How health care managers weather change: Implications for management education programs

Author: Janny Maddern

Maddern, Janny, 2018 How health care managers weather change: Implications for management education programs, Flinders University, College of Education, Psychology and Social Work

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Despite the documented importance of middle managers in the implementation of change, there has been little research on how middle managers in health care experience and make sense of contemporary radical changes and how they might develop the capabilities to deal with them. This research explores and analyses health care manager experiences of changes to organisational funding, structures, workforce and services in South Australia and identifies possible implications for postgraduate health care management programs at Flinders University and in South Australia generally.

A qualitative, interpretive research design in the form of a collective case study was used to elicit information about middle managers’ experiences, views and responses to major change. A purposive sample of seven participants was chosen from managers who responded to a call for expressions of interest distributed by the South Australian Branch of the Australasian College of Health Service Management (ACHSM), the professional body for health care managers. The sample drew on different age groups, a variety of professional backgrounds and roles, and a range of organisations within the Greater Adelaide Statistical area (ABS, 2016). This area includes a few small country hospitals. The gender balance of the sample (six females, one male) reflected the balance within the health care professions.

Semi-structured interviews were used to explore the rich experiences of each participant. The theory of weathering change (Raffanti, 2005a; 2005b) provided the framework for documenting the various stages of coping with unrelenting change and analysing resisting and acquiescing response behaviours. This was combined with broader theme analysis to identify major managerial coping strategies and possible areas for further skill and knowledge development.

Weathering is ‘a basic social-psychological process that enables individuals to endure changes in a manner consistent with their personal and professional needs, goals, and values’ (Raffanti, 2005a, p. 28). Based on the sizing-up and filtering stages of weathering, individuals determine how they will cope with change. The theory acknowledges the combination of personal, professional and social factors determining behavioural responses to imposed change and describes behaviours, rather than attaching negative and enduring psychological labels such as ‘resistors’ to the individuals concerned.

As a result of the research undertaken, I propose a new category, Carefully Shaping Up, as an addition to Raffanti’s resisting and acquiescing categories of coping. Carefully Shaping Up comprises cooperative yet adaptive behaviours used by health care managers in weathering change, and reflects the layers of complexity in managers’ roles and responsibilities. It involves: adhering to personal and professional values and priorities; maintaining strong support networks and personal wellbeing; developing knowledge and skills; keeping informed; and taking responsibility for shaping change.

The accounts of the health care managers indicated areas of skills and knowledge development for consideration by South Australian health management educators when they review curricula and learning processes that aim to foster development of managers’ capacities to cope with change. Because radical change has occurred across Australia, these insights are also of potential interest to postgraduate management educators and researchers nationally.

Keywords: organisational change, health care, middle managers, managers, coping, management education, qualitative interpretive research

Subject: Education thesis

Thesis type: Professional Doctorate
Completed: 2018
School: College of Education, Psychology and Social Work
Supervisor: Professor John Halsey