Minnesota Healthcare Organization Change Program page of
Andrew H. Van de Ven
Vernon H. Heath Professor of Organizational Innovation and Change
University of Minnesota, Carlson School of Management
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Strategic Management and Organization
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Strategic Management Research Center
- Introduction
- Strategic Changes in Healthcare Organizations and Industry
- History of Minnesota Healthcare Organizations and Industry
- Clinic-System Integration and Organizational Change
- Evolution of Best Patient Care Practices in Treatment of Chronic Diseases
- University of Minnesota Faculty and Research Fellows in MHOC Program
- Links to Health Care Organizations
Minnesota Heathcare Organization Change Program
The Minnesota Healthcare Organization Change Research Program investigates the process of large-scale organizational restructuring and change in the Minnesota health care industry. The research project examines various models and processes of change ongoing in physician groups, hospitals, home care, health plans and other services in the Minnesota area.
The program research agenda includes four related areas of study pursued by a different research tearm of overlapping faculty and doctoral students in the Carlson School of Management and School of Public Health at the University of Minnesota.
Focus 1. Strategic changes in Healthcare Organizations and Industry
Focus 2. History of Minnesota Healthcare Organizations and Industry
Focus 3. Clinic-System Integration and Organizational Change
Focus 4. Evolution of Best Patient Care Practices in Treatment of Chronic Diseases
The Minnesota Healthcare Organization Change Research Program has three objectives:
1. Advance scientific knowledge of change processes in health care organizations and professions;
2. Train and mentor Ph.D. students in health care organization and management; and
3. Provide useful reserach information to managers and clinicians who are engaged in the changes.
The program is directed by Professor Andrew Van de Ven and housed in the Strategic Management Research Center of the University of Minnesota. It was launched in 1993 as part of the Center's ongoing Organizational Innovation and Change Research Program. Below is a list of University of Minnesota faculty and research fellows who have participated in the research program. An illustration of the MHOC research agenda.
topStrategic Changes in Healthcare Organizations and Industry
Another study tracks strategic changes currently unfolding in the Minnesota health care organizations and industry. It involves ongoing observations of industry-level issues and actions by the major "players" in the Twin Cities health care market, including hospital systems, HMOs, multispeciality physician groups, purchasing and patient coalitions, state regulatory bodies, insurance companies, and other payor groups.
- Public testimony on health care innovation before subcommittee of the President's Advisory Commision on Consumer Protection and Quality in the Health Care Industry.
- Comparative practices and temporal processes of integrating physicians and clinics in healthcare systems, Symposium Presented at the Academy of Mangement Conference in Toronto, CA, August 2000.
- A. Van de Ven, S. Lofstrom, J. Thompson, F. Schultz, J. S. Bunderson, and R. Rogers, What matters most to patients? participative provider care and staff courtesy, Working Paper, June 2001.
- A. Van de Ven and M. Schomaker, 2002. The rhetoric of evidence-based medicine. Health Care Management Review, 27(3): 88-90.
History of Minnesota Health Care Organizations and Industry
This historical study examines how the Twin Cities health care organizations and industry evolved into their present forms. Currently, the Twin Cities-area health care industry consists of an oligopoly of four major providers: Allina Health System, HealthPartners, HealthSystem Minnesota, and Fairview Health System. These four organizations now serve about 80% of the area's health provider market. The history traces the lineages of changes in leadership
The Minnesota Story on Managed Health Care
Preliminary drafts of book chapters by David Grazman and Andrew Van de Ven
- History of Twin Cities Health Care Industry
- History of Allina Health System
- History of Fairview Hospitals and Healthcare Services
- History of HealthPartners, Inc.
- History of Health System Minnesota
- Slides on evolution of Twin Cities Health Care Industry
Other Papers on Longitudinal Historical Findings and Methods:
- D. Grazman, Environmental Selection in Managerial Adaptation: Emergence of the Twin Cities Health Care: 1853-1995, Doctoral Dissertation, Carlson School of Management, University of Minnesota, Minneapolis, 1997.
- A. Van de Ven and D. Grazman, Evolution in a Nested Organizational Hierarchry: A Geneaology of Twin Cities Health Care Organizations: 1853-1995, Chapter 11 in J. Baum and B. McKelvey (Eds.), Variations in Organizational Science: In Honor of Donald T. Campbell (pp. 185-209). Thousand Oaks, CA: Sage Publications, 1999.
- D. Grazman and Van de Ven, Paper on Resource Scarcity in Evolution of Group Health, Working Paper.
- K. Dooley and A. Van de Ven, A Primer on Diagnosing Dynamic Organizational Processes, Working Paper.
- A. H. Van de Ven and M. S. Poole, Field Research on Processes of Organizational Change. In J. Baum, (Ed.), Companion to organizations, New York: Blackwell, 2002.
- A. H. Van de Ven and R. Engleman, Engaging Researchers and Practitioners in the Scholarship of Discovery Through a Longitudinal Study of Change in Healthcare Organizations, Showcase Symposium at Academy of Management Conference, Denver, August, 2002.
Clinic-System Integration and Organizational Change
The process of clinic-system integration is being examined in this in-depth, longitudinal study of the formation and development of a large medical group of a managed health care system. Created in 1994, the medical group has grown to include 50 primary care clinics throughout Minnesota and Western Wisconsin that employ about 450 physicians and 3000 employees. The study records the chronological sequence of events experienced by group and clinic managers and clinicians as they transition from owner/providers of private-practice clinics to professional employees of this large medical group. It examines the development of administrative adn clinical arrangements, and measures changes in perceptions of managers and clinicians as the clinic-system integration process unfolds. These issues are studied through yearly surveys of all medical group employees and site visits to selected clinics, inteviews with managers and clinicians, and observations of regular meetings of group managers and clinicians.
- Design for Studying Integration of Professionals in Organizations: The Case of Health Care, Slides of Panel Discussion at SMRC Colloquium, January 1998:
- Introduction and Overview, by Andrew Van de Ven
- Integration at Industry Level, by Frank Schultz
- Integration at Organization Level, by Shawn Lofstrom
- Integration at Occupational Level, by Stuart Bunderson
- Integartion at Individual Level, by Jeffrey Thompson
- J. Bunderson, S. M. Lofstrom, and A. H. Van de Ven, Midwest: A Managed Health Care System Incorporates a Medical Practice, Case 8 in P. Ginter, L. Swayne, and W. Duncan, Strategic Management of Health Care Organizations, Fourth edition, Oxford UK, Blackwell Publishers, 2002, pp. 691-711. (Also published in Ginter, Swayne, & Duncan's Third Edition, 1997, pp. 602-619).
- J. S. Bunderson, Professional and Administrative Value Patterns in Medical Group Practices, Doctoral Dissertation, Carlson School of Management, University of Minnesota, Minneapolis, 1998.
- J. Thompson, Individual Transitions Toward Dual Commitment During Organizational Change, Doctoral Dissertation, Carlson School of Management, University of Minnesota, Minneapolis, 1999.
- S. M. Lofstrom, R. Engleman, R. Rogers, F. Schultz, and A. H. Van de Ven, MMG: The Integration Journey, Case 19 in P. Ginter, L. Swayne, and W. Duncan, Strategic Management of Helath CAre Organizations, Fourth Edition (pp. 876-908). Oxford, UK: Blackwell Publishers, 2002.
- J. S. Bunderson, S. M. Lofstrom, and A. H. Van de Ven, Conceptualizing and Measuring Professional and Administrative Models of Organizing, Organizational Research Methods, 3(4): 366-391, 2002.
- J. A. Thompson, and A. H. Van de Ven, Commitment Shift During Organizational Upheaval: An Analysis of Physicians' Transitions form Private Practitioner to Employee, Journal of Vocational Behavior, 2001.
- J. A. Thompson, and A. Van de Ven, Negotiating Change: Vicious and virtuous cycles of employee initiative-taking and organizational response, accepted for presentation at Academy of Management Conference, Denver, August 2002.
- R. Engleman and A. Van de Ven, Motivating and Enabling Conditions of Effective Organizational Change, May 2002, Working Paper.
- R. Rogers and A. Van de Ven, Organizational Diversity, Integration and Performance, Working Paper, June 2002.
- R. Engleman, J. Yu, and A. Van de Ven, I Hate You, Don't Leave Me: The Integration Journey of Midwest Medical Group. In P. M. Ginter, L. E. Swayne, and W. J. Duncan, Strategic Management of Health Care Organizations, Fifth Edition. New York: Blackwell Business, 2004.
- Yu, J., Engleman, R., & Van de Ven, A. H. (2005). The integration journey: An attention-based view of the merger and acquisition integration process. Organization Studies, 26(10): 1501-1528.
Evolution of Best Patient Care Practices in Treatment of Chronic Diseases
The study examines the physician behaviors and clinic/system organizational arrangements that influence best patient care practices in the treatment of chronic diseases. The study objectives are to develop and tests a dynamic contingency theory of how physician behaviors and clinic organizational factors interact and evolve over time to explain changes in best patient care practices. The first phase of the study relies on performance records to identify physicians and clinics that exhibit necessary practice variation in a specific domain of chronic diseases. A non-parametric frontier estimation method, data envelopment analysis, is used to identify physicians and clinics that are on and off a best practices frontier for the management of chronic diseases. In the second phase, primary data are collected from a sample of physicians and clinics to determine the characteristics that differentiate necessary (best practices) from unnecessary variation. The longitudinal phase of the research repeats the first two phases in each of three consecutive years in order to examine how rates of changes in physician practices and clinic organizational characteristics are associated with movements to and from the best practice frontier.
- P. Johnson, et al., Best patient care practices study proposal by Johnson et al., 1996.
- A. Van de Ven, R. Rogers, G. Ellis, R. Engleman, and F. Schultz, A Preliminary Empirical Analysis of Best Practices in Primary Care Clinics, paper presented at the Minnesota Health Services Research Conference, Minneapolis, MN February 24, 2000.
- K. K. Sinha and A. H. Van de Ven, The Design of Work Within and Between Organizations, Organization Science, 16, 2005.
University of Minnesota Faculty and Research Fellows Participating in Healthcare Organization Change Program
Faculty
- Jon Christianson
- Kevin Dooley
- Paul Johnson
- Andrew Van de Ven
Research Fellows
- J. Stuart Bunderson, Washington U.
- Rhonda Engleman, U. of Minnesota
- David Grazman, The Advisory Board Co.
- Shawn Loftsrom, U. of Maryland
- Russell Rogers, Clarke-Bardes Consulting
- Frank Schultz, Michigan State U.
- Jeffrey Thompson, Brigham Young University
- Jisun Yu, U. of Minnesota
Links to Health Care Organizations
Allina Health System
Blue Cross/Blue Shield national site
Farview Hospitals and Healthcare Services
Health Partners, Inc.
Consumer Choice comparisons of clinics
Mayo Clinic
United Health Care, Inc.
Columbia/HCA Healthcare Corp. hospitals company
Medpartners medical information company
National Center for Health Statistics
