Document Type

Article

Publication Date

2-1-2010

Abstract

"Ambidexterity: Noun: 1. ambidextrous ease, skill, or facility; 2. unusual cleverness; 3.duplicity; deceitfulness." Retrieved March 21, 2010, from Dictionary.com website: http://dictionary.reference.com/browse/ambidexterity Despite their research and educational prowess, Academic Medical Centers are in a crisis. Public reporting of quality and patient satisfaction data, increasing costs, stiffer competition, and anticipated tightening of budgets have created new levels of urgency among medical school deans and hospital CEOs to increase the effectiveness of the clinical enterprise on multiple fronts. This study models an AMC as a loosely coupled system and examines how interdisciplinary teams--comprising administrators, physicians, and nurses--work to harmonize seemingly disparate quality improvement goals. Structural equation modeling techniques were used to rigorously test the premise that contextual ambidexterity mediates the relationships between team characteristics, the team's organizational context and goal harmony. Several cross-product terms were modeled to isolate interaction effects. This research contributes to the field in three ways. First, it offers a novel conceptualization of contextual ambidexterity as a two-stage alignment-to-adaptability process and draws linkages to the theory of the Toyota Production System. Second, it offers preliminary guidance on key characteristics of teams that sponsors should seek, and on the nature of the context they should create. Finally, the study suggests that sponsors should be wary of charismatic leaders who achieve goal harmony through equifinal meaning construction which often does not survive post-implementation sensemaking.

Keywords

medical care, ambidexterity, Toyota Production System, reengineering, sensemaking, equifinal meaning.

Rights

© The Author(s). Kelvin Smith Library provides access for non-commercial, personal, or research use only. All other use, including but not limited to commercial or scholarly reproductions, redistribution, publication or transmission, whether by electronic means or otherwise, without prior written permission is strictly prohibited.

Department/Center

Design & Innovation

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