The influence of contextual factors on the functioning of self-managing teams in healthcare organizations
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2021-07-15
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en
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The purpose of this research is to enhance our understanding of the effect of SMTs as a structure-driven solution for problems with affordability, accessibility, quality of care-services and well-being of healthcare professionals, by identifying contextual factors that may hinder the successful implementation of SMTs in healthcare organizations. This purpose can help to understand why SMTs are abandoned in some healthcare organizations, while both theory and practice suggest that they are proper solutions for the problems where healthcare organizations are dealing with (Van Hooft, 1996; Monsen & de Blok, 2013; de Sitter, 1994).
SMTs are most likely to function well, if they are designed conform the characteristics of SMTs as described in theory (Hackman, 2002). Well-functioning means that the SMTs can co-contribute, in coherence with other structural elements on meso- and macro-level, to the alleviation of the problems where healthcare organizations are dealing with. The criteria of the quality of organization and the quality of work can be used to assess the functioning of SMTs (Achterbergh & Vriens, 2019). This assessment consists of three steps: first, the variables of these criteria have to be operationalized to the unique context of a healthcare organization. Subsequently, desired and actual values on the variables can be determined, to identify structure-relate problems with the functioning of SMTs. Secondly, one has to establish whether structural inadequacy of SMTs is causing structure-related problems. If so, the structure needs to be fixed, before contextual factors become relevant to consider. If structural inadequacy is not the reason why the SMTs are not functioning well, then step three can be performed. The third step is to identify factors in the context of the SMTs that may hinder their well-functioning.
Various contextual factors that can hinder the well-functioning of SMTs are identified by means of an integrative literature review. A creative process in which literature was searched, collected, selected, analyzed, integrated, and synthesized, resulted in a theoretical model of contextual factors that may hinder the well-functioning of SMTs in healthcare organizations. Two categories of contextual factors are identified: organizational goals and infrastructure (structure, HR, and technology) (Achterbergh & Vriens, 2019). This model extends the literature on organization design, by providing insight in the possible influence of contextual factors of SMTs on their well-functioning. Moreover, this model suggests that SMTs do not have to be dismissed as an effective, structure-driven solution for problems where healthcare organizations are dealing with, by indicating that the well-functioning of SMTs may be caused by other factors than their structural inadequacy. As such, healthcare organizations may use the model as a guide for the identification of contextual factors that may hinder the well-functioning of SMTs. This may enable healthcare organizations to formulate proper solutions for these problems. Thereby, the well-functioning of SMTs may be enhanced, and as a consequence, the ability of SMTs to contribute to the alleviation of problems where healthcare organizations are dealing with in terms of affordability, accessibility, quality of care-services and well-being of healthcare professionals may be improved.
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Faculteit der Managementwetenschappen