Self-reported teamwork in family health team practices in Ontario:Organizational and cultural predictors of team climate

Objective: To determine the organizational predictors of higher scores on team climate measures as an indicator of the functioning of a family health team (FHT). Design: Cross-sectional study using a mailed survey. Setting: Family health teams in Ontario. Participants: Twenty-one of 144 consecutively approached FHTs; 628 team members were surveyed. Main outcome measures: Scores on the team climate inventory, which assessed organizational culture type (group, developmental, rational, or hierarchical); leadership perceptions; and organizational factors, such as use of electronic medical records (EMRs), team composition, governance of the FHT, location, meetings, and time since FHT initiation. All analyses were adjusted for clustering of respondents within the FHT using a mixed random-intercepts model. Results: The response rate was 65.8% (413 of 628); 2 were excluded from analysis, for a total of 411 participants. At the time of survey completion, there was a median of 4 physicians, 11 other health professionals, and 4 management and clerical staff per FHT. The average team climate score was 3.8 out of a possible 5. In multivariable regression analysis, leadership score, group and developmental culture types, and use of more EMR capabilities were associated with higher team climate scores. Other organizational factors, such as number of sites and size of group, were not associated with the team climate score. Conclusion: Culture, leadership, and EMR functionality, rather than organizational composition of the teams (eg, number of professionals on staff, practice size), were the most important factors in predicting climate in primary care teams.

Organizational Attributes of Practices Successful at a Disease Management Program

Objective: To assess the contribution of organizational factors to implementation of 3 asthma quality measures: enrollment in a disease management program, development of a written treatment plan, and prescription of severity-appropriate anti-inflammatory therapy. Study design: A total of 138 pediatric clinicians and 247 office staff in 13 urban clinics and 23 nonurban private practices completed questionnaires about their practice's organizational characteristics (eg, leadership, communication, perceived effectiveness, job satisfaction). Results: 94% of the clinicians and 92% of the office staff completed questionnaires. When adjusted for confounders, greater practice activity and perceived effectiveness in meeting family needs were associated with higher rates of enrollment in the Easy Breathing program, whereas higher scores for 3 organizational characteristics-communication timeliness, decision authority, and job satisfaction-were associated with both higher enrollment and a greater number of written treatment plans. None of the organizational characteristics was associated with greater use of anti-inflammatory therapy. Conclusions: Three organizational characteristics predicted 2 quality asthma measures: use of a disease management program and creation of a written asthma treatment plan. If these organizational characteristics were amenable to change, then our findings could help focus interventions in areas of effective and acceptable organizational change. © 2009 Mosby, Inc. All rights reserved.

Organizational assessment in paediatric primary care:Development and initial validation of the primary care organizational questionnaire

Primary care in the United States is undergoing many changes. Reliable and valid instruments are needed to assess the effects of these changes. The Primary Care Organizational Questionnaire (PCOQ), a 56-item 5-point Likert scale survey that evaluates interactions among members of the clinic/practice and job-related attributes, was administered to clinicians and staff in 36 primary care practices serving paediatric populations in Connecticut. A priori scales were reliable (Cronbach alpha =0.7). Analysis of variance (ANOVA) showed greater heterogeneity across clinics than within clinics for 13 of 15 a priori scales, which were then included in a principal component factor analysis with varimax rotation. Eigenvalue analysis showed nine significant factors, largely similar to the a priori scales, indicating concurrent construct validity. Further research will ascertain the utility of the PCOQ in predicting the effectiveness of primary care practices in implementing disease management programmes. © 2006 Royal Society of Medicine Press.

Heeding the stains: Lacan and organizational change

Purpose: The purpose of this paper is to add to current discussions on the use of Lacanian psychoanalysis in organizational change. Specifically, It argues that critiques of Lacan's work must be acknowledged and incorporated into these discussions. To date, there remains a silence surrounding these critiques within organization studies.
Design/methodology/approach: The paper presents the existing studies that draw upon Lacan's work in the context of organizational change initiatives. It highlights the value of this theory. Next, it outlines critiques of Lacan's concepts of phallus and incest taboo, and show how these concepts can be exclusionary.
Findings: The paper finds that there remains little debate within organization studies around such critiques. Lacan tends to be employed in ways that risk reproducing particular, exclusionary aspects of his theory. A homophobic and patriarchal legacy persists in appropriations of his writing. It outlines alternative ways of reading Lacan, which aim to avoid such exclusions. It shows how introducing such alternatives is a difficult project, first, given the silence surrounding critiques of Lacan in the organizational change literature. Second, following Foucault, It argues that language has power: a patriarchal schema is self-reinforcing in its persistence within a particular discipline, and thus difficult to dislodge.
Research limitations/implications: Given these findings, the paper concludes that organization theorists and practitioners ought to engage with critiques of Lacan's work, when employing it in their own. The silence surrounding such legacies is dangerous. It argues that the first step in engaging with Lacan's work should be to give voice to such critiques, if his writing is to be employed in the practice and study of organizational change.
Originality/value: This paper provides a unique engagement with Lacan's work in the context of the study and practice of organizational change interventions. It presents an evaluation of well-known critiques and useful recommendations for theorists and practitioners considering a Lacanian approach to this area of management studies. © Emerald Group Publishing Limited.

Exploring the impact of institutional and organizational factors on the reaction of MNCs to the global financial crisis

This paper analyses some of the factors that impact multinational companies' (MNCs) reaction to the global financial crisis. This paper reports the results from a large-scale study of its impact on MNCs in Australia, considering occurrences of site closures, offshoring, outsourcing, labour force reductions, reductions in working hours, salary reductions, and reductions in training and travel. Evidence showed that MNC reactions varied according to certain institutional and organizational effects. For example, MNCs originating from liberal-market economies are more likely to have offshored and outsourced production and reduced employment. The implications for understanding of MNC behaviour are discussed. © 2013 Copyright Taylor and Francis Group, LLC.

Work-worlds colliding: Self-reflexivity, power and emotion in organizational ethnography

While organizational ethnographers have embraced the concept of self-reflexivity, problems remain. In this article we argue that the prevalent assumption that self-reflexivity is the sole responsibility of the individual researcher limits its scope for understanding organizations. To address this, we propose an innovative method of collective reflection that is inspired by ideas from cultural and feminist anthropology. The value of this method is illustrated through an analysis of two ethnographic case studies, involving a ‘pair interview’ method. This collective approach surfaced self-reflexive accounts, in which aspects of the research encounter that still tend to be downplayed within organizational ethnographies, including emotion, intersubjectivity and the operation of power dynamics, were allowed to emerge. The approach also facilitated a second contribution through the conceptualization of organizational ethnography as a unique endeavour that represents a collision between one ‘world of work’: the university, with a second: the researched organization. We find that this ‘collision’ exacerbates the emotionality of ethnographic research, highlighting the refusal of ‘researched’ organizations to be domesticated by the specific norms of academia. Our article concludes by drawing out implications for the practice of self-reflexivity within organizational ethnography.

Non-governmental Organizational Accountability: Talking the Talk and Walking the Walk?

Concern for NGO accountability has been intensified in recent years, following the growth in the size of NGOs and their power to influence global politics and curb the excesses of globalization. Questions have been raised about where the sector embraces the same standards of accountability that it demands from government and business. The objective of this paper is to examine one aspect of NGO accountability, its discharge through annual reporting. Using Habermas’ (1984; 1987) theory of communicative action, and specifically its validity claims, the research investigates whether NGOs use their annual reporting process to account to the host societies in which they operate or steer stakeholder actions toward their own self-interests. The results of the study indicate that efforts by organizations to account are characterized by communicative action through the provision of truthful disclosures, generally appropriate to the discharge of accountability and in a manner intended to improve their understandability. At the same time, however, some organizations exhibit strategically oriented behaviors in which the disclosure content is guided by the opportunity to present organizations in a particular light and there appears a lack of rhetor authenticity. The latter findings cast doubt on the ethical inspiration of NGOs and the values they demand from business communities, and questions arise as to why such practices exist and what lessons can be learnt from them.

The Development of an Immersive Virtual Reality Environment for Manufacturing and Improving Organizational Learning

This paper examines the applicability of an immersive virtual reality (VR) system to the process of organizational learning in a manufacturing context. The work focuses on the extent to which realism has to be represented in a simulated product build scenario in order to give the user an effective learning experience for an assembly task. Current technologies allow the visualization and manipulation of objects in VR systems but physical behaviors such as contact between objects and the effects of gravity are not commonly represented in off the shelf simulation solutions and the computational power required to facilitate these functions remains a challenge. This work demonstrates how physical behaviors can be coded and represented through the development of more effective mechanisms for the computer aided design (CAD) and VR interface.

Structuring reductive media containing protic ionic liquids and their application to the formation of metallic nanoparticles

Herein, we present a facile method for the formation of monodispersed metal nanoparticles (NPs) at room temperature from M^(III)Cl₃ (with M = Au, Ru, Mn, Fe or V) in different media based on N,N-dimethylformamide (DMF) or water solutions containing a protic ionic liquid (PIL), namely the octylammonium formate (denoted OAF) or the bis(2-ethyl-hexyl)ammonium formate (denoted BEHAF). These two PILs present different structures and redox-active structuring properties that influence their interactions with selected molecular compounds (DMF or water), as well as the shape and the size of formed metal NPs in these solutions. Herein, the physical properties, such as the thermal, transport and micellar properties, of investigated PIL solutions were firstly investigated in order to understand the relation between PILs structure and their properties in solutions with DMF or water. The formation of metal NPs in these solutions was then characterized by using UV–vis spectroscopy, transmission electron microscopy (TEM), scanning electron microscopy (SEM) and dynamic light scattering (DLS) measurements. From our investigations, it appears that the PILs structure and their aggregation pathways in selected solvents affect strongly the formation, growths, the shape and the size of metal NPs. In fact by using this approach, the shape-/size-controlled metal NPs can be generated under mild condition. This approach suggests also a wealth of potential for these designer nanomaterials within the biomedical, materials, and catalysis communities by using designer and safer media based on PILs.