Managing Expert Knowledge: Organizational Challenges and Managerial Futures for the UK Medical Profession
Managing Expert Knowledge: Organizational Challenges and Managerial Futures for the UK Medical Profession
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DOI：
10.1177/0170840609104819
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发表时间：
2009-07-01
影响因子：
5.4
通讯作者：
Currie, Graeme
中科院分区：
文献类型：
--
作者：
Waring, Justin;Currie, Graeme
管理和专业管辖权的模糊仍然是组织研究的一个重要领域。这个过程通常被描述为涉及“重新分层”，将专业精英吸引到官僚角色中；或“官僚化”，工作操作程序的标准化。我们通过考虑如何通过应用知识管理技术重新排序专业工作来进一步研究这些过程，特别关注临床风险知识的管理。鉴于专家知识对专业自主的中心地位，我们建议医院风险管理者试图将医学知识管理到组织学习中，这是对临床自由的重大挑战。在考虑这一挑战时，我们注意到变革的发生不是通过自上而下的管理挑战，也不是通过专业人士自下而上的抵制，而是通过这些影响在更广泛的制度背景下的动态调解。因此，我们发现医生通过一些限制知识管理控制的情境反应来应对变化，并加强对医疗自主权的要求。在扩大知识管理的专业管辖权的过程中，我们展示了医生等专业人士如何在寻求避免管理侵占的过程中自己变得管理化。我们不认为专业人士被吸引到管理角色或官僚主义的工作方式中，而是认为管理技术和管辖权也在战略上被吸引到专业实践和身份中。
The blurring of managerial and professional jurisdictions remains a significant area of organizational research. This process is often described as involving 're-stratification', the drawing of professional elites into bureaucratic roles; or 'bureaucratization', the standardization of work operating procedures. We examine these processes further through considering how professional work is reordered through the application of knowledge management techniques, focusing in particular on the management of knowledge around clinical risk. We suggest attempts by hospital risk managers to manage medical knowledge towards organizational learning represent a significant challenge to clinical freedom, given the centrality of expert knowledge to professional autonomy. In considering this challenge, we are attentive to the idea that change occurs not through the top-down challenge of management, nor the bottom-up resistance of professionals, but through the dynamic mediation of these influences within a wider institutional context. Accordingly, we find that doctors respond to change through a number of situated responses that limit management control over knowledge and reinforce claims to medical autonomy. In extending professional jurisdiction for the management of knowledge, we show how professionals such as doctors can themselves become managerialized as they seek to stave off managerial encroachment. Rather than seeing professionals as being drawn into management roles or bureaucratic ways of working, we suggest that managerial techniques and jurisdictions are also strategically drawn into professional practice and identity.