Extensive research has been conducted to define the characteristics of high performance; far less has been done to determine what enables it to be sustained. This study explores that very question; what supports the sustainability of high performance? In reviewing a three year period of data from 2002-2004, twelve hospital facilities in a large US healthcare system were identified as high performers based on consistently strong results in employee engagement, patient satisfaction, employee turnover, internal productivity measures, and superior performance in both financial and quality outcomes. In following these high performers for a second three year period from 2005-2007, a subset of nine facilities continued to outperform the system, while three struggled to maintain consistent results. Using a combination of grounded and generative theory methods, this study explores the intricacies, forces and factors that enabled this group of high performers to sustain their performance.
The findings reveal sustained high performance is not a permanent state that an organization simply achieves. Rather, sustaining high performance is an ongoing effort based on continuous action. Through engaging in three critical "movements": collective/individualism, agile/consistency, and informative/inquiry—as active polarities, the facilities in the study transcended common organization paradoxes that often act as impediments to progress. Ultimately, the study suggests sustaining performance is realized through an organization's willingness and ability to be in perpetual movement around these three polarities. This movement is grounded in an intricate and dynamic balancing that eclipses either/or solutions and instead holds the possibility for a state of both/and. It is in transcending paradox—through movement and in the dynamic balancing of these key polarities—that sustaining high performance is possible. The dissertation concludes by offering implications for future research and recommendations for practice in sustaining high performance.
|Advisor:||Ludema, James D.|
|School Location:||United States -- Illinois|
|Source:||DAI-A 70/02, Dissertation Abstracts International|
|Subjects:||Management, Organizational behavior, Health care management|
|Keywords:||Corporate culture, Health care system, Healthcare/health care, High-performance, Leadership, Management, Organization development, Organizational change|
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