I was recently reviewing a research narrative in which Max, the researcher, was describing what was happening in a health care organisation that was undergoing an organisational merger. Max had responsibility for leading a programme of work aimed at improving the care of patients with diabetes. This involved redesigning their treatment pathway to improve their disease management and reduce what were regarded by the organisation’s management as unnecessary and expensive admissions to hospital, which it thought could be better managed in the community. This work required him to bring together clinicians and managers from three former organisations, one of which he had worked for prior to the merger. His research interest is in exploring the concept of “transformation” and the narrative describes a series of meetings he is having with staff about the work. These meetings are proving difficult, because it is clear from what is being said that the groups from the three organisations have strong “we” identities arising from their former organisations and are all involved in stigmatising gossip based on their prejudices about each other. Max finds himself defending his former organisation when this is being criticised and also feels surprised and uncomfortable when it begins to appear as though the perceived source of the problem- the hospital- may not be the only cause of the problem – as he and his colleagues had formally perceived. He describes vividly the detail of a very difficult meeting in which one of the influential Doctors loses their temper and refuses to co-operate with colleagues from one of the other former organisations on the grounds that what is being proposed could compromise patient care. Max describes the frustration and anxiety this raises for him and others – including a discussion with his manager Carl, in which he is told that “failure is not an option”. (more…)
Posts Tagged ‘NHS’
Posted in complex responsive processes, GH Mead, ideology, management, NHS, Norbert Elias, politics of everyday life, Ralph Stacey, Values, values and norms, tagged complex responsive processes, GH Mead, NHS, Norbert Elias, values and norms on May 8, 2012 | 7 Comments »
Posted in complex responsive processes, complexity, ideology, management, practice, systems, Values, tagged complex responsive processes, evidence based, gesture and response, GH Mead, John Dewey, NHS, Values on April 5, 2010 | 4 Comments »
This post sets out some thoughts provoked by my reading Ralph and Chris’ contributions. It is intended to provoke further conversation and act as an invitation to others to make a further comment.
The observations made by them that speaking about management differently can appear to others as though I am not taking ‘the game’ seriously or calling ‘the game’ into question can be seen as ‘anti-management’; that re-thinking the dominant discourse invites us to think of ourselves differently and therefore to question our identities as managers, and to rethink management from within the practice of management, resonate strongly with my own experience in my working life as a nurse manager. Hence, as I challenge many of the theoretical assumptions I had previously made about management, so my practice as a manager shifts because, quite simply, it no longer makes sense to do some of the things I was doing before. To try and explain more clearly what I mean. I shall write a short piece of narrative based on a conversation that struck me as interesting. Reflective narrative is an important component of the research methodology we are developing on the D.Man programme as part of the theory of complex responsive processes of relating. (more…)