Research Findings

When implementing new practices, engage employees in a process of co-creation


November 18, 2021

Organizations are often a mess. Managers implement all sorts of organizational controls (for example, processes, practices, rules and incentives) to coax employees to do their work in particular ways. Employees often defy managers, performing their work the way they want.

The outcome? Employees feel frustrated that managers are constantly bugging them to perform their work in particular ways that they feel aren’t actually effective. And managers are frustrated that all the work they do to define standardized practices and processes to help their employees is meaningless because the employees don’t actually do what they are told.

A key question for scholars and practitioners alike is how to address this enduring tug of war.

In a recent study, I examined this, asking how organizations can implement new organizational controls that actually help improve performance and make employees more engaged and effective in their roles?

To study this, I spent 18 months in the field at a prominent Canadian hospital analyzing their attempts to implement a standardized practice called the Daily Prep Meeting across a handful of their outpatient clinics. The goal of the practice was to empower employees to proactively plan their day, to improve communication and coordination in the clinics, and, ultimately, to improve the care experience provided to patients.

The new practice required employees—doctors, nurses, clerical staff and the manager—to meet for 15 minutes each morning before clinic started to prepare for the day. During the meeting, they would discuss a series of questions aligned with each of the hospital’s strategic priorities: safety, quality, staff empowerment, innovation, financial health. They asked questions like, “What are some barriers to providing excellent care today?” or “Who is going to need the most support today and how can we help them?”

The good news was that many of the employees agreed that the goals of the practice were important. Many of them felt that there were big communication and coordination problems in the clinics. Clinics would often run late, patients would have to wait hours for their appointments, and employees were frustrated with the status quo.

The bad news was that many of the employees provided countless valid reasons why the standardized practice the managers had developed simply would not work in their clinics’ environments. These issues related to the timing of the Daily Prep meetings, who had to be involved, the relevance of many of the questions, and how it would fit into the existing ways of working within the clinics.

The performance improvement team tasked with implementing the new practice argued that the standardized practice was simply a starting point and encouraged the clinic teams to tweak the design to make it work. In essence, the managers’ approach promoted a process of co-creation where they could marry the known benefits of the standardized process with the lived reality of employees’ day-to-day existences within the clinics.

Two-stage learning process of co-creation

Across all the clinics I studied, I saw the implementation of this new organizational control unfold as a two-stage learning process of co-creation.

In the first stage, the clinic teams learned about the mandated control mechanism (for example, the Daily Prep Meeting). Over many iterations of action and reflection, guided by the performance improvement team, the clinic teams converged on their own assessment of whether the new practice could actually achieve the managers’ intended performance outcomes in their clinic. 

The clinic’s trajectory in the second stage depended on the first stage’s outcome: if the clinic teams felt the practice could achieve the intended outcomes, they followed the customization pathway. If the teams, however, were convinced the practice could not achieve its intended performance outcomes, they followed the transmutation pathway.

Customization pathway

Along the customization pathway, clinic teams became deeply engaged in trying to incorporate the standardized practice into their clinic’s existing ways of working. They engaged in a team learning process, cycling between action (for example, piloting the practice) and reflection (such as thinking about the pilot, figuring out what worked or didn’t work, and making changes to the design of the practice). They played around with many aspects of the practice: the changed the timing and cadence of the Daily Prep Meeting multiple times; they changed who was involved; and most often, the modified the questions that were asked.

With these tweaks, clinics following the customization pathway developed their own version of the Daily Prep Meeting that actually felt useful to the employees. It gave employees a structured way of connecting with their manager and colleagues and helped them prepare for the day.

Transmutation pathway

The implementation process in other clinics was not so smooth. For these clinics, after learning about the Daily Prep Meeting in the first stage of the co-creation process, they collectively realized that the new control mechanism would not actually solve their clinic’s problems.

However, instead of abandoning the implementation or adopting it ceremonially, the clinic teams following the transmutation pathway rolled up their sleeves and got to work. They developed their own locally designed alternative control mechanisms to achieve the intended control outcomes based on their own assessment of their clinic’s problems. They stopped trying to make the standardized practice work and focused instead on solving the problems their own way.

A Collaborative Process of Co-Creating Organizational Controls

With this study, I provide a dynamic view of how organizational control mechanisms can unfold within organizations, highlighting that organizational controls can be co-created through a negotiation between employees and managers as they engage in an iterative learning process.

These findings suggest a model for implementing organizational controls—and change, more broadly—that is far more collaborative than many of our usual approaches to implementing change in organizations.

Beyond that, this study suggests that managers should listen closely to their employees when they say that new controls will not fit within the local context or, perhaps more importantly, will not actually achieve the intended performance outcomes. It is possible that the frontline employees know best. In these situations, mandating adoption will simply increase the frustration for both employees and managers, almost guaranteeing poor performance outcomes. Instead, managers can use the implementation as a catalyst which empowers the employees to figure out other ways of achieving the same goals. That is a win-win situation: employees are empowered and engaged; and the organization realizes its intended goals.

While some may view the implementation in the clinics that followed the transmutation pathway as a failure (since they did not adopt the mandated Daily Prep Meeting), I think that it was precisely in these clinics that the most exciting innovation happened. Rather than just mounting a resistance to the implementation, or abandoning it altogether, the employees banded together to make something better. This highlights the value of engaging employees, providing them with support to design their own processes and practices, and empowering them to solve their problems.

Read more

Jillian Chown. 2021. “The unfolding of control mechanisms inside organizations: Pathways of customization and transmutation.” Administrative Science Quarterly 2021.

image: pxfuel

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