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Prelims

Values, Rationality, and Power: Developing Organizational Wisdom

ISBN: 978-1-83867-942-2, eISBN: 978-1-83867-941-5

ISSN: 2059-6561

Publication date: 21 October 2019

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(2019), "Prelims", Values, Rationality, and Power: Developing Organizational Wisdom (Critical Management Studies), Emerald Publishing Limited, Leeds, pp. i-xix. https://doi.org/10.1108/S2059-65612019044

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Emerald Publishing Limited

Copyright © 2019 Emerald Publishing Limited

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VALUES, RATIONALITY, AND POWER

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CRITICAL MANAGEMENT STUDIES

Series Editor: Albert J. Mills

Title Page

VALUES, RATIONALITY, AND POWER: DEVELOPING ORGANIZATIONAL WISDOM

A Case Study of a Canadian Healthcare Authority

BY

BRAD C. ANDERSON

Kwantlen Polytechnic University, Canada

United Kingdom – North America – Japan – India – Malaysia – China

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Emerald Publishing Limited

Howard House, Wagon Lane, Bingley BD16 1WA, UK

First edition 2019

Copyright © 2019 Emerald Publishing Limited

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A catalogue record for this book is available from the British Library

ISBN: 978-1-83867-942-2 (Print)

ISBN: 978-1-83867-941-5 (Online)

ISBN: 978-1-83909-091-2 (EPub)

ISSN: 2059-6561

List of Figures

Chapter 5
Figure 5.1. Critical Realism’s Stratified Ontology. 54
Chapter 6
Figure 6.1. Organizational Structure of the Seniors Programme. 69
Figure 6.2. Timeline of the Seniors Programme. 69
Chapter 8
Figure 8.1. A Critical Realist Perspective of the Reasons Some VPs Did Not Support the Training Fellowship. 94
Figure 8.2. A Critical Realist Perspective of the Means of Resistance to the Training Fellowship. 96
Figure 8.3(a–c). A Critical Realist Perspective of the Means of Building Support for the Training Fellowship. (a) Collective Decision-making. (b) Appeal to Values and CEO Power. (c) Appeal to Rationality. 102
Figure 8.4(a–c). A Critical Realist Perspective of the Elements of Building and Maintaining Support for the Seniors Programme. (a) The Role of Positive Results in Building and Maintaining Support for the Seniors Programme. (b) Maintaining Support during CEO Transitions. (c) The Role of Communications in Maintaining and Building Support for the Seniors Programme. 109
Chapter 9
Figure 9.1(a–b). A Critical Realist Perspective of the Attributes of People That Kept the Seniors Programme Alive. (a) Sources of Optimism and Enthusiasm; Ability to Build Supportive Infrastructure and Stakeholder Relations. (b) Willingness to Adapt and Do the Work Required for the Project. 115
Figure 9.2(a–b). A Critical Realist Perspective of the Role of Documentation in Keeping the Seniors Programme Alive. (a) The Project Charter. (b) The Project Charter’s Role in Bringing CEO2 to Ottawa. 120
Figure 9.3(a–b). A Critical Realist Perspective of the Role of Collaboration in Keeping the Seniors Programme Alive. (a) Perceptions of the Collaboration at Senior Management Levels. (b) The Role of Collaboration in Gaining CEO2’s Support for the Senior Programme. 123
Chapter 10
Figure 10.1. A Critical Realist Perspective of the Means of Preliminary Research. 127
Figure 10.2. A Critical Realist Perspective of Managing the Differences in Patient Population between the BC and NS Health Authorities. 129
Figure 10.3. A Critical Realist Perspective of the Selection of the BC Coaching Organization. 131
Figure 10.4(a–c). A Critical Realist Perspective of the Elements of Defining the Target Patient Population. (a) Establishing the Need and Responsibility for Defining the Target Patient Population. (b) Identifying Candidate Terms to Define the Target Patient Population. (c) Selecting the Term Used to Define the Target Patient Population. 136
Figure 10.5(a–d). A Critical Realist Perspective of the Elements of the Vision Statement. (a) Developing the Vision Statement. (b) Mixed Reviews of the Vision Statement. (c) How Olga’s Story Defied People’s Perception of Ageing and Frailty. (d) Using the Vision Statement and Olga’s Story to Redefine Rationality. 144
Chapter 11
Figure 11.1. A Critical Realist Perspective of the Motivational Capacity of Shared Values. 149
Figure 11.2(a–b). A Critical Realist Perspective of Reifying Power through Bureaucratic Rationality. (a) Clarity of Goals, Procedures, and Flow of Information. (b) Processes within the BC Coaching Organization. 152
Figure 11.3. A Critical Realist Perspective of Empowerment. 154
Figure 11.4. A Critical Realist Perspective of Communication. 156
Figure 11.5. A Critical Realist Perspective of Shielding Workers from Political Turmoil. 158
Chapter 12
Figure 12.1(a–c). A Critical Realist Perspective of the Elements of the Intention to Spread the Seniors Programme. (a) Reasons to Spread Seniors Programme. (b) Pan-Canadian versus Regional Spread. (c) A Staged Approach to Spread. 163
Figure 12.2. A Critical Realist Perspective of the Elements of the Fellowship’s Assessment of the Collaboration. 166
Figure 12.3(a–c). A Critical Realist Perspective of the Elements Posing Barriers to Spread. (a) How Risk Tolerance and Payment Structures Posed Barriers to Spread. (b) How Diverse Systems Posed Barriers to Spread. (c) How Managing Daily Pressures in Healthcare Regions Posed Barriers to Spread. 172
Chapter 13
Figure 13.1. A Critical Realist Perspective of How Leadership Can Facilitate Spread. 177
Figure 13.2. A Critical Realist Perspective of the Attributes of People that Facilitate Spread. 179
Figure 13.3. A Critical Realist Perspective of Programme Characteristics that Facilitate Spread. 180
Figure 13.4. A Critical Realist Perspective of How the Development of eCGA Facilitated Spread. 182
Figure 13.5. A Critical Realist Perspective of Providing Support to Physicians to Facilitate Spread. 183
Figure 13.6. A Critical Realist Perspective of How Changes to Primary Care Facilitate Spread. 185
Figure 13.7. A Critical Realist Perspective of How to Approach Regions to Facilitate Spread. 187

List of Tables

Chapter 1
Table 1.1. Research Questions. 4
Chapter 3
Table 3.1. Public Values Emphasized in Canada’s 2003 Values and Ethics Code for the Public Service as Identified by Beck Jørgensen and Sørensen (2013). 26
Table 3.2. Cross-reference of Canada Health Act Objectives with Public Values. 27
Table 3.3. Cross-reference of the BC Health Authority’s Vision, Purpose, and Values with Public Values. 27
Chapter 6
Table 6.1. Organizations Involved in the Seniors Programme. 66
Table 6.2. Key Individuals Involved in the Seniors Programme. 67
Table 6.3. Summary of Documents Analysed. 72
Table 6.4. Summary of Interviews. 73
Table 6.5. Codes Used during Data Analysis. 75
Chapter 7
Table 7.1. Summary of the Enabling Structures of Values, Rationality, and Power That Led Interviewees to Become Involved in the Seniors Programme. 81
Table 7.2. Comparison of Values in the Project Charter versus Those Interviewees Perceived in the Seniors Programme. 87
Table 7.3 Comparison of Values in the Canada Health Act versus Those Interviewees Perceived in the Seniors Programme. 88
Chapter 8
Table 8.1. Reasons Some VPs Did Not Support the Training Fellowship and Their Relation to Values, Rationality, and Power. 93
Table 8.2. Means of Resistance to the Training Fellowship and Their Relation to Values, Rationality, and Power. 96
Table 8.3. Means of Building Support for the Training Fellowship and Their Relation to Values, Rationality, and Power. 101
Table 8.4. Elements of Building and Maintaining Support for the Seniors Programme and Their Relation to Values, Rationality, and Power. 108
Chapter 9
Table 9.1. Attributes of People That Kept the Seniors Programme Alive and Their Relation to Values, Rationality, and Power. 114
Table 9.2. Role of Documentation in Keeping the Seniors Programme Alive and Its Relation to Values, Rationality, and Power. 119
Table 9.3. Role of Collaboration in Keeping the Seniors Programme Alive and Its Relation to Values, Rationality, and Power. 122
Chapter 10
Table 10.1. Means of Preliminary Research and Their Relation to Values, Rationality, and Power. 127
Table 10.2. Challenges the Fellowship Had Managing the Differences in Patient Population between the BC and NS Health Authorities and Their Relation to Values, Rationality, and Power. 128
Table 10.3. Selecting the BC Coaching Organization and Its Relation to Values, Rationality, and Power. 130
Table 10.4. Elements of Defining the Target Patient Population and Their Relation to Values, Rationality, and Power. 135
Table 10.5. Elements of the Vision Statement and Their Relation to Values, Rationality, and Power. 143
Chapter 11
Table 11.1. Elements of the Motivational Capacity of Shared Values and Their Relation to Values, Rationality, and Power. 148
Table 11.2. Elements of Reifying Power through Bureaucratic Rationality and Their Relation to Values, Rationality, and Power. 151
Table 11.3. Elements of Empowerment and Their Relation to Values, Rationality, and Power. 154
Table 11.4. Elements of Communication and Their Relation to Values, Rationality, and Power. 156
Table 11.5. Elements of Shielding Workers from Political Turmoil and Their Relation to Values, Rationality, and Power. 157
Chapter 12
Table 12.1. Elements of the Intention to Spread the Seniors Programme and Their Relation to Values, Rationality, and Power. 162
Table 12.2. Elements of the BC Working Group’s Assessment of the Collaboration and Their Relation to Values, Rationality, and Power. 165
Table 12.3. Elements Posing Barriers to Spread and Their Relation to Values, Rationality, and Power. 171
Chapter 13
Table 13.1. Elements of How Leadership Facilitated Spread and Their Relation to Values, Rationality, and Power. 176
Table 13.2. Elements of How Programme Champions Facilitated Spread and Their Relation to Values, Rationality, and Power. 178
Table 13.3. Elements of How Programme Characteristics Facilitated Spread and Their Relation to Values, Rationality, and Power. 180
Table 13.4. Elements of How Developing the eCGA Facilitated Spread and Their Relation to Values, Rationality, and Power. 181
Table 13.5. Elements of How Supporting GPs Facilitated Spread and Their Relation to Values, Rationality, and Power. 183
Table 13.6. Elements of How Changes to the Delivery of Primary Care Facilitated Spread and Their Relation to Values, Rationality, and Power. 185
Table 13.7. Elements of How the Methods Used to Approach Regions Facilitated Spread and Their Relation to Values, Rationality, and Power. 187
Chapter 16
Table 16.1. Summary of Propositions and Recommendations. 216
Chapter 17
Table 17.1. A Framework for Educators to Develop Organizational and Managerial Wisdom. 242

About the Author

Dr Brad C. Anderson teaches business at Kwantlen Polytechnic University, focusing on operations management as well as business analysis and decision-making. Prior to that, he worked as a scientist in the biotech industry where he made drugs for a living (legally!). In addition to his teaching and research interests, he is a published science fiction author. Learn more about him and his work at www.bradanderson2000.com.

Acknowledgements

There are many people to whom I owe a debt of gratitude. Dr. Gabrielle Durepos devoted a tremendous amount of time, effort, and thought into helping me shape this book into what it is. This work would be a mere shadow of itself without her guidance and support. Likewise, Dr. Janice Thomas made the time to take me on as a graduate student despite an already vast array of responsibilities. It was she who introduced me to Bent Flyvbjerg’s book Making Social Science Matter: Why Social Inquiry Fails and How It Can Succeed Again. There are books that change lives, and this book changed mine. I also wish to thank Drs. Gloria Filax, Gina Grandy, and Jim Grant, who took the time to review and provide feedback on my research. Their insights and challenging questions only made this work stronger.

There are many within my research setting to whom I owe thanks. To maintain their confidentiality, however, I can only refer to them by their code names. The Mentor was the first person in the BC Health Authority to introduce me to the Seniors Programme. From day one, she showed interest and passion for my research. Similarly, the Site Director was incredibly supportive, giving me access to a treasure trove of documents. These two plus my other interviewees, the MD Lead, Head Coach, Senior Improvement Lead, CEO1 and CEO2, gave generously their time participating in my interviews. Associated with many of these individuals and the research ethics boards I interacted with are unsung heroes: executive assistants and administrators with whom I worked to arrange meetings, organize interviews, and guide paperwork through the labyrinthine complexity of bureaucracy. Without the generosity and support of these people, this research would not exist.

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