Hospital reorganization and its effects on physicians' network churn: The role of past ties

2021
Hospital reorganizations are difficult and often fail to produce their intended benefits. Prior research has investigated how and under which contingencies changes in organizational structure affect the modification of clinician behaviors, yet we know little about how organizational redesign interventions affect physicians' collaborative networks. This paper explores how hospital reorganizations affect physicians' network churn. We developed hypotheses on the relationship between structural characteristics of networks before reorganization and the formation of cross-unit network ties after reorganization. We tested our hypotheses on a sample of 175 physicians in a large teaching hospital. The hospital had recently adopted a new organizational model aimed at enhancing a process-based approach to care delivery. Our findings revealed that the physicians' propensity to form cross-unit ties after the change was related to the structure of their collaborative networks before the change. In particular, the formation of cross-unit relations was negatively related to the size of advice networks before the reorganization. Furthermore, we found that the diversity of network ties along with the presence of structural holes in the physicians' networks before the change moderated this relationship. We discussed the theoretical and practical implications of our findings. In particular, our results may inform organizational redesign interventions within hospitals.
SOCIAL SCIENCE & MEDICINE
卷号:286
ISSN:0277-9536
收录类型
SSCI
发表日期
2021
学科领域
循证公共卫生
国家
意大利
语种
英语
DOI
10.1016/j.socscimed.2021.113885
其他关键词
HEALTH-CARE-SYSTEM; ORGANIZATIONAL-CHANGE; SOCIAL NETWORKS; KNOWLEDGE TRANSFER; RESPONSE-SHIFT; RESISTANCE; WORK; PROFESSIONALS; INNOVATIONS; ACCEPTANCE
EISSN
1873-5347
被引频次(WOS)
0
被引更新日期
2022-01
来源机构
University of Bologna Luiss Guido Carli University Catholic University of the Sacred Heart
关键词
Hospital  redesign Professional  networks Cross-unit  networks Collaboration Social  network analysis Process-based care