The implications of management by walking about: a case study of a German hospital

Abstract

PurposeThe purpose of this article is to report on case study research conducted in a German hospital and describe the implications that the “Management by walking about” approach had on healthcare employees. “Management by walking about” is widely seen as one of the favoured procedures for increasing employee commitment and shared understanding as well as supporting high trust work relations.Design/methodology/approachThis case study set out to examine the actual labour processes and the concrete experiences of healthcare employees behind the “Management by walking about” approach in a German hospital. This was achieved by means of a six month field study of day‐to‐day life in the hospital's nursing division.FindingsIn this case study, the popular initiative of “Management by walking about” was used as a means of managerial control and, as such, the internal promotion of soaring values and path‐finding visions was met with both scepticism and cynicism.Practical implicationsPre‐commitment and motivation levels were high among healthcare employees, they were passionate about their healthcare work and they actively engaged in open communication and organisational development. But all this had little to do with “Management by walking about”, and its implications raise questions about its influence on high trust work relations more generally.Originality/valueThe paper concludes that a more critical analysis is necessary to challenge the way in which “Management by walking about” is examined by healthcare management academics and practitioners.

‘I think we should just listen and get out’: a qualitative exploration of views and experiences of Patient Safety Walkrounds

“…Our study supports the results of this trial and provides insight into why walkrounds may fail to generate such relationships between senior leaders and front-line staff. Along the same lines, a German study described the potentially counterproductive effects of ‘management by walking around’ on wards and floors due to reinforcement of hierarchical relationships, with leaders asserting managerial control and establishing the expectations, norms and hospital standards during these visits 23. A US study of 30 Veterans Affairs hospitals found that organisations showing characteristics of a hierarchical culture, specifically emphasising rules and control, “may dampen awareness of safety problems and hamper quality improvement efforts by impeding the open flow of information and stifling input from the frontline” 24…”

Activating Organizational Culture to Achieve Requirements of Management by Wandering Around

“…The purpose of the study was to examine the impact of implying management by wandering on healthcare employees in one of the German hospitals (Beil-Hildebrand, 2006). Management by wandering was considered as one of the procedures that increase the employees' commitment.…”

The evolving literature on safety WalkRounds: emerging themes and practical messages

“…Including a broader set of perspectives might provide more nuanced results. For example, three studies that use in-depth interviews to explore the impact of safety rounds on frontline staff find that safety rounds negatively impact individuals who participate in the rounds 32 56 57…”

“…Organisations also spend too much time focusing on prioritising problems at the expense of taking action 62. When safety rounds are characterised in these ways, frontline workers become frustrated with them,32 55 feel the programme produces fallible insights55 57 and respond with scepticism and cynicism 56 62…”