Values and strategies: management of radical organizational change in a university hospital

Int J Health Plann Manage. 2017 Apr;32(2):114-132. doi: 10.1002/hpm.2332. Epub 2016 Jan 17.


Managers' experiences of radical change were studied in a Norwegian university hospital, which was relocated from a traditional building to a new, high-tech building. The university hospital was also accredited as a health promoting hospital. Thirteen managers at different levels in the organization and a personnel safety representative were interviewed as part of a trailing research project. The aim of the study was to elucidate the managers' value orientation and strategies for dealing with value tensions. A combination of a hermeneutical, reflective method and a template for quality, efficiency and integrity guided the analysis. The template was based not only on the main findings but also on the core values of a model of organizational health. The results show that clinical managers focus on quality and top managers, not unexpectedly, focus on efficiency. Managers at both levels were concerned about their own integrity, and also about the integrity of their clinician colleagues, as well as showing concern for the hospital's mission, in terms of organizational effectiveness. The discussion was conducted in terms of dominance, cycling and balancing strategies, of which the last was the most prevalent. However, sustainable strategies for dealing with value tensions also call for value-based management and value-conscious leadership. Copyright © 2016 John Wiley & Sons, Ltd.

Keywords: change; hospital management; integrity; quality; sustainability; values.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diffusion of Innovation*
  • Female
  • Hospital Administrators / psychology
  • Hospitals, University / organization & administration*
  • Humans
  • Interviews as Topic
  • Leadership
  • Male
  • Middle Aged
  • Norway
  • Organizational Innovation
  • Qualitative Research
  • Social Values*