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" Organizational behavior in the Health Service : "
Sparks, Richard E.
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Latin Dissertation
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| Record Number
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1092912
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TLets255847
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| Main Entry
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Sparks, Richard E.
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| Title & Author
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Organizational behavior in the Health Service :\ Sparks, Richard E.
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| College
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University of Manchester
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| Date
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1989
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| student score
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1989
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| Degree
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Ph.D.
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| Abstract
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Decision theory suggests two general ways to study decisions: t e process ylich the decision was made or the attributes of the decision itself.Within the process branch, Allison (1971) and Allen (1979) analyzed a single~cision using the Rational model, the Organizational Process model, and theJreaucratic Politics model, each of which contributed to explaining the decision.Llison and Allen also argued for how their findings could be applied moreenerally. Aharoni (1966) and Heclo and Wildavsky (1974) used a second approach t:udy pieces of many decisions. The emphasis was on understanding the whole procesather than on explaining any particular decision. This approach is largely freef decision models and describes important factors within the process.One set of attributes comes from Cooke and Slack (1984) who suggested that!cisions can be analyzed by three related pairs of variables: Operational -:rategic, Independent - Dependent, and Structured - Unstructured. To these, theesearcher added Relative Importance and Innovation.This paper uses both the process and attribute approaches to analyze eleven cas~udies of local capital allocation decisions in two health districts in northernngland. Some of the cases were chosen to allow direct comparison betweenrganizations, circumstances, and individuals. Like Allison or Allen, each decisioas examined through each model (Hypothesis 1: Each decision model helps explainach decision). Following Aharoni or Heclo and Wildavsky. the examination of manyecisions allows delineation of important factors within the process (Hypothesis 2here are specific factors which are important to explain the process). Finally,ach decision is also classified using Cooke and Slack's decision attributesHypothesis 3: Decisions can be explained using the various decision attributes).Information was gathered through interviews with participants and examination 0elevant documents. Some of the decisions were concurrent with the researcher'stay and could be watched as they happened. However, most events occurred beforehis involvement.Part way into the study, it became clear that each district had anrganizational process for the kinds of decisions in the study. This process wasased on three elements: the rules and regulations within the NHS which prescribehat is acceptable and how it is to be done; past events and personalities withinhe health district itself which influenced current processes; and events outsidehe NHS which established the climate within which all of this took place.etailing this process became the basis for Part II.Because an organizational process describes the overall approach, the OrganizaionalProcess model should also best explain the case study decisions (Hypothesis). This alternative to Hypothesis 1 was tested in Part III, where each case studS described and analyzed. However, the results show that the Bureaucratic Politic~del is also important in explaining the decisions, with the Rational model less,aeful. Thus, neither Hypothesis 1 nor Hypothesis 4 is totally supported.As expected in Hypothesis 2, many factors affected decisions (see Part IV), sompecific to the setting and some with broader applicability. The more interestingnes are Staff and Patient Welfare, the Availability of Money, and the Threshhold:ffect. Also in Part IV, the results from Part III are combined in a matrix, witheciaion models on one axis and decision attributes on the other, to analyze how:he two approaches are related. The results show some of the expected relationshipletween models and attributes on a broad basis but not on a detailed basis.Significance: This study broadens decision theory by taking a first step in:ombining the attribute and process approaches. It also illuminates the need for:urther study by showing how incompatible the results of the twosaPDrQaches are.ee "Notes on reverse
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Decision theory
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| Added Entry
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University of Manchester
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