Master of Public Health - MPH / Background: The appointment system learning initiative (ASLI) was introduced in 2016 as a way of implementing appointment systems in the City of Cape Town, in response to lengthy waiting times at PHC facilities It was intended as a safe space for learning, and piloted facility-generated planning in which knowledge was shared in workshops over 18 months. Variability in how well appointment systems had taken root was noted at the second feedback workshop. Currently, there is little information on the experiences, perceptions and roles of managers with regard to the initiative, or what unforeseen issues may have had an impact. Aim: This study aimed to reach an understanding of how the Appointment Systems Learning Initiative approach and its implementation was experienced by participating facility and PPHC managers at City Health facilities in Cape Town. This includes an exploration of the roles and experiences of health managers, including their perceptions of the benefits and challenges of the process. Methods: A qualitative, exploratory design was used. Individual, semi-structured interviews were conducted with a sample of twelve facility managers and two PPHC managers. Manager’s roles were analysed deductively according to Mintzburg’s 2009 framework, while other data analysis was inductive. Ethical clearance was obtained from UWC BMREC prior to commencement. Informed consent was obtained from participants and confidentiality was preserved at all stages of research. Results: Managers viewed the learning experience positively and felt that facility-generated planning was preferable to hierarchical imposition of programmes. They found it motivating to learn how other facilities had solved problems and designed their systems. Contextual changes to the health system affected ASLI by increasing the pace and prescriptiveness of implementation, and impeded the capacity for PPHC managers to offer support. Facility managers fulfilled critical leadership roles according to Mintzberg’s model, but the way in which they carried out roles such as delegation, team building or communicating may have affected implementation. Challenges included issues with human resources, insufficient time available for managing implementation, lack of preparation beforehand, insufficient support and contextual changes. Benefits included shorter working hours for staff, better organisation in facilities, shorter waiting times and improved satisfaction for end-users.

Strategy and its successful implementation is the responsibility of all stakeholders in an organisation; however, thus far, most empirical research in the field of strategy has mainly focused on Boards of Directors or senior management. The dearth of research, as evidenced from the review of the literature concerning the roles of middle managers in strategy implementation, coupled with the disagreement of senior management on their importance, leaves room for discovery. Acknowledging the importance of middle managers’ roles and agreeing what is expected from them in strategy implementation prompts organisations to create the conditions to enable them for strategy implementation. These ideas led to this investigation by exploring what enables the roles and practices of middle managers in strategy implementation. This research adopts the interpretive research approach in an effort to investigate middle managers’ involvement in strategy implementation across three industrial manufacturing organisations in the Kingdom of Bahrain. Through the development of a conceptual framework incorporating aspects of roles, role expectations, practices and context, the thesis highlights the difference between the perception of roles and expectations and roles in practice. The chosen respondents were senior and middle managers. The main findings of the research showed that there exists a gap between the perception of senior managers and middle managers on the roles of middle managers and on aspects enabling their strategic agency; this resulted in an ‘implementation gap’, which can hinder the successful execution of organisation strategy. This thesis discovers that the issues of management are the same regardless of the geographic situation or cultures within which the organisations operate, and that there are lessons to be learned from each other. A conceptual framework emerged from the exploratory qualitative research which confirms and opens up new avenues in understanding the roles of middle managers in practice in the area of strategy implementation. The implications are a need to understand it more empirically and a need to bridge the gap in practice. Key words: Strategy implementation, Middle manager, Roles, Role expectations, Practices.

La Gendarmerie nationale est une institution militaire française qui œuvre dans le domaine de la sécurité. Opérant dans les espaces ruraux et suburbains, elle a historiquement adopté une configuration particulière centrée sur la disponibilité des forces et un déploiement élargi sur le territoire. Poussée par des logiques de rationalisation issues de la nouvelle gestion publique et par des mouvements internes de contestation sociale, l’institution s’est engagée depuis la fin du XXème siècle dans un processus de transformation qui influence en profondeur la gestion de ses personnels. On observe alors une modification des règles du jeu sur lesquelles se base l’exercice du commandement. La condition du gendarme intègre de nouveaux droits jusqu’alors refusés ou fortement restreints par le statut militaire, et les marges de manoeuvre traditionnellement admises, basées sur la soumission sans réserve aux modes de la discipline et de la disponibilité, sont relativisées. Dans ce contexte, l'étude s’est intéressée à la pratique quotidienne des officiers en position de commandement, ainsi qu’à la manière dont ceux-ci abordent les transformations contemporaines de leur institution. Construite à la manière d’une enquête de terrain ethnographique, la démarche de recherche a permis une analyse en détail du travail de ces « chefs » au travers d’un répertoire de rôles. Ces rôles ont été envisagés comme des moyens d’agir sur le collectif, et décryptés au sein d’une grille de lecture stratégique. L’étude a ainsi pu mettre en évidence le choix qui est fait par certains officiers d’adopter une posture de soutien en lieu et place de la posture d’autorité traditionnelle dans le monde militaire / The Gendarmerie nationale is a military institution and one of the two French national police forces, with responsibilities regarding population security in rural and suburban areas. Due to public management reforms and several social movements, this institution is currently experiencing important changes in people management. As a result, the set of game rules that applies to command itself is subject to modifications. The gendarme condition – meaning the entire scale of rights, obligations and missions attached to the position – is evolving and traditional postures, based on disciplinary attitudes and availability standards, are weackened. This study focuses on the day-to-day work of officers in command positions and how these chiefs handle their new situation. Based on an ethnographic approach, the research process analyzes chief-work throught a set of roles, which are discused as means for action in a strategy-based approach. It shows how certain officers in command position choose to reshape the way they make use of their roles, adopting a support based posture rather than a more traditional authority based posture

This study uses information gleaned from a sample of 102 public sector project managers to assess the interrelationships among project manager roles, responsibilities, and competencies in the planning and implementation stages of the project life cycle. The results of confirmatory factor analysis and structural equation modeling revealed that project managers use different subsets of their skills to influence outcomes at these two stages of the project. For example, while the project manager's organizational and technical skills tend to have some influence during the project planning stage, managerial, leadership and people skills appear to have more influence during the project implementation stage. Implications of these and our other findings for the practice of project management in public sector organizations are discussed.

Comment un médecin peut-il devenir médecin-gestionnaire ? Un médecin peut-il même simplement devenir médecin-gestionnaire ? Cette thèse a pour vocation de mieux comprendre le phénomène de transition vers un rôle de médecin-gestionnaire, phénomène jugé difficile autant en pratique qu'en théorie. Celui-ci tend à se développer avec l'introduction de la gestion de la performance dans les organisations publiques européennes. Cette recherche prend comme illustration le rôle de responsable de pôle, nouveau rôle mêlant responsabilités médicales et gestionnaires, instauré au sein des hôpitaux publics français. Cette thèse s'articule autour de trois études menées de manière progressive. Une première étude envisage la transition de manière globale, en s'attachant à l'analyse des ajustements entre le médecin et son nouveau rôle. Elle est menée à partir d'une étude de cas et d'entretiens auprès de deux établissements de santé (un Centre Hospitalier Universitaire et un Centre Hospitalier) et de leurs 22 responsables de pôle. Elle met en avant l'importance de la dimension individuelle dans la transition analysée. Une deuxième étude se focalise sur l'influence de l'identification au rôle de médecin-gestionnaire sur la transition. Elle est menée à partir d'une étude de cas et d'entretiens auprès de 4 responsables de pôle d'un CHU et de leurs principaux collègues. Elle soulève l'effet de customisation de la posture d'identification au rôle sur la tenue de ce dernier. Une troisième étude s'oriente finalement sur le travail identitaire des médecins dans la tenue de leur rôle de médecin-gestionnaire. Elle est également menée à partir d'une étude de cas auprès des 4 mêmes responsables de pôle, mais au travers d'observations directes de leur comportement en réunion. Elle fait émerger l'importance de l'utilisation de l'identité en action pour tenir un rôle de médecin-gestionnaire. La thèse que nous défendons est que la transition vers un rôle de médecin-gestionnaire peut s'effectuer à partir d'ajustements et avec des postures d'identification variées, du moment que l'identité du médecin est retravaillée dans l'action. Nous conseillons aux établissements de santé de privilégier des dispositifs d'accompagnement personnalisés sur le terrain afin d'aider les médecins à comprendre la logique de leur rôle. / How can a doctor become a doctor-manager? Can a doctor even become a doctor-manager? This dissertation aims at better understanding the phenomenon of transition from a regular doctor role to a doctor-manager role, a transition that is experienced as difficult in practice and theory. This phenomenon tends to be developed with the spread of performance management within European public organizations. This research draws upon the example of the clinical director role, a new role in French public hospitals that is mixing both medical and managerial responsibilities. This dissertation is based on three progressive studies. A first study examines this transition with a global view by analyzing the adjustments between a doctor and his/her new role. It is carried out through a case study within two health care organizations (a teaching hospital and a hospital) and through interviews with their 22 clinical directors. This study shows the importance of the individual dimension for the transition to succeed. A second study focuses on the influence of role identification on the way a doctor-manager role is enacted. A case study and interviews with 4 clinical directors and their main colleagues within a teaching hospital are used to reach this goal. This study reveals the customization effect of identification on a doctor-manager role. A third and last study deeply focuses on the identity work of doctors in their enactment of a doctor-manager role. We address this issue by using a case study with the same 4 clinical directors, but through direct observations of their behavior during meetings. This study shows the importance of activating of identity into the context to enact a doctor-manager role. Finally, our main argument in this dissertation is that a transition to a doctor-manager role can be lead through various adjustments and identification situations, as long as identity is reworked during role enactment. We suggest to hospital directors to give priority to the use of field management tools oriented on personalization, in order to help doctors understand the logic of their roles.

The aim of this thesis is to define the concept of the career opportunity map. This map shows first-year students at economic universities the real functions at selected positions in companies. Profiles positions should also point out where management skills are applied in practise. The theoretical part of the thesis is devoted to the definition of basic concepts and techniques of Design Thinking. The next step is to outline methods that are used in the practical part. Likewise, the reader will find here the selected management approach by various authors. The practical part presents a plan of research, outputs of research with experts, outputs of the workshop with the students and the samples of profile jobs. Result of this work will define specific forms of the concept and recommendations for future extension.