Download [PDF] Reframing Organizations: Artistry, Choice, and Leadership PDF Click button below to download or read this book Description Set aside trends to focus on the fundamentals of great leadership Reframing Organizations provides timetested guidance for more effective organizational leadership. Rooted in decades of social science research across multiple disciplines, Bolman and Deal's four-frame model has continued to evolve since its conception over 25 years ago; this new sixth edition has been updated to include coverage of cross-sector collaboration, generational differences, virtual environments, globalization, sustainability, and communication across cultures. The Instructor's guide has been expanded to provide additional tools for the classroom, including chapter summary tip sheets, mini-assessments, Bolman & Deal podcasts, and more., These recent revisions reflect the intersection of reader recommendations and the current leadership environment, resulting in a renewed practicality and even greater alignment with everyday application. Combining the latest research from organizational theory, organizational behavior, psychology, sociology, political science and more, the model detailed here provides real guidance for real leaders. Guide, motivate, and inspire your team's best performance as you learn to: Optimize group, team, and organizational structureBuild a positive, collaborative dynamic across generations, teams, and sectorsUnderstand power and conflict amidst the internal and external political landscapeShape your organization's culture and build a cohesive sense of spirit Bolman and Deal's four-frame model has withstood the test of time because it offers an accessible, compact, and powerful set of ideas for navigating complexity and turbulence., In today's business climate, leadership trends come and go; today's flash in the pan is tomorrow's obsolete strategy, but a leadership framework built on a solid foundation will serve your organization well no matter what the future holds. Reframing Organizations provides clear guidance and up-to-date insight for anyone facing the challeng
Improving outcomes for patients with acute myocardial infarction (AMI) is a priority for hospital leadership, clinicians, and policymakers. Evidence suggests links between hospital organizational culture and hospital performance; however, few studies have attempted to shift organizational culture in order to improve performance, fewer have focused on patient outcomes, and none have addressed mortality for patients with AMI. We sought to address this gap through a novel longitudinal intervention study, Leadership Saves Lives (LSL).
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This manuscript describes the methodology of LSL, a 2-year intervention study using a concurrent mixed methods design, guided by open systems theory and the Assess, Innovate, Develop, Engage, Devolve (AIDED) model of diffusion, implemented in 10 U.S. hospitals and their peer hospital networks. The intervention has three primary components: 1) annual convenings of the ten intervention hospitals; 2) semiannual workshops with guiding coalitions at each hospital; and 3) continuous remote support across all intervention hospitals through a web-based platform. Primary outcomes include 1) shifts in key dimensions of hospital organizational culture associated with lower mortality rates for patients with AMI; 2) use of targeted evidence-based practices associated with lower mortality rates for patients with AMI; and 3) in-hospital AMI mortality. Quantitative data include annual surveys of guiding coalition members in the intervention hospitals and peer network hospitals. Qualitative data include in-person, in-depth interviews with all guiding coalition members and selective observations of key interactions in care for patients with AMI, collected at three time points. Data integration will identify patterns and major themes in change processes across all intervention hospitals over time.
LSL is novel in its use of a longitudinal mixed methods approach in a diverse sample of hospitals, its focus on objective outcome measures of mortality, and its examination of changes not only in the intervention hospitals but also in their peer hospital networks over time. This paper adds to the methodological literature for the study of complex interventions to promote hospital organizational culture change.
Previous studies, with some exceptions [10-12], have suggested links between hospital organizational culture and measures of hospital performance [13-22]; however, effective interventions to change organizational culture in order to improve performance have proven elusive and few high-quality studies exist. A 2011 Cochrane review of organizational culture change interventions was unable to draw conclusions about effective approaches for changing culture as no studies met the methodological criteria for inclusion [23]. Prospective studies have largely focused on targeted areas such as emergency departments [24] or specific operating rooms [25] rather than across departments or units, or have shown improvements in staff satisfaction, work attitudes, and safety climate [26,27] but not patient outcomes [28,29]. More comprehensive efforts to improve hospital culture, such as the Robert Wood Johnson Pursuing Perfection program, have illuminated key elements of cultural transformation [20], but have not been well positioned to document improvements in patient outcomes in response to shifts in culture [16]. In summary, despite evidence about the prominence of specific features of organizational culture in top performing hospitals, prospective efforts to evaluate consequential improvements in clinical practices and outcomes through shifts in organizational culture have been disappointing.
We sought to address this gap through a novel longitudinal intervention study, Leadership Saves Lives (LSL), directed at influencing organizational culture in hospitals with the goal of improving evidence-based practices and outcomes for patients hospitalized with AMI. We employed an established theory of organizational culture [30], which has been used widely in the study of healthcare organizations and culture change [31-33]. This theory argues that organizational culture is evolutionary in nature, and is characterized by the shared assumptions, values, and patterns of behavior that enable the hospital to survive in a complex and changing environment [30]. We were also guided by a model of diffusion of innovations (Assess, Innovate, Develop, Engage, Develop (AIDED)) [34] that draws on empirical literature on scale up of public health innovations [35-37] and concepts of molecular biology applied to viral spread [38]. The current study addresses limitations of prior research by using a longitudinal mixed methods approach [39] in a diverse sample of hospitals, including objective outcome measures, and examining changes not only in the intervention hospitals but also in their peer hospital networks over time.
We use an open systems theory [48] framework which suggests that organizations survive within the larger environment by importing information from external sources, converting that information to improve their internal practices, and exporting knowledge to the larger environment. In this import-conversion-export model of organizational behavior, effective management of the organizational boundary is paramount to survival in a changing environment [49]. The role of leadership is to manage this boundary [50] so that the organization can absorb needed external resources, apply these resources to the primary task of the organization, and produce meaningful output for the environment. Productive exchange between the organization and its environment is theorized to promote system performance improvement, the goal of our intervention. While organizations also pursue problem solving and innovation using internal resources, theory suggests that they must also have the capacity to draw from outside in order to successfully adapt to the environment and survive [51]. In this study, we seek to encourage organizational leadership such that the intervention hospitals will promote positive shifts in organizational culture that accelerate learning and improvement, integrate evidence-based practices into the routine work of the organization, and spread these features of organizational culture and practices to other hospitals in their professional networks. The intervention focuses on the potential impact of leadership, broadly conceived, as the core lever for fostering effective and sustained improvements.
The semiannual workshops are designed to strengthen leadership capacity within the guiding coalition and catalyze progress toward improved organizational culture and reduced mortality. To build a culture that supports creative problem solving, workshop content includes teaching and experiential learning on bringing the right perspectives to the table (role definition, group boundaries, working with hierarchy, investing in management capacity), encouraging participants to contribute their individual skills to the common goal (leadership and followership, representational groups, psychological safety), and managing conflict while building accountability within the group. In addition to a focused investment in the culture within the coalition during the workshops, the group is facilitated through a problem solving process [63] to identify root causes of AMI mortality and address those through both integration of external evidence and generation of local solutions [51]. During the first workshop, the guiding coalition prioritizes root causes of AMI mortality and develops strategies to address during the intervention period. Between workshops, they make and measure progress toward their improvement objectives. Subsequent workshops explore implementation challenges and opportunities for continued leadership development. Participants complete an evaluation form at the conclusion of each hospital workshop to report their immediate perceptions of the quality and utility of the workshop, as well as to inform planning for future workshops. 2ff7e9595c
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