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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Now showing 1 - 10 of 37
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Item type:Publication, Organizational Change in Hospitals: Managing the Dynamic Interplay of Multiple Discourses(2005-07-01); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, "Sub-Cutane" Change: Introducing Fast Track Surgery in the Context of Multiple Discourses(2007-08-07); ; Vonarx, WidarRecontruction of the introduction of a new surgical regime for enhanced rehabilitation in the clinic of surgery in which different discourses of the involved professionals (nursing, surgeons, anaesthesiologists, administration) were to be balanced throughout the process.Type:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Organisatorischer Wandel als Entfaltung von Paradoxien : Systemtheoretische Rekonstruktion einer KrankenhausfusionType:doctoral thesisIssue:3363 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Kalibrierungsmodus für die Krise - Paradoxien im Umgang mit der Pandemie in einem KrankenhausType:journal articleJournal:Und & Oder - Paradoxien bewusst gestaltenVolume:1Issue:1 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Integrierte Gesundheitsversorgung: eine unwahrscheinliche Leistung(Schweizerische Ärzteverlag EMH, 2013-06-26); ; Type:journal articleJournal:Schweizerische Ärztezeitung (SÄZ)Volume:2013Issue:26 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Entschieden ist nicht erledigt – die kommunikative Verfertigung von Entscheidungen in Spitälern(2019-01)Type:journal articleJournal:Leidfaden, Fachmagazin für Krisen, Leid und Trauer - Some of the metrics are blocked by yourconsent settings
Item type:Publication, "Bootstrapping" to handle the decision-making paradox(2013-06-20); ; ; Many scholars increasingly suggest adopting a paradox lens to study organizations. They consider paradoxes as integral to organizations (Clegg, Vieira da Cunha, & Pina e Cunha, 2002; Ford & Backoff, 1988; Lewis, 2000; Luescher & Lewis, 2008), in which paradox is defined as an operation that implies the conditions for its possibility and impossibility (Ortmann, 2004). These works, however, remain vague on what "integral" means. Do organizations need to handle paradoxes or are they manifestations of handling paradoxes themselves? We argue that organizations represent manifestations of paradoxes and develop practices of handling paradoxes. To illustrate this claim, we draw on an in-depth case study on decision-making in a pluralistic context. First, the study demonstrates that a paradox underlies decision-making in pluralistic contexts: The autonomy of organizational members who pursue diverse interests requires decisions which span professional boundaries; at the same time, the autonomy of organizational members impedes such decisions (Bate, 2000; Ericson, 2001; Glouberman & Mintzberg, 2001; Jarzabkowski & Fenton, 2006; Lozeau, Langley, & Denis, 2002). Second, results from a decision premise (Luhmann, 2000) analysis show that organizational members apply a "bilateral-situative" decision-making practice, a both/and approach which both acknowledges their autonomy and enables decisions across boundaries. A decision-premise focuses on who decides on what, when, and how within an organization. A decision-premise specifies what an organization regards as "organizational". To argue our claim theoretically, we draw on the concept of "bootstrapping" by American sociologist Barry Barnes (Barnes, 1983) which addresses the issue of self-reference in reproducing social phenomena. "Bootstrapping" means that ongoing flows of activities, like actions, communications or decisions, pass through a label - like "organizational" - that filters activities as to whether they belong to the label, and then attaches this label to the activity so that it counts as expressing the label, i.e. as belonging to or expressing "organizational". Such a label like "organizational" allows to distinguishing what is organizational, while all other activities are disregarded. The label in turn emerges through this ongoing flow of activities, in which the process consists of activities that result endogenously from the same process as well as from exogenous inputs. "Bootstrapping" conceptualizes the way of how decisions and decision-premises relate with one another, either in a way that reproduced the label or undermines it over time. Our empirical results exemplify the former, i.e. the reproduction that allows handling the paradox of decision-making in a pluralistic setting. Thus, we argue that a pluralistic organization is a manifestation of a paradox, rather than having a paradox. The latter alternative in which the label is undermined over time, would involve a continuous change of the label or an episodic attempt of altering it. This study speaks to three bodies of literature: First, our study speaks to pluralistic organization by arguing that they are manifestations of paradox and that they developed specific ways of handling them. Second, the empirical results exemplify an organizational perspective on paradoxes, whereas most paradox literature focuses in individuals and groups. Third, bootstrapping offers an insight into how two components of a duality relate over time through feedback. This conceptualization complements the existing view of duality (Farjoun, 2010; Feldman & Pentland, 2003). These works elaborate on what one component serves for the other component, thus representing a functional perspective. In comparison, our conceptualization of bootstrapping with decision-premises as the label captures not only such functions but also opens the pathway to pursue the opposite, a disfunctional relation. Bootstrapping allows explaining reproducing and changing a temporal social order as a self-referential process.Type:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Exploring the role of reflexivity in the change process of interconnected organizational routines(2014-06-12); Wolf, CarolaAnalyzing the change of organizational routines in a public health care organization, this paper contributes to a better understanding of how organizational routines change when a network of interconnected routines is affected by a change initiative. We focus on the role of reflexivity (Feldman, 2000) and individual as well as collective agency (Howard-Grenville, 2005) in different stages of the change process. We identify the establishment of reflection routines as a key success factor for implementing routine change and enabling continuous adaptation of organizational routines. The process of "routinizing reflection" that we observe in our empirical case explains how collective reflection becomes established within an organization and how it drives the change of organizational routines not only as temporary episodic change but as a basis for ongoing continuous adaptation of routines.Type:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, "Sub-Cutane Change" as a practice for protective interrupting : Handling stability and change in a pluralistic organizationTaking a process perspective, we explore stabilizing and changing. Building on insights of routines, improvising and changing scripts, we on the relationship between a change initiative and the daily organizing and explore the question: how is stabilizing of a change initiative accomplished while it attempts to alter daily organizing in which it is embedded? Within a single longitudinal case of introducing a new surgical treatment practitioners explained their conducting change as "sub-cutane change". We interpret sub-cutane change as an emergent process pattern to conduct a change initiative within an organizational setting like surgery that requires a high degree of stable practice. Sub-cutane change addresses the topic of simultaneously stabilizing a change initiative while changing the daily organizing in which it was embedded. An important insight of the presented case is that both require mutual protection from each other. Changing is precarious because it means to interrupt ongoing daily practice. But as the organization continues operating, it enacts that which is to change. Continued operating provides functional legitimacy that can block the change initiative. As a conclusion, stabilizing in change is understood as an ongoing accomplishment.Type:conference paper - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evolutionäre Proezessoptimierung : Nachhaltige Wirkungen durch kontextsensitives VorgehenType:newspaper articleJournal:Schweizerische ÄrztezeitungVolume:90Issue:36
