This paper explores the professionalization project of paramedics, based on an ethnographic study of UK National Health Service (NHS) ambulance personnel. Drawing on concepts derived from institutional theory and the sociology of professions, we argue that the project is enacted at two levels, namely a formal, structural and senior level reflecting changing legitimation demands made on NHS practitioners and pursued through institutional entrepreneurship, and an informal, agentic, ‘street level’ enacted by the practitioners themselves via ‘institutional work’. Focusing on this latter, front‐line level, our ethnographic data demonstrate that the overall impact of the senior level professionalization project on the working lives of paramedics has been somewhat muted, mostly because it has had limited power over the organizations that employ paramedics. Given the slow progress of the senior level professionalization project, paramedics at street level continue to enact subtle forms of institutional work which serve to maintain ‘blue‐collar professionalism’ – a form originally identified in Donald Metz's ethnography of ambulance work. Our analysis draws attention to the complex and contested nature of professionalization projects, in that their enactment at senior and street levels can be somewhat misaligned and possibly contradictory.

Lean thinking has recently re-emerged as a fashionable management philosophy, especially in public services. A prescriptive or mainstream literature suggests that lean is rapidly diffusing into public sector environments, providing a much-needed rethink of traditional ways of working and stimulating performance improvements. Our study of the introduction of lean in a large UK public sector hospital challenges this argument. Based on a three-year ethnographic study of how employees make sense of lean ‘adoption’, we describe a process in which lean ideas were initially championed, later diluted and ultimately eroded. While initially functioning as a ‘mechanism of hope’ (Brunsson, 2006) around which legitimacy could be generated for tackling longstanding work problems, over time both ‘sellers’ and ‘buyers’ of the concept mobilized lean in ambiguous ways, to the extent that the notion was rendered somewhat meaningless. Ultimately, our analysis rejects current prescriptive or managerialist discourses on lean while offering support for prior positions that would explain such management fashions in terms of the ‘life cycle of a fad’.

No abstract

This paper advances participatory methods in management research. We propose the term participatory organizational research to describe this adjunct to action research. We illustrate the potential of the method to allow sometimes unheard organizational members to generate alternative perspectives that can offer the potential for the co-production of new forms of knowledge that are locally relevant. Participatory methods originate from work with marginalized groups and have been used more commonly in community and organizational development. The aim of such research is, generally, to change the social and organizational conditions within which participants operate by using their perspectives as active participants to develop alternative possibilities. As such, this research method has significant potential for management researchers in providing the means for unheard organizational members to voice their perspectives: a central component, we argue, in knowledge co-production. Based on a participatory study of care quality in elder care institutions, we examine in detail how participatory organizational research can enable voice and explore some of the structural limitations particularly in respect of research ethics

The full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. AbstractThe paper examines the escalation of commitment to failing strategies from a psychodynamic perspective as an affective process connecting organizational, systemic and individual levels.We propose a theory of organizational blind spots to explain how such escalation of commitment occurs. Blind spots develop an organizational defence mechanism for coping with problems resulting from attempts to implement unrealistic strategy or policy goals.Unrealistic strategic aims mobilize and reinforce blind spots through processes of splitting, blame and idealization, thus enabling organizations to persist with unsuccessful courses of action. Organizational blind spots arise when leadership and/or operational members in organizations are unable to acknowledge unworkable strategies. Vignettes from the National Health Service in England (the NHS) are used to illustrate how blind spots sustain an illusory possibility of success while commitment to a failing strategy escalates. The theory of blind spots offers a novel social-psychological approach to understanding how these dysfunctions of strategy develop and become institutionalized, putting organizations in jeopardy and threatening their survival.