Lecture 2 Transdisciplinary perspectives on challenges in organizations

Question 1

What is a societal system

Answer 1

A collection of recurring interactions, through which actors produce practices, serving a specific goal, within a confined part of reality
- interaction and relationships of parts that make up the system

Question 2

Health system systemic features

Answer 2

• specialization: disease-specific diagnostics & treatments
• standardization: protocols and guidelines
• ethical guidelines for treatments
  –> health system is fragmented, highly specialized and little communication between disciplines and clinical and public users

Question 3

When does change of system occurs

Answer 3

if system does not respond to a societal need anymore. From fragemented & specialized to integral & holistic

Question 4

System has 3 dominant structures, which together form a constellation

Answer 4

structures: organizing
cultures: thinking
practices: doing

Question 5

Constellations are stable/unstable

Answer 5

Stable, because actors tend to stick to their routines, ways of thinking&organizing. Resistant to change

Question 6

Organizational actors and power

Answer 6

• state level: public funding, safety & quality agencies
• market level: technological/pharmaceutical industry
• community level: consumer groups
• third sector level: research foundations, charities, universities

Question 7

Individual actors and power

Answer 7

• state level: policy-makers, regulators, voters
• market level: consumer, (health) professionals
• community level: citizens, friends
• third-sector level: patient advocates, researchers, research participants

Question 8

characteristics power

Answer 8

power can be:
- visible: institutions, structures, resources, rules
- hidden: agenda-setting, dominant voices
- invisible: embedded in beliefs, language or assumptions

Question 9

Three drivers to change

Answer 9

1. tension: between dominant constellation and broader landscape
2. stress
3. pressure

Question 10

Multi-level perspective

Answer 10

describes how dominant cultures, structures and practices are replaced
explains interaction among 3 levels: landscape, regime, and niches

Question 11

Regime

Answer 11

• network of actors with shared assumptions that interact in an incumbent constellation
• resistant to change
• gives societal system stability and guides decision-making
• resilient: absorb shocks and external changes while basically remaining unchanged

Question 12

Niches

Answer 12

• spaces outside regime where actors develop alternative practices
• areas for ‘radical’ novelties
• change agents undertake action, create small network and invest time&resources
• niche experiments are crucial to test&experiment with novelties involving new sets of cultures, structures and practices

Question 13

Landscape

Answer 13

• overall societal setting in which transitions occur
• consists of:
  material infrastructure
  macro economy
  demography and natural environment
  shared cultures, world views and social values
• develops independently, but is never neutral to influences of regime
• changes are often long-term, although shocks can occur overnight

Question 14

3 main ideal-typical processes, patterns of change

Answer 14

1. reconstellation
2. empowerment
3. adaptation

Question 15

Reconstellation

Answer 15

top-down constellation change

Question 16

empowerment

Answer 16

bottom-up constellation change. Niche develop and slowly gain power. Vulnerable to backlash

Question 17

adaptation

Answer 17

constellation incorporates functioning from other constellations. May lead to lock-in