Workers Applying Different Discretionary Schemas
Academy of Management 2023
Dr Danielle Tucker
University of Essex, UK

Slide
Discretion and Change Management
Agency and Discretion
 Assumption of top-down implementation of strategy with workers as
passive recipients of change
 Clashing schemas: organisational objectives versus individual
employee objectives
 What might discretion look like… (the good, the bad and the
subversive)
2

Slide
Todays session
From Tucker, D. A.; Hendy, J. and Chrysanthaki, T. (2022) How does policy alienation
develop? Exploring street-level bureaucrats’ agency in policy context shift in UK
telehealthcare. Human Relations. 75(9), 1679–1706
Evolving
group
(street-level)
context
Shift in definition
of legitimate
practice and
policy outcomes
Evolving
Policy
(external)
Context
Shift in policy agenda and
meaning
Changes in
organizational
relationships
Redefining agency
in organizational
decision making
POWERLESSNESS
MEANINGLESSNESS
SLBs experience
personal and group
threat
Interpersonal relationships
foster insider/outsider
mentality
Increasing hierarchy
and distance
Subversive use of discretion
Increasing
cohesion between
SLBs
SLBs collective reclaiming of policy meaning in secret
Evolving
Organizational
(internal)
Context
Create alternative
narrative retaining
original meaning

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I need between 100-120 words for each assignment, and I want individual references with each response. Please, no plagiarized work Module 1 DQ 1 Outcome measures are significant in showing the worth of the Doctor of Nursing Practice's role in health care. Identify a practice-level outcome study or project and describe the expectation of its effect on health care. Which outcome measure do you think aligns with your DPI project (Quality Improvement Project)? Why? Provide examples and literature support. DQ 2 In this week's readings, theories of accident causation, human error, foresight, resilience, and system migration were discussed. Identify a safety theory and propose quality measures to improve patient safety. Which theory or framework are you using to guide your DPI Project's intervention and outcome? Please define what constructs of your chosen DPI Project theory will help you change/improve clinical practice to improve a specific patient outcome? Provide examples and literature support. Resources Henneman, E. A. (2017). Recognizing the ordinary as extraordinary: Insight into the “way we work” to improve patient safety outcomes. American Journal of Critical Care , 26 (4), 272–277. doi:10.4037/ajcc2017812 Smith, S. A., Yount, N., & Sorra, J. (2017). Exploring relationships between hospital patient safety culture and Consumer Reports safety scores. BMC Health Services Research , 17, 1-9. doi:10.1186/s12913-017-2078-6 Module 2 DQ 1 Discuss economic methodology, including the concept of cost-based analysis. If you will not be addressing this in your DPI Project, provide an example of a program where it could be used to show outcomes. Provide examples and literature support. DQ 2 Discuss a change theory and how it can be or has been applied in nursing practice to integrate care delivery sustainability. How will you use change theory in the design of your project to support the sustainability of your practice improvement intervention? Provide examples and literature support. Resources Uluskan, M., McCreery, J. K., & Rothenberg, L. (2018). Impact of quality management practices on change readiness due to new quality implementations. International Journal of Lean Six Sigma , 9 (3), 351-373. doi:10.1108/IJLSS-05-2017-0049 Steele Gray, C., Wilkinson, A., Alvaro, C., Wilkinson, K., & Harvey, M. (2015). Building resilience and organizational readiness during healthcare facility redevelopment transitions: Is it possible to thrive? HERD: Health Environments Research & Design Journal , 9 (1), 10-33. doi:10.1177/1937586715593552 Allen, B. (2016). Effective design, implementation and management of change in healthcare. Nursing Standard , 31 (3), 58. doi:10.7748/ns.2016.e10375 Module 3 DQ 1 New health care delivery models are being presented to accommodate the shift in health care objectives. Many of these models are community-based and focused on improving quality outcomes, population health, and reducing readmissions.

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1.10 Contact Info for Site Approver & Expected Approval Date 1.Jennifer Lopez (713)770-7107-pending & pending 2.Robert Garza (713)791-1414 3. Karl Covington (713)695-8686 Section #2 To be completed by Learner 2.1 Project Write approximately one paragraph that describes the action research project and the basis for it being addressed. The action research project deals with a pertinent leadership effectiveness issue created by the healthcare reform process in healthcare institutions across the United States. The reform process has created a dynamic environment that is in constant flux. Essentially, healthcare reform institutionalization has proved to be very beneficial. For instance, strives to reduce high costs of healthcare. Additionally, it ensures that effective delivery of primary care is achieved so as to reduce the prevalence of chronic illnesses such as diabetes and cardiac-related health problems. The shift towards preventive care for the reduction of chronic illnesses requires more engagement between the patients and the doctors and closer follow-ups of patient outcomes. This requires a leadership that is effective in engendering a workforce that is responsive to long-term patient needs. This means the healthcare professionals such as the physicians and nurses need effective leadership in hospital management so as to ensure they are motivated and engaged in the change process through teamwork and partnerships within hierarchical structures. Therefore, the purpose of this action research is to provide a leadership model and qualities of leadership most relevant for the dynamic healthcare environment. The action research project evaluates the case about the Hospital Corporation of America (HCA), Houston, Texas, to understand the leadership mechanisms within the institution and how they influence employee and patient outcomes. Based on the findings of the studies conducted, the possibility of using the leadership model proposed to improve outcomes will be elaborated upon. Comment by Heather: Please consider revising this sentence. The project cannot deal. Comment by Zerwekh, Tyler: How so? Reference? Comment by Heather: Incomplete sentence. Please revise. Comment by Zerwekh, Tyler: Strides? Comment by Heather: I understand why you would select this word- but at quick glance it can be confusing and even mistook for engineering. You may want to reconsider a synonym like generate or produce. Comment by Heather: Will your research be providing the model or will it be looking at existing models? Will you be doing a pilot study will you introduce a model and then examining the model through prospective follow-up? Of are you just looking at the current leadership style then gaging outcomes? It is a bit ambiguous in nature how you will be conducting your study. Comment by Zerwekh, Tyler: This still reads confusing. Consider revising Comment by Heather: I think really you are looking at how the leadership mechanisms impact or influ ...

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This piece of work theoretically or descriptively considered the impact of the external environment on the structure of organizations. The key variables being organizational structure the dependent variable and the external environment of the organization as the independent variable . Dimensions of organizational structure adopted were centralization, formalization, standardization, specialization and configuration while the measures of external environment applied were level of uncertainty or changeability, intolerance or xenophobia and complexity. The theoretical foundation was hinged on social identity theory and contingency theory. Meaning, types and factors affecting organizational structure were considered alongside environmental factors. It was observed that the external environment has great impact on the organization and is largely responsible for the dynamic nature of the business world. It was therefore recommended that an adequate environmental scanning be carried out to ascertain the stability or otherwise of the environment to be able to know which structural type to adopt at every point in time. Hannah Chika, Anyanwu | Dr. Justin Mgbechi. O. Gabriel "Macro Environment and Organisational Structure: A Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-1 , December 2020, URL: https://www.ijtsrd.com/papers/ijtsrd35834.pdf Paper URL : https://www.ijtsrd.com/management/organizational-behaviour/35834/macro-environment-and-organisational-structure-a-review/hannah-chika-anyanwu

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CHANGE AGENTS, NETWORKS, AND INSTITUTIONS: A CONTINGENCY THEORY OF ORGANIZATIONAL CHANGE JULIE BATTILANA Harvard University TIZIANA CASCIARO University of Toronto We develop a contingency theory for how structural closure in a network, defined as terms of the extent to which an actor’s network contacts are connected to one another, affects the initiation and adoption of change in organizations. Using longitudinal survey data supplemented with eight in-depth case studies, we analyze 68 organizational change initiatives undertaken in the United Kingdom’s National Health Service. We show that low levels of structural closure (i.e., “structural holes”) in a change agent’s network aid the initiation and adoption of changes that diverge from the institutional status quo but hinder the adoption of less divergent changes. Scholars have long recognized the political nature of change in organizations (Frost & Egri, 1991; Pettigrew, 1973; Van de Ven & Poole, 1995). To implement planned organizational changes—that is, premeditated interventions intended to modify the functioning of an organization (Lippitt, 1958)— change agents may need to overcome resistance from other members of their organization and en- courage them to adopt new practices (Kanter, 1983; Van de Ven, 1986). Change implementation within an organization can thus be conceptualized as an exercise in social influence, defined as the alteration of an attitude or behavior by one actor in response to another actor’s actions (Marsden & Friedkin, 1993). Research on organizational change has improved understanding of the challenges inherent in change implementation, but it has not accounted system- atically for how characteristics of a change initia- tive affect its adoption in organizations. Not all organizational changes are equivalent, however. One important dimension along which they vary is the extent to which they break with existing institutions in a field of activity (Battilana, 2006; Green- wood & Hinings, 2006). Existing institutions are defined as patterns that are so taken-for-granted that actors perceive them as the only possible ways of acting and organizing (Douglas, 1986). Consider the example of medical professionalism, the institutionalized template for organizing in the United Kingdom’s National Health Service (NHS) in the early 2000s. According to this template, physicians are the key decision makers in both the administra- tive and clinical domains. In this context, central- izing information to enable physicians to better control patient discharge decisions would be aligned with the institutionalized template. By con- trast, implementing nurse-led discharge or pread- mission clinics would diverge from the institutional status quo by transferring clinical tasks and decision-making authority from physicians to nurses. Organizational changes may thus converge with or diverge from an institutional status quo (Amis, Slack, & Hinings, 2004; D’Aunno, Succi, & Alexan ...

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AOM symposium presentation - Danielle Tucker

1. Exploring Street-level Bureaucrats’ Discretion in Strategic Implementation of Policy in UK Tele- healthcare Transforming the Organization: The Implications of Workers Applying Different Discretionary Schemas Academy of Management 2023 Dr Danielle Tucker University of Essex, UK

2. Slide Discretion and Change Management Agency and Discretion  Assumption of top-down implementation of strategy with workers as passive recipients of change  Clashing schemas: organisational objectives versus individual employee objectives  What might discretion look like… (the good, the bad and the subversive) 2

3. Slide Todays session From Tucker, D. A.; Hendy, J. and Chrysanthaki, T. (2022) How does policy alienation develop? Exploring street-level bureaucrats’ agency in policy context shift in UK telehealthcare. Human Relations. 75(9), 1679–1706 Evolving group (street-level) context Shift in definition of legitimate practice and policy outcomes Evolving Policy (external) Context Shift in policy agenda and meaning Changes in organizational relationships Redefining agency in organizational decision making POWERLESSNESS MEANINGLESSNESS SLBs experience personal and group threat Interpersonal relationships foster insider/outsider mentality Increasing hierarchy and distance Subversive use of discretion Increasing cohesion between SLBs SLBs collective reclaiming of policy meaning in secret Evolving Organizational (internal) Context Create alternative narrative retaining original meaning

AOM symposium presentation - Danielle Tucker

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