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Toward Transforming Health Systems: A Practice Study of Organizing and Practical Inquiry in Academic Medicine

Ellison, Thomas A.
http://orcid.org/0000-0002-9030-9436
http://rave.ohiolink.edu/etdc/view?acc_num=antioch1445818686

Abstract Details

2015, Ph.D., Antioch University, Leadership and Change.
Transformation of health care systems will be grounded in new professional relations and collective, cross-disciplinary actions to impact care delivery. Organizing such relations and actions involves practical inquiry rather than applying professional knowledge. This dissertation presents an exploratory, performative study of the initial organizing of the Health Systems Innovation and Research (HSIR) Program in Health Sciences at the University of Utah. The HSIR program was conceived principally to catalyze cross-disciplinary innovation and health services research and enhance care delivery changes by documenting care improvements and publishing research. This study includes a composite narrative of the organizing and practical inquiry work of HSIR organizers, which highlights many questions, issues, possibilities, and priority shifts that would likely face those who would seek to transform care delivery and the cultures of academic medicine. The study identifies improvement, integration, and transformative strategies as pathways to effect change in health systems. The study includes a narrative-based analysis of cultural, dynamic, and narrative resources to enhance understanding of the HSIR story and the implications of cultural and dynamic influences for the Program’s future and health systems transformation. This analysis emphasizes the cultural and dynamic influences of academic and clinical departments and other sources of dynamic influence that were operating to hinder or facilitate the larger objectives of HSIR organizers. The study also explores the significance of collective practical inquiry, exploratory inquiry, and culture change to the practice and theory of leadership and change. The HSIR study was conducted using a practice study methodology developed from practice and narrative theories, with contributions from complexity, process, learning, organizing, social construction, and relational theories and empirical studies of professionals undergoing change. The methodology recognizes an expansive, relational complex of practice as the empirical world to be studied, and was designed to explore practical inquiry, organizing, and collective actions of professionals in changing organizational situations. Methodological design principles focus data collection and analysis on situated activities, local discoveries, practical understandings, dynamic and cultural influences, narrative connections, future possibilities, and significant matters identified by practice participants. The electronic version of this dissertation is at Ohiolink ETD Center, http://etd.ohiolink.edu and AURA, http://aura.antioch.edu/
Alan Guskin, Ph.D. (Committee Chair)
Laura Roberts, Ph.D. (Committee Member)
Jon Wergin, Ph.D. (Committee Member)
William Plater, Ph.D. (Other)
450 p.
Health Care Management; Organization Theory; Organizational Behavior; Social Research
Practice theory; organizing; organizational change; dynamics; culture change; narrative; practical inquiry; exploration; integration; transformation; professionals; collective action; health systems; academic medicine; practice studies; leadership

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Citations

  • Ellison, T. A. (2015). Toward Transforming Health Systems: A Practice Study of Organizing and Practical Inquiry in Academic Medicine [Doctoral dissertation, Antioch University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1445818686

    APA Style (7th edition)

  • Ellison, Thomas. Toward Transforming Health Systems: A Practice Study of Organizing and Practical Inquiry in Academic Medicine. 2015. Antioch University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=antioch1445818686.

    MLA Style (8th edition)

  • Ellison, Thomas. "Toward Transforming Health Systems: A Practice Study of Organizing and Practical Inquiry in Academic Medicine." Doctoral dissertation, Antioch University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1445818686

    Chicago Manual of Style (17th edition)

antioch1445818686
660
© 2015, all rights reserved.
This open access ETD is published by Antioch University and OhioLINK.