Managing social capital to facilitate an organisational climate for innovativeness in an acute health

310 Pages·2015·5.04 MB·English

Working together: Managing social capital to facilitate an
organisational climate for innovativeness in an acute health
service context

by

Helen Patricia Black
Bachelor of Business (Honours)

Griffith Business School
International Business and Asian Studies
Griffith University

Submitted in fulfilment of the requirements of the degree of
Doctor of Philosophy

October, 2014
ii
Abstract
This research addresses the need to consider the organisational context and
climate in the innovation process in an acute health service context. A critical
review of the literature indicates an overlap exists between social capital and an
organisational climate for innovativeness; however, the literature is
underdeveloped in addressing the relationships between social capital and
organisational climate explicitly. Exploring how social capital evolves offers a new
perspective to management of change and innovativeness in a dynamic and
socially complex environment such as operating theatre suites.

The social capital and organisational climate for innovativeness literature is scarce
in the context of health services. Health services in Australia and elsewhere are
under constant pressure to increase throughput of patients and improve
efficiencies, particularly in the area of surgical intervention. Many change
initiatives are designed with standardised implementation without regard for the
influences of the organisational context in the process (Greenhalgh et al., 2005,
Greenhalgh et al., 2004). Therefore, acute health services, and in particular
operating theatre environments, are rich sites to explore the influence of
organisational climate on innovativeness.

This research uses a sequential mixed methods approach to explore the
relationship between social capital and organisational climate for innovativeness
in three differently sized operating theatre suites in New South Wales (NSW),
Australia. The differences in operating theatre suite size provided an opportunity
to explore the impact of size in relation to eight organisational climate dimensions,
in accordance with the survey initially employed by Garcia-Goni, Maroto, and
Rubalcaba (2007).
This research used a validated survey questionnaire (Garcia-Goni, Maroto, and
Rubalcaba, 2007) incorporating Likert scales for a series of statements about
climatic dimensions including: value of learning (Hurley and Hult, 1998, Gong et
al., 2009, Hsu, 2006); openness (Laursen and Salter, 2006, Tominc and Rebernik,
2010, Marcati et al., 2008); learning orientation (Calantone et al., 2002, Baker,
1999, Mavondo et al., 2005, Scott and Bruce, 1994, Kanchana et al., 2011); and
organisational innovativeness (Wang, 2004). In addition, organisational
commitment (Eisenberger et al., 1990, Meyer et al., 2007, Meyer and Allen, 1997),
team spirit (Montes et al., 2005, Lee et al., 2008, Scott and Lauer, 2002, Ekvall,
1997, Ekvall, 1996), internal politics (Hislop et al., 2000, Miller et al., 2008,
Golembiewski and Vigoda, 2000), and job satisfaction (Shipton et al., 2004, Alas
and Ubius, 2009, Eisenberger et al., 1990, Siegel and Kaemmerer, 1978). These
eight dimensions of the organisational climate for innovativeness were identified
in the literature as factors that have an influence on innovation outcomes.
The survey was distributed to three sites, and a response rate of 32% was
achieved, with a total of 133 surveys returned. The organisational climate for
innovativeness of each operating theatre suite was explored through the
aforementioned eight dimensions using ANOVA and t-tests. In addition, the
strength of each operating theatre suite’s organisational climate for innovativeness
was measured using the 𝐴𝐷 measure, which is the average deviation from the
𝑀
mean for individuals in each operating theatre suite, providing a basis for
quantitative comparison. Further analysis included linear regression and
moderation models to explore relationships between dimensions chosen to
represent the organisational climate for innovativeness.
After the survey was employed, qualitative methods, including 17 semi-structured
interviews and several weeks of observation, were used to enhance understanding
about social capital formation, maintenance, and influence on organisational
climate for innovativeness. Interviews consisted of open questions around themes,
such as innovative processes, social networks, team spirit, communication, politics,
education and satisfaction. Qualitative data was analysed with coding assistance
from QSR NViVO 9 software, before comparative analysis was used to develop
themes.
Using mixed methods provided an opportunity to gain a depth of understanding
that could not be achieved by either method in isolation. Triangulation of
qualitative and quantitative methods in this research provided a more complete
viewpoint combining micro and macro level results beyond a level of
understanding achievable with a single method. Triangulation between the
methods adds richness to understanding the complex moderators of the
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relationship between social capital and an organisational climate for
innovativeness, such as size and organisational structure.
This research found that each of the operating theatre suites investigated has
unique organisational contexts that influence social capital and organisational
climate for innovativeness. Findings indicate that social capital and organisational
climate for innovativeness should not be managed in isolation and that managers
need to consider organisational contextual factors such as size, structure and social
capital facilitation when facilitating organisational innovativeness.
This research makes an original contribution to theory and practice in an explicit
attempt to link social capital and organisational climate for innovativeness in an
organisational context. In doing so, it identifies important theoretical and
managerial implications of relevance to the relationship between social capital and
organisational climate for innovativeness.
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Statement of Originality

This work has not previously been submitted for a degree or diploma in any
university. To the best of my knowledge and belief, the thesis contains no material
previously published or written by another person except where due reference is
made in the thesis itself.

(Signed)_____________________________
Helen Patricia Black
viii
Table of Contents
Working together: Managing social capital to facilitate an organisational climate for
innovativeness in an acute health service context .......................................................... i
Abstract ............................................................................................................................ iii
Statement of Originality ................................................................................................. vii
List of Tables .................................................................................................................. xiii
List of Figures ................................................................................................................. xiv
Acknowledgements ........................................................................................................ xv
1 Introduction ............................................................................................................... 1
1.1 Background to research ...................................................................................... 2
1.2 Justification for research .................................................................................... 9
1.3 Research questions ........................................................................................... 10
1.4 Overview of the methodology .......................................................................... 10
1.5 Outline of the thesis .......................................................................................... 12
1.6 Definitions of key terms ................................................................................... 15
1.7 Delimitations of the scope ................................................................................ 16
1.8 Summary .......................................................................................................... 17
2 Health Context ........................................................................................................ 19
2.1 Introduction ...................................................................................................... 19
2.2 The Australian health system ........................................................................... 19
2.3 New South Wales (NSW) Health ..................................................................... 21
2.4 Local health districts ........................................................................................ 22
2.5 Hospital Management ....................................................................................... 23
2.6 Operating theatre suites .................................................................................... 26
2.7 Summary .......................................................................................................... 30
3 Social capital ........................................................................................................... 33
3.1 Introduction ...................................................................................................... 33
3.2 What is social capital? ...................................................................................... 34
3.3 Social capital as individual and collective asset ............................................... 37
3.4 Networks .......................................................................................................... 39
3.5 Network structures and tie strength .................................................................. 41
3.6 Trust .................................................................................................................. 45
3.7 Norms ............................................................................................................... 47
3.8 Summary .......................................................................................................... 49
4 Organisational context ............................................................................................ 53
4.1 Introduction ...................................................................................................... 53
4.2 The role of organisational context in the innovation process ........................... 54
4.2.1 Organisational structure ............................................................................ 55
4.3 Organisational climate and culture ................................................................... 57
4.3.1 Organisational climate .............................................................................. 59
4.4 Innovation and innovativeness ......................................................................... 61
4.4.1 Attributes of innovation ............................................................................ 63
4.4.2 Innovativeness ........................................................................................... 65
4.5 Dimensions of the organisational climate for innovativeness .......................... 67
4.5.1 Value of learning ....................................................................................... 68
4.5.2 Openness ................................................................................................... 69
4.5.3 Learning orientation .................................................................................. 70
4.5.4 Innovativeness ........................................................................................... 71
4.5.5 Organisational commitment ...................................................................... 72
4.5.6 Team spirit ................................................................................................ 73
4.5.7 Internal politics ......................................................................................... 74
4.5.8 Job satisfaction .......................................................................................... 76
4.5.9 Organisational climate for innovativeness ................................................ 77
4.6 Interaction of organisational climate for innovativeness and social capital ..... 77
4.7 Research Questions .......................................................................................... 79
4.8 Summary .......................................................................................................... 80
5 Methodology ........................................................................................................... 82
5.1 Introduction ...................................................................................................... 82
5.2 Research question and sub-questions ............................................................... 83
5.1 Methodology .................................................................................................... 84
5.2 Introduction and justification of the methods used .......................................... 86
5.3 Research cases .................................................................................................. 89
5.4 Quantitative data collection .............................................................................. 90
5.4.1 The survey questionnaire instrument ........................................................ 91
5.4.2 Pilot study ................................................................................................. 97
5.4.3 Survey distribution .................................................................................... 97
5.5 Quantitative data analysis ................................................................................. 98
5.5.1 Survey measures ....................................................................................... 99
5.5.2 Analysis Technique ................................................................................. 103
5.5.3 Levene’s test for homogeneity ................................................................ 103
5.5.4 Analysis of Variance (ANOVA) and t-testing ........................................ 104
5.5.5 Linear and moderation modelling ........................................................... 106
5.6 Qualitative data collection .............................................................................. 106
5.6.1 Semi-structured Interviews ..................................................................... 106
5.6.2 Observation ............................................................................................. 108
5.6.3 Reflective journal .................................................................................... 109
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