Theses and Dissertations

Date of Award

2009

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Education (EdD)

Department

Abraham S. Fischler College of Education and School of Criminal Justice

Advisor

Mary Lynn Vogel

Committee Member

Marian Torrence

Committee Member

Maryellen Maher

Keywords

Organizational Development/Social Exchange Theory/Organizational Theories/Organizational Culture/Organizational Effectiveness

Abstract

Green (2003) described a number of strategies that hospitals had employed in the past 15 years in an attempt to improve the relationship with physicians. One of the emerging strategies was the implementation of a compact between key organizational players. This applied dissertation described the evaluation of a compact implemented between the employed primary care providers and the leadership of a health care organization in the researcher’s state. The compact was intended to meet three objectives: (a) improve the communication between the parties, (b) increase the role of providers in decisions that impacted them, and (c) clarify the expectations of both parties necessary to meet the goals of the providers and the organization. For the purpose of this study, providers included physicians, nurse practitioners, and physician assistants. The compact identified the expectations of providers and the organization on eight dimensions.

The study employed case-study methodology to describe the experience of providers and leaders with the compact. Fourteen procedures directed the research. Semistructured interviews were conducted with 3 leaders and 15 employed providers. Both providers and leaders were asked to rate how well each party was fulfilling the expectations of the compact. The interview results were themed and compared between the two groups. Descriptive statistics were used to compare ratings between providers and leaders. Both providers and leaders rated the organization higher than they did providers in fulfilling the expectation of the compact.

Although providers acknowledged positive regard for the compact, only three providers could recall its original intent. Sixty percent of providers could recall using the compact during discussions or decision-making activities. Providers and leaders recommended revisiting the compact and indicated a number of opportunities for improving communication, enhancing the role of providers in decision-making processes, and clarifying the expectations of both parties.

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