Top Management Team Diversity, Equality and Innovation in the Health Care Industry

[We’re pleased to welcome A. Erin Bass of the University of Nebraska Omaha. She recently published an article in the Journal of Leadership and Organizational Studies entitled “Top Management Team Diversity, Equality, and Innovation: A Multilevel Investigation of the Health Care Industry,” which is currently free to read for a limited time. Below, she writes about her research.]

What motivated you to pursue this research?

I was motivated to pursue this research because I have always been interested in inequality issues, and equality is important in every aspect of organizations–from hiring to promotions to compensation. In this article, I examine equality issues in healthcare–an industry in which this issue is becoming more and more of a headline. When I speak to my female colleagues in healthcare, they all agree that equality issues are something they deal with on a daily basis. I wanted to see if equality matters for a key organizational outcome–innovation. The article indicates important relationships between female representation and compensation and innovation. I hope this angle can be used to encourage more equality in healthcare.

Were there any specific external events—political, social, or economic—that influenced your decision to pursue this research?

I was unaware of what a great presence female medical professionals have on social media and beyond! For example, my colleague, Dr. Sasha Shillcutt, is not only an anesthesiologist at the University of Nebraska Medical Center, she is also an entrepreneur, creating a huge online community, https://www.becomebraveenough.com/, to support equality issues for females in healthcare. In speaking to her and others, I realized this is a huge issue and one that I wanted to contribute to. By linking equality to an important organizational outcome, innovation, I demonstrate how equality is not just a feel-good motive–it has important organizational implications as well!

In what ways is your research innovative, and how do you think it will impact the field?

I hope this research will make healthcare organizations realize the value of equality in top management teams, and how having females represented and equally compensated will actually drive innovation for the organization. In an era with rapid innovation and hyper-competition, what organization wouldn’t want to promote equality to help drive new technologies and solutions?!?

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Read the September Issue of Administrative Science Quarterly!

asqa_63_3_coverWe are pleased to announce that the September Issue of Administrative Science Quarterly is now available to read for a limited time.

Check out the editorial which discusses the ASQ Scholarly Award for Scholarly Contribution which was awarded to  Adam M. Kleinbaum for his article, “Organizational Misfits and the Origins of Brokerage in Intrafirm Networks.”


In the research article, “The Structural Origins of Unearned Status: How Arbitrary Changes in Categories Affect Status Position and Market Impact,” included in this issue, the relationship among status, actors’ quality, and market outcomes are discussed. You can find the abstract below.

customer-experience-3024488__340.jpgFocusing on the categorical nature of many status orderings, we examine the relationship among status, actors’ quality, and market outcomes. As markets evolve, the number of categories that structure them can increase, creating opportunities for new actors to be bestowed status, or it can decrease, dethroning certain actors from their superior standing. In both cases, gains and losses of status may occur without changes in actors’ quality. Because audiences rely on status signals to infer the value of market actors, these exogenously generated status shifts can translate into changes in how audiences perceive actors, resulting in benefits for unearned status gains and costs for unearned status losses. We find support for our hypotheses in a sample of equity analysts at U.S. brokerage firms. Using data on the coveted Institutional Investor magazine All-Star award, we find that analysts whose status increases because of a category addition see corresponding increases in the stock market’s response to their earnings estimates, while those who lose status see corresponding reductions. Our results suggest that the greater weight accorded to high-status actors may be misguided if that status occurs for structural reasons such as category changes rather than because of an actor’s own quality.


This intriguing study, “Anchored Personalization in Managing Goal Conflict between Professional Groups: The Case of U.S. Army Mental Health Care” delves into conflict between groups that pursue different goals. You can find the abstract below:

Mental-health-2313426_640Organizational life is rife with conflict between groups that pursue different goals, particularly when groups have strong commitments to professional identities developed outside the organization. I use data from a 30-month comparative ethnographic field study of four U.S. Army combat brigades to examine conflict between commanders who had a goal of fielding a mission-ready force and mental health providers who had a goal of providing rehabilitative mental health care to soldiers. All commanders and providers faced goal and identity conflict and had access to similar integrative mechanisms. Yet only those associated with two brigades addressed these conflicts in ways that accomplished the army’s superordinate goal of having both mission-ready and mentally healthy soldiers. Both successful brigades used what I call “anchored personalization” practices, which included developing personalized relations across groups, anchoring members in their home group identity, and co-constructing integrative solutions to conflict. These practices were supported by an organizational structure in which professionals were assigned to work with specific members of the other group, while remaining embedded within their home group. In contrast, an organizational structure promoting only anchoring in one’s home group identity led to failure when each group pursued its own goals at the expense of the other group’s goals. A structure promoting only personalization across groups without anchoring in one’s home group identity led to failure from cooptation by the dominant group. This study contributes to our understanding of how groups with strong professional identities can work together in service of their organization’s superordinate goals when traditional mechanisms fail.


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Ranking photo attributed to Free Photos.

Mental Health photo attributed to Free Photos.

Utilizing Task Analysis to Identify Coordination Requirements in Three different Clinical Settings

[We’re pleased to welcome authors Dr. Sarah Henrickson Parker of Virginia Tech, Dr. Jan B. Schmutz of ETH Zürich, and Dr. Tanja Manser of the University of Applied Sciences and Arts Northwestern Switzerland. They recently published an article in Group and Organization Management entitled “Training Needs for Adaptive Coordination: Utilizing Task Analysis to Identify Coordination Requirements in Three Different Clinical Settings” which is currently free to read for a limited time. Below, Dr. Manser speaks about the motivation and challenges of this research:]

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What motivated you to pursue this research?

We were interested in understanding general principles of coordination in healthcare teams across different healthcare settings. All of the authors have conducted research in this area for quite some time but usually one study only allows us to study teams in a specific clinical setting. We were interested in seeing if there were any general principles that applied across clinical settings. If so, these could have a much larger impact on the training of healthcare professionals.

What has been the most challenging aspect of conducting your research? Were there any surprising findings?

As this was a secondary analysis of existing data, we each had our own challenges with the initial data collection. It is always fun, exciting and challenging to work with healthcare providers in both real and simulated settings. One exciting finding of the current study is the overlap in coordination requirements across clinical settings and tasks. Triggers for re-coordination, anchoring points for coordination, and a deliberate transition from implicit to explicit coordination during unexpected clinical situations were all consistently noted as exemplars of excellent team coordination.

What advice would you give to new scholars and incoming researchers in this particular field of study?

It is important to immerse yourself in the work context you are studying and to continue to build relationships with those that are doing the work. We believe that the interactions with healthcare providers allow us, as psychologists, to make sure our work is interpreted correctly from a scientific point of view but also relevant and used as intended from an applied point of view. Our experience this requires researchers to be able to speak the language of both clinical care and work psychology.

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Book Review: Selling Our Souls: The Commodification of Hospital Care in the United States

bookjacketSelling Our Souls: The Commodification of Hospital Care in the United States. By Adam D. Reich Princeton, NJ: Princeton University Press, 2014. 248 pp. ISBN 978-0-6911-60405, $39.50

Nick Krachler recently published a book review in ILR ReviewAn excerpt from the review:

Reich’s main focus is on the institutional legacies that shape how the people working in his cases reconcile the contradictions between their non-economic values and market pressures. The former public hospital’s contradiction is between the scarcity of resources and the practice of providing extensive uncompensated care to underinsured and uninsured patients. The people in this hospital view care as a social right, and Reich interprets their disregard for efficiency and profitability as rebuffing market pressures. In the Catholic hospital, the contradiction is between the values of sacrifice and dignity, with which many in the hospital identify, and management’s Current Issue Covermarketing of these values to attract high-paying patients, the treatment of uninsured patients with little dignity, and the lowest wages for nurses and ancillary workers among the three cases studied. Reich interprets this case as moralizing market pressures. In the integrated health management organization, customized care according to each patient’s special needs contradicts the organization’s prevailing operating principle of standardizing and rationing care by scaling up efficient practices. Reich interprets this case as taming market pressures through the use of bureaucracy and big data. The author lays out these three types of moral–market relationships by examining the conception of care, the structure of physicians’ work, and the power and division of labor between physicians, nurses, and ancillary workers including the role of labor relations in each of the cases. Another interesting argument in the book is that these three different moral–market relationships correspond to three different historical periods. I find Reich’s well-grounded discussion and critique of the three models highly persuasive.

If you’d like to read the full review from ILR Review, you can click here to access the book review for the next two weeks. Interested in staying up to date with all the latest content published by ILR ReviewClick here to sign up for e-alerts!

ILR Review Special Issue: Work and Employment Relations in Health Care

8639003804_2bd2b5f140_zThe August special issue of ILR Review is now available and open to access for the next 30 days! Included in the special issue on Work and Employment Relations in Health Care are papers that discuss the relationship between nurse unions and patient outcomes, the effect of electronic health record adoption on physician productivity, and the impact nurse staffing strategies have on patient satisfaction. In the introductory editorial essay, Ariel C. Avgar, Adrienne E. Eaton, Rebecca Kolins Givan, and Adam Seth Litwin outline the problems inherent in US health care, most notably the fact that despite outspending other countries on health care costs per capita, the US demonstrates above-average rates of medical errors and below-average life expectancies. As the health care system moves toward reform, the authors argue for careful consideration of how workplace dynamics impact the outcomes for everyone involved in health care. The editorial thus highlights the importance of research on work and employment relations in the health care industry:

This special issue of the ILR Review is designed to showcase the central role that work organization and employment relations play in shaping important outcomes such as the quality of care and organizational performance. Each of the articles included in this special issue makes an important contribution to our understanding of the large and rapidly changing health care sector. Specifically, these articles provide novel Current Issue Coverempirical evidence about the relationship between organizations, institutions, and work practices and a wide array of central outcomes across different levels of analysis. This breadth is especially important because the health care literature has largely neglected employment-related factors in explaining organizational and worker outcomes in this industry. Individually, these articles shed new light on the role that health information technologies play in affecting patient care and productivity (see Hitt and Tambe; Meyerhoefer et al.); the relationship between work practices and organizational reliability (Vogus and Iacobucci); staffing practices, processes, and outcomes (Kramer and Son; Hockenberry and Becker; Kossek et al.); health care unions’ effects on the quality of patient care (Arindrajit, Kaplan, and Thompson); and the relationship between the quality of jobs and the quality of care (Burns, Hyde, and Killet). Below, we position the articles in this special issue against the backdrop of the pressures and challenges facing the industry and the organizations operating within it. We highlight the implications that organizational responses to industry pressures have had for organizations, the patients they care for, and the employees who deliver this care.

You can read the special issue of ILR Review free for the next 30 days by clicking here. Want to stay current on all of the latest research published by ILR Review? Click here to sign up for e-alerts!

*Nurse image attributed to COD Newsroom (CC)

Mindfulness and Selflessness in Care-Giving

Every day we mustbench deal with situations that might make us feel anxious or uncomfortable, especially those who work in care-giving settings. For those providing care to patients who’ve elected to no longer receive medical treatment, the sense of anxiety and discomfort with mortality and morbidity can prevent providing the best quality care possible. Dr. Hilary Bradbury at Oregon Health and Science used the Buddhist’s practice of mindfulness to not only explore how caregivers might deal with their own feelings, but also how to provide the best care for their patients. Driven by her own experience as a volunteer and the use of action research, Dr. Bradbury published her fascinating findings in an article titled “Collaborative Selflessness: Toward an experiential understand of the emergent ‘responsive self’ in a Care-giving Context” with the Journal of Applied Behavioral Science.

I started to work as a volunteer with dying patients on the palliative care wards of the academic medical center where I teach in Portland. Doing so led me to see that the action research work that I practice and write about could be of value. As I have a meditation practice, I offered that as something to develop a co-inquiry about in the context of palliative care. So this paper is really the fruit of a marriage between various scholarly and practical loves which combined to be of value to dying patients and those who volunteer to sit with them. In essence by bringing my healthcare colleagues together for daily meditation over 12 weeks, there were many positive outcomes at individual and patient and healthcare provider team levels.

We focus a lot on the work volunteers did to notice and release anxiety in mindful meditation practice. We might think, well of course anxiety is common when working with the dying. But it is so common for all of us to feel low (or high!) levels of anxiety all the time, and too often this goes unnoticed and wreaks havoc on our sense of wellbeing. Mindfulness practice allows that anxiety (and lots of other experiences!) to be seen without making it too big a deal.

The biggest insight of the paper came when the volunteers began to examine their own experience of, rather than merely their thoughts about, working with dying people. 

I am therefore most pleased to have prompted for more of a conversation among action researchiJABS coverng scholar-practitioners on what really is the nature of the self that arises in collaboration. I bring the pragmatists and Buddhist psychology to bear on the findings. Moreover I am happy to bring the voice of contemporary action research back to JABS. Action researchers often get tired of mainstream journals we find too conservative in their embrace of post-conventional social science. I am happy to say that in this case, I experienced JABS as offering really excellent reviewers. Now I hope for new interlocutors on contemporary action research and mindfulness.


Read the entire article online in Journal of Applied Behavioral Science, and sign up for e-alerts here so you don’t miss out on JABS’ latest articles and issues.

American Health Care, Transformed

In the latest issue of Administrative Science Quarterly, W. Chad Carlos of Cornell University’s Johnson Graduate School of Management reviewed “Social Movements and the Transformation of American Health Care,” edited by Jane C. Banaszak-Holl, Sandra R. Levitsky, and Mayer N. Zald:

The American health care system is broken. Despite spending more money on health care than any other industrialized nation, the U.S. ranks among the lowest in many indicators of health care quality. Social Movements and the Transformation of American Health Care offers a glimpse into this complex system, highlighting the diverse issues and actors promoting change.

Click here to read on and here to read more book reviews from Administrative Science Quarterly.

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