THE ROLE OF PLANS IN THE FORMATION OF A NEW INNOVATION PRACTICE: AN INNOVATION OBJECT PERSPECTIVE

This paper explores the role of plans, as objects, in the formation of new innovation practice in organisations. A vocabulary for analysis is developed from innovation object theory. First, findings from an ethnographic study in a hospital organisation show that a plan serves several functions depending on its activation for use: a checklist of past practice (tertiary object), an opener for debates over current practice (secondary object) and a trigger for future practice development (primary object). Second, a framework is offered that shows how a plan supports different functionalities (evaluating, debating, further exploring) in a temporal dynamics of practice formation. Third, thus, plans play a significant role not only in planning activities, but also as connectors that shape and patch together pieces of past, present and future into what actually become new organisational practice. Finally, implications for innovation theory and management are drawn from these novel contributions.

Complementary work in the hospital: How infection preventionists perceive opportunities for cooperation with higher status physicians

Social scientists and management scholars have tended to see workplace interaction through the lens of hierarchy. However, modern workplaces include many people who do not fit neatly into such hierarchies because their work is designed to assess, support, sanction, or monitor other workers who already have well-established positions. Motivated by this observation, we conducted interviews with 193 infection preventionists—healthcare workers whose job it is to work with higher status physicians to monitor and suppress healthcare-acquired infections—to assess how workers outside of existing hierarchies can integrate their work. Inductive analyses of these interviews suggest three strategies: deference; relying on bureaucracy’s routines and practices; and recruiting higher status confederates, which we call side-channeling. From these analyses, we introduce the concept of complementary work to describe labor that seeks to supplement existing workplace hierarchies.

The Communicative Constitution of Organization, Organizing, and Organizationality

Although the lion’s share of scholarship in management and organization studies conceives of organizations as entities within which communication occurs, “Communication Constitutes Organization” (CCO) scholarship has attracted interest because it makes a productive reversal, that is, by asking how organization happens in communication. Over the past decade, Organization Studies has become the key scholarly outlet for CCO thinking in the management and organization studies field. Accordingly, in this paper we discuss seven articles that have appeared in this journal as evidence of the perspective’s centrality. We first situate CCO theorizing within the linguistic turn, and position CCO with respect to other lines of scholarship underwritten by a rich conception of language and discourse. We examine the varied ways CCO thinking has found organization in communication, locating in the seven articles productive tensions between the process of communication, on the one hand, and organization, organizing, and organizationality, on the other. We contribute to CCO scholarship with reflections on these three theoretical orientations and provide a set of possibilities for its further development.

Boundary Objects and the Technical Culture Divide: Successful Practices for Voluntary Innovation Teams Crossing Scientific and Professional Fields

This article examines the creation and stabilization of early-stage boundary objects by voluntary teams spanning divergent professional and scientific fields. Cross-disciplinary collaborators can share similar goals, yet nonetheless face frictions from differences in professional expertise, practices, and technical systems. Yet if boundary objects help to span disciplinary divides, the same challenges are likely to hinder initial boundary object development. Comparative ethnography of three projects adapting Grid computing technology to fields of science highlights challenges for boundary object creation, including a “mind-set shift” before the technology could stabilize. Enriching our knowledge of boundary object beginnings, we find successful stabilization requires both appropriate localization and further resources, which enable the simultaneously global–local nature of boundary objects. This essential feature is understudied in management research. Developing the boundary object concept on its own terms enhances empirical and theoretical application, particularly when researchers prefer one main theory of objects, rather than a “pluralist” approach.

The Silent Politics of Temporal Work: A Case Study of a Management Consultancy Project to Redesign Public Health Care

In this article, we discuss temporal work and temporal politics situated between groups with different temporal orientations, arguing that attention needs to be paid to covert and unarticulated silent politics during temporal work. Drawing on a case study of a management consultancy project to redesign public health care, we explain how unarticulated temporal interests and orientations shape the construction of problems, which, in turn, legitimate tasks and time frames. We also show how task and time frames are temporarily fixed and imposed through boundary objects, and the way these may then be reinterpreted and co-opted to deflect pressure to change. Thus, we argue, unarticulated, covert and political temporal inter-dynamics produce expedient provisional temporal settlements, which resolve conflict in the short term, while perpetuating it in the longer run.

NHS top managers, knowledge exchange and leadership: the early development of Academic Health Science Networks – a mixed-methods study

Background

Academic Health Science Networks (AHSNs) were recently created in the NHS to accelerate the spread of innovations that could promote population-level health gain and also pursue novel goals of wealth creation. They are 15 regionally based networks. They reflect a continuing stream of national health policy on stimulating NHS knowledge mobilisation, which has now created a novel institutional architecture.

Objectives

The overall research aims were (1) to explore AHSNs’ strategies and practices of knowledge mobilisation in their formative phase, when they were building up health- and wealth-related networks; and (2) to investigate how knowledge leadership took place in these settings and the characteristics of people perceived as knowledge leaders (KLs). Specific research objectives operationalised these broad aims.

Design

It was a mixed-methods study with a large qualitative component but also social network analysis (SNA). It contained a sequence of work packages: (1) an initial literature review to inform interviews; (2) an analysis of the national policy stream in this field; (3) a SNA of the AHSNs’ health and wealth networks; (4) five case studies of different AHSNs with 10 innovation tracers; and (5) interviews with individuals nominated as KLs.

Setting

We studied a sample of five of the 15 English AHSNs, along with the development of the national policy stream.

Participants

We interviewed and surveyed AHSNs and other relevant staff, including national policy-level respondents.

Data sources

(1) A review of national- and AHSN-level documents, grey literature and relevant academic material; (2) semi-structured interviews with AHSN very senior managers, along with other staff, policy respondents and nominated ‘KLs’; and (3) a SNA (with two time points) using snowball survey methods.

Review methods

The literature review took a structured and narrative-based approach in what was a diffuse and multidisciplinary academic field.

Results

(1) We found that different networks were emerging around AHSNs’ health and wealth goals and, perhaps not surprisingly, the wealth networks were at an exploratory stage; (2) we found that these networks took different forms in different AHSNs; (3) we developed a general typology of the approaches AHSNs took towards spreading new ideas and innovations; and (4) we uncovered some characteristics of ‘KLs’.

Limitations

The study proceeded with the AHSNs still in a formative phase (early 2014 to early 2016). The SNA had two data points that were close together. We could not undertake a longer-term impact assessment. Future work should take a more longitudinal approach.

Conclusions

The study’s results have implications for (1) AHSN knowledge mobilisation strategies and networks, (2) the shape of AHSN regional knowledge networks and (3) the construction of knowledge leadership in these settings.

Future research

Our top priority recommendations were (1) a longer-term AHSN impact assessment and (2) greater exploration of the AHSNs’ novel wealth creating role.

Funding

The National Institute for Health Research Health Services and Delivery Research programme.

Modalities of opposition: Control and resistance via visual materiality

This article examines how the material, and specifically visual, aspects of organizing contribute to understanding control and resistance issues in organizations. Whereas the role of visuality in workplace power relations has been acknowledged, the processes by which specific visual affordances contribute to power contests are not well understood. We argue that the diverse affordances of visual images offer opportunities for both control and resistance, where control is exerted via the normalizing and objectifying feature of visuality, while resistance draws on bricolage and juxtaposition to subvert dominant management discourses. Based on an ethnographic study of an industrial print company, we show how the diverse uses of visuality create a field for negotiating organizational tensions. We draw conclusions for the study of visual affordances as a tool for control and resistance struggles in organizations.

In search of innovative capabilities of communities of practice: A systematic review and typology for future research

The concept of communities of practice has generated considerable debate among scholars of management. Attention has shifted from a concern with the transmission and reproduction of knowledge towards their utility for enhancing innovative potential. Questions of governance, power, collaboration and control have all entered the debate with different theorizations emerging from a wide mix of empirical research. We appraise these key findings through a critical review of the literature. From a divergent range of findings, we identify four main ways in which communities of practice enable and constrain innovative capabilities as (a) enablers of learning for innovation, (b) situated platforms for professional occupations, (c) dispersed collaborative environments and (d) governance structures designed for purpose. Our conclusion signals the way forward for further research that could be used to improve our understanding of different contextual forms and how they may align with organizations in enabling rather than constraining innovative capabilities.

Dominant Cognitive Frames and the Innovative Power of Social Networks

In this paper, we illustrate the link between social network structures, dominant cognitive frames on network purpose and the innovative power of a network, through a mixed-method comparative analysis of two knowledge translation networks (KTNs) in the English National Health Service (NHS). Our findings illustrate several challenges for networked forms of organization linked to different manifestations of social networks (centralized/decentralized) and dominant cognitive frames (polarizing/loosely clustered). Our paper contributes a better understanding of how dominant frames on network purpose emerge alongside the development of network structure itself, and explores how this interplay between dominant frames and social networks impacts upon the collaborative work that supports the network’s innovative power.

'They hear "Africa" and they think that there can't be any good services'--perceived context in cross-national learning: a qualitative study of the barriers to Reverse Innovation

Background

Country-of-origin of a product can negatively influence its rating, particularly if the product is from a low-income country. It follows that how non-traditional sources of innovation, such as low-income countries, are perceived is likely to be an important part of a diffusion process, particularly given the strong social and cognitive boundaries associated with the healthcare professions.

Methods

Between September and December 2014, we conducted eleven in-depth face-to-face or telephone interviews with key informants from innovation, health and social policy circles, experts in international comparative policy research and leaders in Reverse Innovation in the United States. Interviews were open-ended with guiding probes into the barriers and enablers to Reverse Innovation in the US context, specifically also to understand whether, in their experience translating or attempting to translate innovations from low-income contexts into the US, the source of the innovation matters in the adopter context. Interviews were recorded, transcribed and analyzed thematically using the process of constant comparison.

Results

Our findings show that innovations from low-income countries tend to be discounted early on because of prior assumptions about the potential for these contexts to offer solutions to healthcare problems in the US. Judgments are made about the similarity of low-income contexts with the US, even though this is based oftentimes on flimsy perceptions only. Mixing levels of analysis, local and national, leads to country-level stereotyping and missed opportunities to learn from low-income countries.

Conclusions

Our research highlights that prior expectations, invoked by the Low-income country cue, are interfering with a transparent and objective learning process. There may be merit in adopting some techniques from the cognitive psychology and marketing literatures to understand better the relative importance of source in healthcare research and innovation diffusion. Counter-stereotyping techniques and decision-making tools may be useful to help decision-makers evaluate the generalizability of research findings objectively and transparently. We suggest that those interested in Reverse Innovation should reflect carefully on the value of disclosing the source of the innovation that is being proposed, if doing so is likely to invoke negative stereotypes.

Translational networks in healthcare? Evidence on the design and initiation of organizational networks for knowledge mobilization

International attention has focussed on the variations between research evidence and practice in healthcare. This prompted the creation of formalized translational networks consisting of academic-service partnerships. The English Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are one example of a translational network. Using longitudinal, archival case study data from one CLAHRC over a 3-year period (2008-11), this article explores the relationship between organizational form and the function(s) of a translational network. The article focuses on the research gaps on the effective structures and appropriate governance to support a translational network. Data analysis suggested that the policy of setting up translational networks is insufficient of itself to produce positive translational activity. The data indicate that to leverage the benefits of the whole network, attention must be paid to devising a structure which integrates research production and use and facilitates lateral cross-disciplinary and cross-organizational communication. Equally, appropriate governance arrangements are necessary, particularly in large, multi-stakeholder networks, where shared governance may be questionable. Inappropriate network structure and governance inhibits the potential of the translational network. Finally, the case provides insights into the movement of knowledge within and between network organizations. The data demonstrate that knowledge mobilization extends beyond knowledge translation; knowledge mobilization includes the negotiated utilization of knowledge - a balanced power form of collaboration. Whilst much translational effort is externally focused on the health system, our findings highlight the essential need for the internal negotiation and mobilization of knowledge within academia.

Developing a Relational View of the Organizing Role of Objects: A study of the innovation process in computer games

Innovation processes create distinctive challenges for coordination. Objects are seen as supporting coordination in such settings by enabling the emergent action needed to deal with a dynamic and uncertain process. Thus, previous work has highlighted the role of different types of objects in coordinating the collaborative tasks undertaken by expert groups, either by motivating the creation of new knowledge or through the translation of understanding. Through an empirical study of innovation processes in the computer games sector, our paper adds to this previous work by finding that the relations between objects, and not the objects alone, help to orchestrate multiple collaborative tasks towards a final outcome within temporal and resource constraints. The relational view which emerges from this study shows how such a ‘system of objects’ is able to stabilize coordination of the process while preserving the emergence and autonomy of games developer practices needed to achieve innovation.

Balancing exploration and exploitation in transferring research into practice: a comparison of five knowledge translation entity archetypes

BACKGROUND

Translating knowledge from research into clinical practice has emerged as a practice of increasing importance. This has led to the creation of new organizational entities designed to bridge knowledge between research and practice. Within the UK, the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) have been introduced to ensure that emphasis is placed in ensuring research is more effectively translated and implemented in clinical practice. Knowledge translation (KT) can be accomplished in various ways and is affected by the structures, activities, and coordination practices of organizations. We draw on concepts in the innovation literature--namely exploration, exploitation, and ambidexterity--to examine these structures and activities as well as the ensuing tensions between research and implementation.

METHODS

Using a qualitative research approach, the study was based on 106 semi-structured, in-depth interviews with the directors, theme leads and managers, key professionals involved in research and implementation in nine CLAHRCs. Data was also collected from intensive focus group workshops.

RESULTS

In this article we develop five archetypes for organizing KT. The results show how the various CLAHRC entities work through partnerships to create explorative research and deliver exploitative implementation. The different archetypes highlight a range of structures that can achieve ambidextrous balance as they organize activity and coordinate practice on a continuum of exploration and exploitation.

CONCLUSION

This work suggests that KT entities aim to reach their goals through a balance between exploration and exploitation in the support of generating new research and ensuring knowledge implementation. We highlight different organizational archetypes that support various ways to maintain ambidexterity, where both exploration and exploitation are supported in an attempt to narrow the knowledge gaps. The KT entity archetypes offer insights on strategies in structuring collaboration to facilitate an effective balance of exploration and exploitation learning in the KT process.

Leadership as boundary work in healthcare teams

This paper proposes that boundary work is inherent to leadership practices in healthcare settings, and explores this phenomenon in interprofessional healthcare teams. Specifically, the study focuses on leading through and across boundaries in four interprofessional healthcare teams operating in the area of mental health services. We give special consideration to the specific contexts of these teams, and address the boundaries that are constructed and managed in interactions. Our qualitative study revealed that leadership can be exercised by different members and at different levels within the teams, and that it involves managing the boundaries between (a) roles of different members of the leadership constellation, (b) leadership and clinical roles, (c) formal leaders and other members of the team, (d) different professions, (e) personal life experiences and professional work, and (f) the team and what members consider to be the environment. We identify different types of boundary work tactics that involve opening, closing, and contesting/negotiating boundaries. In addition, we address the potential consequences of each of these tactics. We consider the implications of our findings to leadership research and practice in healthcare contexts and beyond.

Distributed Leadership in Policy Formulation: A Sociomaterial Perspective

Leadership in public policy making is challenging. There is tension in gaining commitment from competing stakeholder groups, in sustaining public engagement in technically complex areas and securing broad-based support. Our paper illuminates these challenges through a case study of health policy development in the UK. We go beyond individual roles and leader–follower exchange relationships to develop the concept of distributed leadership using a sociomaterial approach to reveal how and why leadership is distributed across sociomaterial practices which together (re)configure policy coalitions and context. In so doing we also show how legitimacy and trust are sociomaterially enacted and shape leadership in public policy.

Learning during crisis as a ‘war for meaning’: The case of the German Escherichia coli outbreak in 2011

Previous research has examined learning from crises. However, comparatively neglected is the analysis of learning during such events. This explorative case study reports findings on how learning took place during the outbreak of Escherichia coli in Germany in 2011, which resulted in 53 fatalities. We identify three broad communities: (a) public agencies, (b) research institutions and hospitals and (c) opposition parties and non-governmental organizations. We discuss their conflicting interests in the face of the unfolding crisis, and we explore how their (re)actions and sensemaking affected the way the outbreak progressed. By conceptualizing the crisis as an epistemic object, we show how transepistemic sensemaking both enabled and constrained learning. The crisis, as an epistemic object, is a contested terrain, and each epistemic group’s commitments influenced the trajectory of their responses, demanding a processual perspective to capture the constantly realigning ways actors interpret and react upon the crisis. This study demonstrates how learning during a crisis may thus be transitory since it is hampered by a ‘war for meaning’. This ‘war’ potentially also prevents significant learning subsequent to a crisis, as institutional and epistemic commitments are quickly reformed and transepistemic engagements are closed.

Subjects of Inquiry: Statistics, Stories, and the Production of Knowledge

Statistics and stories are often equated with different types of knowledge in contemporary western societies: statistics are associated more with the authority of objective, disinterested experts while stories are able to encapsulate subjective, personal experience. In this paper, we explore how both genres were used to produce knowledge in the context of a public inquiry on the problems facing older workers in securing and maintaining employment. Drawing on the concept of power/knowledge relations we examine how statistics and stories were used in different inquiry texts and trace their use across texts over time. Our findings show that to establish their authority as a valid form of knowledge representing the subject of inquiry, statistics and stories both had to be embedded in the appropriate discursive conventions. In the case of statistics, knowledge had to be expressed through discursive conventions that conveyed distance from the subject of inquiry, i.e. independent, objective research. In contrast, stories produced knowledge through discursive conventions that established proximity to the older worker – by being or knowing an older worker. The study shows the effects of these discursive conventions on how knowledge is institutionalized through processes of textual re-inscription, as well as the way in which they constructed a marginalized older worker subject.

Object-Control: A Study of Technologically Dense Knowledge Work

Drawing on the literature on active objects and combining it with an ethnographic study of engineering work, this paper offers an alternative and complementary understanding of the problem of control in knowledge-intensive work. This problem largely concerns the question of how creative processes of knowing are enabled on behalf of the organization. The dominant response to this question revolves around the idea that when work becomes complex, managers attempt to control the norms and identifications of employees, rather than their behaviours. Through the concept of object-control, the idea is introduced that organizational objects participate on behalf of the organization in processes of knowledge control by interpellating organizational members; that is, organizational members are invited to interact with the objects and to creatively develop knowledge in order to solve organizational problems. The study covers ground that the established notions of normative control and identity regulation have neglected, and suggests new ways of advancing the scholarship of organizational control by taking the active participation of organizational objects into account.

Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC)

BACKGROUND

The English National Health Service has made a major investment in nine partnerships between higher education institutions and local health services called Collaborations for Leadership in Applied Health Research and Care (CLAHRC). They have been funded to increase capacity and capability to produce and implement research through sustained interactions between academics and health services. CLAHRCs provide a natural 'test bed' for exploring questions about research implementation within a partnership model of delivery. This protocol describes an externally funded evaluation that focuses on implementation mechanisms and processes within three CLAHRCs. It seeks to uncover what works, for whom, how, and in what circumstances.

DESIGN AND METHODS

This study is a longitudinal three-phase, multi-method realistic evaluation, which deliberately aims to explore the boundaries around knowledge use in context. The evaluation funder wishes to see it conducted for the process of learning, not for judging performance. The study is underpinned by a conceptual framework that combines the Promoting Action on Research Implementation in Health Services and Knowledge to Action frameworks to reflect the complexities of implementation. Three participating CLARHCS will provide in-depth comparative case studies of research implementation using multiple data collection methods including interviews, observation, documents, and publicly available data to test and refine hypotheses over four rounds of data collection. We will test the wider applicability of emerging findings with a wider community using an interpretative forum.

DISCUSSION

The idea that collaboration between academics and services might lead to more applicable health research that is actually used in practice is theoretically and intuitively appealing; however the evidence for it is limited. Our evaluation is designed to capture the processes and impacts of collaborative approaches for implementing research, and therefore should contribute to the evidence base about an increasingly popular (e.g., Mode two, integrated knowledge transfer, interactive research), but poorly understood approach to knowledge translation. Additionally we hope to develop approaches for evaluating implementation processes and impacts particularly with respect to integrated stakeholder involvement.