managing for shared purpose: how … for shared purpose: how business enterprises scale-up...

MANAGINGFORSHAREDPURPOSE:HOWBUSINESSENTERPRISESSCALE-UPVALUE-RATIONALITYFROMCOLLEGIALITYTOCOLLABORATIONPaulS.Adler(UnivofSouthernCalifornia)CharlesHeckscher(Rutgers)DraftMarch6,2016PleasedonotcirculateAbstract

Thispaperaimstocharacterizetheorganizationalform(ordesign)thatcansupporta

sharedcommitmenttothebusinessenterprise’s“purpose.”Purposeherereferstotheorganization’sfundamentalraisond’ȇtre–whatitcontributestosociety.Aconsiderablebodyoforganizationaltheoryteachesusthat(a)incontextswheretasksarerelativelyknowledge-intensive,interdependent,andnon-routine,organizationalperformancewilldepend(ceterisparibus)onthediscretionaryeffort,cooperation,andcreativityofarelativelywideswatheofemployees,and(b)thesebehaviorswillbeencouragedbyasenseofsharedpurpose.Notwithstandingtheconsiderabledifficultiesinvolved,manyenterprisesattempttoinstillsuchasenseofpurpose.Currenttheoryprovideslittleguidanceastotheorganizationalformthatwouldsustainthissharedcommitment.

Tocharacterizethatform,webuildonMaxWeber’sanalysisofthefourbasicideal-typesofsocialactionandthecorrespondingideal-typesoforganization.Ourargumentproceedsintwosteps.First,wearguethatcreatingandsustainingpurposerequiresanorganizationalformthatinstitutionalizesthevalue-rationaltypeofaction.Webercharacterizedsuchaforminhisdiscussionofthecollegialtypeoforganization.However,Weber,likemanysincehim,alsoarguedthatthecollegialtypecannotbesustainedinlarger,moreheterogeneous,capitalistenterprisesunderperformancepressure.Insuchsettings,theseskepticsassert,value-rationalityandthecorrespondingcollegialtypeoforganizationinevitablygivewaytoinstrumental-rationalityandthecorrespondingbureaucratictype.

Second,inresponse,wearguethatthegroundsforthisskepticismhavebeenprogressivelyerodedbyasuccessionofmanagementinnovationsdevelopedoverthecenturythatseparatesusfromWeber’swritings.Thissustained,albeitdispersed,innovationefforthasgivenrisetoafamilyofneworganizationaltechnologiesthatenablethescaling-upofvalue-rationality.Thisclusterofinnovationsyieldsadistinctvariantofthevalue-rational-basedorganizationalideal-type,onethatwecall“collaborative.”

Thiscollaborativemodelsitsuneasilywithintheprofitabilityconstraintsofthebusinesssector.Whilethoseprofitabilityconstraintssometimesencouragetheemergenceofthecollaborativeform,theysometimesundermineit,inparticularbypushingexecutivestomakedecisionsthatreinforceemployees’instrumentalorientationorthatcontradictemployees’understandingoftheorganization’spurpose.Asaresult,theimplementationofthiscollaborativemodelisprecarious,evenasthemodelitselfhasbeenprogressivelyrefinedthroughthesevariousmanagementinnovations.Thisprecariousnesshasrenderedalmostinvisiblethatprogress,andweaimtoremedythisinvisibilitybyshowinghowthesevariousmanagerialinnovationsresolvethefundamentalchallengesinvolvedinscaling-upvalue-rationality.

Fromcollegialitytocollaborationp.2

MANAGINGFORSHAREDPURPOSE:HOWBUSINESSENTERPRISESSCALE-UPVALUE-RATIONALITYFROMCOLLEGIALITYTOCOLLABORATION

Underbothcompetitiveandsocial-culturalpressure,manybusinessenterprisesattemptto

createasharedcommitmenttotheorganization’spurpose(Hollensbe,Wookey,Hickey,George,&Nichols,2014:1228).Thispaperattemptstocharacterizetheorganizationalform(ordesign)thatcansupportsuchpurpose.

Byorganizationalpurposewerefertotheultimatereasonfortheorganization’sexistence—whatitcontributestosociety—asdistinctfromthegoalspursuedbytheindividualsinit.Bycommitmenttothispurpose,wemeana“volitionalpsychologicalbondreflectingdedicationtoandresponsibilityfor”thispurpose(Klein,Molloy,&Brinsfield,2012).Bysharedcommitment,werefertothecommitmentexperiencedbyalargeproportionoftheorganization’smembers:thedegreeofsharingmayvary,butataminimum,itgoesbeyondthetopmanagementteam.Forthesakeofsimplicity,wewillhenceforthrefertothisconstructas“sharedpurpose”orsimply“purpose.”

Purposematters,amongotherthings,formotivation.Purposeisrelatedtothejobcharacteristicsmodelconceptof“tasksignificance”—thefeelingthatone’sjobwillhaveanimpactonthewell-beingofothers(Grant,2008;Hackman&Oldham,1976;Humphrey,Nahrgang,&Morgeson,2007).Ourfocushere,however,isnotonwhatIdoandmyeffectsonotherpeople:itisonwhatwedoasanorganizationandtheimpactofourcollectiveeffortsonthebroadersociety.Ourfocalquestionisnotaboutindividualpsychologybutaboutorganizationaldesign.Purposeinoursenseismorecloselyrelatedtoconceptssuchasorganizationalmission—howtheorganizationaimstofulfillitspurpose—andorganizationalvision—whattheorganization(orthesocietyitserves)willlooklikeifitspurposeisfulfilled.

Usingpurposeinthissense,BillGeorge,formerMedtronicChairman,expressedhisviewofitsimportancethisway:

“Everyonewantstobefairlycompensatedforhisorherefforts.Butthatisnotenoughfortoday'semployees.Theirrealmotivationcomesfrombelievingthattheirworkhasapurpose,andthattheyareapartofalargerefforttoachievesomethingtrulyworthwhile.Whenacompanyoffersthemthissenseofpurposeconsistentlyoveralongperiodoftime—withoutdeviatingandwithoutvacillating—thenemployeeswillbuyintothecompany'smissionandmakethecommitmenttofulfillingit.Theywillgotheextramiletoservecustomers.Thatmaymeanworkingwellintothenightoracceleratingthetimetableforacrucialnew-productintroduction”(George,2001).

AndpurposeneednotbeasexaltedaswemightfindinamedicaldevicescompanysuchasMedtronic.Arguably,FederalExpress’s“Absolutely,positivelyovernight”hasplaysasimilarroleinamuchmoremundanebusiness.

WeneednotacceptatfacevaluesuchbroadassertionsasGeorge’snorthesimilaronesmadebywriterssuchasCollinsandPorras(1996)toacceptasastartingpointthatinatleastinsomesettingspurposemattersforemployeemotivationandtherebyforfirmperformance.Indeed,aconsiderablebodyoforganizationaltheoryteachesus(a)thatincontextswheretasksarerelativelyknowledge-intensive,interdependent,andnon-routine,organizationalperformancewilldepend(ceterisparibus)onthediscretionaryeffort,cooperation,andcreativityofarelativelywideswatheofemployees,and(b)thatthesecollaborativebehaviorswillbeencouragedbyasharedcommitmenttotheorganization’spurpose(Adler,2001;Foss&Lindenberg,2013;Grant,1996).Asreviewedinmoredetailbelow,theorysuggeststhatinsuchcontextsrequiringextensivecollaboration,nocombinationoffinancialincentivesandbureaucraticcommandswillbeaseffectiveasthespontaneouseffortsencouragedbyastrongcommitmenttothatcommonpurpose.

Whatorganizationalformcouldsupportsuchpurpose?Asweshowbelow,scholarlyresearchonpurposehasonlyrecentlyresumedafteralonghiatus,andasyetwehavelittletheoreticalletaloneempiricalguidanceonthiskeyissue.Withtheaimofestablishingatheoretical

platformforfutureresearch,weturninthepresentpapertoMaxWeber’sanalysisoffourbasictypesofsocialactionandthecorrespondingtypesoforganization.

OuruseofWeberproceedsintwosteps--appropriation,thenextension.First,weappropriateakeyconceptfromWeber,toproposethattheidealorganizationalformforsupportingsharedpurposeisonethatinstitutionalizesvalue-rationalactionasthemodal,taken-for-grantedtype.Weberdefinesvalue-rationalactioninawayhighlycongruentwiththeideaofsharedpurpose,asaction“determinedbytheconsciousbeliefinthevalue,foritsownsake,ofsomeethical,religious,political,aestheticorotherformofbehavior,independentlyofitsprospectsofsuccess”(Weber,1968,p. 24).Here,theendsofaction—designinglife-savingmedicaldevicesorfulfillingthepromiseofovernightdelivery—arenotthemselvesunderstoodasmerelymeanstosomeotherends,butarepursuedfortheirownsake,asintrinsicallyvaluabletothebroadersociety.Value-rationalactionischaracterizedbycontinualandrationalconsiderationofsuchultimatevaluesinchartingtheappropriatecourseofconduct.Sharedpurposewouldbesupportedbest,weargue,byanorganizationalforminwhicheveryoneorientedtheirbehaviortothatultimatevalue.Ultimatevaluesvary,ofcourse,acrossindividualsandorganizations:weareinterestedhereinthosethatinformtheraisond’ȇtreofthebusinessenterprise,andwethereforefocusonexternally-orientedvaluesthatspeakto“howweservesociety,”asdistinctfrominternally-orientedvaluessuchas“integrity”(Amann,2012)or“loyalty”(Reichheld&Teal,2001)thatexpressintra-organizationalaspirationsthatspeakto“whoweare.”

Thereisconsiderabledoubt,however,thatvalue-rationalitycanbeinstitutionalizedinlarger,moreheterogeneousenterprisesunderperformancepressure.Weberhimselfthoughtnot.Hesawvalue-rationalityservingasthefoundationforwhathecalledthe“collegial”typeoforganization,wheresharedsocializationandsmallscalewouldsupportahighlyegalitariandecision-makingstructureorientedtoanultimatevalue(Satow,1975;Waters,1989;Weber,1978,pp.263,271-82,994-98,1089-90);buthewasbluntinhisconclusionthatoncesuchanorganizationcameunderthepressuresofgreatersize,functionalcomplexity,heterogeneousskills,andintensifiedperformancedemands,value-rationalactioncouldnolongerbesustainedasthemodalformofaction,andcollegialitywouldnecessarilymutateintoinstrumentally-rationalbureaucracy(Weber,1978:p.271ff.).Inabureaucracy,theorganization’spurposeistheprovinceofthetopmanagementteam:therestoftheorganizationismobilizedtoactinwaysconsistentwiththatpurposethroughhierarchicalauthority,incentives,andproceduresratherthanthroughcommitment.

ThesecondstepinourargumentisthereforetoextendWeber,byarguingthatthegroundsforWeber’sskepticismhavebeenprogressivelyerodedbyasuccessionofmanagementinnovationsdevelopedoverthecenturythatseparatesusfromhiswritings.Thissustained,albeitdispersed,innovationefforthasgivenrisetoafamilyofneworganizationaltechnologiesthatenablethescaling-upofvalue-rationalitysothatitcangroundlarge,complexorganizationsunderperformancepressure.Wewillhighlightthesignificanceofabroadrangeofinnovationsinstrategyprocesses,operationalsystems,reportingstructures,aswellasskillformationandcompensationpolicies.Thisclusterofinnovationsyieldsamutationthattakesusfromcollegialitytoadistinctiveorganizationalformwithinthevalue-rational-basedideal-type,onethatwecall“collaborative.”

Thiscollaborativeform(ordesignormodel–wewillusethetermsinterchangeably)sitsuneasilywithintheprofitabilityconstraintsofthebusinesssector.Whilethoseprofitabilityconstraintssometimesencouragetheemergenceofthecollaborativeform,theysometimesundermineit,inparticularbypushingexecutivestomakedecisionsthatreinforceemployees’instrumentalorientationorthatcontradictemployees’understandingoftheorganization’spurpose.Asaresult,theimplementationofthiscollaborativemodelisprecarious,evenasthemodelitselfhasbeenprogressivelyrefinedthroughthesevariousmanagementinnovations.Thisprecariousnesshasrenderedalmostinvisiblethatprogress,andweaimtoremedythisinvisibility

byshowinghowthesevariousmanagerialinnovationsresolvethefundamentalchallengesinvolvedinscaling-upvalue-rationality.

Webeginbyclarifyingfurthertheconceptofpurposeandidentifythekeypracticalimpedimentstoachievingit.Wethenexplainwhyvalue-rationalitywouldbeasuitablefoundationforanorganizationalformaimingtosurmountthoseimpediments.ThesubsequentsectionusesWeber’stheorytoidentifyfourkeychallengesfacingeffortstoscaleupvalue-rationality.WethenleverageotherconceptsinWeber’scorpustocharacterizetheoreticallytheorganizationalprinciplesthatcanovercomeeachofthosechallenges,andweidentifyseveralmanagementtechniquesthatembodyeachofthoseprinciplesandthatjointlycharacterizetheemergentcollaborativeform.Toillustratethesetechniquesandshowhowtheycanbecombined,wedrawonseveralstudiesofonelargehealthcaredeliveryorganization.Weconcludebydiscussingwherethiscollaborativemodelmightbemostversusleastusefulandunderwhatconditionsitismoreversuslesslikelytoemergeandstabilize.

PURPOSEANDITSIMPEDIMENTSTheideaofpurposehasonlyrecentlyresurfacedinmanagementdiscourseafteralong

periodofneglect(Singleton,2014;Singleton,2011).MaryParkerFollettwrotein1927:“Theleaderreleasesenergy,unitesenergies,andallwiththeobjectnotonlyofcarryingoutapurpose,butofcreatingfurtherandlargerpurposes.AndIdonotmeanherebylargerpurposesmergersormorebranches;Ispeakoflargerinthequalitativeratherthanthequantitativesense.Imeanpurposeswhichwillincludemoreofthosefundamentalvaluesforwhichmostofusagreewearereallyliving.”(Follett,Metcalf,&Urwick,1942:168).

Adecadelater,ChesterBarnardfurtherdevelopedthisidea,arguingthatformalorganizationsweredefinedbytheconjunctionofpurpose,participantswillingtoservethatpurpose,andacommunicationsystemtyingtheireffortstogether(Barnard,1938:82).Barnardsawpurposeinoursenseasauniversalrequirementinbusiness.Hepostulatedthattheorganizationcouldnotbeeffectiveunlessitfunctionedasa“cooperative”system,bywhichhemeantthatallitspersonnelwerewillingtosubordinatetheirpersonalneedsandpreferencestothecooperativepursuitofthatpurpose.Theprimaryfunctionofthecommunicationsystemwasnottocommunicatemanagementordersdownward,butratherto“inculcate”thissenseofpurposeacrosstheentireorganization:“Theinculcationofbeliefintherealexistenceofacommonpurposeisanessentialexecutivefunction”(Barnard,1938:87).

SinceBarnard,somepopularbusinesswriterscontinuedtohighlightthecentralityofpurpose.PeterDrucker,forexample,arguedthatthepurposeofthefirmcouldonlybetomeetacustomer’sneeds,thatthispurposeshouldtakeprecedenceoverthesearchforprofits,thatthislogicalorderingwouldbethebestwaytoassurelong-termprofitability,andthatthecustomer’sneedsshouldguidethedailyworkofeveryoneintheorganization(Drucker&Maciariello,2008:101).Morerecently,CollinsandPorras(Collins&Porras,1996;Porras&Collins,1997)havesoughttomaketheconceptofpurposecentraltotheirtheoryoforganizationalandstrategiceffectiveness.

Scholars,however,havelongbeenskepticalofwhattheysawastheexcessivelynormativeframingimpliedbytheconceptofpurpose.Indeed,avenerablelineageoforganizationtheoryhasbeenskepticalofthepracticalsignificanceoftheconceptoforganizationalpurpose,asnotedbyMarchandSutton(1997):

“Organizationsarecommonlydefinedasinstrumentsofpurpose.Theyareseenascoordinatedbyintentionsandgoals.Suchaformulationhasoftentroubledstudentsoforganizations.Itisnotclearthatorganizationalpurposecanbeportrayedasunitaryorthatthemultiplepurposesofanorganizationarereliablyconsistent.Itisnotclearthatasingleconceptionofpurposesissharedamongparticipantsinanorganization”(March&Sutton,1997:698).

Letusbrieflyreviewthemainreasonsforthisskepticism.Theyfallintotwoclusters:lackofpurposeandmultiplicityofpurposes.

First,somescholarsarguethatbusinessenterprisestodayarestillmostlybasedonwage-labor—alternativegovernancestructuressuchasself-employmentandpartnershipsarerelativelyrare—andinsuchorganizations,employees’relationtotheenterpriseareessentiallyinstrumental.Suchapremiseissharedbybothstandardmicro-economictheoryandalonglineageofcriticalsociology(Bendix,1956;Etzioni,1975;Marx,1990[1867]).Employeesworktoearnawage,nottoparticipateinthepursuitofanycollectivepurposethattheirmanagersmighthaveinview.Inthissamelineofreasoning,manyarguethateveniftheideaofsharedpurposeisattractiveformotivationalreasons,managersofbusinessorganizationsmustfirstandforemostsatisfythedemandsofinvestorsforthehighestpossiblefinancialreturns:iftheultimatepurposeofthefirmistoenrichinvestors,suchapurposeisunlikelytogarnerthecommitmentofmanyemployees(Marens,2009).

Thesecondimpedimentisthepossiblemultiplicityofpurposes.Purposeswithinthecapitalistfirmareoftenintensionwitheachother.Themostprominenttensionconcernsprofit.Profitisitselfanultimatevalueinourcapitalistsociety,inthesensethatactionsaimingatincreasingprofitareceterisparibusregardedaslegitimate;torealizeanyprofits,however,thefirmmustprovideuse-valuesdesiredbyitscustomers,and“providingvaluetoourcustomers”isinthissenseanequallyimportantultimatevalue;butthepressuresfrominvestorstomaximizeprofitsarenotalwayseasytoreconcilewiththepressuresfromcustomersforhigh-qualityuse-values.1Moreover,ontheuse-valuesideofthistension,therearetypicallymultipledimensionsofqualitywhoserelativeimportanceiscontested.Notsurprisingly,therefore,weoftenfindthatdifferentgroupswithintheorganizationpursuedivergentpurposes.Inahospitalforexample,wemightfindthatdoctors,nurses,patients,andadministratorsallhavedifferentviewsofultimatepurposeoftheorganization(e.g.Morgan&Ogbonna,2008).

Notwithstandingthechallengesinvolved,someexecutivesseethepotentialbenefitsofsharedpurposeassufficienttowarrantseriouseffortstomovefroma“contested”or“estranged”relationshipamongtheircompetingpurposestoan“aligned”relationship(BesharovandSmith2014),fromsegmentingorcompromisesolutionstocreativeintegrationandsynthesissolutions(BattilanaandLee2014,PrattandForeman2000),andfrommultiple,competing,materialgoalstoasharedpurpose(BartlettandGhoshal1994,2002;Cartonetal2015).

VALUE-RATIONALITYASTHEPATHTOPURPOSETheprevioussectionleadsustotheconclusionthateffortstocreateandsustainshared

purposeencounterimportantpracticalimpediments,butthattheseimpedimentsdonotdetereveryonefromtrying.Thosewhowouldtry,however,findverylittletheoreticalguidanceontheformoforganizationthatcouldsupporttheirefforts.Thepresentpaperadvancesthepropositionthatsharedpurposecanbecreatedandsustainedifvalue-rationalitycanbeinstitutionalizedasthemodal,taken-for-grantedtypeofsocialactionwithintheorganization.Inthissection,wecontrast

1Asweseeit,bothprofitanduse-valueare“ultimatevalues”:thedebatebetweenthosewhoseethefundamentalpurposeofthefirmascreatingshareholderwealthandthosewhoseeitasmeetingtheneedsofcustomersandotherstakeholders(forexampleFreeman,Wicks,andParmar(2004);SundaramandInkpen(2004))seemstoustomissanessentialpoint—thatthecapitalistfirmischaracterizedpreciselybythetensionbetweenthesetwosetsofvalues:theysometimesreinforceeachother,butsometimesnot.Thedisjunctionbetweenthetwosetsofvaluesisnotonlyacontingentresultoftheconfrontationofthecomplexityoftheworldwithhumanfrailties—forexample,inourdifficultyseeinghowtoreconcileshort-termandlong-termgoals—butastructuralfeatureofourcapitalisteconomies,afeaturethatgivesitbothitscharacteristicdynamismanditsmarketfailures.

value-rationalitywiththeothertypesofaction,andinthefollowingsectionweidentifyfourkeychallengesinsustainingvalue-rationalityinlarge,complexbusinessenterprises.

MaxWeberarguedthatsocialaction—ourinteractionswithotherpeople—canbecharacterizedintermsoffourbasictypes(Weber,1978:24ff.).Andeachofthesefourtypesofactioncanbeinstitutionalizedasthemodaltypeofactioninadistinctideal-typeoforganization.Inpractice,realactionandrealorganizationstypicallyinvolveamixofthesetypes.

AsnotedintheIntroduction,value-rationalactionisactionorientedtowardssomeultimatevalue—agoalthatisnotmerelyameanstosomeotherend.Value-rationalitygroundsthe“collegial”organizationaltype:agroupofequals,makingdecisionsbasedonconsensus,boundtogetherbytheircommoncommitmenttothatultimatevalue.Oneexample:doctorsshareacommitmenttotheultimatevalueofrestoringthehealthofthepatient,andthiscommonpurposeenablessmoothintegrationoftheirvariouseffortsasthegathertodiagnoseandcureapatient.Doctors’cooperationwillbefarlesseffectiveifitisdrivenexclusivelybyfinancialincentivesorbureaucratically-definedprocedures(James,2012).Tobemaximallyeffective,doctorscanneverlosesightoftheend-valueoftheiractions—thepatient’shealth—butmustcontinuallyorienttheiractionbyexplicitreferencetothisultimatepurpose:thisputsthemsquarelyinthecategoryofvalue-rationalaction.

Theconceptualproximityofpurposetotheideaofvalue-rationalactioncanbecontrastedwithitsconceptualdistancefromtheotherthreetypesofaction.Weaddresstheseinturn.

Affectualaction—whereactionisorientedbyemotionalattachments—groundsthecharismatictypeoforganization,whichisbasedonanemotionalconnectiontoaninspiringleaderandhisorhervision.Affectualaction,likevalue-rationalaction,isorientedbyafocusonitsendsratherthanitsmeans,but,unlikevalue-rationalaction,itisnon-rationalinitschoiceofbothmeansandends.Asaresult,thecharismaticorganizationaltypecansupportsharedpurposeinsmaller,morehomogeneousorganizations(Ling,Simsek,Lubatkin,&Veiga,2008);anditcanbeveryeffectivewherethepurposeisessentiallycreativeandrevolutionary(Howell&Avolio,1993;Jyoti&Dev,2015);butitisunsuitedtosustainingpurposeinlarger,morecomplexbusinessenterpriseswherepurposeinvolvesnotonlycreativeinnovationbutalsodisciplinedefficiency(Pillai&Meindl,1998;Weber,1978:Vol.2,Ch.III).

Actionistraditional(“traditionalistic”wouldbealessambiguoustranslation)whenitisorientedbyreverenceforestablishedcustoms.Traditionalisticactiongroundstheclantypeoforganization.(Onthisgrounding,seeOuchi(1979:838);OuchiandJaeger(1978:307).)Actionandorganizationherearenotgoal-oriented,butdefinedbytheactors’non-rationalattachmenttospecificmeans.Traditionalisticactionandorganizationarethereforeweakatcultivatingasharedcommitmenttoassuringthattheenterpriseprovidevaluetotherestofsociety.

Actionisinstrumentally-rationalwhenitisorientedtoselectingthemostefficientmeansforachievingagiven,taken-for-grantedendofindividualmaterialself-interest.Instrumentally-rationalactionsgroundstwocomplementaryorganizationalforms—thelegal-rationalbureaucracyandthecompetitivemarket:inbothcases,individualmaterialinterestsbindthecollectivity.2AsWeberargued,bureaucracyisaverypowerfulmeansbywhich“masters”(topexecutives)can

2Toclarifyourterminology:Wewillusethetermorganizationaltypetorefertothefour“ideal-types”oforganizationdelineatedbyWeber.Wewillusethetermsform,design,andmodelinterchangeablytorefertothemoreconcreteexpressionsoftheseideal-types.Thus,thelegal-rationalideal-typeyieldstworelatedorganizationalforms—bureaucracyandmarket.Similarly,wewillarguebelowthatthevalue-rational-basedideal-typeyieldstworelatedorganizationalforms—collegialandcollaborative.

orchestratetheactionofotherstoachievethesemasters’purposes,butbothbureaucracyandmarketarepoorvehiclesforbuildingsharedcommitmenttoorganizationalpurpose.3

Thisfour-folddistinctionhelpsusidentifytheimportancebutalsothelimitationsofSelznick’sclassicworkonLeadershipinAdministration(Selznick,1957).Selznickheredistinguishesthe“technical”fromthe“institutional”dimensionsoftheorganization.Thetechnicaldimensioncallsfordeploymentofinstrumentally-rationalbureaucraticstructures.Theinstitutionaldimensionrequiresthearticulationand“institutionalembodiment”oforganizationalpurpose.Byinstitutionalembodiment,Selznickreferstothedeploymentofbothformalandinformalstructuretoconsolidatethesalienceandacceptanceofpurpose(Besharov&Khurana,2015;Hinings&Greenwood,2015).ButSelznick’sportraitoftheorganizationasavalue-infusedinstitutionwithpurposereliesonamixoftraditionalisticandaffectual-charismaticmechanisms:nowhereinthisvolumenorinhislaterMoralCommonwealth(1994)doesSelznickrefereitherexplicitlyorimplicitlytovalue-rationalityorcollegiality.WenoteinpassingthatEtzioni’s“normative”typeoforganization(contrastedwiththeutilitarianandcoercivetypes)isevennarrower,relyingentirelyoncharismaasthesourceofthesharednormsandgoals(Etzioni,1975:XII,XIII).Mintzberg’s“missionary”typeisinthisrespectidenticaltoEtzioni’snormativetype(Mintzberg,1989:ch.12).Theseclassicsoforganizationalsociologythusofferlittleinsightintoourcentralquestion.

FOURCHALLENGESINSCALING-UPVALUE-RATIONALITYAswenotedintheIntroduction,Weberarguedthatvalue-rationalitycouldbe

institutionalizedininsmall-scalecollegialgroups,buthedoubtedthatvalue-rationalitycouldbesustainedinlarger,morecomplexorganizationsunderpressuretomake“precise,clear,andaboveall,rapiddecisions”(Weber,1978:Vol.I,p.277).Inhisview,value-rationalitylackedafeatureessentialforsuchsizeandcomplexity,namely“legitimatedomination”andtheassociatedcapacityforimperativecommand.Indeed,aswehavejustseen,undervalue-rationality,actors’behaviorisorientedaboveallbytheirpersonalcommitmenttoultimateend-values;inasocialorderbasedonvalue-rationality,actioniscoordinatedamongactorsnotbycommandsbutbytheirsharedcommitmentthoseend-values.SuchasocialorderisthereforeapoorinstrumentforHerrschaft—forimplementingthedominatingwillofamaster.Morerecentscholarshiphasoftenconcurred(Mommsen,1974;Waters,1989),andperhapsitisthisskepticismthatexplainsthelacunawenotedaboveinSelznick,Etzioni,andMintzberg.

AfewothersociologistssinceWeberhavebeenmoreoptimisticaboutthepossibilityofscalingupvalue-rationality,thinkingofthetaskascreatingnotaformofadministrationthatwouldsustainHerrschaft,butaformofself-governmentbyacollectivity.Thesescholarshaveclaimedthatvalue-rationalityfunctionsasthecentralorganizingprincipleofsuchlarge-scalecollectivitiesasideologically-drivenpoliticalparties(Willer,1967),constitutionalstates(Spencer,1970),autonomousprofessionalorganizations(Satow,1975),andsome“alternative”cooperatives(Rothschild-Whitt,1979).HeckscherandAdler(2006)extendthismoreoptimisticaccountwithasetofcasestudiesthathighlighttheemergenceofthevalue-rationalforminthecontemporarycorporatesector.

Skepticscounterthatinthesecases,truevalue-rationalityistypicallyprecarious.Evenradicalpoliticalpartiesoftensuccumbtothe“ironlawofoligarchy”(Michels,1966);constitutionalstatesoftenbecomeauthoritarianwhentheirdominantpowersarechallenged(Schmitt,1988);

3Notethatthetaken-for-grantedend-valueofinstrumental-rationalityisnotalwayspresentedinthescholarlyliteratureasindividualmaterialself-interest;butWallace(1990)quotingWeber(1978:p.30,331)makesaconvincingcasethatthisisthelogicalimplicationofpositinginstrumental-rationalityasatypeofactionuntoitself,ratherthanmerelyasacontingentfeatureoftheotherthreetypes.

liberalprofessionsoftendevolveintoself-interestedmonopolies(Brint,1994;Waters,1989);andcooperativeundertakingsoftenreverttohierarchicaldomination(Freeman,1972).

Wecantracethechallengesinscaling-upvalue-rationalityineachoffourdimensionsoforganization.Werevieweachbrieflynowandthesubsequentsectiondiscusseshowtheymightbeovercome.Values:fragmentation.

Valuesplaythepivotalroleinvalue-rationalaction,andsharedvalues—intheformofpurpose—playthecentralroleinassuringthecohesionofacollegialstructure.Butthiscohesiondependsonsharedoccupationalsocialization,andasaresult,collegialstructuresrelyonoccupationalhomogeneity.Howthencanasenseofsharedpurposebecreatedandsustainedacrossanenterpriserequiringthecoordinatedeffortsofmultipledifferentoccupations?More:eveniftheyshareacommonbackground,oncepeopleareemployedbytheenterpriseandassignedtoadistinctsubunitwithaspecificsetsoftasks,newsubunitsub-culturesemerge:howcanthatsharedvaluecommitmentbesustainedinthecontextofsuchsubunitdifferentiation?Howcanpurpose’ssaliencebemaintainedgiventhepressofmoreimmediatedailytasks,diverseinterests,anddiverseidentities(Martin,1992)?Norms:goaldisplacement

Normsarethebehavioralexpectationsmembershaveofeachotherinthespecializedrolestheyplayatwork.Anylarger,morecomplexorganizationunderperformancepressurewillneedtostandardizeandformalizesomeofthesenorms(forexample,as“bestpractices”)inordertoachieveacceptablelevelsofefficiencyandcontrol.TheresultingchallengeisonedescribedbyMerton(1940)as“goaldisplacement”:insteadoforientingtheirconducttowardtheultimatevalue(purpose),memberswillorientthemselvestotheirsuperiors’demandforconformancewiththeseprocedures.Authority:centralization.

Atasmallscale,thecollegialstructure—aflatstructurecharacterizedbymutualadaptationamongpeers—sufficestocoordinateaction.Butatlargescaleandwithfunctionallydifferentiatedsubunits,organizationsunderperformancepressurecannotoperateeffectivelywithoutahierarchyofauthority(Jaques,1989).Thishierarchicalauthoritystructureinturnchallengestheveryfoundationofvalue-rationalaction,whichisactionwhereactorsdecideforthemselvesonthemostappropriatecourseofconductasafunctionoftheirowncommitmenttotheultimatevalue. Capabilities:specialization.

Largercomplexenterprisesrelyonspecializedskillsandonsubunitsthatgrouptogethersuchspecialties.Suchdifferentiationposesintegrationchallenges,bothbecauseactors’skillsetsarenarrowed,andbecausetheycometovaluetheirown“thoughtworld”overothers(Dougherty,1992).Thestandardmechanismsforcoordinatingthesesubunits—standards,plans,andspecializedintegratingroles—areeffectivepreciselybecausetheyobviatetheneedforwidelysharedpurpose,leavingthegreatermassofmembersfreetocultivatetheirspecializedskillsandtofocusonsubunits’localgoals(Galbraith,1973;Grant&Baden-Fuller,1995).Whengreatertaskinterdependencerequiresmoreintensivecross-unitintegration,theappropriatemechanismisthecross-functionalteam(VandeVen,Delbecq,&Koenig,1976);buthereorganizationsencounteraseveretradeoffbetweenbreadthanddepthofskills.Indeed,thereareimportanttensionsbetweencompensationpoliciesthatsupportthedevelopmentanddeploymentofbroadskillsrequiredforeffectiveparticipationincross-functionalteamsversusthepoliciesthatsupportthedeeplyspecializedskillsrequiredinacomplexdifferentiatedorganizationalstructure(Kretschmer&Puranam,2008).

FROMCOLLEGIALITYTOCOLLABORATIONWeneedamodeloforganizationthatsupportsunityofpurposeacrossheterogeneous

groupsengagedininterdependent,uncertainactivity—unitaryorconjunctivecollaborationefforts,asdistinctfromadditivecooperationeffortsordisjunctivecoordinationefforts(Steiner,1972).4Theprevioussectionexplainedwhythecollegialmodeldoesnotscaletosupportsuchcollaboration.Tosustainpurposeinlarger,morecomplexbusinessenterprises,weneedaneworganizationalformdoesnotpresupposehomogeneityofbackgroundortasks.

Ourthesis,asnotedintheIntroduction,isthatthepersistentneedforcollaborationinindustryhaspromptedrepeatedeffortstobuildsuitableorganizations,andthatevenwithoutthebenefitofatheoreticalmodeltoguidetheseefforts,theyhavegivenrisetoafamilyofmanagerialinnovationsthat,takentogether,havebeguntogivebodytoanovelmodel.

Takingcognizanceofthispracticaleffortinspiresustothecorrespondingtheoreticaleffort.ItisinthisspiritthatweproposetobuildonWeber’sconceptofvalue-rationalitytoarticulatetheorganizationalprinciplesthatwouldcharacterizethiscollaborativeform,andthenusetheseinsightstobringtotheforethedeepersignificanceofthesevariousscatteredmanagerialinnovations.

Ourunderlyingtheoryisthateachofthefourdefiningcharacteristicsofthecollaborativetypeaddressesoneofthekeychallengesinscaling-upvalue-rationalitydiscussedintheprevioussection.Figure1showshowex-antepurpose(i.e.thedesireddegreeofpurpose)leads,underconditionsoflargesizeandcomplexity,tothesechallenges,andhowthecollaborativeformovercomeseachofthesetoleadtoex-post(i.e.realized)purpose.Thesectionsbelowexplicateinturneachofthefourdefiningcharacteristics.

------------------InsertFigure1abouthere

------------------Aswithotherideal-typeformulations(Doty&Glick,1994),ourworkingassumptionisthat

anygivenorganizationwillembodyamixoforganizationalideal-typesandformswherethecollaborativeformmightbeabsent,dominant,orpresentbutovershadowedbyothers.Wepostulatethatthemorepronouncedthecollaborativefeatures(inabsolutetermsandrelativetootherforms),thegreaterwillbetheorganization’scapacityforsustainedpurpose.

Inordertoillustrateourargument,wewillrefertotheexperienceofonehealthcareorganizationthathasachievedanotablelevelofsharedpurpose—KaiserPermanente.Thiscase

4AccordingtotheprimarymeaningsgivenintheMerriamWebsterOnlinedictionary,coordinationisthe“harmoniousfunctioningofpartsforeffectiveresults”;cooperationmeansan“associationofpersonsforcommonbenefit”;andcollaborationmeans“toworkjointlywithothersortogetherespeciallyinanintellectualendeavor.”ThesedefinitionssuggestaGuttmanscalethatparallelsThompson’s(1967):pooledcoordinationviastandards,sequentialcooperationviaplansandschedules,andreciprocalcollaborationviamutualadjustment.Alongthisscale,thereareincreasinglevelsandscopeoftaskinterdependence,andmorejointeffortrequiredtodeterminemeansandendsoftheactivity.Mostcritically,coordinationandcooperationassumethattheends(goals)oftheactivityaregivenattheoutset,wherecollaborationischaracterizedbyjointefforttodefinenotonlymeansbutalsoends. ThischaracterizationfitstheuseofthetermcollaborationinkeystudiessuchasMartinandEisenhardt(2010),Thompsonetal.(2009),andWood&Gray(1991).LikeLindenbergandFoss(2011)welinkcollaborationto“jointproduction,”thatis,“anyproductiveactivitythatinvolvesheterogeneousbutcomplementaryresourcesandahighdegreeoftaskandoutcomeinterdependence(thus,contextsinwhichworkeffortsareseparableandautonomousfalloutsidetherealmofouranalyses)”.

allowsustoillustrateinonesettingsomeofthevariousspecificmanagementtechniquesthatoperationalizethefourcharacteristicsofthecollaborativeorganizationalform—seeFigure2forasummary.

------------------InsertFigure2abouthere

------------------Bywayofintroduction,weoffersomebackgroundonthisillustrativecase.Ouraccountis

basedonseveralstudies(Eaton,Konitsney,Litwin,&Vanderhorst,2011;Kochan,Eaton,McKersie,&Adler,2009;Litwin,2010;McKersieetal.,2008;Schillingetal.,2010a;Schillingetal.,2011b;Schillingetal.,2010b;Whippyetal.,2011)andthefirstauthor’sfieldresearchintermittentlysince2004.Thedemandforcollaborationandthelimitsofcollegialityinhealthcare

UShealthcaredeliveryorganizationsareunderincreasingpressuretoimprovecollaboration.Thispressureisdrivenbydemandstoassurepatientsfasteraccessandshorterhospitalstays;toadoptmorerapidlyradicalinnovationsintheirinfrastructure(forexample,withelectronichealthrecords);tostayabreastofrapidandradicalinnovationindiagnosticandtreatmenttechnologies;tobeflexiblyresponsivetotheincreasingvarietyofpatientneedsaswellastotheurgencyofmanyoftheseneeds;andtominimizeerrorsinhand-offsacrossdistinctrolesanddepartments.

Oneassetthatthehealthcareindustrymightleverageinattemptingtorespondtothispressureforcollaborationismedicalprofession’scollegialcommitmenttotheultimatevalueofassuringthepatient’shealth.However,thiscollegialityisrestrictedtophysicians,andincreasinglyrestrictedtospecializedcollegeswithinthatbroaderprofessionalumbrella.Itextendswithconsiderablygreaterdifficultytonurses—whooftenhavetheirowndistinctunderstandingofpurpose—andrelationsareevenmorefraughtwiththemyriadancillaryclinicalspecialtiesandadministrativefunctions.Moreover,asithasbeenunderstoodtraditionally,theprofession’svaluesorientsdoctorsandnursesawayfromanyconcernforeconomicefficiency,tothepointwhereanyconsiderationofcosthasbeenconsideredunethical(Angell,1993).Asaresult,thehealthcarefieldisunderincreasingpressedtorethinkmedicalvaluessoastomakeroomforpreventivecare,forpopulationhealthoutcomes,andfortheresponsibleuseofsociety’slimitedeconomicresources(Adler,Kwon,&Heckscher,2008).

Further:thepracticeofmedicineintheUShasoftendiluteditsdedicationtothepatient’shealthwithstrongelementsoftheguild-liketraditionalism,aswellaswithbureaucraticandmarkettypesofinstrumentalrationality(Adleretal.,2008).Theguild-likeelementshavelongbeenvisibleintheprofessionalloyaltythatbindsdoctorstogetherindefenseofpeersagainstcriticismorinterferencebyoutsiders,andinthedebilitatingeffectsofstatustensionsinmanyinteractionsbetweenphysiciansofdifferentspecialtiesandbetweenphysiciansandnurses.Theinstrumental-rationalelementsarevisibleinthegrowthofbureaucracy—intheformgovernmentmandatesandinternalbureaucraticcontrols—aswellasintheincreasingrelianceonfinancialincentivesto“drive”changesinbehavioramonghealthcaredeliveryorganizationsandprofessionals.Theseefforts,however,tendtoreinforceself-interestorientationsandyieldlittleoftheneededcollaboration(Cromwell,Trisolini,Pope,Mitchell,&Greenwald,2011;Jha,Joynt,Orav,&Epstein,2012).

KaiserPermanente(here,“Kaiser”forshort)isonehealthcareorganizationintheUSthathaslongsoughttoencouragedoctorstopracticemedicineinamorevalue-rationalandcollaborativeway(McCarthy,Mueller,Wrenn,&Fund,2009).Kaiseristhelargesthealthcareproviderandoneofthelargesthealthcareinsurancecompaniesinthecountry:asof2014,ithadover9millionhealth-planmembers,over177,00employees,over17,000physicians,38medicalcenters,and620medicaloffices.Itisorganizedasaconsortiumofthe(not-for-profit)Kaiser

FoundationHealthPlan(insurance),the(not-for-profit)KaiserFoundationHospitals,andasetofaffiliatedregionalPermanenteMedicalGroups(whicharefor-profitphysicianpartnershipsorprofessionalcorporationsthatdobusinessalmostexclusivelywithKaiser).

ThechallengeofcollaborationinthehealthcareindustryhasnotonlyaffectedKaiser’smanagementbutalsotheunionsthatrepresentmostofitsemployees.GoingbacktoKaiser’searliestyears,unionshavelongbeenanessentialpartofthebusiness.MostofKaiser’snon-physician,non-managerialemployeesareunionized,andmanyofKaiser’shealth-planmembersalsounionized.Asaresult,andunlikemanyotheremployersintheUS,itisdifficultforKaisermanagerstoignoreorattackunionswithoutriskingbothinternalorganizationalturmoilanddamagetotheirreputationintheirtargetmarket.Conversely,however,theunionsseethatusingtheirpowerinconfrontationalwayswouldriskdestroyingKaiser,andthat,comparedtootheremployers,Kaiserpaysandtreatsitsworkersrelativelywell.Thepartiesrecognizedthisinterdependenceinalandmark“partnership”agreementthatwasincludedinthecollectivebargainingcontractin1997.Thisagreementlaunchedalabor/managementpartnershipthatwasuniqueinitsscaleandambition,anditisstillfunctioningatthetimeofthispaper’swriting(Kochanetal.,2008;Kochan,Eaton,McKersie,&Adler,2009)(Kochan,2013).ThecollaborationenabledbythispartnershiphasbecomecentraltoKaiser’seffortstomeetitsever-intensifyingcompetitivechallenges,providingafoundationforcombiningtop-downinitiativesbyspecializedtechnicalstaff(e.g.fornewcomputerizedmedicalrecords)withbottom-upinputandinvolvementbyabroadrangeofpersonnel(forlocalimprovementprojects),aswellaswithextensivelaterallearning(sothatsimilarlocationscansharelessonslearned).(Formorecriticalviewsofthepartnershipasunioncapitulation,seeBorsos(2013)andEarly(2011).)

Thefollowingsectionsshowhowvalue-rationalitycanbescaleduptosupportlarge-scalecollaboration,andweusetheKaisercasetoillustratesomeofthecorrespondingmanagementtechniques.Deployingthesevariousmanagerialtechniques,Kaiserhasindeedseendramaticperformancegains.Kaiserperformsnearthetopoftherankingsofhealthcaredeliveryorganizationsinmanyofthekeyoperationalmetrics(Schillingetal.,2010a;Whippyetal.,2011),andhasdevelopedanimpressivecapacityforradicalinnovation(Nelson,2010).Surveysofworkerattitudesconductedjointlybyunionandmanagementshowimprovedworkermorale,too,withwidespreadsupportforthepartnershipprocessanditsoutcomes(whichhave,inrecentyears,includedwageandbenefitgainsaswellasgrowthinunionmembership)(Kochan,2013).

VALUESWhenorganizationsattempttoscaleupvalue-rationality,thekeychallengeinthevalues

dimensionisthatofavoidingfragmentation.Letusunpackthatidea.Thecollaborativeorganizationalformmust,first,ensurethesalienceoftheultimatevaluesassuperordinategoals(Sherif,1958).Second,whereasthecollegialformreliesoncommitmenttoanultimatevalueintowhichitsmembersarealreadysocialized,thecollaborativeformmustfindawaytoforgeandsustainasharedpurposeagainstthefragmentationpressurescreatedbyadiversityofbackgroundsandadiversityoffunctionallydifferentiatedroles.Wededuce—extendingWeber’sconceptioninthedirectionproposedbyHabermas(1992)—thatbothend-goalsandmeansforachievingthemmustremainsubjecttodiscussionbasedonpublicstandardsofvalidity,ratherthanrevertingtobureaucraticauthority,traditionalisticstatusorcharismaticleadership.Third,ifpurpose(asvalue-rationalaction)istobeinstitutionalized,ultimatevaluesmustguideeverymember’sactions,notonlythetopexecutives’.Therefore,thecollaborativeorganizationformmustbeoneinwhichtheorganization’sultimatepurposesareatthecenteroforganizationallifeandinwhichallmembersshareanunderstandingofthosepurposes.Membersmustidentifywiththesepurposesastheirown:thepurposesmustbepersonallymeaningful,andeachmember’schoicesmustbeguidedbytheirowncommitmenttothesepurposes.Fourth,value-rationalactionmeansthatmembersusethoseultimatevaluestochooseappropriateactionswhenfacedwithnewandunforeseen

circumstances.Thecollaborativeorganizationalmustthereforeformulateitsultimatevaluesinawaythatallowsmemberstoconnectthemtodailydecision-making.

Thecollaborativeorganizationalform,wesubmit,canmeetthischallengebyinstitutionalizinganethicofcontribution,whichwedefineasasharedconvictionthatthemostimportantvirtueiscontributingtotheachievementtheorganization’spurpose.Thesalienceofthissharedpurposecanthenmotivateandguidedecision-making.SeveralmanagementtechniqueshaveevolvedsinceWeber’stimethatoperationalizesuchanethicofcontributionandtherebycreateacontextthatsupportspurposeincomplexorganizations.

Someofthesetechniqueshelpfocusinternaldiscussiononthecontributiontheorganizationmakestothebroadersociety—howitmeetscustomers’needs.Thesetechniqueshaveblossomedinrecentdecadesascompaniesorientthemselvesawayfromcommodityproductsandtowardscustomer-specific,integratedsolutions.NumerouscompanieshaveadoptedtechniquessuchasQualityFunctionDeployment(Akao,2004),a“front-back”organizationstructures(Brady,Davies,&Gann,2005;Galbraith,2002),theBalancedScorecard(Kaplan&Norton,2001),andtheHoshinKanriplanningprocess(Cole,1999).Theseallarticulatemultidimensionalvalueprioritiesinwaysthatalloweveryonetoconnecttheirdailyworktothesatisfactionofcustomerneeds.Thesetechniqueshelptranslatethevalueprovidedbytheorganizationtoitscustomersintotermsthatcanguideeverydaydecision-makingthroughouttheorganization.

Othertechniqueshelporchestrateabroadervarietyofvoicesinthestrategydiscussion.Forvalue-rationalitytobetrulyrational,boththeultimatevaluesthemselvesandthemeansofachievingthemmustbesubjecttodiscussionbasedonpublicstandardsofvalidity(Habermas,1992).Inthisrespecttoo,historyhasovertakenWeber.WhereWeberassumedthatvalue-rationalityreliedonnon-rationalcommitmentstotheultimatevalues—Nietzscheanactsofwill(Hennis,1988)anddevotiontoquasi-religious“deities”(Friedland,2013)—Habermasandlaterscholarshaveidentifiedarangeoftechniquesformakingvalue-rationaldiscoursemorethoroughlyrationalthroughanoperationalizationofthe“idealspeechsituation”(Habermas,2001).Inthepracticalworldofindustry,wefindthestrategyprocess—defining,implementing,monitoring,andadjustingstrategy—sometimestakingadialogicalanddeliberativeformthatcorrespondssurprisinglycloselytoHabermas’smodel.Arangeoftechniquesarenowavailabletosupportsuchstrategydialoguebothwithintheorganization,asparticipativestrategyprocesses(Forester,1999),andbeyondtheorganizationalboundaries,intheformofmulti-stakeholderstrategydialogues(Roloff,2008;Zadek,2008).Andarangeoftechniqueshasemergedtofacilitateexplicitdiscussionofvaluesandpurposeandorchestratingculturechange(theliteratureisenormous:e.g.Kim,2005;Lewis,1996;Scott,Mannion,Davies,&Marshall,2003;Shook,2010).

Athirdbundleoftechniquesaimtoshape“organizationalculture”—members’valuesandidentities.Whileorganizationalcultureasa“fad”mayhavepassed(PhillipsCarson,Lanier,Carson,&Birkenmeier,1999),itbequeathedaconsiderablebodyofmanagerialtechnologythatfacilitatesdeliberateeffortstoprovokereflectionandchange(Cameron&Quinn,2005;Schein,2010).Kaiserillustration.

Kaiserillustratesthekeyroleofanethicofcontributionincreatingandsustainingsharedpurpose.Manyhealthcareorganizationsare“segmented,”wherethehospitalmanagersoperateunderinstrumentally-rationalmarketvaluesandthedoctorswhopracticeinthehospitaladheretoverydifferent,professionalvalues.Somewhatcontroversially,Kaiserpushedhardforasinglesharedpurpose:managersanddoctorsalikeareexpectedtoconsiderbothpatientclinicaloutcomesandtheeconomicconsequencesofclinicaldecisions.Wheremanydoctorsinprivatepracticelongrefusedanyroleincontrollinghealthcareexpenditures,Kaiser’sdoctorsparticipateinthateffort.ThecreationandmaintenanceofthissharedpurposeissupportedbynumerousforumswhereKaiser’sphysiciansdiscussthemeaningofthiscomplex,multi-dimensionalvalue-commitment.

DoctorsoutsideKaiserareoftenlefttomaketheirowncostversusqualitytradeoffchoicesinthediagnosticsandtreatmentstheyorder;increasinglyoften,theyarepenalizedfinanciallybytheiremployersorinsurancecompaniesfororderingthemoreexpensiveoptionevenwhenthatoptionpromisedbetterclinicalresults.AtKaiser,incontrast,therewasastrongcommitmentthatthesechoiceswouldnotdegradeclinicaloutcomes;however,wherethereisanequallyeffectiveoptionthatislessexpensive,doctorsareencouragedtoconsiderit.Forexample,Kaiserdoesitsownresearchontheclinicalequivalenceofgenericmedicationsanddisseminatesthoseresultstoitsdoctors.Thesecost/qualitychoicesandtheassociatedresearcharediscussedinweeklyormonthlymeetingsofphysiciansatthemedical-officebuildinglevel,inmonthlymeetingsofphysiciansintheirspecialtydepartments,andinbi-monthlyoff-siteretreatsfordoctorsfromtheentireservicearea.Medicaldepartmentsregularlyreviewunblindedcomparisonsofdoctors’outcomes.Asonedoctorexpresseditinaninterviewweconducted:“AtKaisertherewillbenocost/qualitytradeoffs.Butwemustbegoodstewardsofourmembers’dollars.”ThesetechniquesfosteradistinctivelycollaborativeidentityamongKaiserdoctors.Wheredoctorselsewherearethetargetsofextensive“drugdetailing”effortsbypharmaceuticalcompanies,Kaiserbanneddrugdetailinginitsfacilities.Conversely,whenKaiser’sdoctorschooseaquestionablepathofdiagnosisortreatment,theyarelikelytoreceiveacallfromacolleagueaskingforapeer-to-peerdiscussionoftheirchoices.(Theprocessiscalled“academicdetailing”:see,forex.,Postlethwaite,Shaber,Mancuso,Flores,andArmstrong(2007).)Kaiserthuscarefullycultivatesanethicofcontribution.

Theoperationalizationofanethicofcontributionandtheinstitutionalizationofvalue-rationalityacrossphysicianandnon-physiciancategoriesatKaiserhavealsobenefittedfromthedefinitionofthe“ValueCompass”in2010(Schillingetal.,2011a).TheCompassshows“patientandmemberfocus”atthecenterandfourgoalsatitsfourpoints—“Bestquality,bestservice,mostaffordable,bestplacetowork.”TheValueCompassoperationalizestwokeyfeaturesofcollaborativeorganizationalform.First,thesegoalswerenotdictatedbytopmanagement;instead,theywerejointlydefinedthroughintensivedialoguebetweenmanagementandunions(KaiserPermanente&CoalitionofKaiserPermanenteUnions,2012).Second,itdefinesthesharedpurposeoftheorganizationintermsthatcaninformdailyworkacrosstheentireorganization.Asdiscussedfurtherbelow,peopleatalllevelsareengagedinworkingouthowtheycantranslatethetop-levelValueCompassgoalsintotheirlocalworkprocesses,givingthemaunityofpurposeintheirdailyworkandtheirdailyimprovementefforts.

NORMSThekeychallengeinthenormsdimensionisgoaldisplacement.Inasmall,collegialgroup,

interactionalnormscanremaininformalwithoutlosingtoomuchefficiency;butacrossalarger,heterogeneousorganization,efficientcoordinationrequiresmoreformalizednorms.ThisformalizationwasamajorfactormotivatingWeber’sskepticism:hefearedthatformalizationwouldbetheoccasionforspecializedstaffstoimposeproceduresontheoperatingcore.Formalizationwouldthusunderminethesalienceoftheorganization’sultimatevalues,replacingtheethicofcontributionwithabureaucraticethicofinstrumental-rationalconformance.

Forvalue-rationalactiontoprevailatscale,thecollaborativeorganizationmustinstitutionalizeameta-normofsubstantiverationality.Thatis,thebehavioralexpectationsforeachrolemustbeevaluatedconstantlyforboththeirefficiencyandtheirappropriatenesstotheultimatepurpose(Kalberg,1980).

Inthecollaborativeform,normsmightbemoreorlessformalizedasprocedures,butwhatevertheextentofformalization,theseproceduresaredesignedandimplementedwiththeorganizations’ultimatepurposeconstantlyinview.ThissubstantivetypeofrationalitycontrastswithwhatWeber(1978:p.85)called“formal”rationality,whichisoperativewhenthecourseofactionisdecidedinlightofitsconformancewithrationally-derived,formalizedrules.Substantiverationalitydoesnotprecludeformalrationality,butitsubordinatesthelattertotheactors’

constantconsiderationofultimatevalues(Biggart&Delbridge,2004).(Intheclassiccaseoflegalreasoning,thedistinctionbetweenformalandsubstantiverationalityisthatbetweendecisionsbasedonconsistencywithestablishedcanonsoflegalreasoninganddecisionsbasedonwhethertheoutcomeisconsideredjust.)

Thisprincipleofsubstantiverationalitycanbeoperationalizedifactorsatalllevelsmanagetheirinterdependenciesthroughacombinationof(a)dialogueaimedatdecidinghowbesttopursuetheirsharedgoals,and(b)formalproceduresthatarethemselvestheproductofdialogueaimedatdecidingwhichproceduresmightbestsupportsuchsharedgoals.Wecallthiscombination“interactiveprocessmanagement.”Thisinteractiveprocessgeneratesnorms—bothformalizedandinformal—thatarewidelyexperiencedas“enabling”ratherthanascoercivelyimposedormerelyceremonial(seeAdler,1999a;Adler&Borys,1996,buildingonGouldner's(1954)distinctionbetweenrepresentative,punishment-centered,andmockbureaucracy).

Suchnormsallowthecollaborativeorganizationalformtoovercometheriskofgoaldisplacementandsustainpurpose.SinceWeber’stime,managementtechniqueshavebeendevelopedtoside-stepthisriskbyfosteringcollaborationintheprocessofformalizationitself.Protocolssuchforkaizen,processmapping,brainstorming,participatorymeetingmanagement,decision-makingwithmultiplestakeholders,andprojectmanagementnowallowthecollaborativeorganizationtomobilizesizeablecross-functionalandcross-organizationalteamstowardsbothmanagingtheircurrentinterdependenciesanddesigningformalsystemsthatcanfacilitatethatmanagement.Theformalizationoftheseprotocolsgeneratessystems—bothformalandinformal—thatareexperiencedasenabling:theyfacilitatethefluidmovementofpeopleamongprojectsinordertobringspecializedknowledgetobearattherighttimesandplaces,andthefluidformationofprojectteams(seeforex.Geraldi,2009;Mom,VanDenBosch,&Volberda,2009).Suchnormsfacilitatecollaborationbyprovidingaplatformforthedeliberateandcontinualrenegotiationofworkingrelations;theymakeitpossibleforpeopletoadjusttheirexpectationsofeachotherastaskdemandsshift(Juillerat,2010).Kaiserillustration.

ThefabricofnormsatKaiserexemplifiesseveralfeaturesofthecollaborativemodelandtheoperationalizationofthesubstantiverationalityprinciple.WhileKaiserphysiciansaremanagedunderrelativelyformalizedprocedures,Kaiser’sleadershiphassoughttoensurethatthesesystemsareexperiencedasenablingtoolsratherthanascoercivebureaucraticconstraints.

Clinicalguidelinesillustratethepoint.Wheremanydoctorsinprivatepracticechafeunderthebureaucraticconstraintsofmedicalguidelinesimposedbygovernmentorinsurancecompanies,Kaiser’sdoctorscollaboratewiththeirKaiserpeersandwithotherclinicalandnon-clinicalpersonneltodefineguidelines.Whentheactivityisentirelywithinpurviewofamedicalspecialty,therelevantgroupofdoctorswilldeveloptheseguidelinesthemselvesorreviewandadaptnationally-establishedguidelines.Whentheactivityinvolvesmultiplespecialtiesandotherstaff,theseguidelinesaredevelopedandrefinedwithinputandparticipationofabroaderrangeofoccupations(Whippyetal.,2011).

Thelabor/managementpartnership,too,bothinitsstrategicandoperationalformshasshapednormstosupportvalue-rationalcollaboration.Asalaborrelationsstrategy,thepartnershiphelpsKaisersustainpurposethroughitsrelianceonnormsof“interest-basedbargaining”(McKersieetal.,2008).Interest-basedbargainingisaniceexampleofhowsubstantiverationalitycanbeoperationalizedandinstitutionalizedthroughinteractiveprocessmanagement.Underthesenorms,managementandlabornegotiatetofindareaswheretheycanfindcommonpurposeandcraftwin-winsolutionsthatcreateabiggerpie(“integrative”bargaining).Inareaswheretherearenowin-winsolutionstobefound,theybargainovertherelativesharesofthepie(“distributive”bargaining).Takingtheintegrativepartseriouslymeansthattheunionisdeeplyinvolvedinhelpingshapetheorganization’sgoalsaswellasitsoperations.Takingthedistributivepart

seriouslymeansthat,evenastheycollaboratewithmanagement,unionsworktopreserveandstrengthentheircapacityforindependentaction.

Asanoperationsstrategy,labor-managementpartnershiphasledtothecreationof“unit-basedteams,”whereunionizedstaff,management,andphysicianscooperateinexaminingeverystepoftheworkprocesstoanalyzewhy,when,andhowpeopleperformtheirtasks,andtoaskiftheremightbeamoreefficientandeffectivewaytooperate(Cohen,Ptaskiewicz,&Mipos,2010).Thisteam-basedinnovationeffort,too,embodiessubstantiverationality,astheseunit-basedteamsworkonimprovementsthattheyseeasmostrelevanttotheirwork,choosingtargetsthatcontributeinsomewaytooneoftheover-archingorganizationalpurposesdefinedbytheValueCompass.(Thecollectivebargainingagreementprotectsunionmembersfrombeinglaidoffasaresultofanyoftheseimprovementefforts:wherechangesinservicesortechnologyhavemadejobsredundant,theagreementprovidesrelativelygenerousprovisionsforretrainingandacommitmenttodoingwhateverisfeasibletofindemploymentelsewherewithinKaiser.)TheUBTsrelyonastandardizedprocedureina“plan-do-study-act”cycle,andhaveinstitutionalizeddaily“huddles”toreviewworkandimprovementprioritiesfortheday.

By2013,over80%ofdepartmentsatKaiserhadatleastonesuchUBTteam.Workingintheseteams,physicianshavebeenchallengedtogiveuptheirhierarchical,status-basedauthorityandtoworkcollaborativelywithnurses,technicians,cleaners,andadministrators(Cohenetal.,2010).In2013,aboutaquarteroftheseteamswerefocusedonimprovingservicequality,aboutaquarteronreducingcostswithoutimpairingquality,andabout10%onimprovingclinicalperformancethroughpreventionanddiseasemanagement.

AUTHORITYThekeychallengeintheauthoritydimensionposedbyeffortstoscaleupvalue-rationality

iscentralization.Large,complexbusinessorganizationsunderperformancepressuretypicallyrequirethecentralizationofatleastsomedecisions.However,theconceptofvalue-rationalactionseemstoprecludearoleforcentralizedauthority,sinceinvalue-rationalactioneachactordecidesontheircourseofactionasafunctionoftheircommitmenttotheultimatevaluesratherthansubmittingtoanyelse’scommand.

Thecollaborativeorganizationalformmeetsthischallengebyensuringthatauthorityflowstothoserecognizedasbeingbestpositionedtocontributetothepurposeoftheorganization.Authorityhereisendorsedfrombelowasafunctionofsharedpurpose,ratherthandelegatedfromaboveandacceptedinutilitarianexchange,oracceptedpassivelyastraditional,orderivedfromaffectual,charismaticbonds.Regardlessofthedegreeofcentralization—whetherauthorityis“distributed”(Cullen&Yammarino,2014),centralized,ordual(asinmatrixforms)—authorityflowstothosewhoarewidely-acknowledgedasbestabletocontributetotheorganization’ssharedpurposes(assuggestedbyAime,Humphrey,DeRue,&Paul,2013).

Thisidealisoperationalizedinthecollaborativeformthroughtheprincipleofparticipativecentralization.Underthisprinciple,centralizationisparticipativeintwosenses:(a)thedegreeofcentralizationisdecidedparticipatively,and(b)whereandinsofarasauthorityiscentralized,itneverthelessfunctionsinaparticipativemanner.Ifmemberssharethepurposesoftheorganization,theresultingauthoritystructure(whethermoreorlessextensive)willnotbeexperiencedasalienating,butinsteadwillbeexperiencedas“autonomy-supporting”(Deci&Ryan,1987)andwillsupportvalue-rationalcollaboration.

Muchofthescholarshipinourfieldwouldbeskepticalofanyconceptthatpurportstocombineparticipationandcentralization,assumingthatcentralizationandparticipationarepolaropposites(e.g.McCaffrey,Faerman,&Hart,1995).However,astheseconstructshavebeendefinedmorepreciselyinorganizationalresearch,theyshouldnotbetakentobemutuallyexclusive.Centralizationisassessedbyascertainingthelowesthierarchicallevelatwhichadecisioncanbemadewithoutpriorconsultationwithasuperior(Pugh&Hickson,1976).Participationisassessed

byascertainingthelowesthierarchicallevelatwhichrealinfluenceonthedecisionisexerted(Hage&Aiken,1970).Whereascentralizationandautonomyareinacleartrade-offrelation,centralizationandparticipationarebetterconceptualizedasindependent,orthogonaldimensionoftheauthoritystructure.Thecollaborativeorganizationis,weargue,highonbothdimensions.

Thematrixtypeofauthoritystructureisonekeyinnovationinmanagementtechniquethathasoperationalizedcontribution-baseauthorityandtherebyfacilitatedparticipativecentralizationandsustainedpurpose.Whenorganizationsrelyonthefamiliarmonocraticcentralizedhierarchyofauthority,theresultistypicallyanoveremphasisonlocalgoalsratherthanorganizationalpurpose.Collaborationthereforeoftenrequiresamatrixstructurewithmultipledimensionsofaccountability,wheredecisionsonthelocusofauthorityarecontingentonthenatureofthedecisionsthatneedtobetaken(Galbraith,1994).Matrixstructures,however,arenotoriousforthechallenging“organizationalpolitics”engenderedbytheirmultiplereportingrelationships,andasaresult,thesestructuresaredifficulttosustainandorganizationshavesufferedmanyimplementationfailures(Burns,1989;Larson&Gobeli,1987).Nevertheless,competitivepressureshavepushedfirmstopersistintryingtomasterthesechallenges,andinmanyfirmstodaymatrixisataken-for-grantedcondition;indeed,therehasbeenanevolutionovertimetowardmatrixstructureswithmorethantwodimensions(Galbraith,2008;Heckscher,2007;Strikwerda&Stoelhorst,2009).Thekeytomasteringtheseimplementationchallengesliesinavalue-rationalcommitmenttosharedpurposeandtheethicofcontribution:itisthissharedpurposethatenablesindividualcontributors,functionalmanagers,andprojectmanagersfindcommongroundintheirdecision-making.Kaiserillustration.

Tofacilitatethepursuitofitsdiversegoals,Kaiserhascreatedasizable“PerformanceImprovement”staff,whichfunctionsinamatrixrelationshipwithline-managementclientgroups(Schillingetal.,2010a).Indeed,Kaiser’sauthoritystructureisextensivelymatrixed.Managersandnon-managerialpersonnelhavelearnedtoaccommodatethemselvestotheunusualdegreeoforganizationalcomplexityrequiredtoensurethattheorganization’sultimatepurposeiskeptconstantlyinview.

Thelabor-managementpartnershiphelpsKaisermeetitsexternalchallengesbysupportingparticipativecentralizationacrossthewiderorganization.First,theunit-basedteamsaffordimportantopportunitiesfordistributedleadership:leadershipwithintheseteamsisdeterminedbycontribution,notbyhierarchicalposition.Second,theseteamsarecharteredthroughanexplicitnegotiationprocessthatisanchoredintheValueCompass:theteamsnegotiatewithgoalswithmanagementandunionsponsorasafunctionoftheirabilitytoadvanceoneormoreoftheValueCompassgoals(KaiserPermanenteLaborManagementPartnership,2015).Andthird,totheextentthatdecisionsneedtobecentralized,ahierarchyofjointlabor/managementcommitteesgovernsdecision-making,fromthenational,totheregional,anddowntothefacilitylevel.Whilethiscentralizedstructurehasundoubtedlyaddedorganizationaloverhead,itensuresthatthedecisionsmadecentrallybyhigher-leveldecision-makersareseenaslegitimatebylowerlevelsintheorganization.Theunioncoalition’spartnershipwithmanagementinjointpursuitoftheValueCompassgoalsreassuresmembersthatthatthesecentralizeddecisionsareorientedtowardstheorganization’sultimatepurposes.ThislegitimacyhasenabledKaisertoundertakeseveralpotentiallyhighlycontroversialmoveswithoutmajorinternalconflict.Someofthesemovesinvolvedcost-cuttingandworkforceredundancies:thesewerehandledwithoutconflictthankstoadvanceplanningandpartnershipcommitmentstoretrainingandredeployment.

CAPABILITIESThekeychallengeinthecapabilitiesdimensionliesinspecialization.Asorganizationsgrow

insizeandcomplexity,tasksbecomespecializedandvalue-rationalactionstumblesforlackofthecapabilitiesrequiredforeffectivecollaborationacrossthesedifferentiatedskillsandmind-sets.

Thecollaborativeorganizationisdistinctiveindeliberatelyfosteringthedevelopmentofthecapabilitiesthatactorsneedinordertocontributetotheorganization’spurpose.Insteadofleavingmembers’freetodeveloptheirskillsinwhateverdirectionappearstothemasinstrumentallyrationalinpursuitoftheirindividualcareerandlabor-marketgoals,thecollaborativeorganizationdeliberatelyplansmembers’skilldevelopmenttosupporttheirabilitytocontributetotheorganization’sultimatepurposes.(SeealsoLindenbergandFoss2011,p.509ontheimportanceof“Trainingschemesthatincreasetheunderstandingofhowsubgoalachievementhelpsrealizehigher-ordergoalsinthefirm.”)

Thecollaborativeorganizationalformsystematicallycultivates“T-shaped”skills(Iansiti,1993;Leonard-Barton,1995).T-shapedtechnicalskills—deepknowledgeinone’sownspecialtycombinedwithbreadthofknowledgeoftherelatedtechnicalspecialties—facilitatetheemergenceofthe“commonground”thatiscriticaltolearningfromandcollaboratingwithothers(Puranam,Singh,&Chaudhuri,2009).Thesetechnicalskillsmustbebuttressedbycomplementarysocialskillstoenableeffectivecross-functionalteamwork(Cordero,1999;Kang&Snell,2009).Thecollaborativeformthusrejectstheolderideaof“expertise”(describedbyWeberinhistreatmentofformalrationalityinbureaucracy),inwhichspecializedknowledgeisappliedseparatelyandautonomouslybyeachactortoproblemswithinhisorherdomain(or“office”).Thecollaborativeformrequiresthatone’sspecializedknowledgebecombinedwithothers’withanintentionalfocusonthecommonpurpose.

Thecollaborativeorganizationalformbuildsthesecapabilitiesthroughbothpersonnelselectionandskillformation.Asconcernsselection,thecollaborativeorganizationselectspeoplewiththeappropriateT-shapedskillsandteamworkpropensitiesinsofarasthisunusualcombinationisavailable.Avastportfoliooftechniques(andanassociatedfieldofscholarship—industrial/organizationalpsychology)hasemergedsinceWeber’stimetoassistorganizationsinselectingpersonnelwhofitsuchdemands(see,forex.,Schmidt&Hunter,1998).

Asconcernsskillformationtrajectories,thecollaborativeorganizationdoesnotleaveitentirelytoindividualemployeestodecideforthemselvesbasedontheirindividualinstrumental-rationalcareeradvancementgoals.Collaborativeorganizationsleveragetheethicofcontributionandthesalienceofsharedpurposetoorientthisskillformationprocesstowardstheorganization’spurposes,withpoliciesthatencouragemembersbothtodeepenandtobroadentheirskillsthroughaplannedsequenceofprojectexperiencesandcross-functionalassignments.OrganizationssuchasToyotamobilizethissenseofsharedpurposetoassuretheirworkers’buy-intothefirm’sformalized,comprehensive,andlong-termskill-developmentpolicies(Adler,1999b;Brown&Reich,1997).Bothmanagementandshop-floorpersonnelaresystematicallyrotatedthroughvariousdepartments,progressivelybroadeninganddeepeningtheirskills.

Ahostofnewmanagementtechniqueshaveariseninthepastfewdecadestoidentifyandplanforthedevelopmentofvariouswork-relatedcompetencies(Dubois,1998,2010;McClelland,1973).Today,wehavemanyinformation-technologytoolsthatsupportallaspectsofcompetencymapping,diagnosis,developmentplanning,andmonitoring(Draganidis&Mentzas,2006).Informationtechnologyalsocontributesmoredirectlytotheorganizationalcapabilitiesrequiredbycollaborationwhenitisdeployedintheorganization’soperatingcoretostretchoutwardthetrade-offfrontierbetweencost-efficiencyandflexibility,reducingminimumefficientscaleandreducingthegapbetweencustomizationandmassproductionbydeployingmasscustomizationtechniques(Pine,1993).

ToensurethatskillsaredevelopedanddeployedinthisT-shapeddirection,thecollaborativeformrequiresadistinctivecompensationapproachthatrewardspurpose-oriented

skillformation.Here,compensationisbasedbothontheentireorganization’sprogresstowardsitspurposesandontheindividual’scontributiontothatprogress.Thecollaborativeorganizationmaydifferentiatecompensationamongindividualsbasedonperformance,butitdoesnotdosothroughtheusualpay-for-performanceapproach,whichrewardspeopleformeetingfixedtargetssetbyhigherauthorities.Instead,thekeycriterionistheindividual’scontributiontothecomplex,multidimensionalorganizationalpurposes,thusbothleveragingandbuttressingtheorganization’sethicofcontribution(seeLindenbergandFoss2011,p.512,ontheimportanceof“Grouprewardsthatemphasizethecontributiontocommongoalsatahigherorganizationallevelthanthegroupitself”).Organizationshavedevelopedinnovativewaystoassessandreinforceorientationtoteamworkandtohelpingothers(Gittell,2000;Rubinstein&Kochan,2001).Just“doingagoodjob”isnotsufficient;individualsarestretchedtothinkandactbeyondtheirjobsandtoavoidthedysfunctionsofinappropriatebureaucraticrule-following.Becauseformalsupervisorscannotbeawareoftheentirerangeofactivitiesoftheirsubordinateswhentheselatterareengagedonmultipleprojectsandcontributingoncross-cuttingdimensions,collaborativeorganizationsusesystemssuchas360-degreefeedbacktodevelopandvalidatereputationalinformation(Bracken,Timmreck,Fleenor,&Summers,2001;Peiperl,2001).Kaiserillustration.

DoctorsnewtoKaisergothroughathree-yearprobationaryperiodduringwhichtheyareregularlyevaluatedandcoachednotonlyontheirtechnicalcompetencebutalsoontheircollegialrelationswithotherdoctors,therespecttheyshowforotherstaffandpatients,andtheirwillingnesstocontributeideasandefforttoimprovingtheorganization’sperformance.Managers,includingphysicianswhotakeonmanagerialresponsibilities,undergoregular360assessments.PhysiciansareresponsiblecollectivelyforthemanagementoftheregionalPermanenteMedicalGroups,andasaresult,aconsiderableproportionofthembroadentheirskillsbyacquiringsophisticatedmanagement,business,andleadershipcompetencies.

Moregenerally,allKaiserstaffcategories,fromphysicianstojanitorialpersonnel,havebeendrawnintopartnershipactivities,andinparticular,intotheworkofunit-basedteams,wheretheyhavedevelopednewskillsinproblem-solving,leadingmeetings,analyzingworkprocesses,identifyingimprovementopportunities,presentingcogentargumentsinteammeetingsandinbiggerforums,energizingotherstogetinvolved,dealingwithconflictingviewsanddivergentinterests,andunderstandingthebusinesssideofKaiserandtheeconomicsofhealthcare.Kaiserhasconsiderablyexpandedtheirinternaltrainingprogramstosupportthedevelopmentofthesenewskills.KaiserhasalsoinvestedenormousresourcestocreateanITinfrastructure—”KPHealthconnect”—thatsupportscollaborativeresponsestotheindividualpatient’sneeds(Mohrman&Kanter,2012).Litwin(2010)showsthatthistechnologyinfrastructureyieldsgreaterperformanceoutcomeswhereitisassociatedwithhigherlevelsofemployeeinvolvementthroughKaiser’slabor-managementpartnership.

Tosupportpurpose,Kaiseralsoimplementsdistinctivecompensationpolicies.UnlikeindependentpractitionerswhooncepredominatedintheUShealthcaredeliverysystem,Kaiser’sphysiciansaresalariedmembersofagrouppractice.RecentyearshaveseenashiftinpaymentsystemsforKaiser’sphysicians,awayfromstraightsalarytowardsmoreperformance-basedpay,butdesignedneverthelesstobuttressthevalue-rationalethicofcontribution.Some30%ofthephysician’ssalaryis“atrisk,”butthatcomponentisbasedentirelyonpatientsatisfactionandclinicaloutcomes—notoncostnoronphysicians’“utilization”rates.Anycostssavingsthemedicalgroupmakes(relativetothetargetedoverallcost-per-patientovertheyear)arereinvestedinmedicalequipmentandprograms.

Non-managerialpersonnelunderthePartnershipagreementshareinKaiser’snetrevenuesbasedonbonusplansregionallynegotiated.Thebonusespayoutequalamountstoalltheregion’semployeesbasedonwhethertheregionhasmettargetsthatarenegotiatedbetweenunionsand

managementandthatreflectamixofvariablesfromthevariouspointsontheValueCompass,suchasattendance,safety,service,andclinicaloutcomes.Startingwiththe2012collectivebargainingagreement,thesebonusesarealsobasedonthehealthstatusofKaiser’sownpersonnel.

DISCUSSIONANDCONCLUSIONThispaperaimedtospecifytheorganizationalformthatcouldcreateandsustainawidely-

sharedcommitmenttotheorganization’spurposeinlarge,complexbusinesses.Weshowedthatvalue-rationalactionprovidesthemostappropriatefoundationforsuchpurpose,andweidentifiedfourkeychallengesinscalingupvalue-rationalitybeyondsmallcollegialgroups.Wepointedtowaysinwhich,notwithstandingWeber’sownskepticism,arobustorganizationalform—welabeledit“collaborative”—couldinstitutionalizevalue-rationalitythroughthedeploymentofmanagerialtechniquesdevelopedsinceWeber’stime.

Inthisconcludingsection,weaddressinturnthemoderatorsthatconditionthevalueofpurposetoperformanceandthosethatconditionthevalueofthecollaborativeformtopurpose.Wethenturntosomelimitationsandpossibleextensions.Moderators

Frompurposetoperformance.Priorresearchsuggeststhattheimportanceofpurposetofirmperformancedependsontaskinterdependenceanduncertainty.Wherecoretasksaremoreroutineandlessinterdependent,employees’conformanceisperhapsmoreimportantthantheirdiscretionaryeffort,cooperation,andcreativity,andheretheappropriatedesignofextrinsicrewardsandsanctionswilllikelybemoreeffectivethanthecreationandongoingmaintenanceofasenseofsharedpurpose.Thecoretaskcharacteristicsdependinpartonindustry,industrycontext,andfirmstrategy.

Industrycontextwarrantsspecialconsideration:inthebusinesssector,purposeitselfisaproblematicfeatureoforganizations.Perhapsmostfundamentally,intherealworldofbusiness,marketcompetitionandwage-costpressureoftenpushexecutivestomakechangesthatconflictwithotherelementsofsharedpurpose.Itishardlysurprising,then,thatthestabilizationofthevalue-rationalorganizationformisdifficultandnotyetcompleteinanyfor-profitbusinesssettingthatweknowof.

WeshouldnoteinparticularthatourportraitofthecollaborativeformatKaisershouldnotbereadtoimplythatKaiserstandsasapristineembodimentofthatmodel.TherearemanymomentsandlocationsatKaiserwherethepressureofperformanceandofhumanfrailtiesbeliethataspiration.Ontheotherhand,theperformancebenefitsofpurposeandcollaborationareconsiderable,atleastwheretaskinterdependenceanduncertaintyarehigh,andorganizationssuchasKaiserareinterestingbecausewecanseetracedthereinoutlinewhatsuchaformconsistsof.

Fromcollaborativeformtopurpose.Theimportanceofthecollaborativeorganizationalformforcreatingandsustainingpurposewilllikelydependonorganizationalsizeandcomplexity.Asimplerform—thecollegialmodeldiscussedbyWeber—willbemorecosteffectiveforsmallerorganizationswithmorehomogeneousmembers(intermsofpriorsocializationandcurrenttaskrequirements).Thecollaborativeformdependsonreliablemechanismsforestablishingandupdatingreputations;butweknowthatthesemechanismsarevulnerabletoopportunisticmanipulation.Thehighlevelofparticipationincollaborativeorganizationsrequiresconsiderablemeetingtime;butsuchmeetingsarecostlyandburdensome.Thecollaborativeformrequiresopennesstodiversity,difference,anddisagreement;butitofferslittleassurancethesewillnotexplodethecollectivityorsealtheorganizationofffromtheoutsideworldasaclosedsect.

Inamorespeculativevein,futureresearchmightalsoconsiderwhetherthecollaborativeform,ratherthanbeingjustoneorganization-designoptionamongseveral,representsinsteadanevolutionaryadvancebeyondthoseothers.Inthisperspective,ifasocialinnovationprocesshasyieldednewmanagementtechniquesthatalloworganizationstoinstitutionalizevalue-rationality

inlarge,complexorganizations,perhapsthiscollaborativeorganizationalformmightbecomeanefficientsolutiontothechallengesfacingabroaderrangeoforganizations.Ifwehavelearnedhowtosustainpurposeinlarger,morecomplexorganizations,thenperhapsitbecomescosteffectivetoshiftworkdesignstoallowforandleveragemoreemployeediscretionandcreativityeveninsettingswherepreviouslythemarketorbureaucraticformsoforganizationseemedoptimal.

WemightlinkthisconjecturetoBarleyandKunda’s(1992)argumentthatmodelsofmanagementhaveswunginapendulummovementbetweentheculturalantinomiesofcontrolandcommitment.Ouranalysissuggeststhatacrossthesequenceof“commitment”models—fromIndustrialBetterment,toHumanRelations,toOrganizationalCulture—thereisanunderlyingtrendlinerepresentingtheprogressiveemergenceandrefinementofthevalue-rationalcollaborativeideal-type.Futureresearch

Micro-foundations.Futureresearchshouldaimtoexplicatetheindividualcognition,motivation,emotion,orbehaviorsimplicitinourcausalmodel.Animportantnextstepinthelineofresearchwehaveproposedwouldbetodevelopamulti-levelmodelthatallowsustoseehowthecollaborativeorganizationalformshapescollaborativeindividualbehaviors,andthenhowtheseindividualbehaviorsaggregatetogeneratetheex-postpurposeinFigure1.

Extensiontoambidexterity.Agrowingliteratureonambidexteritysuggeststhatcreatingandsustainingasenseofsharedpurposemightbeacriticalsuccessfactorfororganizationspursuingsimultaneouslyexplorationandexploitation.Thelocusanddegreeofrequisitecollaborationvariesacrossthevariousambidexterityapproaches;butinallofthem,alltherelevantactorsmustfeelconfidentthatotherswillbeorientedtotheirsharedultimatepurposeevenincircumstancesthatcannotcurrentlybedefinedorpredicted—andthevalue-rationalcollaborativeformoffersthisadvantage.

Inthefunctionalapproachtoambidexterity,thefirmneedsasenseofsharedpurposeacrossfunctionally-differentiatedsubunits,suchasR&Dandoperations(e.g.Lovelace,Shapiro,&Weingart,2001):theR&Dunitmustbewillingandabletoanticipatedownstreamissues(suchas“manufacturability”),andtheoperationsunitsmustbewillingandabletoembraceratherthanresistthedisruptionoccasionedbytheintroductionofnewdesigns.Inthestructuralapproach,ambidexterityrequiresastrongsenseofsharedpurposewithinthetop-managementteamifitistocombinesuccessfullytheeffortsofexploitationandexplorationbusinesslines(e.g.Jansen,George,VandenBosch,&Volberda,2008;Tushman,Smith,Wood,Westerman,&O'Reilly,2010).Inthecontextualapproach(Gibson&Birkinshaw,2004)itseemslikelythatachievementoftheambidexteritywouldbenefitfromthecollaborativeforminsofarasitwouldhelpactorsmanagetheirinterdependenceunderthestressofjugglingincommensurableexploitationandexplorationgoalsintheireverydayworkactivities.

Extensionstootherhybridorganizations.Ourargumentmightalsobeextendedfurther,tosituationswheretheorganizationfacesmultipleheterogeneousdemandsofvariouskinds.Forexample,manyorganizationstodayareunderpressurebothtoofferhigherqualityproductstotheircustomersandtoreducetheirenvironmentalfootprint.Moregenerally,manyorganizationsareunderpressuretosatisfythedemandsofmorediversestakeholders.Incurrentscholarship,thesechallengeshavebeenaddressedbytheliteratureon“hybrid”organizationsininstitutionaltheory(Greenwood,Raynard,Kodeih,Micelotta,&Lounsbury,2011)orhybrididentities(Albert,Ashforth,&Dutton,2000).Insofarastheseorganizationsaimtosynthesizemultiplepurposes,ourcollaborativemodelprovidesacompassheadingthatcanguidetheirefforts.

Extensiontonon-profit,volunteerorganizations.Ourconceptofpurposeisclosetotheconceptof“civicaction”advancedbyLichtermanandEliasoph(2014),buttheworldofcivicvoluntaryactionthattheystudyispopulatedbysmallerandsimplerorganizations.Ourargumentimpliesthatlargermorecomplexorganizationsofthistypearelikelytobemoreeffectiveifthey

adoptthecollaborativeformsketchedhere.Futureresearchcouldusefullytestourargumentandenrichtheconceptintheprocess.LichtermanandEliasoph’sconceptof“styles,”forexample,suggeststhatwithinthecollaborativeform,wearelikelytofindavarietyofwaysofenactingvalue-rationality.

Externallegitimacy.Onelessonfromthisidentityliteratureisthat,insofarasorganizationsaimtocreateahybrididentity,theymustcontendnotonlywiththeinternalmanagerialchallengesthathavebeenthefocusofthepresentpaper,butalsowithexternallegitimacychallenges.Eachoftheconstituentidentitiesandlogicswilltypicallyrequiresomedegreeofsupra-organizationalinstitutionallegitimacy,andthesuccessoftheorganizationinhybridizinginternallywillbeinfluencedbythesebroaderfield-levelactorsandfactors.Kaiserprovidesaniceexample.Kaiser’ssuccesshingedconsiderablyonitsabilitytoenrollarangeofexternal,field-levelactorssoastolegitimateitsefforts,suchasthemedicalprofession,patient-rightsgroups,andtherelevantstateagencies.Scott,Ruef,Mendel,andCaronna(2000)exploresomefacetsofthisstruggle,andfutureresearchmightexplorehowappealstovalue-rationalityacquirelegitimacyinthisbroader,field-leveltransformation.

Externalenablers.Theimportanceofthebroadercontextextendsbeyondthesymbolic-culturallegitimacyitmaybestow:thecollaborativeformisfarmorelikelytoemergeandpersistiftheorganizationfunctionsinacontextthatblocksthefirmanditscompetitorsfromtakinga“lowroad”ofworkintensificationasapathtoprofitabilityandcompetitivesurvival.Kristensen(Kristensen,forthcoming)forexample,discussesformsofintra-andinter-firmorganizationinDenmarkthatappearveryclosetoourvalue-rationalcollaborativemodel,andexplainshowtheseformsareencouragedonthe“supplyside”byenablinglabortotakeactivepartinshapingenterprisessupportedbysocialwelfareservices(training,child-andeldercare,supportforhousing,etc.)andonthe“demandside”bygovernmentpoliciesthatareresponsivetonewneeds(suchasenvironmentalprotection,health,andcityplanning).

References

Adler,P.S.1999a.Buildingbetterbureaucracies.AcademyofManagementExecutive,13(4):36-

50.Adler,P.S.1999b.HybridizationofHumanResourceManagementattwoToyotatransplants.InJ.K.

Liker,W.M.Fruin,&P.S.Adler(Eds.),RemadeinAmerica:TransplantingandtransformingJapanesemanagementsystems,:75-116.NewYork,NY:OxfordUniversityPress.

Adler,P.S.2001.Market,Hierarchy,andTrust:TheKnowledgeEconomyandtheFutureofCapitalism.OrganizationScience,12(2):215-234.

Adler,P.S.,&Borys,B.1996.TwoTypesofBureaucracy:EnablingandCoercive.AdministrativeScienceQuarterly,41(1):61-89.

Adler,P.S.,Kwon,S.,&Heckscher,C.2008.Professionalwork:Theemergenceofcollaborativecommunity.OrganizationScience,19(2).

Aime,F.,Humphrey,S.,DeRue,D.,&Paul,J.2013.Theriddleofheterarchy:Powertransitionsincross-functionalteams.AcademyofManagementJournal,57(2):327-352.

Akao,Y.2004.Qualityfunctiondeployment:integratingcustomerrequirementsintoproductdesign.NewYork:ProductivityPress.

Albert,S.,Ashforth,B.E.,&Dutton,J.E.2000.OrganizationalIdentityandIdentification:ChartingNewWatersandBuildingNewBridges.AcademyofManagementReview,25(1):13-17.

Angell,M.1993.Thedoctorasdoubleagent.KennedyInstituteofEthicsJournal,3(3):279-286.Barley,S.R.,&Kunda,G.1992.Designanddevotion:Surgesofrationalandnormativeideologiesof

controlinmanagerialdiscourse.AdministrativeScienceQuarterly,37(3):363.Barnard,C.I.1938.Thefunctionsoftheexecutive.Cambridge,MA:HarvardUniversityPress.Bendix,R.1956.Workandauthorityinindustry.NewYork:JohnWiley&Sons.Besharov,M.L.,&Khurana,R.2015.Leadingamidstcompetingtechnicalandinstitutional

demands:RevisitingSelznick’sconceptionofleadership.InstitutionsandIdeals:PhilipSelznick’sLegacyforOrganizationalStudies(ResearchintheSociologyofOrganizations,Volume44)EmeraldGroupPublishingLimited,44:53-88.

Biggart,N.W.,&Delbridge,R.2004.Systemsofexchange.TheAcademyofManagementReview,29(1):28-49.

Borsos,J.2013.TheSurrenderofOakland:The2012NationalAgreementbetweentheCoalitionofKaiserPermanenteUnionsandKaiserPermanente.WorkingUSA,16(2):269-276.

Bracken,D.,Timmreck,C.,Fleenor,J.,&Summers,L.2001.360feedbackfromanotherangle.HumanResourceManagement,40(1):3-20.

Brady,T.,Davies,A.,&Gann,D.M.2005.Creatingvaluebydeliveringintegratedsolutions.InternationalJournalofProjectManagement,23(5):360-365.

Brint,S.G.1994.InanAgeofExperts:TheChangingRoleofProfessionalsinPoliticsandPublicLife.Princeton,N.J.:PrincetonUniversityPress.

Brown,C.,&Reich,M.1997.Micro-macrolinkagesinhigh-performanceemploymentsystems.OrganizationStudies,18(5):765.

Burns,L.R.1989.Matrixmanagementinhospitals:Testingtheoriesofmatrixstructureanddevelopment.AdministrativeScienceQuarterly:349-368.

Cameron,K.S.,&Quinn,R.E.2005.Diagnosingandchangingorganizationalculture:Basedonthecompetingvaluesframework:JohnWiley&Sons.

Cohen,P.M.,Ptaskiewicz,M.,&Mipos,D.2010.Thecaseforunit-basedteams:Amodelforfront-lineengagementandperformanceimprovement.ThePermanenteJournal,14(2):70-75.

Cole,R.E.1999.Japanesequalitytechnology.InJ.Liker,M.Fruin,&P.S.Adler(Eds.),RemadeinAmerica:TransplantingandTransformingJapaneseManagementSystems:

TransplantingandTransformingJapaneseManagementSystems:203-231.NewYork:OxfordUniversityPress.

Collins,J.C.,&Porras,J.I.1996.Buildingyourcompany'svision.HarvardBusinessReview(September-October):65-77.

Cordero,R.1999.DevelopingtheknowledgeandskillsofR&Dprofessionalstoachieveprocessoutcomesincross-functionalteams.TheJournalofHighTechnologyManagementResearch,10(1):61-78.

Cromwell,J.,Trisolini,M.G.,Pope,G.C.,Mitchell,J.B.,&Greenwald,L.M.2011.Payforperformanceinhealthcare:Methodsandapproaches:RTIPress.

Cullen,K.,&Yammarino,F.J.2014.Specialissueoncollectiveandnetworkapproachestoleadership.TheLeadershipQuarterly,25(1):180-181.

Deci,E.L.,&Ryan,R.M.1987.Thesupportofautonomyandthecontrolofbehavior.Journalofpersonalityandsocialpsychology,53(6):1024-1037.

Doty,D.H.,&Glick,W.H.1994.Typologiesasauniqueformoftheorybuilding:Towardimprovedunderstandingandmodeling.AcademyofManagementReview,19(2):230-251.

Dougherty,D.1992.Interpretivebarrierstosuccessfulproductinnovationinlargefirms.OrganizationScience,3(2):179-202.

Draganidis,F.,&Mentzas,G.2006.Competencybasedmanagement:areviewofsystemsandapproaches.InformationManagement&ComputerSecurity,14(1):51-64.

Drucker,P.F.,&Maciariello,J.A.2008.ManagementRevEd:Zondervan.Dubois,D.D.1998.Thecompetencycasebook:twelvestudiesincompetency-basedperformance

improvement.AmherstMA:HRDPress.Dubois,D.D.2010.Competency-basedhumanresourcemanagement.BostonMA:Nicholas

BrealeyPublishing.Early,S.2011.TheCivilWarsinUSLabor:BirthofaNewWorkers'MovementOrDeathThroes

oftheOld?:HaymarketBooks.Eaton,A.E.,Konitsney,D.,Litwin,A.S.,&Vanderhorst,N.2011.ThePathtoperformance:AStudyof

high-performingunit-basedteamsatKaiserPermanente:KaiserPermanent,Labor-ManagementPartnership

Etzioni,A.1975.ComparativeAnalysisofComplexOrganizations,Rev:SimonandSchuster.Follett,M.P.,Metcalf,H.C.,&Urwick,L.F.1942.Dynamicadministration.Forester,J.1999.Thedeliberativepractitioner:Encouragingparticipatoryplanningprocesses.

CambridgeMA:TheMITPress.Foss,N.J.,&Lindenberg,S.2013.Microfoundationsforstrategy:agoal-framingperspectiveonthe

driversofvaluecreation.TheAcademyofManagementPerspectives,27(2):85-102.Freeman,J.1972.TheTyrannyofStructurelessness.BerkeleyJournalofSociology,17:151-164.Freeman,R.E.,Wicks,A.C.,&Parmar,B.2004.StakeholderTheoryand"TheCorporateObjective

Revisited".OrganizationScience,15(3):364-369.Friedland,R.2013.God,loveandothergoodreasonsforpractice:Thinkingthroughinstitutional

logics.InstitutionalLogicsinAction:ResearchintheSociologyofOrganizations,39:25-50.

Galbraith,J.1973.DesigningComplexOrganizations.Reading,MA:Addison-Wesley.Galbraith,J.2002.Organizingtodeliversolutions.OrganizationalDynamics,31(2):194-207.Galbraith,J.2008.DesigningMatrixOrganizationsthatActuallyWork:HowIBM,Proctor&

GambleandOthersDesignforSuccess.SanFrancisco,CA:Jossey-Bass.Galbraith,J.R.1994.CompetingwithFlexibleLateralOrganizations(2nded.).Reading,MA:

Addison-Wesley.Geraldi,J.2009.Reconcilingorderandchaosinmulti-projectfirms.InternationalJournalof

ManagingProjectsinBusiness,2(1):149-158.

Gibson,C.,&Birkinshaw,J.2004.Theantecedents,consequences,andmediatingroleoforganizationalambidexterity.AcademyofManagementJournal,47:209-226.

Gittell,J.H.2000.Paradoxofcoordinationandcontrol.CaliforniaManagementReview,42(3):101-117.

Gouldner,A.W.1954.PatternsofIndustrialBureaucracy.Glencoe,IL:FreePress.Grant,A.M.2008.Thesignificanceoftasksignificance:Jobperformanceeffects,relational

mechanisms,andboundaryconditions.JournalofAppliedPsychology,93(1):108.Grant,R.M.1996.TowardaKnowledge-basedTheoryoftheFirm.StrategicManagementJournal,

17:109-122.Grant,R.M.,&Baden-Fuller,C.1995.AKnowledge-basedtheoryofInter-firmcollaboration.

AcademyofManagementJournal:17-21.Greenwood,R.,Raynard,M.,Kodeih,F.,Micelotta,E.R.,&Lounsbury,M.2011.Institutional

complexityandorganizationalresponses.TheAcademyofManagementAnnals,5(1):317-371.

Habermas,J.1992.Moralconsciousnessandcommunicativeaction.CambridgeMA:TheMITPress.

Habermas,J.2001.Onthepragmaticsofsocialinteraction:preliminarystudiesinthetheoryofcommunicativeaction:MITPress.

Hackman,J.R.,&Oldham,G.R.1976.MotivationthroughtheDesignofWork:TestofaTheory.OrganizationalBehavior&HumanPerformance,16(2):250-279.

Hage,J.,&Aiken,M.1970.SocialChangeinComplexOrganizations.NewYork:RandomHouse.Heckscher,C.2007.TheCollaborativeEnterprise.NewHaven,CT:YaleUniversityPress.Hennis,W.1988.ThetracesofNietzscheintheworkofMaxWeberMaxWeber:Essaysin

Reconstruction:146-162.London:Allen&Unwin.Hinings,C.,&Greenwood,R.2015.Missinginaction:ThefurthercontributionofPhilipSelznickto

contemporaryinstitutionaltheory,Institutionsandideals:PhilipSelznick’slegacyfororganizationalstudies:121-148:EmeraldGroupPublishingLimited.

Hollensbe,E.,Wookey,C.,Hickey,L.,George,G.,&Nichols,C.V.2014.Organizationswithpurpose.AcademyofManagementJournal,57(5):1227-1234.

Howell,B.M.,&Avolio,B.J.1993.TransformationalLeadership,TransactionalLeadership,LocusofControl,andSupportforInnovation:KeyPredictorsofConsolidated-Business-UnitPerformance.JournalofAppliedPsychology,78(No.6):891-903.

Humphrey,S.E.,Nahrgang,J.D.,&Morgeson,F.P.2007.Integratingmotivational,social,andcontextualworkdesignfeatures:ameta-analyticsummaryandtheoreticalextensionoftheworkdesignliterature.JournalofAppliedPsychology,92(5):1332.

Iansiti,M.1993.Real-worldR&D:Jumpingtheproductgenerationgap.HarvardBusinessReview,71(3):138-147.

James,J.2012.Healthpolicybrief:pay-for-performance.HealthAffairs,11:2043-2050.Jansen,J.,George,G.,VandenBosch,F.,&Volberda,H.2008.SeniorTeamAttributesand

OrganizationalAmbidexterity:TheModeratingRoleofTransformationalLeadership.JournalofManagementStudies,45(5):982-1007.

Jaques,E.1989.Requisiteorganization:TheCEO'sguidetocreativestructureandleadership:CasonHallArlington,VA.

Jha,A.K.,Joynt,K.E.,Orav,E.J.,&Epstein,A.M.2012.Thelong-termeffectofpremierpayforperformanceonpatientoutcomes.NewEnglandJournalofMedicine,366(17):1606-1615.

Juillerat,T.L.2010.Friends,notfoes?:Workdesignandformalizationinthemodernworkcontext.JournalofOrganizationalBehavior,31(2-3):216-239.

Jyoti,J.,&Dev,M.2015.Theimpactoftransformationalleadershiponemployeecreativity:theroleoflearningorientation.JournalofAsiaBusinessStudies,9(1):78-98.

KaiserPermanente,&CoalitionofKaiserPermanenteUnions.2012.NationalAgreement.

KaiserPermanenteLaborManagementPartnership.2015.Kalberg,S.1980.MaxWeber'sTypesofRationality:CornerstonesfortheAnalysisofRationalization

ProcessesinHistory.TheAmericanJournalofSociology,85(5):1145-1179.Kang,S.C.,&Snell,S.A.2009.Intellectualcapitalarchitecturesandambidextrouslearning:a

frameworkforhumanresourcemanagement.JournalofManagementStudies,46(1):65-92.

Kaplan,R.S.,&Norton,D.P.2001.Transformingthebalancedscorecardfromperformancemeasurementtostrategicmanagement:PartII.AccountingHorizons,15(2):147-160.

Kim,W.C.2005.BlueOceanStrategy:HowtoCreateUncontestedMarketSpaceandMakeCompetitionIrrelevant/W.ChanKim,ReneeMauborgne–HarvardBusinessReview.

Klein,H.J.,Molloy,J.C.,&Brinsfield,C.T.2012.ReconceptualizingWorkplaceCommitmenttoRedressaStretchedConstruct:RevisitingAssumptionsandRemovingConfounds.AcademyofManagementReview,37(1):130-151.

Kochan,T.A.2013.TheKaiserPermanenteLaborManagementPartnership:2009-2013.CambridgeMA:MITSloanSchoolInstituteforWork&EmploymentResearch.

Kochan,T.A.,Eaton,A.E.,McKersie,R.B.,&Adler,P.S.2009.Healingtogether:thelabor-managementpartnershipatKaiserPermanente.Ithaca:ILRPress.

Kristensen,P.H.forthcoming.ConstructingChainsofEnablersforAlternativeEconomicFutures:DenmarkasanExample

.AcademyofManagementPerspectives.Larson,E.W.,&Gobeli,D.H.1987.Matrixmanagement:contradictionsandinsights.California

ManagementReview,29(4):126-138.Leonard-Barton,D.1995.WellspringsofKnowledge:BuildingandSustainingtheSourcesof

Innovation.Boston,MA:HarvardBusinessSchoolPress.Lewis,D.1996.Theorganizationalculturesaga-fromODtoTQM:acriticalreviewoftheliterature.

Part1-conceptsandearlytrends.Leadership&OrganizationDevelopmentJournal,17(1):12-19.

Lichterman,P.,&Eliasoph,N.2014.CivicAction.AmericanJournalofSociology,120(3):798-863.Ling,Y.,Simsek,Z.,Lubatkin,M.H.,&Veiga,J.F.2008.TheimpactoftransformationalCEOsonthe

performanceofsmall-tomedium-sizedfirms:doesorganizationalcontextmatter?JournalofAppliedPsychology,93(4):923.

Litwin,A.S.2010.Technologicalchangeatwork:Theimpactofemployeeinvolvementontheeffectivenessofhealthinformationtechnology.IndustrialandLaborRelationsReview,64(5):863-888.

Lovelace,K.,Shapiro,D.L.,&Weingart,L.R.2001.Maximizingcross-functionalnewproductteams'innovativenessandconstraintadherence:Aconflictcommunicationsperspective.AcademyofManagementJournal,44(4):779-793.

March,J.G.,&Sutton,R.I.1997.Crossroads-organizationalperformanceasadependentvariable.Organizationscience,8(6):698-706.

Marens,R.2009.It'snotjustforcommunistsanymore:Marxianpoliticaleconomyandorganizationtheory.InP.S.Adler(Ed.),TheOxfordHandbookofSociologyandOrganizationStudies:ClassicalFoundations:92-117.NewYork:OxfordUniversityPress.

Martin,J.1992.Culturesinorganizations:Threeperspectives.N.Y.:OxfordUniversityPress.Martin,J.A.,&Eisenhardt,K.M.2010.Rewiring:Cross-business-unitcollaborationsin

multibusinessorganizations.TheAcademyofManagementJournal53(2):265-301.Marx,K.1990[1867].Capital(B.Fowkes,Trans.).London:Penguin.McCaffrey,D.P.,Faerman,S.R.,&Hart,D.1995.Theappealanddifficultiesofparticipativesystems.

OrganizationScience,6:603-627.

McCarthy,D.,Mueller,K.,Wrenn,J.,&Fund,C.2009.KaiserPermanente:Bridgingthequalitydividewithintegratedpractice,groupaccountability,andhealthinformationtechnology.NewYork:CommonwealthFundNewYork.

McClelland,D.C.1973.Testingforcompetenceratherthanfor"intelligence".AmericanPsychologist,28(1):1-14.

McKersie,R.B.,Sharpe,T.,Kochan,T.A.,Eaton,A.E.,Strauss,G.,&Morgenstern,M.2008.BargainingTheoryMeetsInterest-BasedNegotiations:ACaseStudy.IndustrialRelations,47(1):66-96.

Merton,R.K.1940.Bureaucraticstructureandpersonality.SocialForces,18:560-568.Michels,R.1966.PoliticalParties.NewYork,NY:TheFreePress.Mintzberg,H.1989.Mintzbergonmanagement:Insideourstrangeworldoforganizations:

SimonandSchuster.Mohrman,S.A.,&Kanter,M.H.2012.DesigningforHealth:LearningfromKaiserPermanente.InS.

A.Mohrman,&A.B.R.Shani(Eds.),OrganizingforSustainableHealthCare:77-111.Bingley,UK:Emerald.

Mom,T.,VanDenBosch,F.,&Volberda,H.2009.UnderstandingVariationinManagers'Ambidexterity:InvestigatingDirectandInteractionEffectsofFormalStructuralandPersonalCoordinationMechanisms.OrganizationScience,20(4):812-828.

Mommsen,W.J.1974.Theageofbureaucracy:PerspectivesonthepoliticalsociologyofMaxWeber.NewYork:Blackwell.

Morgan,P.I.,&Ogbonna,E.2008.Subculturaldynamicsintransformation:amulti-perspectivestudyofhealthcareprofessionals.HumanRelations,61(1):39-65.

Nelson,F.2010.FullNelson:Healthcareinnovation:Kaiser'sGarfieldCenter.InformationWeek,Feb23.

Ouchi,W.G.1979.Aconceptualframeworkforthedesignoforganizationalcontrolmechanisms.ManagementScience,25(September):833-848.

Ouchi,W.G.,&Jaeger,A.M.1978.TypeZorganization:Stabilityinthemidstofmobility.AcademyofManagementReview(April):305-314.

Peiperl,M.2001.Getting360degreesfeedbackright.HarvardBusinessReview,79(1):142-147.PhillipsCarson,P.,Lanier,P.A.,Carson,K.D.,&Birkenmeier,B.J.1999.Ahistoricalperspectiveon

fadadoptionandabandonment.JournalofManagementHistory,5(6):320-333.Pillai,R.,&Meindl,J.1998.Contextandcharisma:A"meso"levelexaminationoftherelationshipof

organicstructure,collectivism,andcrisistocharismaticleadership.JournalofManagement,24(5):643-671.

Pine,B.J.1993.Masscustomization:Thenewfrontierinbusinesscompetition.Boston,MA:HarvardBusinessSchoolPress.

Porras,J.I.,&Collins,J.C.1997.Builttolast:HarperBusiness.Postlethwaite,D.,Shaber,R.,Mancuso,V.,Flores,J.,&Armstrong,M.A.2007.Intrauterine

contraception:evaluationofclinicianpracticepatternsinKaiserPermanenteNorthernCalifornia.Contraception,75(3):177-184.

Pugh,D.S.,&Hickson,D.J.1976.Organizationalstructureinitscontext:TheAstonprogrammeI.Lexington,MA:LexingtonBooks.

Puranam,P.,Singh,H.,&Chaudhuri,S.2009.IntegratingAcquiredCapabilities:WhenStructuralIntegrationIs(Un)necessary.OrganizationScience,20(2):313-328.

Roloff,J.2008.Learningfrommulti-stakeholdernetworks:Issue-focussedstakeholdermanagement.JournalofBusinessEthics,82(1):233-250.

Rubinstein,S.A.,&Kochan,T.A.2001.LearningfromSaturn:possibilitiesforcorporategovernanceandemployeerelations.Ithaca,NY:CornellUniversityPress.

Satow,R.L.1975.Value-rationalauthorityandprofessionalorganizations.AdministrativeScienceQuarterly,20(4):526-531.

Schein,E.H.2010.Organizationalcultureandleadership:JohnWiley&Sons.Schilling,L.,Chase,A.,Kehrli,S.,Liu,A.Y.,Stiefel,M.,&Brentari,R.2010a.KaiserPermanente's

performanceimprovementsystem,Part1:Frombenchmarkingtoexecutingonstrategicpriorities.JointCommissionJournalonQualityandPatientSafety,36(11):484-498.

Schilling,L.,Dearing,J.W.,Staley,P.,Harvey,P.,Fahey,L.,&Kuruppu,F.2011a.KaiserPermanente'sperformanceimprovementsystem,Part4:Creatingalearningorganization.JointCommissionJournalonQualityandPatientSafety,37(12):532-532.

Schilling,L.,Dearing,J.W.,Staley,P.,Harvey,P.,Fahey,L.,&Kuruppu,F.2011b.KaiserPermanente'sperformanceimprovementsystem,Part4:Creatingalearningorganization.JointCommissionJournalonQualityandPatientSafety,37(12):532-543.

Schilling,L.,Deas,D.,Jedlinsky,M.,Aronoff,D.,Fershtman,J.,&Wali,A.2010b.Kaiserpermanente'sperformanceimprovementsystem,part2:Developingavalueframework.JointCommissionJournalonQualityandPatientSafety,36(12):552-560.

Schmidt,F.L.,&Hunter,J.E.1998.Thevalidityandutilityofselectionmethodsinpersonnelpsychology:Practicalandtheoreticalimplicationsof85yearsofresearchfindings.PsychologicalBulletin,124(2):262.

Schmitt,C.1988.Thecrisisofparliamentarydemocracy.Boston:MITPress.Scott,T.,Mannion,R.,Davies,H.T.O.,&Marshall,M.N.2003.Implementingculturechangeinhealth

care:theoryandpractice.InternationalJournalforQualityinHealthCare,15(2):111-118.

Scott,W.R.,Ruef,M.,Mendel,P.J.,&Caronna,C.2000.InstitutionalChangeandHealthCareOrganizations:FromProfessionalDominancetoManagedCare.Chicago:UniversityofChicagoPress.

Selznick,P.1957.Leadershipinadministration;asociologicalinterpretation.Evanston,Ill.,:Row.

Selznick,P.1994.Themoralcommonwealth:Socialtheoryandthepromiseofcommunity:UnivofCaliforniaPress.

Sherif,M.1958.Superordinategoalsinthereductionofintergroupconflict.AmericanJournalofSociology:349-356.

Shook,J.2010.Howtochangeaculture:LessonsfromNUMMI.MITSloanManagementReview,51(2):42-51.

Singleton,L.2014.UnderstandingtheEvolutionofTheoreticalConstructsinOrganizationStudies:Examining“Purpose”.PaperpresentedattheAcademyofManagementProceedings.

Singleton,L.G.2011.UnderstandingtheEvolutionofTheoreticalConstructsinOrganizationStudies:ExaminingCooperationandPurpose.BostonCollege.

Steiner,I.D.1972.Groupprocessandproductivity.NewYork,:AcademicPress.Strikwerda,J.,&Stoelhorst,J.2009.Theemergenceandevolutionofthemultidimensional

organization.CaliforniaManagementReview,51(4):11-31.Sundaram,A.K.,&Inkpen,A.C.2004.Thecorporateobjectiverevisited.Organizationscience,

15(3):350-363.Thompson,J.D.1967.OrganizationsinAction:SocialScienceBasesofAdministrativeTheory.

NewYork:McGraw-Hill.Thomson,A.M.,Perry,J.L.,&Miller,T.K.2009.Conceptualizingandmeasuringcollaboration.

JournalofPublicAdministrationResearchandTheory,19(1):23.Tushman,M.,Smith,W.,Wood,R.,Westerman,G.,&O'Reilly,C.2010.Organizationaldesignsand

innovationstreams.IndustrialandCorporateChange:1331-1366.VandeVen,A.H.,Delbecq,A.L.,&Koenig,R.J.1976.Determinantsofcoordinationmodeswithin

organizations.AmericanSociologicalReview,41:322-338.

Wallace,W.1990.Rationality,humannature,andsocietyinWeber'stheory.TheoryandSociety,19(2):199-223.

Waters,M.1989.Collegiality,bureaucratization,andprofessionalization:AWeberiananalysis.AmericanJournalofSociology,94:945-972.

Weber,M.1978.Economyandsociety.BerkeleyCA:UniversityofCaliforniaPress.Whippy,A.,Skeath,M.,Crawford,B.,Adams,C.,Marelich,G.,Alamshahi,M.,&Borbon,J.2011.Kaiser

Permanente'sperformanceimprovementsystem,part3:multisiteimprovementsincareforpatientswithsepsis.JointCommissionJournalonQualityandPatientSafety,37(11):483-495.

Wood,D.J.,&Gray,B.1991.Towardacomprehensivetheoryofcollaboration.TheJournalofAppliedBehavioralScience,27(2):139.

Zadek,S.2008.Globalcollaborativegovernance:thereisnoalternative.CorporateGovernance,8(4):374-388.

Figure1:Sustainingpurposeinlarge,complexorganizations

Ex-antepurpose

Scale,Complexity Challengesinscaling

upvalue-rationality:•Fragmentation

•Goaldisplacement

•Centralization

•Specialization

Keyfeaturesofthecollaborativeform:

• Ethicofcontribution

• Substantiverationality

• Contribution-basedauthority

• Contribution-orientedcapabilitydevelopment

Ex-postpurpose

Figure2:Scaling-upvalue-rationality Challengesof

scalingupvalue-rationality

Keyfeaturesofthecollaborativeform

Managerialtechniquesthatoperationalizethecollaborativeform’scharacteristicfeatures,withexamplesfromKaiserPermanente

Values Fragmentation:lossoftheorganization’sabilitytodefineacommonpurposeorpreserveitssalience

Institutionalizeanethicofcontribution

1.Focusoncustomerneeds(Solutions-orientedbusinessmodel,Front-backstructure,QualityFunctionDeployment,etc.)tolinkstrategytodailywork

*ValueCompassguidesactivityateverylevel

2.Widestrategydialogue

*ValueCompassdefinedjointlybyPartnership

3.Cultivatepurpose-orientedidentities

*Regularunblindedcomparisonofdoctorsoutcomes

*Regularmeetingsamongdoctorsoncost-efficacytension

*Bandrugdetailingandfosteracademicdetailing

*Recruitfor,andcelebratecombinedidentities

Norms Goaldisplacement:conformancereplacespurpose

Institutionalizeameta-normofsubstantiverationalitytocreateenablingsystems

1.Interactiveprocessmanagement(Protocolsforkaizen,processmapping,brainstorming,participatorymeetingmanagement,decision-makingwithmultiplestakeholders,andprojectmanagement)

*Standardizedproceduresforclinicalguidelinedevelopment

*StandardizedproceduresforPDSAcycle,dailyhuddles,etc.

2.Interactiveprocessdesign

*Participativedesignandrefinementofprocedures

*Multi-stakeholderparticipationinclinicalguidelinedevelopmentandrevision

*Unit-basedteamsdevelopandrefineprocessestoimproveservicequality,clinicalperformance,workersafety,andreducecosts

Authority Centralization:Delegatedauthoritydisplacesendorsedauthority,andcentralizationunderminesautonomy

Contribution-basedauthoritytocreateparticipativecentralization

1.Participativedecision-makinginsettingthedegreeofcentralization

*UBTsarecharteredbyjointlabor-management/doctorsponsors

2.Participativeexerciseofcentralizedauthority

*Hierarchyoflabor-managementcouncilsfromBoarddowntounitlevel

*UBTsaimatentireworkgroup,butarerepresentativewherethatismoreproductive

3.Distributedleadership

*UBTsledbywhomeverismostqualifiedtoleadtheproject

4.Multidimensionalauthoritystructures

*SpecializedstaffsforPerformanceImprovementandInnovationmatrixedwithlineorganizationsonprogramsand

projects

*Medicalspecialty-coordinatorsacrosstheRegiondriveperformanceimprovementamongdoctors

Capabilities Specialism Contribution-orientedcapabilitydevelopmenttocreateT-shapedcapabilities

1.Purpose-orientedrecruitingandselectioncriteria

*Doctorsrecruitedforandevaluatedperiodicallyduringthree-yearprobation,ontechnicalcompetence,butalsocollegiality,respectforotherstaffandpatients,willingnesstocontributeideas,effortstoimprovetheorganization’sperformance

2.Socialandtechnicalcompetenciesformation

*Jointmanagement-unionfundforskilldevelopmentinproblem-solving,leadingmeetings,analyzingworkprocesses,identifyingimprovementopportunities,presentation,leadership,economicsofhealthcare

*Leadershiptrainingfordoctors

3.Contribution-orientedrewards

*Compensationbasedoncontributiontosharedpurpose

*30%ofdoctors’salaryis“atrisk,”basedonpatientsatisfactionandclinicaloutcomes–notoncosts

*360evaluationsofdoctorsandmanagers

*Workers’bonusdependsonregion-wideresultsonattendance,safety,service,clinicaloutcomes,andhealthstatusofKPpersonnel

4.Technologyinfrastructuresupport

*ITjointlyplannedandimplemented

*ITsupportsbothcentralizedanddistributedauthority

*ConductanddisseminateKPresearchongenericdrugequivalents

managing for shared purpose: how … for shared purpose: how business enterprises scale-up...

Documents

principal collegiality and school district effectiveness...

naf teacher collegiality 08

a passion for teaching - · pdf filethe collegiality of the...

collegiality, the nursing practice environment, and missed

episcopacy - conciliarity - collegiality - primacy : the

linda holbeche phd/media/employers/documents/cam… ·...

promoting ongoing cross institutional aall collegiality,...

our shared purpose newsletter - november 2018...our shared...

shared beliefs and practices for putting purpose … ·...

our shared purpose - university of...

collegiality in action - ohlone college · collegiality in...

arm shared purpose

purpose-driven leadership in action: harnessing humanity and...

collegiality as a leadership strategyetheses.bham.ac.uk ›...

a shared purpose for english language learners · a shared...

csr for purpose, shared value and

collegiality as a fourth criterion for personnel decisions...

collegiality, ethics and the dilemmas of professionalism

many voices, shared purpose - iupui

collegiality and intellectual love - core · collegiality...