Literature DB >> 20421827

Organizations as machines, organizations as conversations: two core metaphors and their consequences.

Anthony L Suchman1.   

Abstract

One factor contributing to the limited success of organizational change initiatives is the use of an outmoded conceptual model: the organization as machine. This metaphor leads to the creation of detailed blueprints for desired changes; invites unrealistic expectations of control; and creates anxiety, blame and defensiveness when events inevitably do not proceed according to plan, thus hindering the work. An alternative conceptualization--the organization as conversation--portrays an organization not as a reified object upon which we can act but as self-organizing patterns of thinking (organizational identity and knowledge) and relating (organizational culture) that exist in the medium of human interaction in which we participate. Principles of complexity dynamics (self-organization) have important implications for organizational change practices. (1) Organizational change requires mindful participation--reflecting on and talking about what we are doing together here and now, what patterns of thinking and interacting we are enacting, and what new behaviors might interrupt old patterns or give rise to new ones. (2) Diversity and responsiveness favor the emergence of novel patterns. Skilled facilitation can enhance these characteristics when novelty is desirable; checklists and protocols can diminish these characteristics when consistency and reliability are needed. (3) We cannot know in advance the outcomes of our actions so we need to hold plans lightly, value "not knowing" and practice emergent design. The organization-as-conversation perspective also has important implications for T3 translational research, redefining its purpose, suggesting new methodologies, and requiring new approaches for evaluating proposed and completed projects.

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Year:  2011        PMID: 20421827     DOI: 10.1097/MLR.0b013e3181d55a05

Source DB:  PubMed          Journal:  Med Care        ISSN: 0025-7079            Impact factor:   2.983


  6 in total

1.  Journey toward a patient-centered medical home: readiness for change in primary care practices.

Authors:  Christopher G Wise; Jeffrey A Alexander; Lee A Green; Genna R Cohen; Christina R Koster
Journal:  Milbank Q       Date:  2011-09       Impact factor: 4.911

2.  Using fuzzy set qualitative comparative analysis (fs/QCA) to explore the relationship between medical "homeness" and quality.

Authors:  Nels Marcus Thygeson; Leif I Solberg; Stephen E Asche; Patricia Fontaine; Leonard Gregory Pawlson; Sarah Hudson Scholle
Journal:  Health Serv Res       Date:  2011-08-22       Impact factor: 3.402

3.  We Can Work it Out: The Importance of Rupture and Repair Processes in Infancy and Adult Life for Flourishing.

Authors:  Mary Morton
Journal:  Health Care Anal       Date:  2016-06

4.  Experiences from implementing value-based healthcare at a Swedish University Hospital - an longitudinal interview study.

Authors:  Kerstin Nilsson; Fredrik Bååthe; Annette Erichsen Andersson; Ewa Wikström; Mette Sandoff
Journal:  BMC Health Serv Res       Date:  2017-02-28       Impact factor: 2.655

Review 5.  Reducing Infections "Together": A Review of Socioadaptive Approaches.

Authors:  Pranavi Sreeramoju
Journal:  Open Forum Infect Dis       Date:  2019-02-02       Impact factor: 3.835

6.  Healthcare improvement as planned system change or complex responsive processes? a longitudinal case study in general practice.

Authors:  Barbara J Booth; Nicholas Zwar; Mark F Harris
Journal:  BMC Fam Pract       Date:  2013-04-23       Impact factor: 2.497

  6 in total

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