Emphasis on learning and adaptation is associated with centralized decision making
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Abstract We test the separate and joint effects of centralization and organizational strategy on the performance of 53 UK public service organizations. Centralization is measured as both the hierarchy of authority and the degree of participation in decision making, whereas strategy is measured as the extent to which service providers are prospectors, defenders, and reactors. We find that centralization has no independent effect on service performance, even when controlling for prior performance, service expenditure, and external constraints. However, the impact of centralization is contingent on the strategic orientation of organizations. Centralized decision making works best in conjunction with defending, and decentralized decision making works best in organizations that emphasize prospecting. Show
Journal Information The Journal of Public Administration Research and Theory was established in the late 1980s to serve as a bridge between public administration and public management scholarship on the one hand, and public policy studies on the other. Its multidisciplinary aim is to embrace the organizational, administrative, and policy sciences as they apply to government and governance. Publisher Information Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. OUP is the world's largest university press with the widest global presence. It currently publishes more than 6,000 new publications a year, has offices in around fifty countries, and employs more than 5,500 people worldwide. It has become familiar to millions through a diverse publishing program that includes scholarly works in all academic disciplines, bibles, music, school and college textbooks, business books, dictionaries and reference books, and academic journals. To read the full version of this content please select one of the options below:
Larry
Hearld (Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA) Allyson Hall (Health Services Administration, University of Alabama at
Birmingham, Birmingham, Alabama, USA) Reena Joseph Kelly (Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA)
Aizhan Karabukayeva (Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA) Jasvinder Singh (Division of Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA) The purpose of this study was to examine the organizational context that may support learning and change readiness climates that previous research has found to be conducive to implementing evidence-based interventions. Design/methodology/approachAn exploratory, mixed method evaluation that included 15 rheumatology clinics throughout the United States was performed. Quantitative data were collected using a web-based survey completed by 135 clinic members. Qualitative data were collected via semi-structured interviews with 88 clinic members. FindingsIn general, clinics reported strong, positive learning and change readiness climates. More complex organizations (e.g. multispecialty, academic medical centers) with rational/hierarchical cultures and members with longer tenure were associated with less supportive learning and change readiness climates. The authors’ findings highlight opportunities for organizational leaders and evidence-based intervention sponsors to focus their attention and allocate resources to settings that may be most susceptible to implementation challenges. Originality/valueFirst, the authors address a deficit in previous research by describing both the level and strength of the learning and change readiness climates for implementing an evidence-based shared decision-making aid (SDMA) and examine how these vary as a function of the organizational context. Second, the study examines a broader set of factors to assess the organizational context (e.g. organizational culture, organizational structure, ownership) than previous research, which may be especially salient for shaping the climate in smaller specialty clinics like those we study. Third, the authors utilize a mixed methods analysis to provide greater insights into questions of how and why organizational factors such as size and structure may influence the learning and change readiness climate. Keywords
AcknowledgementsResearch reported in this article was funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (SDM-2017C2-8224). Conflicts of interest: The authors are not aware of any conflicts that would have biased the study findings. CitationHearld, L., Hall, A., Kelly, R.J., Karabukayeva, A. and Singh, J. (2022), "Organizational context and the learning and change readiness climate for implementing an evidence-based shared decision-making aid in US rheumatology clinics", Journal of Health Organization and Management, Vol. 36 No. 1, pp. 121-140. https://doi.org/10.1108/JHOM-10-2020-0397 Publisher:Emerald Publishing Limited Copyright © 2021, Emerald Publishing Limited Related articlesWhich of the following statements regarding centralized organizations is accurate?The correct answer is e. In a centralized organization, decision-making is concentrated at a single point in the organization .
When decisionIn short, a decentralized organization is one where day-to-day operations and decision-making power is delegated from the top level of management to the middle and entry levels. On the other hand, centralized organizations are those where these aspects are concentrated in top management.
What is the structural configuration that leaders use to arrange an organization's activities and operations to achieve its goals?Organizational structure refers to how individual and team work within an organization are coordinated. To achieve organizational goals and objectives, individual work needs to be coordinated and managed.
Is economic development that generates wealth and meets the needs of their current generation while focusing on future generations?Sustainable development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs.
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