Explaining process orientation failure and success in health care - three case studies

Research output: Contribution to journalArticle


Purpose - In order to improve cooperation and collaboration between units, clinics and departments, many health care organizations (HCOs) have introduced process orientation. Several studies indicate problems in realizing these ambitions. The purpose of this paper is to explain and understand the success and failure of process orientation in HCOs. Design/methodology/approach - The authors conducted three case studies and applied Actor-Network Theory as an analytic lens. Findings - The realization of process orientation is hindered by neglect or resistance from physicians, who find the process targets to be of low medical priority. However, the authors also see that medical priorities are no stable entities but are susceptible to negotiations. Over time, process organization, process mapping, process measurement activities and the acting of enroled actors may have impact on medical priorities. Originality/value - Contrary to previous research, the findings indicate that New Public Management may not be the main obstacle against processes, that accounting figures may not be hard to disregard and that the role of leadership is not paramount.


  • Stefan Hellman
  • Gustaf Kastberg
  • Sven Siverbo
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Health Care Service and Management, Health Policy and Services and Health Economy


  • Health care, Actor Network Theory, Medical profession, Organization and, control, Process orientation
Original languageEnglish
Pages (from-to)638-653
JournalJournal of Health Organisation & Management
Issue number6
Publication statusPublished - 2015
Publication categoryResearch