Mathias Rask Østergaard-Nielsen

Uncertainty and Influence: Involving Frontline Professionals in Organizational Decision-Making

The aim of this dissertation is to improve our knowledge about involvement of frontline professionals in organizational decision-making in the public sector. The dissertation combines insights from the theoretical framework of bounded rationality with theories on employee involvement, professionals, and crises. Empirically, it relies on time and unit fixed effects panel analyses of survey data, and survey experiments, collected and carried out among healthcare professionals employed at Danish public hospitals. The empirical findings can be summarized in three main points. First, by investigating managers’ inclination to involve frontline professionals in response to performance feedback and crisis, the dissertation finds that managers are more inclined to involve frontline professionals in organizational decisions when these decisions can be characterized as being relatively more uncertain. Second, the dissertation finds that frontline professionals perceive that it is better to be consulted and/or to enter in joint decision-making with management compared to having no influence, whether the organizational decisions are about formulating the organization’s vision or changing work processes. Interestingly, the results also indicate that frontline professionals prefer consultation over joint decision-making. Third, the dissertation finds a negative association between involvement in organizational goal prioritization and perceived organizational goal conflict, and a positive association between involvement in organizational goal prioritization and job satisfaction. Importantly, the negative association between involvement in organizational goal prioritization and organizational goal conflict is strong for professions with low (medical secretaries) or medium (e.g., nurses) levels of discretion and insignificant for professions with high levels of discretion (physicians).

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