1,720,987 research outputs found
HOW INSTITUTIONAL CONDITIONS SHAPE THE QUALITY OF WORK PRACTICES: EVIDENCE FROM THREE CARE COORDINATION PROGRAMS IN NEW YORK STATE
Get PDFCommentators have often celebrated care coordination as an encompassing solution capable of reducing costs and increasing quality in US healthcare. It is unclear, however, under which conditions organizations implement high-quality work practices that are essential for achieving improved outcomes in the context of care coordination programs.
My paper examines two institutional factors that improve the quality of work practices: occupational community, and regulatory intensity. I argue that the interaction of both factors produces higher quality than either would in isolation. I also demonstrate how in the absence of both factors, a prioritization of cost-effectiveness reduces the quality of work practices. To make my argument I draw on 80 semi-structured interviews, 80 documents, and 15 hours of observation in my study of three care management agencies that focus on serving low-income chronic disease patients in one of the most resource-poor communities in New York State
"As-if Unions": Rise of the American Model of Freelancer Unionization
No full text74 pagesIn this study, I explore how a hybrid union of freelance media workers in New York was successful in maintaining union membership compared to other types of unions operating in the same space. I use an inductive approach to gather and analyze data in the form of 39 semi-structured interviews with union members, leaders, and legislators. I argue that hybrid union has structures and processes that interact with each other to drive the freelancer focus of the union, gain meaningful workplace rights, and regulate the industry. The contribution of my work is in uncovering the mechanism of hybridity and its many dimensions that might be helpful to further class interests within organizations.2026-09-0
Building a Cooperative Labor Movement: Strength & Struggle in Union Cooperatives
No full text59 pagesThis study investigates the conflicts and compatibility between worker cooperatives and labor unions, specifically how the point of interaction impacts the long-term dynamics of labor peace within worker-owned businesses. Amid periods of inequality and heightened class conflict, workers historically seek collectivist solutions that combine the power of the working class. In this regard, workers cooperatives and labor unions represent different solutions to the same problem. This motivates increasing interest by the labor movement in incubating new worker cooperatives and situating organized labor within the “solidarity economy.” Yet worker co-ops hold fundamentally different financial and managerial considerations to compete in a capitalist economy. This study posits that the institutions leading the incubation of unionized worker co-ops shapes management’s long-term orientation toward the union. Two case studies in New England, Co-op Rhody and Worx Printing, demonstrate union-incubated co-ops featuring highly collaborative relationships between cooperative management and the union – seeing both co-ops and unions as complementary vehicles for worker empowerment. Another case study, Gimme Coffee in Ithaca, NY, was incubated by a private business consultant without the support of their union. As a result, Gimme replicates the class conflict found in traditional businesses. These outcomes of labor conflict and democracy are considered within other structural differences such as the contrasting percentage of workers represented by the union and/or holding ownership stake – structural factors influenced by the synergy between unions and co-ops, or lack thereof. This analysis provides insights into the potential for a more integrated and powerful labor movement that combines the strengths of both unionization and worker ownership.2027-06-1
The Effect of Labor Unions on Occupational Safety: Evidence from the U.S. Steel Industry
No full text72 pagesThis study advances industrial relations research by documenting the relationship of union representation and industrial injury. I argue that the conventional analyses of a union injury differential are flawed and introduce new methods to determine a casual effect. Initial OLS regression analyses of the total 2018 population of U.S. iron and steel mills show no association, negative or positive, between union representation and industrial injury. To address covariate imbalance in the data, I use propensity score methods to draw a matched sample of 118 establishments from the total 2018 population of U.S. iron and steel mills. Subsequent multivariate regression analyses reveal that union representation is negatively associated with industrial injury. Specifically, union representation is associated with a reduction of nearly 2 injuries per 100 full time-employees in a given calendar year. The relationship of union representation and industrial injury is moderated by establishment size, such that the effect of union representation declines as establishment size increases. The final predictive model explains 42.4 percent of variance in industrial injury among iron and steel mills
Review of 'Cleaning Up: How Hospital Outsourcing is Hurting Workers and Endangering Patients'
No full text[Excerpt] Researchers sensitive to the plight of low-wage workers in advanced industrialized economies have long sought to convey the magnitude of the problem by retelling sorrowful tales of worker exploitation. Sadly, even their most sympathetic readers have numbed to these accounts. Author Dan Zuberi has found a clever way to transcend this apathy in his new monograph based on about 100 interviews plus behind-the- scenes observations of the impact of hospital support staff outsourcing on patients and workers. Through a well-developed understanding of the work process and changes in the employment relationship, he ties outsourcing and the resulting exploitation of hospital cleaners and food service workers to the spread of viruses, antibiotic-resistant bacteria, and other deadly pathogens. In so doing, he succeeds in delivering his intended take-home message that “worker exploitation hurts us all” (p. 124).Litwin9_Review_of_Cleaning_Up.pdf: 189 downloads, before Oct. 1, 2020
Review of \u3ci\u3eCleaning Up: How Hospital Outsourcing is Hurting Workers and Endangering Patients\u3c/i\u3e
Get PDF[Excerpt] Researchers sensitive to the plight of low-wage workers in advanced industrialized economies have long sought to convey the magnitude of the problem by retelling sorrowful tales of worker exploitation. Sadly, even their most sympathetic readers have numbed to these accounts. Author Dan Zuberi has found a clever way to transcend this apathy in his new monograph based on about 100 interviews plus behind-the- scenes observations of the impact of hospital support staff outsourcing on patients and workers. Through a well-developed understanding of the work process and changes in the employment relationship, he ties outsourcing and the resulting exploitation of hospital cleaners and food service workers to the spread of viruses, antibiotic-resistant bacteria, and other deadly pathogens. In so doing, he succeeds in delivering his intended take-home message that “worker exploitation hurts us all” (p. 124)
Technological Change at Work: The Impact of Employee Involvement on the Effectiveness of Health Information Technology
Get PDFThe link between employee involvement (EI) and organizational performance is not clear-cut, and the diffusion of information technology (IT) in the workplace complicates this relationship. The author argues that new technologies offer an important avenue by which EI can improve firm performance. He also contends that those studies that do consider EI in the context of technological change may be focusing exclusively on workplace-level features of the employment relationship, ignoring variation in functional- and strategic-level aspects of employment relations. To test this hypothesis, he uses Kaiser Permanente Northwest Region\u27s patient scheduling module as an exemplar to investigate the extent to which this particular technology interacts with EI to affect clinic-level improvements in patient satisfaction. He studies the impact of the technology over the period October 2004 to August 2007 across 16 clinics to determine variation across sites. Measuring outcomes from a data set that includes employee and patient surveys, interviews, archival data, and clinic observations, he finds that the use of IT is associated with performance increases and that these effects are greater in those clinics achieving higher mean levels of EI. This study presents the first empirical evidence of the potential of EI to enhance the effectiveness of health IT
Examination of the adoption and use of EHRs
Get PDFThesis (Ph. D.)--Massachusetts Institute of Technology, Sloan School of Management, 2008.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Includes bibliographical references.This dissertation advances theory on the interplay of workplace technological change and features of the employment relationship to inform an active policy debate. In particular, many connect US healthcare's lackluster economic performance -- both historically and relative to other industries -- to its apparent reluctance to adopt electronic health record (EHR) systems. Drawing on management and employment relations theory as well as a multi-method field study of a large-scale healthcare provider, I first demonstrate that performance improvements depend not on the technology per se, but rather on the concomitant adoption of both the information technology (IT) and the rest of its reinforcing work system. In line with prior research, the work system includes workplace-level employment practices like teamwork and training. However, I advance our understanding of these complementarities by showing that their emergence depends on the scope of participatory structures included in the work system. Irrespective of how engaged workers are in the IT initiative, participation only complements the effectiveness of the EHR system where workers could 1.) renegotiate IT-engendered changes in the terms and conditions of employment, and 2.) influence the configuration and deployment of the technology. Based on these findings, IT adoption does not ensure improved performance, implying a shortcoming in policies promoting the diffusion of EHRs rather than the adoption of EHR-inclusive work systems. Drawing once again on both theory and the field study, I propose that only certain medical practices -- most notably, those that finance patient care on a prepaid or "capitated" basis -- internalize the benefits of EHR investment.(cont.) Therefore, physicians affiliated with such organizations are more likely to report that their practice adopted the technology along with financial incentives to encourage its optimal use. Those practices whose IT adoption cannot be explained by their business strategy will be less likely to introduce the requisite incentives. Econometric evidence derived from a nationwide sample of physicians finds strong support for these hypotheses. Therefore, this dissertation warns of the imminent decoupling of EHR technology from its work system while advancing management and employment relations theory.by Adam Seth Litwin.Ph.D
The Tools of Management: Data Practices for Worker Advocacy
No full text250 pagesThis dissertation explores the impact of data-driven approaches to worker advocacy. I combine historical and design research, organized around a case study of management-engineering projects conducted by the International Ladies Garment Workers Union (ILGWU). I survey how workplace data been used to advocate for US workers in the past, how the decisions and challenges of using data to represent worker perspectives map onto analogous methodological challenges that impact the design of workplace measurement analytics today, and how these design techniques and insights from the past can be be applied in present-day workplace advocacy for workers in data-driven workplaces. I conclude with key trade-offs in relying on worker data and data expertise for worker advocac
Equilibrating the Exchange: Disintermediation in Triadic Labor Markets of the Remote Gig Economy
No full text107 pagesThis multi-method study examines the factors influencing workers’ disintermediation behaviors—efforts to circumvent labor market intermediaries and engage directly with employers—within triadic labor markets of the remote gig economy. Using complementary qualitative and quantitative data from two of the largest global digital labor market intermediary (DLMI) organizations, the study identifies disintermediation as a strategic response by workers to recalibrate power dynamics in the face of unbalanced exchange relationships with DLMIs. Unbalanced exchanges arise from workers' perception of DLMIs as violating their perceived reciprocal agreements. Contrary to the dominant discourses, which emphasize dependence as the point of departure for understanding the dynamics and outcomes of worker-organization relationships in the remote gig economy, this study posits that an exchange-based view of the relationships offers a rather more nuanced and comprehensive perspective
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