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June 2014 - present
July 1994 - May 2014
Publications
Publications (131)
In this inductive study we explore the relational microdynamics of organizational resilience in adventure racing. Drawing from an organizing lens, we frame resilience as an ongoing process by which organizational actors work together to absorb strain and maintain functioning within dynamically uncertain and adverse environments. Adventure racing ex...
Our article reviews research on “organizational science and health care,” defined broadly as research focusing on topics commonly studied in the organizational and management literatures and conducted in health care settings. Using almost 700 articles published in leading organizational science (OS) and health care (HC) journals over the past decad...
Amid longstanding recognition that healthcare challenges are often managerial, not just clinical, many have called for greater attention to developing physicians’ business management abilities. However, the Covid-19 pandemic has amplified the urgency of building physicians’ business knowledge and skills—from understanding health economics and finan...
This initial, exploratory study on gender bias in collaborative medical decision making examined the degree to which physicians' reliance on a team member's patient care advice differs as a function of the gender of the advice giver. In 2018, 283 anesthesiologists read a brief, online clinical vignette and were randomly assigned to receive treatmen...
Resilience matters now more than ever in healthcare, with the COVID-19 pandemic putting healthcare providers and systems under unprecedented strain. In popular culture and everyday conversation, resilience is often framed as an individual character trait where some people are better able to cope with and bounce back from adversity than others. Rese...
Physicians are being increasingly called upon to engage in leadership at all levels of modern health organizations, leading many to call for greater research and training interventions regarding physician leadership development. Yet, within these calls to action, the authors note a troubling trend toward siloed, medicine-specific approaches to lead...
Organizational crises have often stimulated scholarly theorizing that has been productive for our field. Rarely, however, are there opportunities to theorize regarding crises that happen in our own professional associations. A crisis experienced by Professor Anita McGahan when she was the President of the Academy of Management, described in an acco...
The healthcare industry is on the journey toward high reliability. The industry works diligently to improve safety and quality, adopting some vitally important high reliability organization practices. While positive steps forward, these practices tend to be discrete initiatives to address specific challenges, and high reliability remains elusive. T...
Sensemaking is typically understood as the ongoing production of images, labels, stories or symbols in order to stabilize the streaming of experience. People make sense by focusing on a limited set of cues and elaborating those few cues into a plausible, momentarily useful, guide for action. And actions themselves partially define the guide that th...
Efforts to improve quality of care and patient safety have concentrated on provider practice and frontline care processes. Little attention has focused on understanding the role that leadership decisions play in creating risk within a health care system. The framework and tool described in this article builds on Reason's construct of latent organiz...
The importance of patient safety has grown tremendously; however, there are insufficient resources dedicated to its practical application. We provide an overview of the framework for addressing patient safety within the Johns Hopkins Health System, which approaches patient safety in the context of risk at the patient, provider, unit, and system lev...
Objective
To describe the important distinctions between traditional biomedical and high reliability organisation (HRO) approaches in advancing healthcare delivery. To further describe how these two concepts can be integrated in a learning health system to improve care for patients, providers’ experience and healthcare organisations’ effectiveness....
Mary Dixon-Woods is supported by a Wellcome Trust Senior Investigator award (WT097899).
This chapter explores some basic ideas concerning organizational and cultural determinants of safety. Our goal is to be descriptive rather than prescriptive—to deepen the understanding of some basic organizing concepts and the mechanisms through which they exert their effects. We begin by examining some often overlooked assumptions about the nature...
Research on crisis management and resilience has sought to explain how individuals and organizations anticipate and respond to adversity, yet—surprisingly—there has been little integration across these two literatures. In this paper, we review the literatures on crisis management and resilience and discuss opportunities to both integrate and advanc...
In recent years, research on mindfulness has grown rapidly in organizational psychology and organizational behavior. Specifically, two bodies of research have emerged: One focuses on the intrapsychic processes of individual mind-fulness and the other on the social processes of collective mindfulness. In this review we provide a pioneering, cross-le...
Sensemaking is typically understood as the ongoing production of images, labels, stories or symbols in order to stabilize the streaming of experience. People make sense by focusing on a limited set of cues and elaborating those few cues into a plausible, momentarily useful, guide for action. And actions themselves partially define the guide that th...
Employee performance often moves in lockstep with job satisfaction. Using the 2015 Federal Employee Viewpoint Survey, we have identified important and common management and labor needs across more than 80 federal agencies. Drawing on the vast trove of organizational science research that examines the effects of organizational designs and processes...
Background
Three decades of research findings have documented the health effects of handling hazardous drugs. Oncology nurses are vulnerable due to frequent administration of antineoplastics, low adherence to equipment use, reported barriers to use, and perceived low risk of health effects. No interventions have been tested in a controlled, multi-s...
In this paper, we propose that performance under uncertainty and ambiguity is enabled by a two-pronged set of practices enacted by leaders and frontline workers. These contextualized practices fuel performance by enabling teams and organizations to both discern, interpret and make sense of important discrepancies as situations unfold (what we refer...
Despite admonishments that anthropomorphizing represents a serious error in scientific thinking, this review shows that anthropomorphizing has been a critically important tool for developing influential theories in organization studies. Analyzing the literatures related to organizational identity and organizational knowledge reveals how organizatio...
It is time to rethink and reframe crisis management. The literature in this crucial domain of organizational research and practice is missing the mark. Whereas much of the research is focused on the large-scale crises that blindside companies, the reality in today’s business environment is quite different. True, some organizations experience large-...
Uncertainty has figured prominently in organization studies as a critical contingency with which organizations and decision makers must contend. Yet scholars studying the dynamics of organizational routines have paid relatively little attention to uncertainty’s effects. This paper addresses this gap by exploring how differing levels of perceived un...
This is a world suffused with dynamic complexity in which the past no longer stands as a sensible guide to the present. This poses problems for sensemaking as people seek to redeploy concepts in order to ward off blind perceptions and redirect perceptions to ward off empty conceptions. It also prompts a reappraisal of the link between sensemaking a...
The factors that compel individuals to exert the extraordinary effort needed to create high reliability—consistent error-free performance under trying conditions—remain unspecified. Here, we propose that when individuals experience emotional ambivalence and prosocial motivation, it induces the broad thinking and other-orientation that undergird min...
The increasingly complex and volatile nature of organizational environments and technologies exposes many organizations to unexpected, unpredictable, and uncertain vulnerabilities. A growing stream of organization theory proposes that the capability to adapt flexibly in real time results from organizing processes that foster collective mindfulness....
Background:
Studies show that implementing huddles in healthcare can improve a variety of outcomes. Yet little is known about the mechanisms through which huddles exert their effects. To help remedy this gap, our study objectives were to explore hospital administrator and frontline staff perspectives on the benefits and challenges of implementing...
In health care, reliability is the measurable capability of a process, procedure, or health service to perform its intended function in the required time under actual or existing conditions (as opposed to the ideal circumstances under which they are often studied). This article outlines the current state of reliability in a clinical context, discus...
We develop theory about how growing at work is an interpretive accomplishment in which individuals sense that they are making progressive self-change. Through a study of how employees interpret themselves as growing at three organizations, we develop a theoretical account of how employees draw from contextual and personal resources to interpret the...
Ray, Baker, and Plowman's (2011) study of organizational mindfulness highlights latent tensions in the mindfulness literature and promising avenues for future research. Their study provides a springboard for reconciling the literature by differentiating organizational mindfulness from mindful organizing, establishing where organizational mindfulnes...
This is a study of a method of mortality review, adopted by the Michigan Society of Thoracic and Cardiovascular Surgeons, to enhance understanding of mortality and potentially avoidable deaths after cardiac surgery, utilizing a voluntary statewide database.
A system to categorize mortality was developed utilizing a phase of care mortality analysis...
Positive organizational scholarship is concerned with dynamics that enable organizational strength and flourishing. In this chapter, we argue that organizations that manage unexpected events and prevent small problems from becoming large crises are engaged in important acts of positive organizing. We assume that adverse events, crises, and accident...
Aircraft carriers, electrical power grids, and wildland firefighting, though seemingly different, are exemplars of high reliability organizations (HROs)--organizations that have the potential for catastrophic failure yet engage in nearly error-free performance. HROs commit to safety at the highest level and adopt a special approach to its pursuit....
Academic and professional disciplines, such as organisation and management theory, psychology, sociology and engineering, have, for years, grappled with the multidisciplinary issues of safety and accident prevention. However, these ideas are just beginning to enrich research on safety in medicine. This article examines a domain of research on syste...
Building on coherence theory and a pragmatist tradition, we offer an inductive model of top-down theorizing that can be a source of new theories of organization. We explain how an initial hypothesis is refined to enhance its potential contribution (consistent with abduction). But, unlike abduction, we explain how inquiry begins-how research tension...
In this dissertation, I examine the work involved in attempting to rebuild teacher education into an enterprise more directly focused on the practice of teaching. As a vehicle for doing so, I analyze a significant instance of teacher education reform: efforts associated with the Holmes Group at Michigan State University (MSU) in the 1980s and 1990s...
Governments often provide assistance to firms, especially energy-efficiency and renewable-energy businesses (Marcus, Anderson, Cohen, and Sutliffe, 2010). For example, in the 1970s the U.S. federal government offered subsidies to firms that developed solar panels and tax credits to consumers who purchased these products (Marcus, 1992). There have b...
Medical error has reached epidemic proportions, and researchers have developed insufficiently sophisticated models of safety culture to match the complexity of the challenge of safety in health care. This has left providers and researchers with an inadequate conceptual toolkit for improving safety. To rectify the resulting crisis we consolidate fra...
"Dysfunctional momentum" occurs when people continue to work toward an original goal without pausing to recalibrate or reexamine their processes, even in the face of cues that suggest they should change course. In the authors' study of firefighting teams as a metaphor for business organizations, where dysfunctional momentum arises daily, they found...
he collapse of the roof of the Baltimore & Ohio (B&O) Railroad Museum Roundhouse onto its collections during a snowstorm in 2003 provides a starting point for our exploration of the link between learning and rare events. The collapse occurred as the museum was preparing for another rare event: the Fair of the Iron Horse, an event planned to celebra...
Research on organizational safety and reliability largely has emphasized system-level structures and processes neglecting the more micro-level, social processes necessary to enact organizational safety. In this qualitative study we remedy this gap by exploring these processes in the context of wildland fire management. In particular, using intervie...
Actors often leave in pursuit of new ventures, even though entrepreneurial opportunities may exist inside the firm. While a bulk of work has focused on understanding the determinants of entrepreneurial transition (e.g., Aldrich and Ruef, 2006; Dobrev and Barnett, 2005; Robinson and Sexton, 1994; S??rensen, 2007a; 2007b),
whether nascent entrepreneu...
Individuals typically describe information overload as the situation of receiving too much information. Organizational scholars define overload as a state induced when the amount of input to a system exceeds its processing capacity or when information processing capabilities and the information loads encountered are mismatched. Perception plays a k...
Prior research has found that safety organizing behaviors of registered nurses (RNs) positively impact patient safety. However, little research exists on the joint benefits of safety organizing and other contextual factors that help foster safety.
Although we know that organizational practices often have more powerful effects when combined with oth...
In this paper we outline the contours of a theory of organizational resilience as well as a research agenda. First, we identify how the notion of resilience has become increasingly important to all organizations and argue that organization theory currently does not reflect its importance. Second we reconcile varying definitions of resilience to cre...
Drawing together research in the upper echelon perspective, strategy, and organizational sociology, this paper examines (1) the relationship between the finance expertise of a venture capital (VC) firm's management team and investment selection, and (2) the moderation of this relationship by the VC firm's social position. We find that while finance...
Evidence that medical error is a systemic problem requiring systemic solutions continues to expand. Developing a "safety culture" is one potential strategy toward improving patient safety. A reliable and valid self-report measure of safety culture is needed that is both grounded in concrete behaviors and is positively related to patient safety.
We...
Thriving in organizations Consider these contrasting images of individuals in relation to their work. ‘Here we house the legions of the walking dead.’ When people join the legions of the walking dead, they begin to live lives of quiet desperation. They tend to experience feelings of meaninglessness, hopelessness, and impotence in their work roles....
Summary This study assessed the applicability of current theories of reliability in dynamic settings by exploring the sensemaking processes experienced by a sample of medical residents around lapses in reliability of patient care. Important differences in lapses surfaced, particularly with respect to whether actors were aware that a lapse was occur...
This collection of essays arose from a call for papers issued by Organization Studies in 2004 to celebrate and critically engage the scholarship of Karl Weick; to carry forward his thinking into new contexts and take stock of recent developments in the themes, issues and theories that have preoccupied Weick in his more than 40 years of scholarship....
Mindfulness as depicted by Levinthal and Rerup (2006) involves encoding ambiguous outcomes in ways that influence learning, and encoding stimuli in ways that match context with a repertoire of routines. We add to Levinthal and Rerup's conjectures by examining Western and Eastern versions of mindfulness and how they function as a process of knowing...
Social mechanisms are theoretical cogs and wheels that explain how and why one thing leads to another. Mechanisms can run from macro to micro (e.g., explaining the effects of organizational socialization practices or compensation systems on individual actions), micro to micro (e.g., social comparison processes), or micro to macro (e.g., how cogniti...
Although organizational environments are a central concern for researchers in organization theory and strategy, many researchers report that informant assessments and archival measures of the environment do not converge. This study investigates whether the observed divergence can be attributed to perceptual error, to real differences in constructiv...
Background:
The study of patient safety can benefit from greater methodological diversity to improve scientific knowledge and to increase the effectiveness and tailoring of strategies aimed at improving it.
Methodological diversity to better capture causal mechanisms and processes:
Additional methods for studying patient safety and errors to ref...
To explore the significant emotional challenges facing resident physicians in the setting of medical mishaps, as well as their approaches to coping with these difficult experiences.
Twenty-six resident physicians were randomly selected from a single teaching hospital and participated in in-depth qualitative interviews. Transcripts were analyzed ite...
Emergency medicine is largely a communicative activity, and medical mishaps that occur in this context are too often the result of vulnerable communication processes. In this year-long qualitative study of two academic emergency departments, an interdisciplinary research team identified four such processes: triage, testing and evaluation, handoffs,...
hriving describes an individual's experience of vitality and learning. The primary goal of this paper is to develop a model that illuminates the social embeddedness of employees' thriving at work. First, we explain why thriving is a useful theoretical construct, define thriving, and compare it to related constructs, including resilience, flourishin...
Sensemaking involves turning circumstances into a situation that is comprehended explicitly in words and that serves as a springboard into action. In this paper we take the position that the concept of sensemaking fills important gaps in organizational theory. The seemingly transient nature of sensemaking belies its central role in the determinatio...
Studies before and since the 1999 Institute of Medicine report have noted the limitations of using medical record reporting for reliably quantifying and understanding medical error. Quantitative macro analyses of large datasets should be supplemented by small-scale qualitative studies to provide insight into micro-level daily events in clinical and...
BACKGROUND: Studies before and since the 1999 Institute of Medicine report have noted the limitations of using medical record reporting for reliably quantifying and understanding medical error. Quantitative macro analyses of large datasets should be supplemented by small-scale qualitative studies to provide insight into micro-level daily events in...
An abstract is unavailable. This article is available as HTML full text and PDF.
How do we organize for high performance in a setting where the potential for error and disaster can be overwhelming? In doing so, how can we best apply the High Reliability Organizing concepts into the prescribed fire and fire use arenas? And, to successfully achieve these outcomes, how can we personally and institutionally overcome our immunity to...
The capacity for learning is directly affected by how potentially dangerous events are interpreted and categorized
The categories used by organizations to classify and sort events are not trivial; they channel attention, shape interpretations, and serve as springboards for action. One example is the way in which organizations categorize small fail...
To describe how communication failures contribute to many medical mishaps.
In late 1999, a sample of 26 residents stratified by medical specialty, year of residency, and gender was randomly selected from a population of 85 residents at a 600-bed U.S. teaching hospital. The study design involved semistructured face-to-face interviews with the reside...
¿Es peligroso saber poco?. No necesariamente. Nuevos datos revelan que el modo en el que los altos directivos interpretan su entorno profesional influye más en el rendimiento que la precisión con la que conozcan ese entorno
To evaluate resident experience and perceptions of medical error associated with emergency department (ED) care.
Using a semistructured interview protocol, three researchers interviewed 26 randomly selected medical, surgical, and obstetrics residents regarding medical error. The authors chose a 16-case subset of incidents involving ED care for init...
Objectives: To evaluate resident experience and perceptions of medical error associated with emergency department (ED) care. Methods: Using a semistructured interview protocol, three researchers interviewed 26 randomly selected medical, surgical, and obstetrics residents regarding medical error. The authors chose a 16-case subset of incidents invol...
High performance is often attributed to an organization's culture. However, culture can just as easily undermine performance when it blinds decision makers to important performance issues and entraps them in unfortunate courses of action from which they cannot disengage. The dynamics of cultural entrapment are explored in the case of the Bristol Ro...
Although research has suggested that teams can differ in the extent to which they encourage proactive learning and competence development among their members (a team learning orientation), the performance consequences of these differences are not well understood. Drawing from research on goal orientation and team learning, this article suggests tha...
Many business thinkers believe it's the role of senior managers to scan the external environment to monitor contingencies and constraints, and to use that precise knowledge to modify the company's strategy and design. As these thinkers see it, managers need accurate and abundant information to carry out that role. According to that logic, it makes...
No abstract available.