Dynamic Capabilities for Accreditation: Evidence in the Healthcare Sector

Meira, Mariana Monteiro; Machado, André Gustavo Carvalho; Gomes, Glauco Ricardo Simões

doi:10.1590/1807-7692bar2019180115

Mariana Monteiro Meira

Centro Universitário de João Pessoa, João Pessoa, PB, Brazil

Mariana Monteiro Meira Centro Universitário de João Pessoa UNIPÊ, BR 230, Km 22, Água Fria, 58053-000, João Pessoa, PB, Brazil. rmonteiro.mariana@gmail.com https://orcid.org/0000-0002-3326-1712

http://orcid.org/0000-0002-3326-1712

André Gustavo Carvalho Machado

Universidade Federal da Paraíba, João Pessoa, PB, Brazil

André Gustavo Carvalho Machado Universidade Federal da Paraíba, Centro de Ciências Sociais Aplicadas, CCSA/UFPB, Cidade Universitária, 58043-210, João Pessoa, PB, Brazil. agcmachado@gmail.com http://orcid.org/0000-0002-0589-896X

http://orcid.org/0000-0002-0589-896X

Glauco Ricardo Simões Gomes

Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

Glauco Ricardo Simões Gomes Universidade Federal de Minas Gerais, Centro de Pós-Graduação e Pesquisas em Administração Avenida Presidente Antônio Carlos, 6627, Pampulha, 31270-901, Belo Horizonte, MG, Brazil. glaucorsg@gmail.com https://orcid.org/0000-0002-9825-9592

http://orcid.org/0000-0002-9825-9592

Breno Augusto Diniz Pereira was the associate editor for this article.

Editorial assistant: Luciane Kato Kiwara

Editor-in-chief: Carlo Gabriel Porto Bellini

Mariana Monteiro Meira

Centro Universitário de João Pessoa UNIPÊ, BR 230, Km 22, Água Fria, 58053-000, João Pessoa, PB, Brazil. rmonteiro.mariana@gmail.com

https://orcid.org/0000-0002-3326-1712

André Gustavo Carvalho Machado

Universidade Federal da Paraíba, Centro de Ciências Sociais Aplicadas, CCSA/UFPB, Cidade Universitária, 58043-210, João Pessoa, PB, Brazil. agcmachado@gmail.com

http://orcid.org/0000-0002-0589-896X

Glauco Ricardo Simões Gomes

Universidade Federal de Minas Gerais, Centro de Pós-Graduação e Pesquisas em Administração Avenida Presidente Antônio Carlos, 6627, Pampulha, 31270-901, Belo Horizonte, MG, Brazil. glaucorsg@gmail.com

https://orcid.org/0000-0002-9825-9592

Contributions

1st author: research question and main objectives; theoretical basis; methodological procedures; results presentation and discussion; conclusions.

2nd author: research question and main objectives; results presentation and discussion; conclusions.

3rd author: results presentation and discussion; conclusions.

Constructs	Definitions	Assumptions	Main authors
Organizational change	"Any change, whether planned or unplanned, in the organization, due to internal and/or external factors, which has some impact on the results and/or people's relationships at work" (Bruno-Faria, 2003Bruno-Faria, M. F. (2003). Criatividade, inovação e mudança organizacional. In S. M. V. Lima (Org.), Mudança organizacional: Teoria e gestão (Chap. 3, pp. 111-141). Rio de Janeiro, Brazil: FGV., p. 128, our translation).	(1) Changes made for accreditation follow the behavior predicted by the punctuated equilibrium model.	(Nelson & Winter, 1982Nelson, R. R., & Winter, S. G. (1982). An evolutionary theory of economic change. Cambridge, MA: Harvard University Press.) (Tushman & Romanelli, 1985Tushman, M., & Romanelli, E. (1985). Organizational evolution: A metamorphosis model of convergence and reorientation. Research in Organizational Behavior, 7, 171-222. Retrieved from https://www.journals.elsevier.com/research-in-organizational-behavior https://www.journals.elsevier.com/resear... )
Dynamic capabilities	"The capacity of one organization to purposefully create, extend and modify its resource base" (Helfat et al., 2007Helfat, C., Finkelstein, S., Mitchell, W., Peteraf, M., Singh, H., Teece, D., & Winter, S. (2007). Dynamic capabilities: Understanding strategic change in organizations. New York, NY: Blackwell Publishing., p. 1).	(2) During the accreditation process, capabilities behave in a dynamic way.	(Helfat et al., 2007Helfat, C., Finkelstein, S., Mitchell, W., Peteraf, M., Singh, H., Teece, D., & Winter, S. (2007). Dynamic capabilities: Understanding strategic change in organizations. New York, NY: Blackwell Publishing.) (Helfat & Winter, 2011Helfat, C. E., & Winter, S. G. (2011). Untangling dynamic and operational capabilities: Strategy for the (n)ever-changing world. Strategic Management Journal, 32(11), 1243-1250. https://doi.org/10.1002/smj.955 https://doi.org/10.1002/smj.955... ) (Winter, 2003Winter, S. G. (2003). Understanding dynamic capabilities. Strategic Management Journal, 24(10), 991- 995. https://doi.org/10.1002/smj.318 https://doi.org/10.1002/smj.318... ) (Teece, Pisano, & Shuen, 1997Teece, D. J. (2007). Explicating dynamics capabilities: The nature and microfoundations of (sustainable) enterprise performance. Strategic Management Journal, 28(13), 1319-1350. https://doi.org/10.1002/smj.640 https://doi.org/10.1002/smj.640... )
Dynamic capability sources	Elements through which it is possible to create and develop dynamic capabilities.	(3) Throughout the accreditation process, dynamic capabilities are created through deliberate learning, relationships and/or acquisitions.	(Zollo & Winter, 2002Zollo, M., & Winter, S. G. (2002). Deliberate learning and the evolution of dynamic capabilities. Organization Science, 13(3), 339-351. https://doi.org/10.1287/orsc.13.3.339.2780 https://doi.org/10.1287/orsc.13.3.339.27... ) (Romme et al., 2010Romme, A. G. L., Zollo, M., & Berends, P. (2010). Dynamic capabilities, deliberate learning and environmental dynamism: A simulation model. Industrial and Corporate Change, 19(4), 1271-1299. https://doi.org/10.1093/icc/dtq031 https://doi.org/10.1093/icc/dtq031... ) (Dyer & Singh, 1998Dyer, J. H., & Singh, H. (1998). The relational view: Cooperative strategy and sources of interorganizational competitive advantage. Academy of Management Review, 23(4), 660-679. https://doi.org/10.5465/amr.1998.1255632 https://doi.org/10.5465/amr.1998.1255632... )
Capability lifecycles	Set of possible paths that characterize the evolution of capabilities through specific stages (Keil et al., 2009Keil, T., McGrath, R. G., & Tukiainen, T. (2009). Gems from the Ashes: Capability creation and transformation in internal corporate venturing. Organization Science, 20(3), 601-620. https://doi.org/10.1287/orsc.1080.0373 https://doi.org/10.1287/orsc.1080.0373... ).	(4) Throughout the accreditation process, dynamic capabilities behave according to the Lifecycle stages proposed by Helfat and Peteraf (2003).	(Helfat & Peteraf, 2003Helfat, C. E., & Peteraf, M. A. (2003). The dynamic resource based view: Capability lifecycles. Strategic Management Journal, 24(10), 997-1010. https://doi.org/10.1002/smj.332 https://doi.org/10.1002/smj.332... )

Change domains	Characteristics
Strategy	Strategy was created through strategic planning.
Structure	Organizational: positions were eliminated and created, the organogram was changed. Physical: ICU and number of beds were expanded; equipment was bought.
Power distributions	Empowerment, new leaders were instituted for each sector, follow-up at each sector became more specialized.
Control systems	Indicators were created based on accreditation requirements and an indicator follow-up system. Communication patterns were reshaped, SOPs were created, protocols were structured, performance assessment was created.
Values	Institutional values were created, conduct policies were created and disseminated.

	Dynamic capabilities
Source	Contract management	Protocol management	Outcome management
Deliberate learning	a) Knowledge codification: manuals, tools and written procedures; b) Experience accumulation: Group meetings about conducting the procedures, considering prior experience; c) Knowledge articulation: Meetings and dissemination of manuals.	a) Knowledge codification: Meetings to design and discuss the protocols; b) Experience accumulation: Meetings to share experiences; c) Knowledge articulation: Meetings to decide on capability creation.	a) Knowledge codification: flow charts and training; b) Experience accumulation: it used the experience of prior capabilities; c) Knowledge articulation: Meetings, training and forums.
Relationship	Outsourcing laboratory, garbage and cleaning management; Alliance with external suppliers and internal sectors.	Alliance with clients and suppliers.	Previous outsourcing and alliances.

Constructs	Assumptions	Empirical evidence
Organizational change	(1) Changes made for accreditation follow the behavior predicted by the punctuated equilibrium model.	Accreditation went through changes in different domains (strategy, structure, control systems, power distribution, values) and followed the Punctuated Equilibrium logics, with periods of convergence and reorientation.
Dynamic capabilities	(2) During the accreditation process, capabilities behave in a dynamic way.	Unlike our initial understanding, we found that the Contract Management capability had a dual behavior, at times having dynamic capability characteristics and at other times having operational capability characteristics.
Dynamic capability sources	(3) Throughout the accreditation process, dynamic capabilities are created through deliberate learning, relationships and/or acquisitions.	Although capabilities were generated through deliberate learning mechanisms (knowledge codification, experience accumulation, knowledge articulation) and relationships (alliance and outsourcing), we did not find sources of capabilities originating from acquisitions.
Capability lifecycles	(4) Throughout the accreditation process, dynamic capabilities behave according to the Lifecycle stages proposed by Helfat and Peteraf (2003)Helfat, C. E., & Peteraf, M. A. (2003). The dynamic resource based view: Capability lifecycles. Strategic Management Journal, 24(10), 997-1010. https://doi.org/10.1002/smj.332 https://doi.org/10.1002/smj.332... .	In consonance with the theoretical assumption, we found that the behavior - over time - of the three dynamic capabilities adheres to the lifecycle proposed by Helfat and Peteraf (2003)Helfat, C. E., & Peteraf, M. A. (2003). The dynamic resource based view: Capability lifecycles. Strategic Management Journal, 24(10), 997-1010. https://doi.org/10.1002/smj.332 https://doi.org/10.1002/smj.332... .

[1] Breno Augusto Diniz Pereira was the associate editor for this article.

Editorial assistant: Luciane Kato Kiwara

Editor-in-chief: Carlo Gabriel Porto Bellini

Brasil

Brasil

Dynamic Capabilities for Accreditation: Evidence in the Healthcare Sector

Abstract