<p> Despite increased awareness of the link between teamwork and medical errors, and increased development of interventions aimed at improving team performance, the incidence of preventable errors in hospitals, and in the surgical environment particularly, remains high. Absent from interdisciplinary team development efforts is empirical evidence informed by the voices of surgical team members specific to their day- to- day experiences of teamwork. For this reason, a case study of interdisciplinary teamwork among Orthopedic Surgery team members was conducted from June to December 2013 to: (a) discover how teamwork behaviors are enacted in the surgical environment to affect the incidence of preventable surgical errors; and (b) understand the experience of teamwork from the perspective of surgical team members.</p><p> The case study data included 37 one-on-one interviews with Orthopedic Surgery team members (including two supervisors), and observations by the researcher guided by the Observational Teamwork Assessment for Surgery (OTAS) instrument. This study finds that while mindfulness is a prerequisite to safety behaviors that are found in the surgical setting, there is a dynamic interplay between processes of collective mindfulness and traditional teamwork behaviors wherein one continuously informs, shapes, and reinforces the other. Noting contributions of the this study to practice, the opportunity exists to expand the present inquiry beyond Orthopedic Surgery to include other surgical specialties as well as non-surgical practices within the hospital and clinic environments.</p>

<p> The administration's healthcare reform act of 2010 brings changes that are targeted to increase the quality of care, cut rising healthcare costs, and improve the health of the population, but the principle objectives of the law can only be met with the active involvement of physicians. However, leading in multidisciplinary healthcare organizations is difficult and physicians prepared for leadership are in short supply. Addressing this shortage first requires an understanding of the leadership practices of physicians in order to develop an effective leadership development program. To this end, the primary purpose of this study is to explore the practices of physician leaders. </p><p> This study used the qualitative phenomenological method to examine the experiences of physicians in their lives as leaders. The theoretical framework used to guide the research was the five practices of exemplary leaders (Kouzes &amp; Posner, 2012). Interviews were conducted with 8 participants and the data were coded and analyzed using HyperRESEARCH, a qualitative coding software package. The validity and reliability of the study were enhanced by presenting an in-depth, vivid analysis of the data, by conducting a peer review and by clarifying the researcher's bias at the outset of the study. The study found that all 5 of the practices in Kouzes and Posner's (2012) theoretical framework were present in physician leaders to varying degrees. Overall, the expressions which represented the practices of "enable others to act," "inspire a shared vision," and "challenge the process," were counted more often than "model the way" and "encourage the heart." </p><p> The study recommends that instructional designers develop a systematic curriculum with advanced leadership concepts. Additional recommendations include executive coaching and change leadership training. Recommendations for future research include increasing the number of participants, replicating the study using a different theoretical framework, including more physicians from small practices, expanding the study to collect demographics of the participants, and using a quantitative method or mixed method to enhance the transferability of the study results.</p>

<p> Historically, leadership research has concentrated on the charismatic and sometimes mythical qualities of a single, heroic leader. In a knowledge-oriented economy, theories of individual leaders are incomplete because they fail to capture the social nature of complex organizations. A distributed perspective of leadership frames leadership in terms of dynamic patterns of social interaction between people and aspects of their situation and considers the context or structure as important as the human agency. </p><p> This qualitative single case study, which involved a self-managed team of professionals in a mid-sized global financial services company, explored leadership as a social process in response to goals of organizational effectiveness and corporate organizational change over time. Specifically, this study described how leadership actions were enacted within the context of emerging social structuring, which enhances the understanding of leadership theory and moves us closer to being able to practically utilize a distributed perspective of leadership. Data were collected through observations, interviews, and document review. </p><p> The findings of strategic alignment with organizational goals and the utilization of advanced technology emerged as external conditions for leadership practice. The nature of interactions within the team was influenced by a combination of five distinct but interdependent elements: shared interest, routines, participation norms, language, and authority structures. The study shows the fluid nature of distributed leadership and the reciprocal dynamics of interactions that coevolve and change over time to best fit with specific circumstances. </p><p> The findings support three conclusions: (1) the role of context as an essential aspect of leadership practice; (2) the relational dynamics of social structuring and the influence of three fundamental elements of social interaction&mdash;meaning, power, and norms&mdash;on leadership action; and (3) the strengthening and sustaining ability of the norm of reciprocity on the dynamic interaction among team members. This study is important because it will help organizations better understand, identify, and apply the principles of a distributed perspective of leadership to future situations and will increase the credibility and viability of collective leadership theories.</p>

<p> Biomedical PhD education is a large and increasingly interdisciplinary segment of higher education. The primarily laboratory-based research training is commonly distributed to a range of administrative units within and outside the research-intensive universities. This organizational fragmentation represents a significant challenge to coordination, oversight, and quality development. The University of Pennsylvania was one of the first institutions to establish a centralized, umbrella-type biomedical graduate program to address these organizational challenges. The thirty-year-old program has been highly successful and is regarded as a model for other institutions. In order to learn from the program's path to success, this research investigated the inner dynamics and leadership actions related to the development of Biomedical Graduate Studies (BGS) at the University of Pennsylvania. The retrospective instrumental case study explored the process from the period prior to the establishment of the program in 1984 until its current configuration in 2014. Data were collected through semi-structured interviews with 18 people representing different time periods and leadership positions in the history of the program, as well as archival material. The data were analyzed to establish the chronology of events and to identify the main themes and leadership actions of the change process. The presented case was subsequently analyzed in light of established theory on organizational change and leadership orientations in higher education. This analysis demonstrated that the change was a multi-dimensional process and could be explained by several theoretical frameworks. There were elements of planning and decisive management, organizational learning, political bargaining, adaptation to environmental factors, and attention to culture and symbolism. The process involved a transformation that empowered the junior faculty, promoted collegiality, and improved the quality of recruitment, student satisfaction, and scientific outcomes. Centralization of student recruitment and funding, detaching the graduate education from the department structure, and collaborative leadership stood out as primary factors for success. This case study may serve as a guideline for other institutions that aim to develop centralized biomedical graduate programs. It also represents a reference for further research in the field of biomedical education management.</p>

<p> Ensuring all residents in Southern California have access to healthy food is one of many examples of an issue too complex and challenging for any one organization to change on its own. More and more, organizations work in collaboration and designate individuals to manage these collaborative change initiatives. This research uncovers the specific influence managers of collaborative change initiatives have in shaping positive outcomes for the collaborations they serve. Based on interviewing 11 managers and funders from six leading collaborative change initiatives, there are two contextual ways in which managers influence collaboration: their position itself carries influence and their ability to navigate the collaborative context they operate in. The main findings of this research share five key ways in which managers influence the collaborations they serve: their own personal characteristics and skills, the relationships they cultivate, the membership they support and empower, the processes they manage, and the culture they shape.</p>

<p> This exploratory research increases knowledge and understanding of blame in the workplace. Attribution theory, moral philosophy, and social cognition provided a theoretical framework to understand individual blame determination as a precursor to understand systemic blame. Systemic blame is informed by complex systems theory and research on "no blame" cultures in a healthcare setting. </p><p> Interpretive description, supported by applied thematic analysis, provided the methodological framework for this qualitative study. The 17 senior leaders interviewed for this research study were selected through purposive sampling, and individually had an average 28 years of experience in healthcare. The semi-structured interviews were designed to gather experiences and stories that informed the participants' perspectives on blame in the workplace. </p><p> Constant comparative thematic analysis of the data resulted in four main findings. First, blame is prevalent in the workplace. Second, blame begets blame through a vicious cycle of blame. In this cycle there is often unwarranted blame. Blame feels bad, which results in fear of blame and avoidance of blame. One way to avoid blame is to blame someone else. This positive reinforcing feedback loop of blame creates a culture of blame. Third, a culture of blame includes characteristics of risk aversion and mistrust. Risk aversion decreases innovation, and mistrust decreases transparent communication. Fourth, blame has an inverse relationship to accountability, where less blame may result in more accountability. These findings both confirm and contradict the current literature. The resulting conclusion is blame is not a game.</p>

<p>Many people, organizations, institutions, and governments want and need to generate creative breakthroughs and foster creativity, but are not aware of what conversational conditions make their occurrence more likely. The creative collaborative process is dependent upon communication. There have been few studies that have analyzed in situ group creativity with a robust communication theory capable of showing what actual kinds of conversations create new and useful meaning. The purpose of this research was to identify conversational conditions that facilitate creative breakthroughs in collaborative workgroups. </p><p> A case study is presented of a 4-month creative collaboration between members of a design consultancy and a senior university design class tasked with designing 21^st century communication products for a well-known greeting-card company client. The research design utilized a social constructionist communication theory, the coordinated management of meaning, (CMM). Creative breakthrough moments were identified in three different interactions from questionnaires and videotaped data. Reflective interviews of all the participants also enabled insight into the creative breakthrough moments and the narrative process that developed new meaning. The videotaped conversational patterns that produced those creative breakthrough moments were then recursively examined and analyzed with conversational analysis, CMM research methodology, and figurative language. Six specific conversational conditions were discerned as present in creative breakthrough emergence. </p><p> A reflexive pattern of critique, relationship, responsibility, idea generation, and reframing authorship enabled participants to co-evolve design narratives that made new meaning. Creative breakthroughs and new creative meaning emerged from an improvisational structure of six specific conversational conditions. By participating within this improvisational structure, group members utilized critique as a creative springboard for innovation and took fresh perspectives. These findings are counter to the dominant themes in design and sociocultural literature that nonjudgmental conditions, brainstorming, and individuals building on input are the main pathways for creativity. </p><p> <i>Key Words</i>: Creative breakthrough, conversational conditions, facilitate, in vivo collaborative workgroups, relational responsibility moves, new meaning-making, improvisational language structure, figurative language, CMM, social constructionist communication theory, creative and generous listening, creative collaboration </p>

<p> This study explores the impact of virtuous positive practices on organization identity, specifically it addresses the question of <i>how</i> organizations use virtuous positive practices to construct a positive organization identity. I use an inductive approach to conduct a case study of two organizations that have a reputation of outstanding culture, employee engagement, customer orientation, and have contributed to their respective communities. The study presents a model with a set of five propositions describing how the two organizations use virtuous positive practices to construct a positive organization identity. Key findings suggest that when virtuous thoughts, inspiring words, and empowering deeds are aligned in the construction process, the resultant identity characteristics are imbued with positivity.</p>

<p> Although the major responsibility for community college governance falls to presidents and administrators, researchers have recognized the integral role of faculty in governing higher education institutions. Few studies, however, have explored the effectiveness of contributions of faculty elected to community college academic senates. The purpose of this research was to investigate the background traits and leadership skills of elected academic senate presidents in order to identify both their perceptions of themselves as leaders and the perceptions of other faculty senate members. This study was based in the theory of transformational leadership in organizations and its impact on the effectiveness of organizations. The research question for this quantitative study focused on the extent to which the elected academic senate presidents' background and leadership traits affect the performance of faculty senates. The Multifactor Leadership Questionnaire (Form 5X; MLQ 5X) and supplemental demographic data were used with faculty at the 112 community colleges in a western state to measure the relationship between leadership behavior and organizational effectiveness. Data were analyzed using Pearson's correlation and <i>z</i> and <i> t</i> tests. Results indicated that there is a significant relationship between senate presidents who were transformational leaders and more effective in leading faculty senates. The implications for social change include informing community college faculty senates and their presidents about effective leadership styles and skills and providing resources to improve faculty governance. The anticipated results are improved college governance, enhanced college service to their communities, and enriched education for their students.</p>

<p> According to a review of the literature, Christian churches are divided because of constant rejection of change. In spite of the 70% failure rate of all organizational change efforts, successful change initiatives are achievable. Senior pastors assume the primary role of leadership within the church, and were tasked with the responsibility of leading God&rsquo;s people through change and guiding the evolution of the church. Parishioners rely on senior pastors to provide the vision, as many parishioners continue to hinder the change efforts of the senior pastor. The hermeneutical phenomenological research design was used in the qualitative study to investigate the phenomenon of change through the challenges experienced by senior pastors of Missionary Baptist Churches of Greater Minneapolis during change. Seventeen senior pastors of Missionary Baptist Churches of Greater Minneapolis participated in audio taped face-to-face interviews. During the analysis five themes emerged: (a) mixed emotions; (b) servant of the Lord; (c) relationships; (d) organizational culture; and (e) communication is the key. Recommendations for senior pastors, organizational leaders, and Seminary and Bible Colleges were developed from the results of the qualitative hermeneutical phenomenological study.</p>