Explore the vast range of titles available.

This two-year ethnographic study of the primary care departments in two U.S. hospitals examines how managers can bring about micro-level institutional change in professional practice even when such change challenges professionals’ specialized expertise, autonomy, individual responsibility, and engagement in complex work, which previous research has shown to create difficulties. In this study, managers in both hospitals attempted to implement the same patient-centered medical home (PCMH) reforms among doctors, had the same external pressures for micro-level institutional change, worked under the same organizational and reimbursement structure, and had the same contextual facilitators of micro-level institutional change present within their organizations. But managers in one hospital successfully accomplished change in professional practice while those in the other did not. I demonstrate that managers can accomplish micro-level institutional change in professional organizations using \"subordinate activation tactics\"—first empowering and motivating subordinate semi-professionals to activate their favorable structural position vis-à-vis the targeted professionals on behalf of managers and next giving semi-professionals positional tools to use in their daily work to minimize the targeted professionals’concerns about the threats associated with change.

Building on the resource-based view (RBV) and competitive dynamics literatures, this paper proposes that considering resources or actions independently offers an incomplete understanding of the drivers of superior performance. Instead, we hypothesize that resources enable competitive actions and that when these actions leverage the firm's resources, superior performance results. We tested these hypotheses with panelized data on the technological resources and competitive actions of firms in the in-vitro medical diagnostic substance manufacturing industry. The results provide substantial support for our hypotheses, specifically with respect to mediation. Our theory and results underscore how the integration of the competitive dynamics and RBV literatures can significantly improve our understanding of firm performance.

Occupational licensing laws have been relaxed in a large number of US states to give nurse practitioners the ability to perform more tasks without the supervision of medical doctors. We investigate how these regulations affect wages, hours worked, and the prevailing transaction prices and quality levels associated with certain types of medical services. We find that when nurse practitioners have more independence in their scope of practice, their wages are higher but physicians’ wages are lower, which suggests some substitution between the occupations. Our analysis of insurance claims data shows that more rigid regulations increase the price of a well-child visit by 3–16 percent. However, we find no evidence that the changes in regulatory policy are reflected in outcomes that might be connected to the quality and safety of health services.

Interprofessional collaboration plays an important role within health professions and between health professions and other professions. The current concept of interprofessional collaboration considers the relationships between the professions and the patients' perspective. The collaboration between speech-language therapists and interpreters enables a patient-centered collaboration and equal communication. To prepare for interprofessional collaboration, interprofessional learning contents during professional training and education are essential.

PurposeAddressing workforce shortages in operations and supply chain management (OSCM) necessitates adaptive measures by both individuals and organizations, with a pivotal role played by Human Resources (HR). This impact pathway delves into how healthcare organizations can effectively manage workforce shortages, informed by HR practices. Through an in-depth understanding of healthcare organizations, the authors pinpoint challenges and concerns linked to workforce shortages. Pathways are proposed to stimulate future OSCM research and collaboration, leveraging innovative and creative methods from the HR field.Design/methodology/approachData was collected from various representatives from healthcare organizations to explore how healthcare organizations for people with intellectual disabilities address the challenges stemming from contemporary workforce shortages.FindingsThree pathways were outlined to address workforce shortages in healthcare supply chains, utilizing intellectual disability care as a representative example. These pathways comprise optimizing the potential of the current workforce, illustrating innovative HR practices for enhancing their performance, and proposing strategies for retaining these valuable workers.Originality/valueDespite its potential, the HR domain remains relatively underdeveloped within OSCM research. The authors show how HR practices can potentially mitigate impending workforce shortages. While utilizing intellectual disability care as a representative example, this paper proposes that the impact pathways identified can be extended to various other healthcare settings.

Health care professionals, organizations, and policy makers are calling for expansion of the nurse practitioner (NP) workforce in primary care to assure timely access and high-quality care. However, most efforts promoting NP practice have been focused on state level scope of practice regulations, with limited attention to the organizational structures. We examined NP practice environments in primary care organizations and the extent to which they were associated with NP retention measures. Data were collected through mail survey of NPs practicing in 163 primary care organizations in Massachusetts in 2012. NP practice environment was measured by the Nurse Practitioner Primary Care Organizational Climate Questionnaire, which has four subscales: Professional Visibility, NP-Administration Relations, NP-Physician Relations, and Independent Practice and Support. Two global items measured job satisfaction and NPs' intent to leave their job. We aggregated NP level data to organization level to attain measures of practice environments. Multilevel logistic regression models were used. NPs rated the relationship between NPs and physicians favorably, contrary to the relationship between NPs and administrators. All subscales measuring NP practice environment had similar influence on the outcome variables. With every unit increase in each standardized subscale score, the odds of job satisfaction factors increased about 20% whereas the odds of intention of turnover decreased about 20%. NPs from organizations with higher mean scores on the NP-Administration subscale had higher satisfaction with their jobs (OR = 1.24, 95% CI [1.12, 1.39]) and had lower intent to leave (OR = 0.79, 95% CI [0.70, 0.90]). NPs were more likely to be satisfied with their jobs and less likely to report intent to leave if their organizations support NP practice, favorable relations with physicians and administration, and clear role visibility. Creating productive practice environments that can retain NPs is a potential strategy for increasing the primary care workforce capacity.

Interprofessional collaboration is a strategy to meet the challenges of increasing complexity in the health system. The basis for cooperation in professional life must already be established in the context of interprofessional education (IPE). Students’ attitude towards IPE is a crucial factor in the development of interprofessional competences.

Time is a critical issue for organizations, especially for healthcare organizations. In the last three decades, concerns over the transformation of healthcare organizations have increasingly gained attention in the literature, indicating how task duration has been reduced to improve clinical-workflow efficiency. This article seeks to raise questions about the experience of acceleration and the ways in which this brings ethical implications to the fore for health professionals within healthcare organizations. Current approaches to acceleration fail to place ethical considerations as their central concern. This article, drawing on the theory of social acceleration and dynamic stabilization of Hartmut Rosa, offers a deeper analysis of ethical perspectives concerning acceleration. To do so, we draw on an in-depth case study, ethnographic immersion, and 48 semi-structured interviews with professionals within a French public hospital. We also carried out 20 telephonic interviews with directors in different hospitals of various sizes. We contribute to the literature by critically exploring the intersection between the experience of acceleration and ethics. We identify four broad categories of ethical implications for health professionals: the expected flexibility of directors facing uncertainty; the erosion of the ethics of care; the process of mechanistic dehumanization; and the adverse effects of speed on emotional work and workers’ well-being.

Different approaches to modelling the distribution of WTP are compared using stated preference data on Tanzanian Clinical Officers’ job choices and mixed logit models. The standard approach of specifying the distributions of the coefficients and deriving WTP as the ratio of two coefficients (estimation in preference space) is compared to specifying the distributions for WTP directly at the estimation stage (estimation in WTP space). The models in preference space fit the data better than the corresponding models in WTP space although the difference between the best fitting models in the two estimation regimes is minimal. Moreover, the willingness to pay estimates derived from the preference space models turn out to be very high for many of the job attributes. The results suggest that sensitivity testing using a variety of model specifications, including estimation in WTP space, is recommended when using mixed logit models to estimate willingness to pay distributions.

In the light of its surprising absence in extant literature in the domain of the sociology of work, specifically within the journal Work, Employment and Society, this article represents a ‘call to arms’ for research focused upon professional misconduct in healthcare. Specifically, interrogation of four dimensions of professional misconduct in healthcare is called for: a broader definition of professional misconduct; antecedents of professional misconduct that recognize the effect of context; professional response to regulation of misconduct; and the hierarchical and affective challenge to frontline professionals blowing the whistle on professional misconduct.