Resilient Organizations

Westphal, Judith A

doi:10.1097/00005110-200509000-00012

Cited by 11 publications

(5 citation statements)

References 14 publications

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“…But prioritizing the individual match between clinician and patient (regardless of team membership) could potentially improve clinician morale and patient satisfaction. Third, interview respondents noted that tensions could arise in the context of matrix reporting structures (Westphal, 2005) featuring staff reporting both to a team leader and a discipline chief (e.g., Chief of Psychiatry). This could be particularly difficult if the discipline chief was seen as not valuing the delivery of team-based mental health care.…”

Section: Discussionmentioning

confidence: 99%

Promoting high-functioning mental health treatment teams in the context of low staffing ratios

Miller

Sullivan

Harvey

et al. 2021

Health Care Manage Rev

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Background: Many previous studies of health care teamwork have taken place in clinical teams with high staffing ratios (i.e., high ratios of staff to patients). Purpose: The aim of this study was to identify clinicians' viewpoints of foundational resources necessary to support good team functioning in the context of low staffing ratios. Methodology: We used administrative data, validated with local mental health chiefs, to identify mental health teams that had achieved high team functioning despite low staffing ratios in U.S. Department of Veterans Affairs medical centers. Guided by a recently developed model of team effectiveness, the Team Effectiveness Pyramid, we conducted qualitative interviews with 21 team members across three teams within two medical centers. Interview questions focused on the resources needed to support good team functioning despite low staffing ratios. We used directed content analysis to analyze results. Results: We found there were several domains of relevant resources: material, staffing, temporal, organizational, and psychological. These represent an expansion of the domains originally included in the Team Effectiveness Pyramid. Conclusions: Within the five domains, we identified key tensions to be addressed when forming teams, including the balances between providing care for new versus established patients, emphasizing shared caseloads within the team versus matching patients to clinicians based on individual expertise, and establishing reporting structures by clinical discipline versus team membership. Practice Implications: Establishing high-functioning health care teams in the context of low staffing ratios requires attention to key resource domains and fundamental trade-offs in how teams are structured.

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Section: Discussionmentioning

confidence: 99%

Promoting high-functioning mental health treatment teams in the context of low staffing ratios

Miller

Sullivan

Harvey

et al. 2021

Health Care Manage Rev

View full text Add to dashboard Cite

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“…Health care executives have looked to other types of organization structure to help them cope with the turbulence of their operating environment 4–7. Matrixed organizational designs in health care today for nursing often include flattened leadership structures, with geographically dispersed nurse executives reporting to a system or a network chief nursing officer (CNO) 8. This matrixed reporting relationship is complicated by centralized support services such as education, staffing, quality, safety, information systems, and professional development 8.…”

Section: Organizational Designmentioning

confidence: 99%

“…[4][5][6][7] Matrixed organizational designs in health care today for nursing often include flattened leadership structures, with geographically dispersed nurse executives reporting to a system or a network chief nursing officer (CNO). 8 This matrixed reporting relationship is complicated by centralized support services such as education, staffing, quality, safety, information systems, and professional development. 8 Even after 3 decades of research on the effectiveness of hierarchical versus matrixed organization structures, leaders still face challenges in being effective and finding fulfillment due to organizational structure.…”

Section: Organizational Designmentioning

confidence: 99%

“…8 This matrixed reporting relationship is complicated by centralized support services such as education, staffing, quality, safety, information systems, and professional development. 8 Even after 3 decades of research on the effectiveness of hierarchical versus matrixed organization structures, leaders still face challenges in being effective and finding fulfillment due to organizational structure. 8,9 In today's health care, matrixed organizations leaders find themselves having to master the challenges of managing cross-divisional teams over whom they have little or no formal authority.…”

Section: Organizational Designmentioning

confidence: 99%

“…8 Even after 3 decades of research on the effectiveness of hierarchical versus matrixed organization structures, leaders still face challenges in being effective and finding fulfillment due to organizational structure. 8,9 In today's health care, matrixed organizations leaders find themselves having to master the challenges of managing cross-divisional teams over whom they have little or no formal authority. 9 Not surprisingly, the skills required to effectively navigate matrixed organizations are different from those needed to succeed in the hierarchical organizational model.…”

Section: Organizational Designmentioning

confidence: 99%

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Leading the Development of a Network-Wide Professional Practice Model

Mislan

Johnson²,

Keitel³

2021

Nursing Administration Quarterly

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The health care settings of today are rapidly evolving in form and function, challenging nurse executives to adopt, adapt, and develop new ways to lead and find professional fulfillment in their roles. The organizational design of many health care settings has changed from a functional to a matrix structure to facilitate more effective and efficient operations. While the structures and reporting relationship of contemporary nurse executives may have changed significantly, the primary responsibility of championing the advancement of the profession of nursing remains essential. The mastery of change management methods is critical for the nurse executive to successfully lead in today's dynamic health care settings. A well-developed and actualized nursing professional practice model is a foundational tool for the nurse executive to employ to advance the profession of nursing in any health care setting or structure. This article describes how a nurse executive used change management methods and principles to lead the development of a new network-wide unifying nursing professional practice model in a highly matrixed health care setting.

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Leadership Perspectives on Integrating Psychologists into Specialty Care Clinics: An Evolving Paradigm

Abouljoud

Ryan

Eshelman

et al. 2018

J Clin Psychol Med Settings

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Integration of health psychologists into specialty care is a shift in the tertiary care construct that addresses all aspects of a patient's presentation, including psychiatric/social history, psychological well-being, and behavioral contributions to the disease process, assuring both optimal health outcomes and cost-effectiveness in a financially challenging healthcare environment. In this paper, we discuss leadership perspectives (physician and psychologists) on the factors involved in integrating a health psychologist into a busy tertiary care environment. Ultimately, we hope that this information provides a primer on how to frame a proposal for an integrated health psychologist emphasizing the elements important to senior medical leadership and administration. First, we briefly discuss the current payer framework, providing support for integration emphasizing costs and other metrics. Second, we introduce organizational structure models and strategies for integration. Lastly, we will discuss the unique skillset psychologists possess, and additional skills necessary, to be effective in the changing landscape of healthcare. We think this information is important both for leaders attempting to integrate a health psychologist into specialty care and for the early career health psychologist embarking on his/her first senior staff position.

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Resilient Organizations

Cited by 11 publications

References 14 publications

Promoting high-functioning mental health treatment teams in the context of low staffing ratios

Promoting high-functioning mental health treatment teams in the context of low staffing ratios

Leading the Development of a Network-Wide Professional Practice Model

Leadership Perspectives on Integrating Psychologists into Specialty Care Clinics: An Evolving Paradigm

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