Hot Lights and Cold Steel: Cultural and Political Toolkits for Practice Change in Surgery

Abstract

One of the great paradoxes of organizational culture is that even when less powerful members in organizations have access to cultural tools (such as frames, identities, and tactics) that support change, they often do not use these tools to challenge traditional practices that disadvantage them. In this study, I compare data about work practice change from my own field study of an elite teaching hospital (conducted in the early 2000s) to previously reported data from field studies of two similar hospitals (one conducted in the 1970s and one in the 1990s). I demonstrate that although cultural toolkits supporting change may allow less powerful organization members to see traditional practices as running counter to their interests, they may not be able to significantly change traditional practices unless they also have access to what I call political toolkits (including tools such as staffing systems, accountability systems, and evaluation systems) that support change. Although cultural tools allow them to reinterpret practices that disadvantage them as unfair, political tools allow them to feel optimistic that others will help them effect change. Whereas cultural tools enable them to develop a “we” feeling with other reformers, political tools allow them to coordinate their change efforts. And although cultural tools provide them with a repertoire of contentious tactics, political tools afford them a sense of security that they can battle defenders of the status quo without ruining their careers. These findings contribute to our understanding of both the cultural construction of organizational life and social movement processes.

From practice to collaborative community in interdisciplinary research contexts

“…The extant literature suggests a chicken-and-egg relationship between the collectivity that forms at the boundary between established organizational structures in collaboration and the practices through which this boundary-spanning collectivity is coordinated (Kellogg, 2011;O'Mahony and Bechky, 2008). Thus the dynamics of the emergence of practices and community is still an important matter of debate that requires further attention.…”

Chief Sustainability Officers: Who Are They and What Do They Do?

“…Organizational research suggests that not all actors are equally successful in implementing change. The change agent's expertise, experiences, location in the structure of an organization and organizational responsibilities are important factors in her success (Kellogg 2011). For example, Lounsbury (2001) found that universities which made a greater commitment to waste recycling were the ones that employed staff with the relevant expertise and who had the commitment to develop and advocate for the introduction of new, more sustainable practices.…”

The Cultural Construction of Organizational Life: Introduction to the Special Issue

“…Vaara and Tienari (2011) in the use of culture for legitimating unproven organizational forms in the context of cross-national mergers and new technologies, respectively. Finally, Wasserman and Frenkel (2011) and Kellogg (2011) are concerned with the political use of repertoires for domination and resistance, where the cultural tools used in organizations are tied to institutional structures outside the organization.…”

“…The article unpacks the roles of managers, employees, and enthusiasts in importing (infusing) and exporting (seeding) understandings and styles between the focal organization and its external cultural context. Kellogg (2011) and Wasserman and Frenkel (2011) turn to the internal dynamics of cultural change. Both emphasize the political dimensions of changes that affect members' identities, interests, and power, and they stress the need to pay attention to the fact that these processes happen in formal organizations.…”

“…Both emphasize the political dimensions of changes that affect members' identities, interests, and power, and they stress the need to pay attention to the fact that these processes happen in formal organizations. Kellogg (2011) examines bottom-up efforts for change. She asks why some organizational members with access to cultural toolkits for change challenge the status quo and others do not, a question with strong parallels in social movement research.…”