Reactions towards organizational change: a systematic literature review

Decentralisation of the Health System Derailed by Organisational Inertia in Machinga, Malawi

BACKGROUND

Managing the transition of a health system (HS) from a centralised to a decentralised model has been touted as a panacea to the complex challenges in developing countries like Malawi. However, recent studies have demonstrated that decentralisation of the HS has had mixed effects in service provision with more dominant negative outcomes than positive results. The aim of this study was to develop a substantive grounded theory (GT) that elaborates on how activities of central decision-makers and local healthcare mangers shape the process of shifting the HS to a decentralised model in Machinga, Malawi.

METHODS

The study was qualitative in nature and employed the Straussian version of GT. Some participants were interviewed twice, and a total of 36 semi-structured interviews were conducted with 25 purposively selected participants using an interview guide. The interviews were conducted at the headquarters of the Ministry of Health (MoH) and other ministries and agencies, and in Machinga District. Data were analysed using open, axial, and selective coding processes of the GT methodology; and the conditional matrix and paradigm model were used as data analysis tools.

RESULTS

The findings of this study revealed seven different activities, forming two opposing and interactional sub-processes of enabling and impeding patterns that derailed the decentralisation drive. The study generated a GT labelled "decentralisation of the HS derailed by organisational inertia," which elaborates that decentralisation of the HS produced mixed results with more predominant negative outcomes than positive effects due to resistance at the upper organisational echelons and members of the District Health Management Team (DHMT).

CONCLUSION

This article concludes that organisational inertia at the personal and strategic levels of leadership entrusted with decentralising the HS in Malawi, contributed immensely to the derailment of shifting the HS from the centralised to the decentralised model of health service provision.

Change competence: An integrative literature review

BACKGROUND

Organizations are in a state of continual evolution, driven by the relentless shifts in their external environments. Numerous theories have been proposed to understand the essential skills and capabilities for successful organizational change. Yet, there remains a gap in capturing a holistic view necessary to fully comprehend the dynamics of competence in today's rapidly changing landscape.

OBJECTIVE

This research aims to explore and consolidate the concept of 'competence' in the context of organizational change processes.

METHODS

Employing an integrative literature review approach, a total of 3,230 studies were screened. Out of these, 32 studies were selected based on strict relevance and quality criteria, providing a robust foundation for the analysis.

RESULTS

The findings reveal a multi-layered nature of organizational change, highlighting that the nature and prerequisites of change vary significantly across different organizational levels. By applying a competence lens, we discern how required competence during change are not uniform but rather vary depending on whether they are applied in an operational or strategic context. This demonstrates a nuanced, level-dependent variability in change competence across the organizational hierarchy.

CONCLUSION

We conceptualize 'change competence' as a dual-faceted construct. It encompasses both the capacity to leverage existing organizational competence and the adeptness to develop new competence, thereby meeting the evolving demands imposed by both internal and external drivers of change. This comprehensive understanding paves the way for more effective strategies in managing organizational change.

Introducing Entropy into Organizational Psychology: An Entropy-Based Proactive Control Model

This paper provides a systematic review of the transfer and quantification of the concept of entropy in multidisciplinary fields and delves into its future applications and research directions in organizational management psychology based on its core characteristics. We first comprehensively reviewed the conceptual evolution of entropy in disciplines such as physics, information theory, and psychology, revealing its complexity and diversity as an interdisciplinary concept. Subsequently, we analyzed the quantification methods of entropy in a multidisciplinary context and pointed out that their calculation methods have both specificity and commonality across different disciplines. Subsequently, the paper reviewed the research on how individuals cope with uncertainty in entropy increase, redefined psychological entropy from the perspective of organizational management psychology, and proposed an "entropy-based proactive control model" at the individual level. This model is built around the core connotation of entropy, covering four dimensions: learning orientation, goal orientation, change orientation, and risk taking. We believe that psychological entropy, as a meta structure of individuals, can simulate, explain, and predict the process of how individuals manage and control "entropy" in an organizational environment from a dynamic perspective. This understanding enables psychological entropy to integrate a series of positive psychological constructs (e.g., lean spirit), providing extensive predictive and explanatory power for various behaviors of individuals in organizations. This paper provides a new direction for the application of the concept of entropy in psychology, especially for theoretical development and practical application in the field of organizational management.

Benchmarking of circular economy behaviors for Iraqi energy companies based on engagement modes with green technology and environmental, social, and governance rating

Greenhouse gas emissions and global warming are recent issues of upward trend. This study sought to underline the causal relationships between engagement modes with green technology, environmental, social, and governance (ESG) ratio, and circular economy. Our investigation also captured benchmarking of energy companies' circular economy behaviors. A hybrid-stage partial least squares structural equation modeling (PLS-SEM) and multi-criteria decision-making (MCDM) analysis have been adopted. This study collected 713 questionnaires from heads of departments and managers of energy companies. The findings of this study claimed that engagement modes with green technology affect the circular economy and sustainability. The findings revealed that ESG ratings have a mediating role in the nexus among engagement modes with green technology and circular economy. The results of the MCDM application revealed the identification of the best and worst energy companies of circular economy behaviours. This study is exceptional because it is among the first to address the issues of greenhouse gas emissions by providing decisive evidence about the level of circular economy behaviors in energy companies.

Reasons for resistance to change in nursing: an integrative review

BACKGROUND

Change is a very complex and multifaceted phenomenon that is intertwined with the understanding of nursing practice, so, resistance to change in nursing can be considered as an important challenge. Knowing the reasons for this resistance can help in solving it in nursing. Therefore, the present study was conducted with the aim of investigating the reasons for resistance to change in nursing as an integrated review.

METHODS

This integrative review was conducted using the Whittemore & Knafl method in 5 stages, including problem identification, searching the literature, evaluating primary sources, analyzing data, and presenting the results. Databases like SID, Irandoc, Magiran, Google Scholar, Web of Science, PubMed, CINAHL, and Scopus were searched using the keywords; "Resistance", "Change", "Nursing", "Resistance to Change" and their Persian equivalents in the time range of 2000 to January 2023. After applying inclusion criteria and assessing the articles using Bowling's Quality Assessment Tool, finally, 15 papers were included from 2964.

RESULTS

After reviewing and critically appraisal of the qualified articles, the findings were placed in three main categories including; (1) individual factors, (2) interpersonal factors, and (3) organizational factors and six subcategories.

CONCLUSION

Undoubtedly, change is an integral component in nursing care, and resistance to it is the result of a set of individual, interpersonal and organizational factors that change managers should pay special attention to in order to make changes due to the reasons of this resistance, and the development process of developing changes in the clinical field is easily possible.

Circular economy of medical waste: novel intelligent medical waste management framework based on extension linear Diophantine fuzzy FDOSM and neural network approach

Environmental pollution has been a major concern for researchers and policymakers. A number of studies have been conducted to enquire the causes of environmental pollution which suggested numerous policies and techniques as remedial measures. One such major source of environmental pollution, as reported by previous studies, has been the garbage resulting from disposed hospital wastes. The recent outbreak of the COVID-19 pandemic has resulted into mass generation of medical waste which seems to have further deteriorated the issue of environmental pollution. This necessitates active attention from both the researchers and policymakers for effective management of medical waste to prevent the harm to environment and human health. The issue of medical waste management is more important for countries lacking sophisticated medical infrastructure. Accordingly, the purpose of this study is to propose a novel application for identification and classification of 10 hospitals in Iraq which generated more medical waste during the COVID-19 pandemic than others in order to address the issue more effectively. We used the Multi-Criteria Decision Making (MCDM) method to this end. We integrated MCDM with other techniques including the Analytic Hierarchy Process (AHP), linear Diophantine fuzzy set decision by opinion score method (LDFN-FDOSM), and Artificial Neural Network (ANN) analysis to generate more robust results. We classified medical waste into five categories, i.e., general waste, sharp waste, pharmaceutical waste, infectious waste, and pathological waste. We consulted 313 experts to help in identifying the best and the worst medical waste management technique within the perspectives of circular economy using the neural network approach. The findings revealed that incineration technique, microwave technique, pyrolysis technique, autoclave chemical technique, vaporized hydrogen peroxide, dry heat, ozone, and ultraviolet light were the most effective methods to dispose of medical waste during the pandemic. Additionally, ozone was identified as the most suitable technique among all to serve the purpose of circular economy of medical waste. We conclude by discussing the practical implications to guide governments and policy makers to benefit from the circular economy of medical waste to turn pollutant hospitals into sustainable ones.

The Influence of the Barriers of Hybrid Strategy on Strategic Competitive Priorities: Evidence from Oil Companies

This study examines the impact of the barrier of adopting hybrid strategy on strategic performance using the oil sector in Iraq as a case. International oil companies consider various strategies in order to achieve superior performance. The procedure needs to overcome certain essential barriers for the adoption of the hybrid strategy that combines the cost leadership and differentiation strategy. The questionnaire was distributed online due to the COVID-19 pandemic that led to the closure of companies in the country. Out of the 537 questionnaires answered, 483 were used for further analysis which yielded usable response rate of 90%. The structural equation modeling results confirmed that the high costs of technologies, the priority of other external matters, inadequate industry regulation, insufficient supply, organizational capabilities, strategic capabilities, and financial capabilities are significantly related to strategic performance. The researchers recommend conducting an in-depth study of the phenomenon based on theoretical and empirical foundations, especially considering the relationship between the barriers of a hybrid strategy and strategic performance based on linear and non-compensatory relationships. This research sheds light on the barriers to adopting the hybrid strategy required by the oil sector as it relies on continuous production.

FEASIBILITY AND SAFETY OF A FIELD CARE CLINIC AS AN ALTERNATIVE AMBULANCE DESTINATION DURING THE COVID-19 PANDEMIC

Background

Anticipating an increased utilization of healthcare facilities during the COVID-19 surge, the San Francisco Department of Public Health developed a plan to deploy neighborhood-based Field Care Clinics (FCCs) that would decompress emergency departments by serving patients with low acuity complaints. These clinics would receive patients directly from the Emergency Medical Services (EMS) system. Transports were initiated by a paramedic-driven protocol, originally by EMS crews and later by the Centralized Ambulance Destination Determination (CADDiE) System. In this study, we evaluated the outcomes of EMS patients who were transported to the FCC, specifically as to whether they required subsequent transfer to the emergency department.

Methods

We performed a retrospective study of all patients transported to the Bayview-Hunters Point (BHP) neighborhood FCC by EMS between April 11th, 2020, and December 16th, 2020. Descriptive statistics and Chi-Square Tests were used to analyze patient data.

Results

In total, 35 patients (20 men, 15 women, average age of 50.9 years) were transported to the FCC. Of these, 16 were Black/African American, 7 were White, 3 were Asian, with 9 identifying as of other races and 9 of Hispanic ethnicity. Twenty-three of these transports resulted from a CADDiE recommendation. Approximately half (n=20) of calls originated within the BHP neighborhood. The most frequent patient complaint was "Pain." Of patients transported to the FCC, 23 were treated and discharged. The 12 remaining patients required hospital transfer, with 3 being discharged after receiving treatment in the emergency department and 9 requiring hospital admission, psychiatric, or sobering services. The likelihood of hospital transfer did not significantly vary by sex (p=0.41), 9-1-1 call origination relative to BHP neighborhood (p=0.92), or CADDiE recommendation (p=0.51).

Conclusion

Three-fourths of patients who required subsequent hospital transfer were admitted or required specialized services, suggesting that the FCC was viable for managing low acuity conditions. However, the underutilization of the FCC by EMS as a transport destination and a high hospital transfer rate indicates training and protocol refinement opportunities. Despite the small cohort size, this study demonstrates that an FCC alternative care site can act as a viable source for urgent and emergency care during a pandemic.