Examining hybrid nurse managers as a case of identity transition in healthcare: developing a balanced research agenda

Currie, Graeme; Croft, Charlotte

doi:10.1177/0950017015572581

Cited by 22 publications

(30 citation statements)

References 70 publications

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“…As has been argued in the paper, different logics can be characterised as "rules of the game" embedded in unconscious social norms that are part of work. One of the key issues is to look at the professionals who can bridge these different rules, so called hybrid professionals [24]. It is through them we may understand how to break the barriers.…”

Section: Future Opportunitiesmentioning

confidence: 99%

The role of professional logics in quality register use: a realist evaluation

Norman

Elg

Nordin

et al. 2020

BMC Health Serv Res

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Background: Clinical practice improvements based on quality-register data are influenced by multiple factors.Although there is agreement that information from quality registers is valuable for quality improvement, practical ways of organising register use have been notoriously difficult to realise. The present study sought to investigate the mechanisms that lead various clinicians to use quality registers for improvement. Methods: This research involves studying individuals' decisions in response to a Swedish programme focusing on increasing the use of quality registers. Through a case study, we focused on heart failure care and its corresponding register: the Swedish Heart Failure Register. The empirical data consisted of a purposive sample collected longitudinally by qualitative methods between 2013 and 2015. In total, 18 semi-structured interviews were carried out. We used realist evaluation to identify contexts, mechanisms, and outcomes. Results: We identified four contextsregistration, use of output data, governance, and improvement projectsthat provide conditions for the initiation of specific mechanisms. Given a professional theoretical perspective, we further showed that mechanisms are based on the logics of either organisational improvement or clinical practice. The two logics offer insights into the ways in which clinicians choose to embrace or reject certain registers' initiatives. Conclusions:We identified a strong path dependence, as registers have historically been tightly linked to the medical profession's competence. Few new initiatives in the studied programme reach the clinical context. We explain this through the lack of an organisational improvement logic and its corresponding mechanisms in the context of the medical profession. Implementation programmes must understand the logic of clinical practice; that is, be integrated with the ways in which work is carried out in everyday practice. Programmes need to be better at helping core health professionals to reach the highest standards of patient care.

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Section: Future Opportunitiesmentioning

confidence: 99%

The role of professional logics in quality register use: a realist evaluation

Norman

Elg

Nordin

et al. 2020

BMC Health Serv Res

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“…As a consequence, there is emphasis within extant literature upon the (identity) transition towards a more managerial agenda that hybrid managers undergo in the enactment of their new role. For example, in the healthcare setting, literature theorises identity transition challenges faced by nurses (Croft et al, 2015a(Croft et al, , 2015bCurrie & Croft, 2015) and doctors (McGivern et al, 2015;Spyridonidis et al, 2015). A similar line of debate about identity transition faced by healthcare professionals is apparent within the specific confines of the Journal of Professions and Organization (Blomgren & Waks, 2015;Carvalho, 2014).…”

Section: The Effects Of Policy: Hybrid Managers As Controlled Professmentioning

confidence: 99%

The (un)desirability of hybrid managers as ‘controlled’ professionals: comparative cases of tax and healthcare professionals: Table 1.

Currie

Burgess

Tuck

2016

Journal of Professions and Organization

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“…Our study extends analysis of how local practitioners respond to demands for hybrid roles, highlighting co-option of professionals towards hybridisation. It emphasises variation in the enactment of new roles oriented towards managing the client and fellow workers amongst professionals on the frontline of regulatory practice (Kuranmaki and Miller, 2006) --some hybrid managers resist, others embrace reform (Burgess and Currie, 2013;Croft and Currie, 2015;Currie and Croft, 2015;McGivern et al, 2015). Our study highlights how hybrids seem the norm amongst professionals, rather than the exception, including professionals such as accountants (Anderson-Gough et al, 2000;Spence and Carter, 2014).…”

Section: Resultsmentioning

confidence: 80%

How hybrid managers act as “canny customers” to accelerate policy reform

Currie

Tuck

Morrell

2015

Acc Auditing Accountability J

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(2015) 'How hybrid managers act as canny customers to accelerate policy reform : a case study of regulator-regulatee relationships in the UK's tax agency.', Accounting, auditing and accountability journal., 28 (8). pp. 1291-1309. Further information on publisher's website:https://doi.org/10.1108/ AAAJ-12-2014AAAJ-12- -1889 Publisher's copyright statement:This article is c Emerald Group Publishing and permission has been granted for this version to appear here http://dro.dur.ac.uk/21891. Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited. Additional information:Use policyThe 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. Findings: Our findings support established accounts of the effect of NPM reform to public professions, as these professionals are co-opted into hybrid management roles. Some hybrid managers resist, others embrace the demands of the new role. Linked to a hitherto neglected aspect of analysis (the extent to which hybrid managers embrace a greater customer orientation) our findings also show a more novel third response: some hybrid managers leave the national tax agency for opportunities in the private sector. These public-to-private professionals we call 'canny customers.' Canny customers are ideally placed to exploit aspects of NPM reform, and thereby accelerate changes in the governance of public agencies, but in a way that might undermine the function of the tax agency and tax professions. Practical implications:In regulatory settings, policy reform to co-opt professionals into hybrid managerial roles may have mixed effects. In settings where a focal dynamic is the regulator-regulatee relationship, effective governance will require understanding of the labour market to temper excess influence by those hybrid managers who become canny customers, Otherwise, in settings where it is easy for individuals to move from regulator to regulatee, the pace and consequences of reform will be harder to govern. This runs the danger of eroding professional values. Our specific case of tax professionals reflects themes in the literature examining hybridisation for accountants, and provides novel insight into the dynamics of professionalism that extend to the case of accountants.Originality/value: Our contribution is to extend the literature on role transition of professionals. We focus on hybrid managers in the context of a regulatory agency: the UK national tax agency. Policy reforms associated with hybridisati...

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Examining hybrid nurse managers as a case of identity transition in healthcare: developing a balanced research agenda

Cited by 22 publications

References 70 publications

The role of professional logics in quality register use: a realist evaluation

The role of professional logics in quality register use: a realist evaluation

The (un)desirability of hybrid managers as ‘controlled’ professionals: comparative cases of tax and healthcare professionals: Table 1.

How hybrid managers act as “canny customers” to accelerate policy reform

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