Patients, Protocols, and Prosocial Behavior: Rule Breaking in Frontline Health Care

Abstract

Rules are essential components of organizations, especially given their foundational role in inducing organizationally preferred behavior and reducing behavioral variability among its members. Despite the existence and prevalence of these centrally important tools, rule deviation occurs. This study proposes to understand the ways in which emergency medical service (EMS) professionals break rules for prosocial purposes—to help patients. In particular, this research seeks to understand how specific organizational and personal attributes influence rule-breaking tendencies. Results indicate that aspects of ethical climate are significantly related to prosocial rule-breaking (PSRB) tendencies, whereas empathy is not. In addition, this study finds that other characteristics, such as a conformist personality, risk taking, expertise, and experience on the job influence PSRB. These findings contribute to the literature on rule deviation and EMS practices and shed light on the complexity of decision making in frontline public services.

Managerial Communication and Frontline Workers’ Willingness to Abide by Rules: Evidence From Local Security Agencies in China

“…There has been an increasing interest in bureaucrats’ attitudes and behaviors in public administration literature in recent years (Borry & Henderson, 2020; Brockmann, 2017; DeHart-Davis, 2009b; Destler, 2017). This article adds to the literature by highlighting the role of proactive intraorganizational communication in street-level bureaucracy management.…”

“…Following previous research on rule breaking and unbureaucratic behavior (Borry & Henderson, 2020; Brockmann, 2017), we used respondents’ answers to the following question to measure bureaucrats’ willingness to abide by various rules: “Do you provide services by strictly abiding by the rules of (1) local policies, (2) administrative regulations, and (3) professional norms?” Respondents’ answers for each of the three items were measured with a 5-point Likert-type scale. Answers ranged from strongly disagree (1) to strongly agree (5).…”

“…Nevertheless, only a modest number of empirical studies in public administration have been dedicated to systematically investigating the determinants of frontline workers’ rule abidance and deviation or the unbureaucratic personality (DeHart-Davis, 2007; Fleming, 2020; Henderson, 2013; Tummers, 2011). Extant explanations for street-level bureaucrats’ rule abidance or rule deviation in the literature can be classified into three categories: rule attributes, situational characteristics, and bureaucrats’ demographic information (Borry & Henderson, 2020; Tummers et al, 2015). We will review each of these in turn.…”

“…Furthermore, most existing theories and hypotheses are based on empirical cases from Western democracies, such as the cops, teachers, and counselors (Maynard-Moody & Musheno, 2003); emergency medical service (Borry & Henderson, 2020; Henderson, 2013); border patrol officers (Guyer, 2013); local government employees (Borry, 2017); Master of Public Administration students (Borry et al, 2018); child protective services (Fleming, 2020) in the United States; and the German state police (Brockmann, 2017). Only a few studies have empirically examined frontline rule abidance in non-Western contexts such as China (Zang & Musheno, 2017; Zhan et al, 2014).…”

Managerial Pro-Social Rule Breaking in the Chinese Organizational Context: Conceptualization, Scale Development, and Double-Edged Sword Effect on Employees’ Sustainable Organizational Identification

“…In general, these studies focus on four themes: first, personal factors, such as risk-taking propensity, conscientiousness, organizational identity, and core self-evaluation [6][7][8]; second, leadership factors, such as benevolent leadership, and moral leadership [7,9,10]; third, organizational factors, such as organizational fairness, counterproductivity norms, and bureaucracy [11][12][13]; fourth, job characteristics, such as job meaning, autonomy, job demand, and work systems [14,15]. Although most of these studies focus on the employee level, the findings of individual, organizational, and job characteristics factors also apply to the manager level.…”