108 semi-structured interviews were conducted with clinics' team members (a physician, nurse, administrator and pharmacist) and their respective managerial units.
Recently, in an attempt to dovetail community care, social care, and primary care, LHCCs have been superseded by Community Health Care Partnerships (CHCPs) which are larger managerial units within the health board structure.
Each employee was assigned the average score value for all employees at his/her managerial work unit [1094 units with an average of 18 employees (range 3 120)].
Lack of recognition by senior management for the work of the units, lack of steer from the government or match between political, managerial and unit agendas, low profiles for endoscopy, and factional discord between different professional groups led to disillusionment, particularly among senior GI physicians and surgeons.
Subsequently, the arithmetic mean values were computed across respondents in a managerial work unit, and for each dimension (scale), this value was assigned to all members of a work unit, independently of their individual response.
Although the component of exposure variation between work units only accounted for 14 35% of the total variation, the exposure contrast across the more than one thousand managerial work units was pretty high (Table 2 and 3).
The managerial and technical units of adhocracies require a degree of autonomy that political masters seldom permit.
A Technical Support Unit of managerial and technical experts, embedded in but distinct from the government, provided support in 5 key areas: strategic planning; monitoring and evaluation; supportive supervision; training; and information, education, and communication.
This way of defining middle management for the review allowed us to exclude line managers and lower-level supervisors with no managerial responsibility for a unit or facility, and senior executive managers who have no direct and on-going interactions with staff in general.
We developed a questionnaire named COMIC (for Culture, Organisation and Management in Intensive Care') [ 34] that combines a set of independent variables that include cultural, managerial, well-being, and unit effectiveness dimensions in order to give an integrative overview of the 'organisation' variable.
It is likely that behind the low observed rates of specialist physician productivity is the ability of doctors to exert some degree of control over the definition and application of managerial guidelines in health units [ 28].
