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Contrasting perspectives in a hospital merger: The case of the SUS eye clinic

Sundqvist, Björn and Alexandersson, Erik (2011) FEKP90 20111
Department of Business Administration
Abstract
Purpose: The purpose of this study is to increase the understanding for if, and how, different views on efficiency and effectiveness characterized the organisation of the eye clinic in the SUS hospital merger. What presumptions operative efficiencies affected hospital management’s merger decision? What were the expected benefits and what kind of organisational structure would help to achieve these? Finally, did different views on efficiencies affect how groups of individuals believe that the transformation should be carried out? In order to satisfy this purpose, we formulated three constituent objectives for research: (1) How do doctors and managers believe efficiency is and/or should be measured?
(2) What do they think is efficient in an... (More)
Purpose: The purpose of this study is to increase the understanding for if, and how, different views on efficiency and effectiveness characterized the organisation of the eye clinic in the SUS hospital merger. What presumptions operative efficiencies affected hospital management’s merger decision? What were the expected benefits and what kind of organisational structure would help to achieve these? Finally, did different views on efficiencies affect how groups of individuals believe that the transformation should be carried out? In order to satisfy this purpose, we formulated three constituent objectives for research: (1) How do doctors and managers believe efficiency is and/or should be measured?
(2) What do they think is efficient in an organisational change process, such as the SUS hospital merger?
(3) What do they believe is efficient in a doctor’s daily work? Methodology: This is a qualitative study where we have adopted an abductive study approach, with an interpretivist/constructivist positioning. Thus we have not tried to identify the absolute truth. Instead we have tried to identify, evaluate and describe the different individuals’ views and perspectives on various aspects. Theoretical perspectives: The theoretical perspectives cover professions and professional bureaucracies, the definitions of effectiveness, efficiency and related concepts, optimal hospital size, quality of care, organizational change and management and merger theory. Empirical foundation: We conducted interviews with six managers from different levels of the vertical hierarchy of the SUS hospital, and eight clinical doctors with different backgrounds and current responsibilities, all working at the Eye clinic. We created and followed a semi-structured interview guide that we used to interview both managers and doctors. During the interviews we focused on open-ended questions that would bring the interviewees to freely express their views on the subject. Conclusions: In response to our research objectives we can conclude that; there is little agreement as to how measurements in healthcare in general, and the SUS hospital in particular, should be defined; there are different views on how to manage organisational change between managers and doctors, where management prefer a top-down approach while doctors believe that they should have more say in how the change is carried out; doctor’s stress the need for customized IT-support, stricter job specialisation, clear patient processes and the possibility to form informal networks and knowledge clusters. It appears that management has a narrow view of what doctor’s feel is necessary for improving efficiency in their daily work since many of these efficiencies have been impaired as a result of the top-down managed merger. In sum, it seems that our initial impression, that different views on efficiencies may cause problems in change processes, still poses a viable correlation between these aspects. (Less)
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author
Sundqvist, Björn and Alexandersson, Erik
supervisor
organization
course
FEKP90 20111
year
type
H1 - Master's Degree (One Year)
subject
keywords
Företagsledning, Management of enterprises, management, change, merger, efficiency, hospital
language
Swedish
id
1979949
date added to LUP
2011-05-23
date last changed
2012-11-13 07:37:16
@misc{1979949,
  abstract     = {Purpose: The purpose of this study is to increase the understanding for if, and how, different views on efficiency and effectiveness characterized the organisation of the eye clinic in the SUS hospital merger. What presumptions operative efficiencies affected hospital management’s merger decision? What were the expected benefits and what kind of organisational structure would help to achieve these? Finally, did different views on efficiencies affect how groups of individuals believe that the transformation should be carried out? In order to satisfy this purpose, we formulated three constituent objectives for research: (1)	How do doctors and managers believe efficiency is and/or should be measured?
(2)	What do they think is efficient in an organisational change process, such as the SUS hospital merger?
(3)	What do they believe is efficient in a doctor’s daily work? Methodology: This is a qualitative study where we have adopted an abductive study approach, with an interpretivist/constructivist positioning. Thus we have not tried to identify the absolute truth. Instead we have tried to identify, evaluate and describe the different individuals’ views and perspectives on various aspects. Theoretical perspectives: The theoretical perspectives cover professions and professional bureaucracies, the definitions of effectiveness, efficiency and related concepts, optimal hospital size, quality of care, organizational change and management and merger theory. Empirical foundation: We conducted interviews with six managers from different levels of the vertical hierarchy of the SUS hospital, and eight clinical doctors with different backgrounds and current responsibilities, all working at the Eye clinic. We created and followed a semi-structured interview guide that we used to interview both managers and doctors. During the interviews we focused on open-ended questions that would bring the interviewees to freely express their views on the subject. Conclusions: In response to our research objectives we can conclude that; there is little agreement as to how measurements in healthcare in general, and the SUS hospital in particular, should be defined; there are different views on how to manage organisational change between managers and doctors, where management prefer a top-down approach while doctors believe that they should have more say in how the change is carried out; doctor’s stress the need for customized IT-support, stricter job specialisation, clear patient processes and the possibility to form informal networks and knowledge clusters. It appears that management has a narrow view of what doctor’s feel is necessary for improving efficiency in their daily work since many of these efficiencies have been impaired as a result of the top-down managed merger. In sum, it seems that our initial impression, that different views on efficiencies may cause problems in change processes, still poses a viable correlation between these aspects.},
  author       = {Sundqvist, Björn and Alexandersson, Erik},
  keyword      = {Företagsledning,Management of enterprises,management,change,merger,efficiency,hospital},
  language     = {swe},
  note         = {Student Paper},
  title        = {Contrasting perspectives in a hospital merger: The case of the SUS eye clinic},
  year         = {2011},
}