Subordinate Activation Tactics: Semi-professionals and Micro-level Institutional Change in Professional Organizations
Subordinate Activation Tactics: Semi-professionals and Micro-level Institutional Change in Professional Organizations
复制标题
下属激活策略：专业组织中的半专业与微观制度变迁
DOI：
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发表时间：
2018
影响因子：
10.4
通讯作者：
Katherine C. Kellogg
中科院分区：
文献类型：
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作者：
Katherine C. Kellogg
这项为期两年的美国医院初级保健部门的人种学研究探讨了管理人员如何在专业实践中带来微观层面的制度变革，即使这种变革挑战了专业人员的专业知识，自主权，个人责任和参与复杂的工作，以前的研究表明，这会造成困难。在这项研究中，两家医院的管理者都试图在医生中实施相同的以患者为中心的医疗之家（PCMH）改革，对微观层面的制度变革具有相同的外部压力，在相同的组织和报销结构下工作，并且具有相同的背景他们的组织内存在微观层面制度变革的推动者。但是，一家医院的管理人员成功地完成了职业实践的转变，而另一家医院的管理人员却没有。我证明，管理者可以完成微观层面的制度变革，在专业组织使用“下属激活策略”-首先授权和激励下属半专业人士，以激活他们的有利结构地位，相对于目标专业人士代表管理者和下一步给予半专业人士，专业人员的定位工具，在他们的日常工作中使用，以尽量减少目标专业人员对与变化相关的威胁的关注。
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.