Abstract
This chapter examined the organizations of a university dealing with healthcare and clinical activities operating in an extremely complex network connection. In the framework of qualitative research, with the help of a series of interviews, the authors researched in which networks the university's healthcare organization and organizational units participate, and how participation in these networks influences the value creation implemented in each field. By what means can the organization handle the contradictions and conflicts that arise along the inter-organizational relations embedded in the networks. Interviews were conducted with institution leaders, business leaders, and care workers. Based on the research results, network complexity results in three types of conflicts in healthcare institutions: conflicts related to organizational management, conflicts arising in organizational processes, and personal conflicts.
TopThe Theoretical Background Of The Topic
Health Care as a Complex Network
Organizations are embedded in extremely heterogeneous networks. These networks provide resources, opportunities, and inter-organizational ties (through which resources and opportunities become available); in addition, they provide a position that makes it possible to exploit resources and opportunities (Uzzi, 1996). The extent and multiplexity of inter-organizational relationships determine the value creation, identity, and performance of organizations (Shipilov et al., 2014). This phenomenon is not only observed in business organizations, but also in such non-business areas with complex networks as healthcare (Provan & Sebastian, 1998).
Berry et al. (2004) distinguishes four types of networks in the public sector. Social networks, which describe interpersonal relationships, policy networks which focus on forming and shaping public policies, public management networks which include actors involved in the micro-implementation of a given service and their relationships. Finally, governance networks, which are aimed at coordinating the activities of actors involved in public services. The types and forms of each network are well captured, but their objectives and rules are different. An actor is not only a member of one type of network, but, where appropriate, it is a member of all the networks, which means that this actor in its operation forces the conflicting and parallel management of different logics and rules.
Healthcare-operated markets in themselves constitute a connectivity market, where the functions of the institutions require a multifaceted use of individual units and resources (Launberg, 2011; Wagrell, 2011), however, medical institutions with a university background have a multiplied network embeddedness in addition to the above. They organize their activities and allocate their resources along a number of functions (production, development, use) (Launberg, 2011). Of course, the appearance of individual functions or a combinations of these functions may have a different character in each clinical organizations but along the lines of each function, these organizations operate under the expectations and constraints of countless networks, which forces complex network management (Chakraborty & Dobrzykowski, 2013). Chakraborty and Dobrzykowski (2013) understand the characteristics that go towards this complexity, based on the concept of complexity, according to which complexity (as a complexity) is subjective, its meaning and value formed and changed according to the purpose of the system considered. In their work, they capture five characteristics to characterize the complexity of clinical networks: (1) the number of subsystems, such as the number of networks in which organizations are embedded in the operation; (2) the existence of reciprocal relations between the participants of each network; (3) the volume and frequency of interactions between the clinical organization and the members of the related networks; (4) the quality and nature of the relationships and (5) level of discrimination between actors. This multiple embeddedness results in a number of conflicts among participants.
Key Terms in this Chapter
Levels of Conflict Within the Organisation: Organisational governance conflicts, which are related to organisation government and development, process conflicts, which concern the implementation of processes and the value creation, and finally personal conflicts, which can be moral or career conflicts.
Complex Network: The networks provide resources, opportunities, and inter-organizational ties (through which resources and opportunities become available); in addition, they provide a position that makes it possible to exploit resources and opportunities. The extent and multiplexity of inter-organizational relationships determine the value creation, identity, and performance of organizations.
Intra-Organisational Conflicts: Conflicts that arise at the individual and group levels in relation to the functioning of the organisation. These can be intrapersonal conflicts, where individuals' own needs and desires conflict, or interpersonal conflicts, where conflicts arise between the views, desires and needs of at least two or more individuals.
Conflicts in Networks: Conflict can be seen as an interactive process that manifests itself in conflict of interest, disagreement or dissonance within or between actors. Conflicts can arise for a variety of reasons: interests, preferences, mutually exclusive use of resources, values, behaviours, or as a result of conflicting, interdependent performances.
Social Embeddedness: The integration mechanisms of the economy are linked to specific social and institutional conditions. The cognitive, cultural, structural and political aspects of the social embeddedness of economic actions have an impact on the functioning of health care organisations.