从战略到行动：高层管理者的支持如何增强中层管理者在医疗保健组织中实施创新的投入度。
From strategy to action: how top managers' support increases middle managers' commitment to innovation implementation in health care organizations.
作者信息
Birken Sarah A, Lee Shoou-Yih Daniel, Weiner Bryan J, Chin Marshall H, Chiu Michael, Schaefer Cynthia T
机构信息
Sarah A. Birken, PhD, is Postdoctoral Fellow, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill. E-mail:
出版信息
Health Care Manage Rev. 2015 Apr-Jun;40(2):159-68. doi: 10.1097/HMR.0000000000000018.
BACKGROUND
Evidence suggests that top managers' support influences middle managers' commitment to innovation implementation. What remains unclear is how top managers' support influences middle managers' commitment. Results may be used to improve dismal rates of innovation implementation.
METHODS
We used a mixed-method sequential design. We surveyed (n = 120) and interviewed (n = 16) middle managers implementing an innovation intended to reduce health disparities in 120 U.S. health centers to assess whether top managers' support directly influences middle managers' commitment; by allocating implementation policies and practices; or by moderating the influence of implementation policies and practices on middle managers' commitment. For quantitative analyses, multivariable regression assessed direct and moderated effects; a mediation model assessed mediating effects. We used template analysis to assess qualitative data.
FINDINGS
We found support for each hypothesized relationship: Results suggest that top managers increase middle managers' commitment by directly conveying to middle managers that innovation implementation is an organizational priority (β = 0.37, p = .09); allocating implementation policies and practices including performance reviews, human resources, training, and funding (bootstrapped estimate for performance reviews = 0.09; 95% confidence interval [0.03, 0.17]); and encouraging middle managers to leverage performance reviews and human resources to achieve innovation implementation.
PRACTICE IMPLICATIONS
Top managers can demonstrate their support directly by conveying to middle managers that an initiative is an organizational priority, allocating implementation policies and practices such as human resources and funding to facilitate innovation implementation, and convincing middle managers that innovation implementation is possible using available implementation policies and practices. Middle managers may maximize the influence of top managers' support on their commitment by communicating with top managers about what kind of support would be most effective in increasing their commitment to innovation implementation.
背景
有证据表明，高层管理者的支持会影响中层管理者对创新实施的投入度。目前尚不清楚的是，高层管理者的支持是如何影响中层管理者的投入度的。研究结果可能会用于改善创新实施的惨淡成功率。
方法
我们采用了混合方法序列设计。我们对120名在美国120家医疗中心实施旨在减少健康差距创新举措的中层管理者进行了调查（n = 120）和访谈（n = 16），以评估高层管理者的支持是直接影响中层管理者的投入度；还是通过分配实施政策和实践来影响；亦或是通过调节实施政策和实践对中层管理者投入度的影响来实现。对于定量分析，多变量回归评估直接和调节效应；中介模型评估中介效应。我们使用模板分析来评估定性数据。
研究结果
我们发现支持每种假设关系：结果表明，高层管理者通过直接向中层管理者传达创新实施是组织的优先事项来提高中层管理者的投入度（β = 0.37，p = .09）；分配实施政策和实践，包括绩效评估、人力资源、培训和资金（绩效评估的自抽样估计值 = 0.09；95%置信区间[0.03, 0.17]）；并鼓励中层管理者利用绩效评估和人力资源来实现创新实施。
实践意义
高层管理者可以通过向中层管理者传达一项举措是组织的优先事项来直接表明他们的支持，分配人力资源和资金等实施政策和实践以促进创新实施，并让中层管理者相信利用现有的实施政策和实践可以实现创新实施。中层管理者可以通过与高层管理者沟通何种支持对提高他们对创新实施的投入度最有效，来最大化高层管理者支持对其投入度的影响。
Zotero 插件