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Litwin - 2011-Technological Change at Work The Impact of Employee
Litwin - 2011-Technological Change at Work The Impact of Employee
Litwin - 2011-Technological Change at Work The Impact of Employee
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Technological Change at Work: The Impact of Employee Involvement on the
Effectiveness of Health Information Technology
Abstract
The link between employee involvement (El) and organizational performance is not clear-cut, and the
diffusion of information technology (IT) in the workplace complicates this relationship. The author argues
that new technologies offer an important avenue by which El can improve hrm performance. He also
contends that those studies that do consider El in the context of technological change may be focusing
exclusively on workplace-level features of the employment relationship, ignoring variation in functional-
and strategic-level aspects of employment relations. To test this hypothesis, he uses Kaiser Permanente
Northwest Region’s patient scheduling module as an exemplar to investigate the extent to which this
particular technology interacts with El to affect clinic-level improvements in patient satisfaction. He
studies the impact of the technology over the period October 2004 to August 2007 across 16 clinics to
identify variation across sites. Measuring outcomes from a dataset that includes employee and patient
surveys, interviews, archival data, and clinic observations, he finds that the use of IT is associated with
performance increases and that these effects are greater in those clinics achieving higher mean levels of
El. This study presents the first empirical evidence of the potential of El to enhance the effectiveness of
health IT.
Keywords
employee involvement, organizational performance, information technology, technological change
Disciplines
Labor Relations | Performance Management | Technology and Innovation
Comments
Required Publisher Statement
© Cornell University. Reprinted with permission. All rights reserved.
Suggested Citation
Litwin, A. S. (2011). Technological change at work: The impact of employee involvement on the
effectiveness of health information technology [Electronic version] Industrial & Labor Relations Review,
64(5), 863-888.
new to the studyof workand em- ested in the connection between EI and
ploymentmight be surprisedto learn
Those performance, their agreement about the
thatthe linkbetweenemployeeinvolvement strengthof the link is far from universal.
(EI) and organizational performance is Nevertheless,thewidespreaddiffusionof in-
more elusivethanit appears. In fact,though formationtechnology(IT) since the 1980s
scholarsfroma numberofmanagementsub- has heightened our need to understand
domains including organizationalbehavior how human and technologicalcapital inter-
(OB), human resources (HR), and even In- act in production.Since it has been shown,
formationSystems(IS) have long been inter- forexample, thatmanyof the benefitsonce
Industrial Relations
andLabor Review, 2011).©byCornell
Vol.64,No.5 (October University.
Print 2162-271X/00/6405
0019-7939/Online $05.00
863
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EMPLOYEE INVOLVEMENT AND THE EFFECTIVENESS OF HEALTH IT 867
yieldedthe same set of tentativeconclusions broadly (e.g., Choe 1996; Hunton 1996a;
as those in OB, namelythatuser participa- Hunton and Beeler 1997; Hunton and Price
tion drivesattitudinaland behavioral mea- 1997) abstractaway from the set of larger
sureslikejob satisfaction but has littleor no institutionalfeatures guiding the various
effecton performance. manifestationsof employee involvement.
The IS literature,however,goes one step These include forcesthatemploymentrela-
further. A numberof studieshave proffered tionsscholarsknowto be essentialto under-
contingencymodels to account fordifferent standing work-relatedphenomena, such
organizationalfactorspotentially moderating as business strategyand the nature of the
the relationshipbetweenuser participation contract- implicit or explicit- governing
in ISD and measures of performance.For the relationshipbetweenworkersand firms
example, Hunton and colleagues (Hunton (Dunlop and Weil 1996; Levine 1995).
1996b; Hunton and Price 1997) employed
experimental techniques, collecting data EmployeeInvolvementand
from individual workersor students after
TechnologicalChange in
seeking to manipulate the degree of per- EmploymentRelations
ceivedinstrumentality ofworkervoice. Some
subjectswere affordedno voice at all, and In this paper, I am leveraging employ-
otherswereplaced along a continuumof in- ment relationstheoryto fillgaps leftby the
creasinglevelsof instrumentality. In the lan- HR and OB literatureson the one hand,
guage of employment relations, rightward and the IS literatureon the other.That is, I
movementsalong thiscontinuumwould be am more closely considering the role of
labeled "informationrights,""consultation technologyin approaches to EI and bring-
rights," and finally,
at thefarright-hand side, ing a broader conceptualizationof the em-
"co-determinationrights" (Freeman and ploymentrelationship than that found in
Lazear 1995). In addition, net increases in received EI research in the IS field.This is
the level of voice instrumentality result in possible because scholarsof employmentre-
improvedattitudinaland performancemea- lations have an abiding interest in what
sures.Withrespectto the findingsregarding Dunlop (1958 [1993]) labeled the "techno-
attitudinalmeasures,theseresultsfallin line logical context."In fact,the field'snuanced
withfindingsfromIS researchpredicatedon conceptualization of technologyis part of
broad, national surveys(e.g., Choe 1996; whatset pluralistindustrialrelations,thatis,
Kimand Lee 1986), multi-organization stud- employmentrelations, apart from earlier
ies (e.g., McKeen, Guimaraes,and Wetherbe approaches to the studyof work and em-
1994; McKeen and Guimaraes 1997), and ployment.Marxists,for example, portrayed
even some mixed-method,multi-site, single- new technologies and the technological
organization studies (e.g., Hunton 1996a; change process as a deliberate strategyon
Hunton and Beeler 1997). However,theper- the partof managersto tightencontrolover
formanceeffectsdetectedunder experimen- workersand the labor process throughde-
tal or quasi-experimental conditionsare not skilling(Braverman1974;Marx1849 [1978]).
consistentlyreplicated in multi-method, Employmentrelationscriticizesthisview as
multi-sitestudies (Brodbeck 2001; Hunton deterministic,adopting more of an institu-
1996a; Hunton and Beeler 1997). tional perspective,payingveryclose atten-
The source of this ambiguityand of the tion to the interplayof technologyand EI in
broaderfindingofweakperformanceeffects production.1
of EI in ISD (He and King 2008) is the IS
literature'stendencyto examine the success
of IT projectsoutsidethe contextof the em- 1Scienceandtechnologystudies
(STS) combatstech-
determinism
nological ina different
manner,byshin-
ploymentrelationship.That is, even those
inga spotlight
onhumanagency.
Though morefocused
analysesthatcontrolforor hold constantfea- on "technologies
ofconsumption"thantherealmof
turesof the technologyitself(e.g., Brodbeck production (cf.Noble1984;Oudshoorn and Pinch
2001) or even of the organization more 2007:556),STScountersdeterministic
approachesby
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870 INDUSTRIAL AND LABOR RELATIONS REVIEW
business strategyoften goes hand-in-hand EI, but it also pays special attention to
withan autocraticapproach to HR in which functional-and strategic-level aspects of the
supervisorsseek to "drive" rather than to employment relationship, holding them
"motivate"workers(Arthur1992). Hence, in place to identifythe moderatingrole of
participatorystructuresat the workplace EI in IT deploymentthroughvariationin
level may prove ineffective,since workers workplace-levelmeasures of EL In thisway,
should see littlereward,and in fact,some one can see how EI complementsIT in the
real penaltiesassociated withthe success of production and deliveryof healthcare ser-
the new technology.Alternatively, EI activi- vices. Establishingthis relationshipreliably
tiesin theworkplacemayemergefrommore requires a deep understandingof the tech-
of a "differentiation" business strategyin nologyand of workplace-level aspectsof the
whichthe firmseeks to leverageits assets- employmentrelationship,includingrelevant
including its human ones- as a source of workflows and measuresof EL The IS litera-
competitiveadvantage.Under thisscenario, turehas actuallypaid close attentionto what
workersare not a "necessaryevil" or a cost employmentrelationsscholarswould label
to be minimized,but ratheran object of in- workplace-level variationin EI, thoughexist-
vestmentthatmustbe developed,rewarded, ing studiesof the effectsof EI and IT on per-
and empowered.As a resultof the commit- formance in employment relations have
ment thattheyreceivefromthe firm,work- actually been criticized for failing to do
ers can comfortably believe that theirwork (Brown and Campbell 2002; Ichniowski
to make the new technologymaximallyef- et al. 1996). Even the IS studies,however,ig-
fectivewillbe rewarded.In thislattercase- nore functional-and strategic-level features
differentiation- even workplace-level EI of the employment relationship. Conse-
structures thatappear identicalto thoseem- quently,I focusfirston issuesat thetwohigh-
ployed under a cost leadership strategy est tiers of the employmentrelationship,
should be farmore instrumental in boosting describingthe workplace-levelEI variations
performance. in these structures.That is, I describe the
Lab-basedexperimentalstudiesin IS nec- functionaland strategicaspectsof EI and of
essarilyneglect forcesabove the workplace the Kaiser Permanente labor management
levelbydesign.That is,the experimentalap- partnership(LMP), particularly withrespect
proach was called on specificallyto forestall to the organization'sstrategyfor its EHR
the influenceof institutionsthatin real or- system.This detail provides the context
ganizational settingswould be situated on needed to reliablyinterpretthe quantitative
the functionalor strategiclevels. However, resultsthatfollow.
in the case of the fieldexperimentsand the
multi-organizational or broad national stud- Functional-and Strategic-Level
ies, these features of the employmentrela-
are unmeasured contextualvariables Aspectsof EmployeeInvolvement
tionship at Kaiser Permanente
that impinge on the relationshipbetween
workplace-levelEI and economic perfor- KaiserPermanente,the integratedhealth
mance. My employmentrelationsapproach insurerand healthcareprovider,was chosen
bridges the gap between HR and OB's ap- forthisstudyin partbecause of itspioneer-
proach to EI (whichunder-theorizes therole ing businessstrategy.It has been a forerun-
of technology)with the IS literature'sap- ner in healthcare's conversion from
proach to EI (whichgivesshortshriftto the paper-based to electronic recordkeeping
nuances of the employmentrelationship). and, at the same time,has a historyof pro-
motingEI as part of an overall labor man-
agement partnership(Kochan et al. 2009).
Technologicaland Once fullydeployed, Kaiser's EHR system,
OrganizationalContext KP HealthConnect,will include a fullcom-
This studynot onlyintegratestechnology plementof interoperableadministrative and
and technologicalchange into researchon clinicalhealthIT applications.One of these,
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EMPLOYEE INVOLVEMENT AND THE EFFECTIVENESS OF HEALTH IT 873
fore the rollout reinforcedthe need for studies (e.g., Bresnahan, Brynjolfsson,
and
some extraflexibility fromthe rank-and-file. Hitt 2002; Kim and Lee 1986; Mirvis,Sales,
In particular,the short time frame meant and Hackett 1991). That is, I demonstrate
that some trainingwould have to occur in thatEI around new IT increasesthe technol-
the eveningsand on weekends, a decision ogy's effectiveness,relyingon variationin
thatwas not welcomedbytheworkforce. workplace-level EI measures, holding con-
Finally, super-users provided ongoing, stant employmentrelationsfeaturesat the
"just-in-time" support for co-workersnot functionaland strategiclevels.
onlyaround the timeof thedeployment,but
thereafter as well.These expertswould even-
return to theirjobs able to serve as Technologyand Workflow
at
tually Kaiser Permanente
theirworkplace'sdefactoleaders and "go-to"
people for all matters technological and Through interviewswith managers and
work-relatedpertainingto the KP Health- labor leaders in Kaiser's national headquar-
Connect schedulingmodule. Indeed, super- ters as well as those in multiple regions,
usersplayedjust as vitala role in theinitiative the Northwestregion's scheduling module
whentheyreturnedfull-time to theirregular emerged as one withclear and measurable
positions. Managers and frontlinestaffre- performance improvement expectations.
portedtheirbeing in demand as KP Health- Furthermore,itwas implementedin organi-
Connectresourcepeople in clinics,providing zational unitsdoing the same workand that
co-workers withquick answersto the sortsof were similarenough on otherdimensionsto
"just-in-time" questions that arose as those provideforsuitablecomparisons.Headquar-
who were alreadyformallytrained became tered in the suburbs of Portland,Oregon,
everydayusers. the regionemploys880 physiciansand 8,900
Despite the sturdystructuresupporting employeesto servejust over 480,000 "mem-
the mandate forworkforceparticipationin bers"(patients). The regionspansthegreater
termsof the organization'slong-termgoals metropolitan Portland and Vancouver,
for the technologyand in the agreement Washingtonareas. It offersambulatorycare
governingemploymentrelationsissuesrelat- through27 outpatientmedical officebuild-
ing to KP HealthConnect, interviewswith ings, 15 of which serve as hubs for primary
frontlinestaffin manyclinicsacrossmultiple care- familypractice,pediatrics,and inter-
Kaiserregionsrevealeda greatdeal ofwork- nal medicine. The studyfocuses on these
place-level variation in just how involved primarycare clinicsin partbecause so many
workersfelt theywere in the project. This of the performanceoutcomes of interestto
deviationbetween stated policies and their Kaiser are shaped by the member's experi-
impacton the ground is actuallyquite com- ence withhis or her primarycare physician
mon in studies linking employmentprac- (PCP). Bounding the sample in this way,
tices to performance (e.g., Bartel 2004; moreover,allows the researcher to spend
Jones,Kalmi, and Kauhanen 2009). Within time in all of the clinics,accountingfor or
well-definedregional boundaries, however, assuring the non-variationin contextual
therewas littleor no variationin functional- characteristics.For example, including ap-
and strategic-levelstructuresbolsteringEI in pointment-making procedures beyond pri-
support of the new technology.Further- marycare would introducevariationacross
more,withintheseconfines,attributes of the specialtiesand ancillaryservices.
IT module itself- includingwhen it "went The schedulingmodule addressed a very
live"- as well as a host of contextualvari- concrete set of organizationalchallenges-
ables, can be reasonably assumed not to inefficienciesand patientdissatisfactionwith
vary. I exploit these advantageous quasi- the appointment-settingprocess. Among
experimentalconditionsin order to under- otherchallenges,thosesupportstaffcharged
take a more carefulanalysisof El's role in withsettingpatientappointmentsusing the
IT implementationthan that permittedby legacy scheduling applications frequently
the research designs employed in earlier found themselves asking even long-term
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EMPLOYEE INVOLVEMENT AND THE EFFECTIVENESS OF HEALTH IT 875
Table2. DefinitionsofVariables
Variable Description Source
Employee Involvement
index sumofresponses to8 survey
items (listedbelow) employees
suggestionshavebeenvalued answeredona 7-point scaleinwhich
Likert-type employees
1 = "strongly and7 = "strongly
disagree" agree",
andthenstandardized
issues
havebeenignored answeredona 7-point scaleinwhich
Likert-type employees
1 = "strongly and7 = "strongly
disagree" agree",
andthenstandardized,withcoding subsequently
reversed
unionized super-user answeredona 7-point scaleinwhich
Likert-type employees
improves myuse 1 = "strongly and7 = "strongly
disagree" agree",
andthenstandardized
affectedstaff
wereaskedfor answered ona 7-point scaleinwhich
Likert-type employees
guidance 1 = "strongly and7 = "strongly
disagree" agree",
andthenstandardized
introduced totechnology binary variable
createdfroma question allowing employees
bya unionmember respondentstochoosebetween a fellowunion
member, a member oftheIT staff,
ora manager
receivedfollow-up
training binary variable
createdfroma question allowing employees
from a unionmember respondentstochoosebetween a fellowunion
member, a member oftheIT staff,
ora manager
ona "super-user"
relies binarycreatedfroma yes-or-no
question employees
intheir clinic
madespecific recommenda- binary createdfroma yes-or-no
question employees
tionsforeffective
use
satisfaction
with of
length answeredona 9-point scaleinwhich
Likert-type patients
tomake 1 = "extremely
phonecallrequired and9 = "extremely
dissatisfied"
appointment andthenstandardized
satisfied",
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880 INDUSTRIAL AND LABOR RELATIONS REVIEW
Variables
Table3. DescriptiveStatisticsforWorker-Level
Included in the EmployeeInvolvementIndex
Variable Mean Std.Dev.
havebeenvalued
suggestions 3.99 1.53
issues
havebeenignored 3.57 1.65
unionizedsuper-user
improvesmyuse 4.01 1.77
affected wereaskedforguidance
staff 3.77 1.52
introduced bya unionmember
totechnology 0.11 0.31
received
follow-up from
training a unionmember 0.18 0.39
relies intheir
ona "super-user" clinic 0.39 0.49
madespecificrecommendations use
foreffective 0.15 0.36
Notes:
Valuesbasedon responsesfromthosemedical (MAs)and
assistants
member intakespecialists
(MISs)reporting
expected use of thesystem
(n = 396).Thefirst
fourcomponents oftheEI indexwereanswered on a
seven-point, scalein which1 = "strongly
Likert-type disagree"and 7 =
agree",
"strongly thoughthevaluesfortheseconditemhavebeenreversed
Theremaining
foreaseofcomparison. fouritems arebinary.
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EMPLOYEE INVOLVEMENT AND THE EFFECTIVENESS OF HEALTH IT 881
vation period of October 2004 to August in the second model revealsa positiveasso-
2007, the Fleetwoodclinic averaged .2 stan- ciation between the use of the scheduling
dard deviationsabove the sample mean, the module and theperformancemeasureitwas
highestof all the clinics.The clinic labeled intended to influence.Despite the negative,
Mullen achieved the lowest performance month-to-month effectof the overall time
and the widestvariationon thismetricover trend("Time Trend"), the post-implementa-
the sample period. tion time trend is actuallypositiveand re-
Table 5 displaysthe multilevelmodels es- mains so for all subsequent estimates.
timatedon the datasetof clinic-months, be- Consistent with anecdotal accounts, cus-
ginning with a simple model considering tomer service sufferedprior to the imple-
onlythe effectsof a linear time trend.The mentationoftheschedulingmodule,a trend
firstmodel showsa smallbut statistically sig- thatreverseditselfwiththe transitionto the
nificantmonth-to-month increase in the de- new system.Moreover,withoutthe new tech-
pendent variable between October 2004 nology,it appears thatmonth-to-month per-
and August 2007. Once a separate, post- formancewould have continued to decline.
implementationtrendis added on the right- The next model adds two dummyvariables
hand side (in the second model), the capturingtransitionto ("TransitionPeriod")
estimatedpartialslope on the originaltime and deploymentof the scheduling module
trendturnsnegativeand remainsso forthe ("Module-in-Use").Both estimatesare posi-
remainingmodels to be estimated.By con- tive and statistically
significantin this and
trast,the post-implementationtime trend the remainingmodels. Also note the point
("Time Since 'Go-Live'") that firstappears estimate on the post-implementation time
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882 INDUSTRIAL AND LABOR RELATIONS REVIEW
trenddoubles. That means thatonce one ac- theorybuilding (see Dunlop 1958 [1993];
countsfora structuralbreak in the timese- Slichter1941; Slichter,Healy,and Livernash
ries, one can see evidence of a large (.44 1960), thatfocushas been largelylimitedto
standarddeviations),one-timejump in per- trade union responses to new technologies
formance as well as a steady,sizable (.06 thatwereintendedto serveas substitutes for
standard deviations) month-to-month per- labor.As IT and othernew technologiesbe-
formanceincreaseassociatedwiththesched- come even more ubiquitous, employment
ulingmodule, despitewhatwould otherwise relations scholars would do well to look
be a declining performancefunction(-.05 withinboth the IT and EI processesat work
standarddeviationseach month) over time. to betterunderstandhow and whytheyin-
These effectsare not sensitiveto changes in teract to affectperformanceoutcomes. In
the waythe transitionperiod is operational- thiscase, reliance on the mixed-methodap-
ized, such as one month or twomonthson proach indicativeof employmentrelations
eitherside of the transitionfromlegacysys- as well as employmentrelationstheoryen-
temsto the new IT. abled an explanation of El's moderationof
The last two models in Table 5 incorpo- the IT-performancelink,one that the OB,
rate the effectsof EI on the efficacyof the HR, and IS literatureshave been unable to
technology.Model 4 incorporates only a establishconclusively.In particular,bymore
main effectforEI. Interestingly, thispredic- richlyconsideringthe role of EI around new
torhas an estimatedperformanceeffectthat workplacetechnologies,thesefindingsbuild
is insignificantlydifferentfrom zero. This on the OB and HR literature'seffortto es-
provides face validity,since the EI variable tablisha link betweenEI and performance.
should onlybe measuringEI related to the This analysisalso benefitsfromthe workof
IT deployment, meaning that its effect IS researchers,who have developed a rich
should onlyshow up when crossedwiththe literatureon the moderatingeffectsof user
technologymeasure. It is also worthnoting participation,but withsimilarlyambiguous
that the inclusion of the EI variable in the resultsto those delivered by OB and HR.
fourthmodel does virtuallynothingto the The distinctionbetweenthe approach of IS
point estimatesof all thosevariablescarried as a field and thisstudyis that ratherthan
overfromthe threeversionsof the equation focusingsolely on workplace-levelfeatures
previouslyestimated. The fifthand final of the employmentrelationshipsuch as the
model in Table 4 adds the two-way interac- incidence of trainingand whetheror not
tion to directlycapture the incremental, employees were asked for feedback, this
moderatingeffectof EI on the IT-perfor- studyis also informedby importantaspects
mance link. Controllingforall of the other of theemploymentrelationshipthatexiston
effects,an increase of one standard devia- the functionaland strategiclevels.Since EI
tion in the EI index increases the effective- is nota purelyworkplace-level phenomenon,
ness of the technology by .27 standard these aspects must be fullyconsidered-
deviations.Interestingly, the estimateforthe eithercontrolledforor held constantbyvir-
main EI measure remainsinsignificant, fur- tue of the researchdesign,in order to make
ther demonstratingthat El's performance valid inferencesfromworkplace-level data.
impactappears to come throughitsmodera- The design of the studyallowsfora clean
tion of the scheduling module's effecton separation of the technologyinputs from
performance, just as one would expectgiven the EI inputsthatmanagementtheorysug-
thespecificflavorofEI thatitmeasures.The gests complementone another in produc-
resultsare also robustto manydifferent ways tion.The greatbenefitof IT is thatit makes
of operationalizingthe EI measure. more information available to frontline
workers (Bresnahan, Brynjolfsson, and
Hitt 2002; Brynjolfssonand Mendelson
Discussion and Conclusions
1993). However,pushinginformationdown-
Though employmentrelationshas long ward and outward- in this case, up-to-date
acknowledgedthe role of technologyin its informationon patients and on physician
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EMPLOYEE INVOLVEMENT AND THE EFFECTIVENESS OF HEALTH IT 883
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EMPLOYEE INVOLVEMENT AND THE EFFECTIVENESS OF HEALTH IT 885
REFERENCES
Appelbaum, Eileen,andRosemary L. Batt.1994.The bookofHumanResource Management, pp. 351-76.
NewAmerican Workplace: Work
Transforming in
Systems London: Sage.
theUnited States.Ithaca:ILR Press(an imprint of , andMarkA. Huselid.1998."HighPerformance
CornellUniversity Press). Work Systems andFirmPerformance: A Synthesisof
Arthur, B. 1992."TheLinkBetween
Jeffrey Business Research and Managerial Implications."In Gerald
andIndustrial
Strategy Relations
SystemsinAmerican Ferris, ed.,ResearchinPersonnelandHuman Resources
SteelMinimills."
IndustrialandLaborRelations
Review, Management, pp.53-101.Greenwich, CT:JAI.
Vol.45,No.3,pp.488-506. Bidwell,Matthew. 2009."Do Peripheral Workers Do
Barki,Henri,andJonHartwick. 1989."Rethinkingthe Peripheral Work?Comparing the Use of Highly
Concept ofUserInvolvement." MISQuarterly,
Vol.13, SkilledContractors andRegular Employees."Indus-
No.1,pp.53-63. trialandLaborRelations Review,Vol.62,No. 2, pp.
Barley,
Stephen R. 1986."Technologyas an Occasion 200-25.
forStructuring:Evidence fromObservationsofCT Boland,Richard J.,Jr.1978."TheProcess andProduct
ScannersandtheSocialOrderofRadiology Depart- ofSystem Design."Management Vol.24,No.9,
Science,
ments."Administrative
Science Vol.31,No.1,
Quarterly, pp.887-98.
pp.78-108. Bollen,Kenneth, andRichard Lennox.1991."Conven-
AnnP. 2004."HumanResource
Bartel, Management tionalWisdom on Measurement: A StructuralEqua-
andOrganizational Performance:
Evidence from Re- tionPerspective." Vol.110,No.2,
Bulletin,
Psychological
tailBanking."
Industrial
andLaborRelations Vol.
Review, pp.305-14.
57,No.2,pp.181-203. Braverman, Harry. 1974.LaborandMonopoly The
Capital:
, CaseyIchniowski,andKathryn Shaw. 2007."How DegradationofWork intheTwentiethCentury.NewYork:
DoesInformation TechnologyReallyAffectProduc- Monthly Review.
Plant-Level
tivity? Comparisonsof Product Innova- Bresnahan, Timothy F.,ErikBrynjolfsson,
andLorinM.
tion,ProcessImprovement and WorkerSkills." Hitt.2002."Information Technology,Workplace Or-
Quarterly
Journal ofEconomics,Vol.122,No. 4, pp. ganization,andtheDemandforSkilled Labor:Firm
1721-58. Level Evidence."Quarterly Journalof Economics,
Batt,
Rosemary L. 1999."Work Technol- Vol.117,No.1,pp.339-76.
Organization,
ogy,andPerformance inCustomerServiceandSales." Brodbeck, FelixC. 2001."Communication andPerfor-
Industrial
andLabor Relations Vol.52,No. 4,
Review, mancein Software Development Projects."
European
pp.539-64. Journal ofWork àf Organizational Vol.10,
Psychology,
Becker,BrianE.,andMark A.Huselid.2010."Strategic No.1,pp.73-94.
HumanResources Management: WhereDo WeGo Brown, Clair,andBenjamin A. Campbell. 2002."The
fromHere?"In AdrianWilkinson, NicolasBacon, Impact ofTechnological Change onWork andWages."
TomRedman andScottSnell,eds.,TheSAGEHand- Industrial Vol.41,pp.1-33.
Relations,
This content downloaded from 132.236.173.158 on Mon, 07 Dec 2015 20:26:23 UTC
All use subject to JSTOR Terms and Conditions
886 INDUSTRIAL AND LABOR RELATIONS REVIEW
This content downloaded from 132.236.173.158 on Mon, 07 Dec 2015 20:26:23 UTC
All use subject to JSTOR Terms and Conditions
EMPLOYEE INVOLVEMENT AND THE EFFECTIVENESS OF HEALTH IT 887
This content downloaded from 132.236.173.158 on Mon, 07 Dec 2015 20:26:23 UTC
All use subject to JSTOR Terms and Conditions
888 INDUSTRIAL AND LABOR RELATIONS REVIEW
PhilipM.,ScottB. MacKenzie,
Podsakoff, Judith
Jeong-Yeon Scully, A.,ShelleyA. Kirkpatrick,
andEdwin A.
Lee, and NathanP. Podsakoff. 2003."Common Locke.1995."LocusofKnowledge as a Determinant
Method BiasesinBehavioral A Critical
Research: Re- oftheEffectsofParticipation
onPerformance, Affect
viewoftheLiterature
andRecommended Remedies." andPerceptions." Behavior
Organizational andHuman
JournalofApplied Vol. 88, No. 5, pp.
Psychology, Decision Vol.91,No.3,pp.276-88.
Processes,
879-903. Skrondal,
Anders,andSophiaRabe-Hesketh. 2004.Gen-
Michael
Porter, E. 1980.Competitive Techniques eralized
Strategy: LatentVariable Multilevel,
Modeling: Longitudi-
Industries
forAnalyzing andCompetitors.
NewYork: Free nal, and StructuralEquationModels. Boca Raton:
Press. Chapman andHall/ CRC.
Marsha
Richins, L. 1983."Negative
Word-of-Mouth Sumner
by Slichter, H. 1941.Union Policies
andIndustrial
Dissatisfied
Consumers: APilotStudy."
JournalofMar- Management.Washington, DC:Brookings.
Vol.47,No.1,pp.68-78.
keting, , James JosephHealy,and E. Robert Livernash.
FritzJ., and William
Roethlisberger, J. Dickson. 1960.TheImpact ofCollective onManagement.
Bargaining
1939.Management andtheWorker:AnAccount ofa Washington,DC:Brookings.
Research
Program Conducted
bytheWesternElectric
Com- Vroom, VictorH.,andPhilip W.Yetton.1973.Leadership
pany,Hawthorne Works,Chicago.
Cambridge, MA: and Decision-Making. Pittsburgh: Universityof
Harvard. Pittsburgh.
Schwab,DonaldP.2005.ResearchMethodsforOrganiza- Yeh,Quey-Jen,andChih-Ling Tsai.2001."TwoConflict
tionalStudies.Mahwah,NJ: LawrenceErlbaum Potentials During IS Development." and
Information
Associates. Management,Vol.39,No.2,pp.135-49.
This content downloaded from 132.236.173.158 on Mon, 07 Dec 2015 20:26:23 UTC
All use subject to JSTOR Terms and Conditions