Resisting hybridisation between modes of clinical risk management: Contradiction, contest, and the production of intractable conflict

Journal article


Fischer, Michael and Ferlie, Ewan. (2013). Resisting hybridisation between modes of clinical risk management: Contradiction, contest, and the production of intractable conflict. Accounting, Organizations and Society. 38(1), pp. 30 - 49. https://doi.org/10.1016/j.aos.2012.11.002
AuthorsFischer, Michael and Ferlie, Ewan
Abstract

This article explores and explains escalating contradictions between two modes of clinical risk management which resisted hybridisation. Drawing on a Foucauldian perspective, these two modes – ethics-orientated and rules-based – are firstly characterised in an original heuristic we develop to analyse clinical risk management systems. Some recent sociologically orientated accounting literature is introduced, exploring interactions between accountability and risk management regimes in corporate and organizational settings; much of this literature suggests these systems are complementary or may readily form hybrids. This theoretical literature is then moved into the related domain of clinical risk management systems, which has been under-explored from this analytic perspective. We note the rise of rules-based clinical risk management in UK mental health services as a distinct logic from ethics-orientated clinical self-regulation. Longitudinal case study data is presented, showing contradiction and escalating contest between ethics-orientated and rules-based systems in a high-commitment mental health setting, triggering a crisis and organizational closure. We explore theoretically why perverse contradictions emerged, rather than complementarity and hybridisation suggested by existing literature. Interactions between local conditions of strong ideological loading, high emotional and personal involvement, and rising rules-based risk management are seen as producing this contest and its dynamics of escalating and intractable conflict. The article contributes to the general literature on interactions between different risk management regimes, and reveals specific aspects arising in clinically based forms of risk management. It concludes by considering some strengths and weaknesses of this Foucauldian framing.

Keywordsclinical risk management; conflict; ethics; Foucault; hybrids; mental health; organizational change; paradigm incommensurability; regulation
Year2013
JournalAccounting, Organizations and Society
Journal citation38 (1), pp. 30 - 49
ISSN0361-3682
Digital Object Identifier (DOI)https://doi.org/10.1016/j.aos.2012.11.002
Scopus EID2-s2.0-84873058834
Open accessOpen access
Page range30 - 49
Research GroupCentre for Sustainable HRM and Wellbeing
Author's accepted manuscript
License
Publisher's version
Permalink -

https://acuresearchbank.acu.edu.au/item/86194/resisting-hybridisation-between-modes-of-clinical-risk-management-contradiction-contest-and-the-production-of-intractable-conflict

  • 69
    total views
  • 415
    total downloads
  • 0
    views this month
  • 6
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Leadership development in higher education : A literature review and implications for programme redesign
Dopson, Sue, Ferlie, Ewan, McGivern, Gerry, Fischer, Michael, Mitra, Mahima, Ledger, Jean and Behrens, Sonja. (2019). Leadership development in higher education : A literature review and implications for programme redesign. Higher Education Quarterly. 73(2), pp. 218-234. https://doi.org/10.1111/hequ.12194
The politics of management knowledge in times of austerity
Ferlie, Ewan, Dopson, Sue, Bennett, Chris, Fischer, Michael, Ledger, Jean and McGivern, Gerry. (2018). The politics of management knowledge in times of austerity Oxford University Press. https://doi.org/10.1093/oso/9780198777212.001.0001
Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study
Hilfiker-Kleiner, Denise, Haghikia, A., Berliner, Dominik, Vogel-Claussen, Jens, Schwab, Johannes, Franke, Annegret, Schwarzkopf, Marziel, Ehlermann, Philipp, Pfister, Roman, Michels, Guido, Westenfeld, Ralf, Stangl, Verena, Kindermann, Ingrid, Kühl, Uwe, Angermann, Christiane E., Schlitt, Axel, Fischer, D., Podewski, Edith, Bohm, Michael, ... Bauersachs, J.. (2017). Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study. European Heart Journal. 38(35), pp. 2671 - 2679. https://doi.org/10.1093/eurheartj/ehx355
A growth mindset approach to preparing trainees for medical error
Klein, Jill, Delany, Clare, Fischer, Michael Daniel, Smallwood, David and Trumble, Stephen. (2017). A growth mindset approach to preparing trainees for medical error. BMJ Quality and Safety. 26, pp. 771 - 774. https://doi.org/10.1136/bmjqs-2016-006416
The silent politics of temporal work: A case study of a management consultancy project to redesign public health care
McGivern, Gerry, Dopson, Sue, Ferlie, Ewan, Fischer, Michael Daniel, Fitzgerald, Louise, Ledger, Jean and Bennett, Chris. (2017). The silent politics of temporal work: A case study of a management consultancy project to redesign public health care. Organization Studies. https://doi.org/10.1177/0170840617708004
Knowledge leadership: Mobilizing management research by becoming the knowledge object
Fischer, Michael D., Dopson, Sue, Fitzgerald, Louise, Bennett, Chris, Ferlie, Ewan, Ledger, Jean and McGivern, Gerry. (2016). Knowledge leadership: Mobilizing management research by becoming the knowledge object. Human Relations. 69(7), pp. 1563 - 1585. https://doi.org/10.1177/0018726715619686
A global call for action to include gender in research impact assessment
Ovseiko, Pavel V., Greenhalgh, Trisha, Adam, Paula, Grant, Jonathan, Hinirichs-Krapels, Saba, Graham, Kathryn E., Valentine, Pamela A., Sued, Omar, Boukhris, Omar F., Al Olaqi, Nada M., Al Rahbi, Idrees S., Dowd, Anne-Maree, Bice, Sara, Heiden, Tamika L., Fischer, Michael D., Dopson, Sue, Norton, Robyn, Pollitt, Alexandra, Wooding, Steven, ... Buchan, Alastair M.. (2016). A global call for action to include gender in research impact assessment. Health Research Policy and Systems. 14(50), pp. 1 - 12. https://doi.org/10.1186/s12961-016-0126-z
The political economy of management knowledge: Management texts in English healthcare organizations
Ferlie, Ewan, Ledger, Jean, Dopson, Sue, Fischer, Michael D., Fitzgerald, Louise, McGivern, Gerry and Bennett, Chris. (2016). The political economy of management knowledge: Management texts in English healthcare organizations. Public Administration. 94(1), pp. 185 - 203. https://doi.org/10.1111/padm.12221
Affective overflows in clinical riskwork
Fischer, Michael D.. (2016). Affective overflows in clinical riskwork. In In M. Power (Ed.). Riskwork: essays on the organizational life of risk management pp. 1 - 26 Oxford University Press. https://doi.org/10.1093/acprof:oso/9780198753223.003.0012
A global call for action to include gender in research impact assessment
Ovseiko, Pavel V., Greenhalgh, Trisha, Adam, Paula, Grant, Jonathan, Hinrichs-Krapels, Saba, Graham, Kathryn E., Valentin, Pamela A., Sued, Omar, Boukhris, Omar F., Al Olaqi, Nada M., Al Rahbi, Idrees S., Dowd, Anne-Maree, Bice, Sarah, Heiden, Tamika L., Fischer, Michael, Dopson, Sue, Norton, Robyn, Pollitt, Alexandra, Wooding, Steven, ... Buchan, Alastair M.. (2016). A global call for action to include gender in research impact assessment. Health Research Policy and Systems. 14(50). https://doi.org/10.1186/s12961-016-0126-z
Epistemic fit and the mobilization of management knowledge in healthcare
McGivern, Gerry, Dopson, Sue, Ferlie, Ewan, Bennett, Chris, Fischer, Michael, Fitzgerald, Louise and Ledger, Jean. (2016). Epistemic fit and the mobilization of management knowledge in healthcare. In In Swan, J., Newell, S. and Nicolini, D. (Ed.). Mobilizing Knowledge in Healthcare: Challenges for Management and Organization pp. 1 - 21 Oxford University Press. https://doi.org/10.1093/acprof:oso/9780198738237.003.0002
The impact of leadership and leadership development in higher education: a review of the literature and evidence
Dopson, Sue, Ferlie, Ewan, McGivern, Gerry, Behrens, Sonja and Fischer, Michael D.. (2016). The impact of leadership and leadership development in higher education: a review of the literature and evidence London, UK: Leadership Foundation for Higher Education.
Knowledge leadership: Mobilizing management research by becoming the knowledge object
Fischer, Michael D.. (2015). Knowledge leadership: Mobilizing management research by becoming the knowledge object. Human Relations. 69(7), pp. 1563 - 1585. https://doi.org/10.1177/0018726715619686
The creation and survival of an academic health science organisation: counter-colonization through a new organizational form?
Fischer, Michael D., Ferlie, Ewan, French, Catherine, Fulop, Naomi and Wolfe, Charles. (2013). The creation and survival of an academic health science organisation: counter-colonization through a new organizational form Oxford, UK: University of Oxford.
Organizational turbulence, trouble and trauma: Theorising the collapse of a mental health setting
Fischer, Michael. (2012). Organizational turbulence, trouble and trauma: Theorising the collapse of a mental health setting. Organization Studies. 33(9), pp. 1153 - 1173. https://doi.org/10.1177/0170840612448155
Reactivity and reactions to regulatory transparency in medicine, psychotherapy and counselling
McGivern, Gerry and Fischer, Michael D.. (2012). Reactivity and reactions to regulatory transparency in medicine, psychotherapy and counselling. Social Science & Medicine. 74(3). https://doi.org/10.1016/j.socscimed.2011.09.035
Continuous subcutaneous insulin infusion leads to immediate, stable and long-term changes in metabolic control
Aberle, I., Zimprich, D., Bach-Kliegel, B., Fischer, C., Gorny, M., Kliegel, A., Langer, K. and Kliegel, Matthias. (2008). Continuous subcutaneous insulin infusion leads to immediate, stable and long-term changes in metabolic control. Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics. 10(4), pp. 329 - 335. https://doi.org/10.1111/j.1463-1326.2007.00707.x