Karla Sayegh, PhD Student in Strategy & Organization, received the best student paper award for her thesis work at the 11th International Organizational Behaviour in Health Care (OBHC) Conference held in Montreal from May 13 –16, 2018.
Her paper, “Wait, the baby could die! Integrating expertise differences in a hospital merger,” was co-authored with Samer Faraj, Professor of Strategy & Organization and Director of the PhD Program in Management at Desautels.
When human lives are at stake, implicated experts must perform their occupational work reliably and consistently. In extreme contexts where the work is unpredictable, complex and time-sensitive, and errors can be fatal; performance differences in work practice are deeply consequential and must be resolved. This 24-month longitudinal field study examines how two groups of medical experts in a single occupation integrated differing performances of care work on a single type of critically ill baby following the largest hospital merger in recent Canadian history. Our findings highlight the salient role of occupational newcomers in mobilizing the structural tools of the occupation (i.e. protocols) as resources to spread accountability across various roles, thereby provoking a resolution of differences among seasoned experts. Our contribution revisits the one-sided view of expertise-based socialization that renders occupational newcomers as green blank slates in need of legitimation from seasoned experts. We extend this view by showing how newcomers can play an active part in re-socializing seasoned hands while themselves becoming socialized. We found this reciprocal socializing process to be a critical mechanism by which expert practice performances were integrated following a radical change in extreme organizing. The deployment of formal occupational tools and rules by novices to activate a crucial integrating condition, accountability, also illustrates the interplay between formal mechanisms and informal approaches in the coordination of expertise. Our study also highlights the importance of examining integration processes in a situated, longitudinal manner in order to understand the dynamics of how expertise-based organizations respond to radical, discontinuous changes such as a mergers or organizational restructurings. Thus, we provide a processual understanding of how expert work practices are integrated within a single high-reliability occupation.
About OBHC 2018
The 2018 OBHC Conference, the primary activity of the Society for Studies in Organizing Heathcare, was jointly hosted by McGill University (Department of Family Medicine, Faculty of Medicine and Desautels Faculty of Management), l’Université de Montréal (École de Santé Publique), and HEC Montréal (Le Pôle santé). The conference took place in the heart of Montreal, at the Centre Mont-Royal.