Participation as a Complicating Mechanism: The Effect of Clinical Professional and Middle Manager Participation on Hospital Performance

One way hospitals complicate themselves is by increasing the participation of clinical professionals and middle managers in making strategic decisions. Using a survey methodology this article investigates the relationships between the participation of clinical professionals (MDs and RNs) and middle managers with hospital costs, as well as the possible moderating effect of strategic complexity.

[1]  A. Murray.  A Contingency View of Porter's “Generic Strategies” , 1988 .

[2]  R R McDaniel,et al.  Physician participation in hospital strategic decision making: the effect of hospital strategy and decision content. , 1991, Health services research.

[3]  J. M. Beyer,et al.  A Reexamination of the Relations between Size and Various Components of Organizational Complexity. , 1979 .

[4]  J. Begun.  Managing with Professionals in a Changing Health Care Environment , 1985, Medical care review.

[5]  J. Alexander,et al.  Hospital-physician integration and hospital costs. , 1988, Inquiry : a journal of medical care organization, provision and financing.

[6]  Jay R. Galbraith.  Organization Design , 1977 .

[7]  Gareth R. Jones,et al.  Costs, Revenue, and Business-Level Strategy , 1988 .

[8]  R. McDaniel,et al.  Diversity as a Management Strategy for Organizations , 1997 .

[9]  S. Floyd,et al.  The strategy process, middle management involvement, and organizational performance , 1990 .

[10]  F. Westley.  Middle managers and strategy: Microdynamics of inclusion , 1990 .

[11]  Dennis A. Gioia,et al.  Strategic Sensemaking and Organizational Performance: Linkages Among Scanning, Interpretation, Action, and Outcomes , 1993 .

[12]  M. Fottler,et al.  Challenges in Health Care Management: Strategic Perspectives for Managing Key Stakeholders , 1990 .

[13]  K. Weick.  FROM SENSEMAKING IN ORGANIZATIONS , 2021, The New Economic Sociology.

[14]  R R McDaniel,et al.  Strategic Leadership: A View from Quantum and Chaos Theories , 1997, Health care management review.

[15]  C. Hill.  Differentiation Versus Low Cost or Differentiation and Low Cost: A Contingency Framework , 1988 .

[16]  Reuben R. McDaniel,et al.  Understanding the Participation of Critical Task Specialists in Strategic Decision Making , 1996 .

[17]  M. Mitchell Waldrop,et al.  Complexity : the emerging science and the edge of order and chaos , 1992 .

[18]  D. Hambrick.  Environment, strategy, and power within top management teams. , 1981, Administrative science quarterly.

[19]  James D. Thompson.  Organizations in Action , 1967 .

[20]  Lawrence R. James,et al.  Organizational climate: A review of theory and research. , 1974 .

[21]  M. Hannan,et al.  The Population Ecology of Organizations , 1977, American Journal of Sociology.

[22]  Gregory G. Dess,et al.  Porter's (1980) Generic Strategies as Determinants of Strategic Group Membership and Organizational Performance , 1984 .

[23]  K. Weick.  The social psychology of organizing , 1969 .

[24]  James B. Thomas,et al.  Interpreting Strategic Issues: Effects of Strategy and the Information-Processing Structure of Top Management Teams , 1990 .

[25]  David J. Miller,et al.  The Architecture of Simplicity , 1993 .

[26]  R. McDaniel,et al.  Strategic directions within health care institutions: the role of the physician. , 1986, Journal of the National Medical Association.

[27]  M. Fennell,et al.  Leadership instability in hospitals: the influence of Board-CEO relations and organizational growth and decline. , 1993, Administrative science quarterly.

[28]  R. Stacey.  The science of complexity: An alternative perspective for strategic change processes , 1995 .

[29]  R R McDaniel,et al.  Internal complexity and environmental sensitivity in hospitals. , 1996, Hospital & health services administration.

[30]  V. Vroom,et al.  Industrial Social Psychology , 1961 .

[31]  Mark S. Granovetter.  The Strength of Weak Ties , 1973, American Journal of Sociology.

[32]  W. Richard Scott.  Organizations: Rational, Natural, and Open Systems , 1981 .

[33]  E. A. Locke,et al.  Participation in Decision-Making: One More Look , 1979 .

[34]  M. Lubatkin,et al.  CULTURAL DIFFERENCES AND SHAREHOLDER VALUE IN RELATED MERGERS: LINKING EQUITY AND HUMAN CAPITAL , 1992 .

[35]  Margaret J. Wheatley.  Leadership and the New Science , 1992 .

[36]  Kathleen M. Eisenhardt,et al.  Making Fast Strategic Decisions In High-Velocity Environments , 1989 .

[37]  J. Hackman,et al.  Impact of employee participation in the development of pay incentive plans: A field experiment. , 1969 .

[38]  D. Vollrath,et al.  Employee Participation: Diverse Forms and Different Outcomes , 1988 .

[39]  Why Organization Development Hasn't Worked (So Far) In Medical Centers , 1976, Health care management review.

[40]  McDaniel Rr,et al.  Internal stakeholder group participation in hospital strategic decision-making: making structure fit the moment. , 1996 .

[41]  Eliot Freidson,et al.  The Reorganization of the Medical Profession , 1940 .

[42]  J. Harris.  The Internal Organization of Hospitals: Some Economic Implications , 1977 .