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Category: Telfer Announcements

Published: 02 February 2017

Samia Chreim has been named the Ian Telfer Professor in Health Organization Studies. Her research provides new insights into the dynamics of organizational change, integration across organizations, and collaboration among professionals. Professor Chreim recently sat down to discuss the evolution of healthcare organizations and noted that transformation will increasingly require coalitions of professionals, with complementary skills and resources.

What sets healthcare organizations apart from other types of organizations?

SC: The healthcare system is currently under a lot of pressure to perform better. Healthcare professionals are frequently asked to adjust or modify the way they work in order to provide better care to patients. But healthcare professionals need to meet different professional goals; they have different roles, cultures and interests. Conflicts are inevitable.

Suppose a health authority grants one group responsibility for a particular procedure, and it was previously the sole responsibility of another group. Any side that perceives a loss of autonomy or authority is likely to strongly resist the change.

But other kinds of changes may encounter opposition simply because they disrupt the normal and accepted way of performing a given task. Take the example of incident reporting for patient safety. If the primary care unit in a hospital has implemented an effective incident reporting system, the hospital might wish to have another unit, for example the mental-health team, adopt that system. However, differences in the culture and professional practices may be incompatible with the new reporting system and prevent its adoption by the mental-health team.

What can managers do to ensure that the required change can be implemented?

SC: One of my studies concerned a collaboration across healthcare organizations in a primary care context. The study showed that to be successful in implementing the change, managers needed to build a winning coalition of professionals and staff who have complementary skills and resources. But to build such a coalition, time needs to be invested in finding common ground across professionals and staff, in putting together trust between professionals and staff involved, and in building the credibility of the change process.

Therefore, there needs to be somebody whose job is to manage the change process. That approach is ultimately going to bring more success than asking busy healthcare practitioners to take on additional change-management tasks. When you don’t have a person that owns and manages the change process, you are likely to see a dilution of change focus and a loss of momentum.

What type of management style or approach should be encouraged, given the need for professionals and staff to coalesce around significant change?

SC: The research provides evidence about the benefits of having a small number of individuals (e.g., managers, professionals) with complementary competencies and resources in bringing important organizational changes to fruition. But this approach might create a lack of clarity. There might be ambiguity about who is responsible for what, which can lead to duplication of efforts or to one or more tasks falling through the cracks. I have also studied situations in which intractable conflicts developed among the members of a management group, and the teams working under them deteriorated as a result.

The risks of these scenarios are at the heart of a big debate about how leadership should be organized. In particular, when and how to share or distribute leadership. Shared leadership happens at different levels, for example, within teams, organizations, and inter-organizational collaborations. Change-management processes, such as the need for integration between healthcare teams, sometimes point to the need for shared leadership. On the other hand, for the reasons I mentioned, shared leadership isn’t necessarily a panacea. Without doubt, understanding when and how leadership can be shared, and what type of collective leadership is appropriate in different change-management settings, will continue to be a hot topic for any healthcare organization for the foreseeable future. 

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Category: Alumni in the Lead

Published: 06 September 2016

Professor Samia Chreim’s research area is Organizational Theory, which she applies to a variety of fields. Her publications are making an impact in the field of health care management and business management. Two of her articles, published in A-journals, are ranked in the top 10 for the year 2015.

The first article, entitled Fix and forget or fix and report: a qualitative study of tensions at the front line of incident reporting, was published in the BMJ Quality and Safety journal, an international peer-reviewed journal that focuses on the quality and safety of healthcare. The article reports on a study led by Tanya Anne Hewitt, Professor Chreim’s former Ph.D. student in Population Health at the University of Ottawa. In a case study, the research explores how safety problems that health practitioners encounter are being addressed. The study reveals that most practitioners, when faced with a safety problem that they can resolve themselves, tend not to report it. Hewitt and Chreim argue that reporting of hazards and safety problems is important, as it helps establish a more preventive approach.

The second article is entitled The (non) distribution of leadership roles: Considering leadership practices and configurations. Published in Human Relations, a highly regarded peer-reviewed journal, it contributes towards a deeper understanding of leadership and social relationships at and around work. In particular, Professor Chreim’s study investigates the leadership configurations that are possible following mergers and acquisitions. The findings show that mergers and acquisitions bringing together previously autonomous work teams have a lot of ambiguity and variation in terms of their leadership configurations.

The journal Human Relations has published a lengthy discussion of Professor Chreim’s article by a renowned scholar in this area. Peter Gronn of Cambridge University writes that Professor Chreim ‘‘is to be commended for an invaluable contribution and for advancing knowledge in this field.’’