Decision-making styles, organizational ıinnovativeness, and change fatigue in healthcare

Öz

Introduction and Objective: Decision-making styles, organizational innovativeness, and change fatigue are three interrelated variables in healthcare management. This study aimed to explore health managers' experiences and perceptions of these variables and identify the individual, organizational, and contextual factors shaping their dynamics. Materials and Methods: Semi-structured in-depth interviews were conducted with 15 health managers from private healthcare institutions in Istanbul, Turkey, representing lower, middle, and upper management equally. Data were collected between April–October 2025 and analyzed through thematic analysis. Findings and Conclusions: Three main themes emerged: (1) Reasons for resistance to change and innovation (13 sub-themes including habitual resistance, staff turnover, and change fatigue from unplanned changes); (2) Facilitators of change and innovation (13 sub-themes including top management support, digitalization, and ownership capacity); (3) The influence of decision-making styles (7 sub-themes including inclusive decision-making, evidence-based rationality, and crisis-induced necessity). Inclusive and evidence-based styles were positively associated with innovativeness; change fatigue adversely affected both innovativeness and decision-making.Participatory and evidence-based decision-making styles are positively associated with organizational innovativeness and may mitigate change fatigue. These findings carry actionable implications for health managers and policymakers.

Anahtar Kelimeler

• Decision-Making Styles
• Organizational İnnovativeness
• Change Fatigue
• Healthcare Management

Sağlık sektöründe karar verme tarzları, kurumsal yenilikçilik ve değişim yorgunluğu

Öz

Giriş ve Amaç: Karar verme stilleri, örgütsel yenilikçilik ve değişim yorgunluğu, sağlık yönetimi alanında birbiriyle ilişkili üç değişkendir. Bu çalışma, sağlık yöneticilerinin bu değişkenlere ilişkin deneyimlerini ve algılarını araştırmayı ve dinamiklerini şekillendiren bireysel, örgütsel ve bağlamsal faktörleri belirlemeyi amaçlamıştır. Materyaller ve Yöntemler: İstanbul'daki özel sağlık kuruluşlarından, alt, orta ve üst yönetimi eşit olarak temsil eden 15 sağlık yöneticisiyle yarı yapılandırılmış derinlemesine görüşmeler yapılmıştır. Veriler Nisan-Ekim 2025 tarihleri ​​arasında toplanmış ve tematik analiz yöntemiyle analiz edilmiştir. Bulgular ve Sonuçlar: Üç ana tema ortaya çıkmıştır: (1) Değişime ve yeniliğe direnç nedenleri (alışılmış direnç, personel devri ve planlanmamış değişikliklerden kaynaklanan değişim yorgunluğu dahil 13 alt tema); (2) Değişim ve yeniliğin kolaylaştırıcıları (üst yönetim desteği, dijitalleşme ve sahiplenme kapasitesi dahil 13 alt tema); (3) Karar verme stillerinin etkisi (kapsayıcı karar verme, kanıta dayalı rasyonellik ve kriz kaynaklı gereklilik dahil 7 alt tema). Kapsayıcı ve kanıta dayalı yaklaşımlar, yenilikçilikle olumlu bir şekilde ilişkilidir; değişim yorgunluğu ise hem yenilikçiliği hem de karar verme süreçlerini olumsuz etkilemiştir. Katılımcı ve kanıta dayalı karar verme yaklaşımları, örgütsel yenilikçilikle olumlu bir şekilde ilişkilidir ve değişim yorgunluğunu azaltabilir. Bu bulgular, sağlık yöneticileri ve politika yapıcılar için uygulanabilir sonuçlar doğurmaktadır.

Kaynakça

1. Argyris, C., & Schön, D. (1978). Organizational learning: A theory of action perspective. Addison-Wesley.
2. Bernerth, J., Walker, H., & Harris, S. (2011). Change fatigue: Development and initial validation of a new measure. Work & Stress, 25(4), 321–337. https://doi.org/10.1080/02678373.2011.634280
3. Brommeyer, M., Whittaker, M., & Liang, Z. (2024). Organizational factors driving the realization of digital health transformation benefits from health service managers: A qualitative study. Journal of Healthcare Leadership, 16, 455–472. https://doi.org/10.2147/JHL.S459064
4. Cao, S., Lin, J., Liang, Y., & Qin, Y. (2024). A concept analysis of change fatigue among nurses based on Walker and Avant's method. Journal of Nursing Management, 2024, Article 8413242. https://doi.org/10.1155/2024/8413242
5. Chung, G., Chung, J., & Regan, M. (2017). Change fatigue and employee readiness for change. Journal of Organizational Change Management, 30(2), 163–180.
6. Creswell, J., & Poth, C. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Sage.
7. Çavmak, Ş., & Söyler, S. (2024). Change fatigue in healthcare staff: A systematic literature review. Selçuk University Journal of Vocational School of Social Sciences, 27(2), 411–421.
8. Damanpour, F. (1991). Organizational innovation: A meta-analysis of effects of determinants and moderators. Academy of Management Journal, 34(3), 555–590. https://doi.org/10.2307/256406

9. Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82. https://doi.org/10.1177/1525822X05279903
10. Krippendorff, K. (2013). Content analysis: An introduction to its methodology (3rd ed.). Sage.
11. Nilsen, P., Seing, I., Ericsson, C., Birken, S., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: An interview-based study. BMC Health Services Research, 20(1), 147. https://doi.org/10.1186/s12913-020-4999-8
12. Oreg, S. (2003). Resistance to change: Developing an individual differences measure. Journal of Applied Psychology, 88(4), 680–693. https://doi.org/10.1037/0021-9010.88.4.680
13. Patton, M. (2015). Qualitative research and evaluation methods (4th ed.). Sage.
14. Schreier, M. (2012). Qualitative content analysis in practice. Sage.
15. Scott, S., & Bruce, R. (1995). Decision-making style: The development and assessment of a new measure. Educational and Psychological Measurement, 55(5), 818–831. https://doi.org/10.1177/0013164495055005013
16. Thunholm, P. (2004). Decision-making style: Habit, style or both? Personality and Individual Differences, 36(4), 931–944. https://doi.org/10.1016/S0191-8869(03)00162-4
17. Wang, C., & Ahmed, P. (2004). The development and validation of the organisational innovativeness construct using confirmatory factor analysis. European Journal of Innovation Management, 7(4), 303–313. https://doi.org/10.1108/14601060410565056
18. Žibert, A., & Starc, A. (2018). Healthcare organizations and decision-making: Leadership style for growth and development. Journal of Applied Health Sciences, 4(2), 209–224. https://doi.org/10.24141/1/4/2/7