Jobson, David G (2013) Explaining the responses of front fine managers to the adoption of electronic rostering in a mental health trust. (DBA thesis), Kingston University, .
Abstract
This research examines how front line managers (FLMs) in a NHS Mental Health Trust responded when Electronic Rostering technology was introduced into their wards, with intentions of improving efficiency, transparency, fairness, skill matching, and safety, and potentially increasing control from above. The study applied a theoretical framework developed from previous research to investigate relationships between the organisational context and FLMs’ characteristics, change management processes and technology efficacy, and analyse their impact upon FLMs’ responses to E-Rostering adoption and consequent outcomes. The research questions focused upon the influences of organisational background and the change management process. The research strategy was an in-depth case study with data collection through semi-structured interviews with managers at ward, service/general, project and senior levels, observation of meetings and training, examination of system records and Trust documents. The theoretical framework was used to design interview guides to help researcher and subjects investigate perceptions of salient factors and FLMs’ responses, and help structure analysis. Cross referencing of data supported reliability and validity of interpretations. The FLMs were ward managers perceiving themselves as professional clinical leaders and operational managers, running wards semi-autonomously. Control of deployment was vital to their authority. They showed power to resist pressures to adopt technology which threatened their control and to resist changes not congruent with their priorities. They negotiated with the project team and adapted practices to produce locally acceptable rosters. Although electronic staff records helped administration, automatic rostering was not efficacious. Rosters needed considerable manual adjustment, meaning ward managers recovered control of deployment and maintained local customs. The study confirms the importance of organisational structure and culture and of political and change management processes, in explaining responses to IT innovation. Change leaders should investigate operational practices, unit cultures and contexts to prepare for technology adoption because these factors will strongly influence FLMs’ responses.
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