Organisational Process Research: Theory and Practice

1. Organisational Process Research: Theory and Practice Professor Ewan Ferlie Dept of Management King’s College London January 2013 Presentation at NHS Confederation Event

2. Introduction • Consider the theory and practice of organisational process research and why it may be a useful and distinctive approach to case based work; • Large scale designs and connection to theory; • Getting beyond the single descriptive case; • Give a worked example from NIHR funded research on managed networks in health care;

3. Organizational Process Research • Pettigrew is a key UK author ; • A major current within general management research, associated with ‘soft’ strategy; • ‘getting beyond the variables paradigm of the 1960s’ (Aston Group) • Interest in processes of strategic change and of resistance to such change; • Historical, cultural and political perspectives; • Fitted well with the UK of the 1980s as a ‘high change’ decade (Pettigrew et al, 1992 on NHS); both private and public sectors; • Also a more managerialist interest in ‘performance’;

4. Some Key Characteristics • Treat ‘implementation’ as problematic and as something to be accomplished; • Comparative case study designs; • n=8! • Purposeful selection of cases; • Longitudinal and retrospective: where there is a clear organisational outcome to explain; • Processual elements – decision streams unfold over time (Mintzbergian notion of strategy); rich seam of organisational politics;

5. Some Key Characteristics • Contextual: • - inner context; • - outer context; narratives of health policy ‘reforming’; • - receptive and non receptive contexts for strategic change (Pettigrew et al , 1992); • Multi layered designs; • Operates at the meso/strategic level rather than the macro (national health policy) or the micro level (the clinical team);

6. Research Methods • Documents; • Observation of meetings; • Semi structured interviews; • Team management and writing up the cases; • What is a good case study? • Comparative analysis;

7. Managed Networks Study • Ferlie et al (2010) – nature, impact and performance of a set of 8 managed networks set up in the early 2000s (2006-09); • Complex and large scale sites; • 4 different pairs; • E.g. Urban and County Cancer Networks; • Attempt at a performance assessment and generation of proxy indicators; • Emblematic New Labour reform to health policy so policy connected; • (luckily for us) end of the New Labour period in May 2010;

8. Managed Networks Study • 8 comparative cases, using standard methods; • Approx 220 interviews; • Retrospective following through of a major tracer issue • E.g. Urology IOG in the cancer networks; • Team of five researchers; • Many team meetings at the end of the project to make sense of what we have found; • Comparative cases written up in a common format;

9. Managed Networks Study • First article addressed health policy implications (Ferlie et a, 2010) and made a measured defence of networks in ‘wicked problem’ arenas as the least bad governance mode; • Of direct policy relevance – Future Forum workstream on networks (2011) picked up the Public Administration article ; • Later article (Ferlie et al, 2012) developed an overall theoretical interpretation of governance modes found – Foucault and governmentality stream of literature;

10. Managed Networks Study • Helped generate a distinctive overall interpretation of a New Labour period (1997-2010) in English health policy; • Networks • Vs • Targets/terror (Hood and Bevan) • Marketisation (Mayes et al)

11. Concluding Discussion • Critics would see it as a relatively conservative variant of case study research; • Large scale and comparative designs (so need big research teams and grants); • Increases external validity concerns; • there is always a concern for informing policy; • In principle, can mix well with more quantitative components in a mixed design; • Not hostile to a notion of proxy ‘performance’ measures (implicitly rather managerialist, see Pettigrew et al, 1992?); not really ‘critical’ enough?;

12. Concluding Discussion • Important element of longitudinality makes it unsuitable for short studies; • Comes with a sophisticated methodological discussion in mainstream org studies literature (Eisenhardt , 1989; Langley, 1999); • Need good writing skills of a historian; • Open to theory, including basic social science theory, as a way of emplacing the many empirical observations;

13. References • Eisenhardt, K. (1989) ‘Building Theories from Case Study Research’. Academy of Management Review, 14(4), 532-550. • Ferlie, E., Exworthy, M., FitzGerald, L. and Addicott, R. (2010) ‘Networks in Health Care: A Comparative Study of Their Management, Impact and Performance’, Final Report to NIHR, HS and DR project: 08/1518/102 • Ferlie, L. FitzGerald, McGivern, G., Dopson, S. and Bennett, C. (2011) ‘Public Policy Networks and ‘Wicked Problems’: A Nascent Solution?’, Public Administration, 89(2): 307-324.

14. References • E. Ferlie, G. McGivern and L. FitzGerald (2012) ‘New Modes of Organizing in Health Care?: Governmentality and Managed Networks in Cancer Services in England’, Social Science and Medicine, 74(3): 340-347 • Langley, A. (1999) ‘Strategies for Theorizing from Process Data’ Academy of Management Review, 24(4), 691-710. • Pettigrew, A. (1990) ‘Longitudinal Field Research on Change: Theory and Practice’. Organization Science, 1(3): 267-292 • Pettigrew, A., Ferlie, E. and McKee, L. (1992) ‘Shaping Strategic Change’, London: Sage