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  • Managing between the agendas: implementing health care reform policy in an acute care hospital

    Author(s)
    Sorensen, Ros
    Paull, Glenn
    Magann, Linda
    Davis, JanMaree
    Griffith University Author(s)
    Sorensen, Ros
    Year published
    2013
    Metadata
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    Abstract
    Purpose - This paper aims to assess administrative and clinical manager stances on health system reform. Understanding these stances will help to identify cultural differences and competing agendas between these two key health service stakeholders and contribute to developing strategies to improve organisational performance. Design/methodology/approach - A qualitative methodology was used comprising in-depth open-ended interviews conducted in 2007 with 26 administrative and clinical managers who managed clinical units. Findings - This paper provides empirical insights into the ways that administrative and clinical mangers ...
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    Purpose - This paper aims to assess administrative and clinical manager stances on health system reform. Understanding these stances will help to identify cultural differences and competing agendas between these two key health service stakeholders and contribute to developing strategies to improve organisational performance. Design/methodology/approach - A qualitative methodology was used comprising in-depth open-ended interviews conducted in 2007 with 26 administrative and clinical managers who managed clinical units. Findings - This paper provides empirical insights into the ways that administrative and clinical mangers conceive of their managerial roles in relation to health care reform and performance improvement in health services. The findings suggest that developing a hybrid clinical manager culture as a means to bridge the gap between administrative and clinical manager stances on reform objectives, while possible, is not yet being realised. Research limitations/implications - The research has relevance for health services that are experiencing organisational transformation. However, its location in one health service limits the generalisability of findings to other sites. Further research is needed to assess the opportunities for a hybrid culture to emerge as well as its effect. Practical implications - While attention is predominantly directed to clinician groups as a key stakeholder in implementing health reform policies, this paper has implications for how administrative managers also structure their roles and responsibilities to create an organisational climate conducive to change. This will include strategies to support clinical managers to make the transition from a predominantly clinical, to a clinical managerial, orientation. Originality/value - This paper addresses a significant problem in health service governance, namely the divide between the value stances of dual hierarchies. This problem is only now gaining prominence as a significant barrier to health reform.
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    Journal Title
    Journal of Health Organization and Management
    Volume
    27
    Issue
    6
    DOI
    https://doi.org/10.1108/JHOM-11-2011-0119
    Subject
    Public Health and Health Services not elsewhere classified
    Medical and Health Sciences
    Commerce, Management, Tourism and Services
    Publication URI
    http://hdl.handle.net/10072/56136
    Collection
    • Journal articles

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