This thesis examines the associations between organisational slack, that pool of actual or potential cushion of resources of an organisation, and executive discretion - the executives’ latitude for strategic action. Bourgeois and Singh (1983), George (2005), Sharfman et al. (1988) and Sharma (2000) have referred to slack as having a discretionary dimension because its ‘ease of recovery’ varies depending on where it is gained from. For the obverse of this association, slack contributes to resource availability in the task environment and therefore executive discretion (Hambrick & Finkelstein, 1987). However until now, this bi-direction association has been largely unexplored empirically. This thesis contributes to both fields by bringing them together to examine and measure aspects of these interactions. These constructs are applied to the annual reports of U.S. firms by measuring industry level discretion using content analysis of presidents’ letters to shareholders and industry average slack using financial ratios. Correlations show that industries with higher levels of slack enjoy greater industry level discretion. However the associations between slack types and industry level discretion are not uniform suggesting that the discretionary dimension of slack is influenced by the task environment and industry context. The present study replicated Keegan and Kabanoff’s (2007) method to examine slack within industries but could not extend their results to available and recoverable slack, which suggest a curvilinear relationship between potential slack and executive discretion. The limited sub-industry results offer opportunity for further research as does the idea of applying the same research question to the organisational and individual level studies of different cohorts of firms and industries. Future efforts should also improve the measurement of the slack construct.

Construction literature forwards innovation as a desirable objective for firms. Innovation is argued to; improve the firm s performance, increase market share, establish a competitive advantage, and ultimately ensure firm survival. Literature has overlooked the role of organisational slack within construction firms as a determinant of innovation despite the concept being well developed within the general management literature. This research uncovers and examines the impact of organisational slack on firm-level innovation as a determinant of innovation within the construction sector. This work forwards organisational slack as an unexplored firm level determinant of innovation within the construction context. Using the resource-based view of the firm, as a framework for firms, the thesis develops links between previously established firm level determinates of innovation to and slack to support its proposal as a determinant of innovation. Following this traditional measures of innovation argued fail to accurately capture innovation in the construction context, with patents represent inventions, while R&D expenditure is not applicable within the construction. Due to these failures of traditional approaches to measuring innovation, firm level performance is forwarded as a proxy measure for innovation outcomes. Developing existing slack literature, this thesis develops hypotheses proposing inverse U-shaped (n) and U-shaped (u) relationships between the level of slack and innovation outcomes. The thesis presents mixed method research. Study 1 adopts a deductive research strategy, incorporating statistical analysis to test the hypothesised relationships. The Research Design develops and Archival analysis research method; mirroring the approaches of econometric research found in slack literature. The data analysis explores two contexts: construction and manufacturing, allowing a comparative baseline to be established. The analysis of data from this study reveals that discrepancies in the R2 between the contexts is largely the result of the inability of control variables (Age, Size and Number of employees), to explain variation in firm performance (as a proxy for innovation outcomes) in a construction context, rather than the unsuitability of slack in the construction context. In construction firms, Unabsorbed Slack and Financial Slack demonstrated statistically significant results supporting an inverse U-shaped relationship with firm performance (n) supporting Hypothesis 1a and 1b. Contrary to this Absorbed Slack and Human Resource Slack demonstrated statistically significant results demonstrating a U-relationship (u) between slack and performance supporting hypothesis 2b (H2b). Study 2 adopts a deductive research strategy, incorporating semi-structured interviews as a source of primary data in order to explore the slack-innovation relationship in greater depth. Primarily, this study provided evidence to suggest that construction firms do not directly measure innovation. Instead, firms choose to measure outcomes of changes within the firm, typically in terms of measure relating to firm financial performance. Evidence from this study supports the proposal of firm financial performance as a viable proxy for innovation outcomes in Study 1. In addition to this when faced with changes to their environment, participants responses typically supported a positive linear relationship between the level of organisational slack and the firm. This research is the first to examine the impact of organisational slack on construction firm financial performance (as a proxy for innovation). This relationship is curvilinear in nature, however, the results are inconclusive if it is inverse U shaped (n) or U shaped (u) based upon conflicting evidence from different slack variables. What can be ascertained however, is that the level of slack impacts firm level performance and theoretically impacts firm level innovation.

La recherche en contrôle a montré que le champ hospitalier français a subi de profonds changements, notamment à travers l’introduction de l’accountability. La conformité aux pressions institutionnelles pousse les organisations à s’orienter vers de nouveaux outils et principes pour renfoncer leur légitimité externe (Power, 2003). Cette même littérature a montré que l’accountability s’infiltre dans la sphère médicale et démontre des phénomènes d’hybridation de rôle chez les médecins hospitaliers, qui sont ainsi sensibilisés aux contraintes financières (Kurunmäki, 1999). La sphère administrative ne fait pas exception et subit également des pressions coercitives. L’objectif de notre thèse est de contribuer à cette littérature en analysant les effets et les rôles de l’accountability dans le secteur hospitalier public français sur la sphère médicale. Pour analyser ces effets, nous nous ciblons sur les dispositifs d’accountability tels que le reporting d’informations (audit financier, pratique budgétaire). Pour répondre à cette problématique, notre terrain s’est focalisé sur des entretiens semi-directifs et une approche ethnographique dans un CHU de grande taille. Premièrement, à travers une étude exploratoire qualitative menée auprès de 19 directeurs administratifs financiers (représentant 19 CHU/CH), nous montrons que l’accountability au travers de l’exemple de l’audit financier amène à des changements organisationnels et sert également à « rendre des comptes » aux parties prenantes externes (Agence Régionale de Santé, banques) mais aussi internes des organisations hospitalières. Nos résultats soulignent notamment que l’audit financier renforce la légitimité de la sphère administrative vis-à-vis de la sphère médicale. Deuxièmement, nous identifions à partir d’une approche ethnographique (observation non-participante et entretiens) menée dans un CHU des acteurs administratifs spécifiques, servant de vecteurs pour l’infiltration de l’accountability dans la sphère médicale : les Techniciens d’Information Médicale. Ces acteurs administratifs ont un rôle essentiel dans l’hybridation des médecins aux compétences gestionnaires, et les sensibilisent aux logiques financières. A travers le reporting de leur activité médicale, nos résultats mettent en lumière une atténuation du clivage traditionnel observé dans la littérature entre acteurs administratifs et corps médical. Nous montrons également que l’infiltration de l’accountability par d’autres agents administratifs spécialisés, tend à sensibiliser les médecins à la réduction de surplus, de slack présent dans la prise en charge des patients. Il s’avère que cette organisation hospitalière privilégie des dispositifs d’accompagnements afin de solliciter les médecins à intégrer de nouvelles responsabilités dans l’efficience de leur rôle. Notre étude montre que les médecins tentent désormais de trouver un équilibre afin d’articuler « logique patient » et logique gestionnaire. Pour cela, nos résultats soulignent une modification des protocoles de soins, du raisonnement ainsi que des valeurs des professionnels de santé qui concilient et promeuvent désormais le médico-économique. / How are accountability measures used by actors in the administrative field? Consequently, which are the associated effects on workers in the health sector?Research in control has shown that the French hospital has undergone profound changes, notably through the introduction of accountability. Compliance with institutional pressure drives organizations to move towards new tools and principles that reinforce their external legitimacy (Power, 2003). The same literature has shown that accountability infiltrates the medical sphere and that a new phenomenon occurs: doctors adopt hybridization role in hospital. This hybridization creates doctors who are aware of financial constraints (Kurunmäki, 1999). The administrative sphere is no exception and is also subject to coercive pressure.The aim of our thesis is to contribute to this literature by analyzing the intra-organizational effects and roles of accountability on the medical logic in the French public hospital sector. To analyze these effects, we focus on accountability mechanisms such as information reporting (i.e. financial audit, budget practice). To answer this problematic, we use semi-structured interviews into French hospitals and we adopt an ethnographic approach of one large university hospital.Firstly, from a series of exploratory interviews with 19 financial administrative directors (in 19 public hospitals), we show that accountability through financial audit leads to organizational changes and also use to “give account” not only to external stakeholders (Regional Health Agency, banks) but also internal hospital organizations. Our results show that the financial audit reinforces the legitimacy of the administrative sphere towards the medical sphere.Secondly, we identify with an ethnographic approach (non-participant observation and interviews) in a UHC of specific administrative actors called “Medical coders” (i.e. actors serving as vectors for the infiltration of accountability in the medical sphere). These administrative members have a key role in hybridization of health professionals to management skills, and sensitize them to financial logics.Through the reporting of their medical activity, our results highlight an attenuation of the traditional cleavage observed in the literature between administrative members and the medical profession.Moreover, we show that the infiltration of accountability by others specialized administrative agents tends to sensitize doctors to the reduction of surplus, and the slack in the care of patients. It turns out that, the hospital organization favors support systems to make physicians integrate efficiency in their health role.Our result show that physicians are now trying to find a balance in order to articulate medical logic and managerial logic. For this, our study highlights a modification of care protocols as well as the reasoning and values of health professionals who reconcile and promote medico-economic logic.This thesis argues that the introduction of accountability within the French public hospital sector has intra-organizational effects on both the administrative and medical spheres and emphasizes that on the basis of the reduction of the organizational slack, the conflicts between medical and managerial logic are lessened.