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

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Explaining process orientation failure and success in health care - three case studies. / Hellman, Stefan; Kastberg, Gustaf; Siverbo, Sven.

In: Journal of Health Organisation & Management, Vol. 29, No. 6, 2015, p. 638-653.

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Hellman, Stefan ; Kastberg, Gustaf ; Siverbo, Sven. / Explaining process orientation failure and success in health care - three case studies. In: Journal of Health Organisation & Management. 2015 ; Vol. 29, No. 6. pp. 638-653.

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TY - JOUR

T1 - Explaining process orientation failure and success in health care - three case studies

AU - Hellman, Stefan

AU - Kastberg, Gustaf

AU - Siverbo, Sven

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

KW - Health care

KW - Actor Network Theory

KW - Medical profession

KW - Organization and

KW - control

KW - Process orientation

U2 - 10.1108/JHOM-09-2013-0186

DO - 10.1108/JHOM-09-2013-0186

M3 - Article

VL - 29

SP - 638

EP - 653

JO - Journal of Health Organisation & Management

T2 - Journal of Health Organisation & Management

JF - Journal of Health Organisation & Management

SN - 1758-7247

IS - 6

ER -