Strategic Management in Hospitals: Tensions between the Managerial and Institutional Lens

Pascuci, Lucilaine; Júnior, Victor Meyer; Crubellate, João Marcelo

doi:10.1590/1807-7692bar2017160092

Cited by 11 publications

(11 citation statements)

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“…Hospitals are challenged by the need to manage the diverging accountability demands of different stakeholder groups. This finding is consistent with a health care related study in Brazil (Pascuci, Júnior, & Crubellate, 2017). As one participant commented: "Competing priorities is a way of life" (I29-Hospital board member).…”

Section: Summary Of Stakeholder Relationshipssupporting

confidence: 83%

Accountability in Ontario's Health Care System: The Role of Governance and Information in Managing Stakeholder Demands

Pilon¹

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This research focuses on nonprofit accountability because accountability failures, such as frauds and scandals, impede an organisation's ability to deliver on its mission and have raised concerns about an organisation's ability to manage their accountability demands. Previous nonprofit studies have focused on what accountability is and to whom organisations are accountable, while less focus has been given to how accountability is managed. Through the concepts of stakeholder relationships, governance mechanisms and information strategies, an accountability system is proposed and serves as the conceptual framework to understand how nonprofit accountability is managed.The objective of this research is to gain a better understanding of the nonprofit accountability system. As such, the study's research question is how do nonprofit organisations manage their accountability system?To answer the research question, a multiple-case study research strategy using a cross-sectional sample of health care organisations, with a particular focus on nonprofit hospitals and two of its salient stakeholders, Local Health Integration Networks (LHINs) and foundations.This study has provided a clearer understanding of the relationship between accountability, governance and information, which contrasts with a majority of studies that have concentrated on specific aspects of accountability. At the practical level, to iii view accountability as a system, makes it easier to identify weaknesses, which could be used as a governance tool to help nonprofit leaders improve their accountability management practices.iv Acknowledgements I would like to thank my research supervisor, François Brouard, for his valuable support. He guided me through the completion of this thesis with rigour, critical sense, sound advice, and a sense of humour.

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Section: Summary Of Stakeholder Relationshipssupporting

confidence: 83%

Accountability in Ontario's Health Care System: The Role of Governance and Information in Managing Stakeholder Demands

Pilon¹

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“…Cada unidade [da Fiocruz] tem sua particularidade, é diferente (...). Não é trivial: um instituto tem 100 anos, outro tem 50, outro tem 30; proporções diferentes de terceirizados, servidor, de outros vínculos trabalhistas.... (...) Essa desorganização interna sempre foi frutífera, principalmente para questões de inovação e de bem-estar... Então talvez tenha um certo grupo que não queira [o alinhamento], por achar que vai plastificar a Fiocruz, que vai deixar ela mais quadradinha [E4] Conforme descrito na literatura (ABDALLAH, 2006;COMEAU-VALLÉ;NORMANDIN & THERRIEN, 2017;PASCUCI;MEYER JÚNIOR e CRUBELLATE, 2017), os entrevistados relataram que também na Fiocruz existem tensões entre duas lógicas, a da pesquisa biológica e as da gestão, que competem pela atenção da liderança. A capacitação em gestão foi percebida por alguns como desnecessária e usurpadora do tempo que deveria ser empregado com atividades mais nobres (ligadas à atividade-fim):…”

Section: Apresentação E Análise Dos Resultados 51-os Desafios De Alinhamento Na Fiocruzunclassified

Alinhamento Estratégico Em Contexto Pluralista: Impactos Da Capacitação De Lideranças Da Fiocruz

Bernardes

Ferreira

Kaufmann

et al. 2020

E&G

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O contexto pluralista concerne as organizações onde há acentuada pressão de stakeholders e reguladores, cujadistribuição de poder internamente é difusa e onde o processo de trabalho éfortemente baseado no conhecimentoespecializado. Pesquisadores tem buscado entender melhor os desafios estratégicos nessas organizações, pois nelas hágrande dificuldade de coordenação e de engajamento para a busca de resultados coletivos. Alguns estudos apontam parao impacto positivo de práticas capitaneadas pela área de gestão de RH e para o papel das lideranças, agenciadoras deestruturas de coesão, para superar as dificuldades. A pesquisa descrita neste artigo investigou o efeito da capacitação emgestão para as lideranças de uma organização pluralista, a Fundação Oswaldo Cruz (Fiocruz), promovida pela área deGestão de RH com vistas a melhorar seu alinhamento estratégico. A análise dos achados, ancorada na perspectiva que foca práticas, identificou pelo menos quatro aspectos onde a capacitação contribuiu para incremento das práticas dos egressos que levam ao alinhamento: na ampliação da visão sistêmica, na adoção de práticas de planejamento e controle, na melhoria do exercício da liderança e na promoção da gestão de significados (sensemaking).

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“…

Hospitals are distinguishable from other entities.These are comprehensive organisations, where professionals conduct specific activities. Their activity is strongly affected by political aspects, as well as their pluralistic context, organisational knowledge, legitimacy, and social capital (Pascuci et al, 2017). The healthcare system

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mentioning

confidence: 99%

“…There are many challenges faced by managers in the healthcare system. including a high level of uncertainty and the complex nature of hospitals (Pascuci et al, 2017), as well as epidemiological and demographic trends, such as an ageing population (Breyer et al, 2010), prevalence of chronic diseases, mutations of diseases and others (Rudawska, 2012). These challenges place further strain on financial resources.…”

mentioning

confidence: 99%

“…However, these resources are limited while healthcare professionals report problems with balancing their financial budget, which reinforces the need for particular supervision of the effective functioning of healthcare entities. This sets out the objectives for measuring and reporting the financial results and achievements of hospitals (Pink et al 2006;Gapenski & Pink, 2007). The example of the last two decades in Poland shows that the financial situation experienced by healthcare entities is poor.…”

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confidence: 99%

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Financial situation and challenges for management of SME hospitals: Evidence from Poland

Szewieczek¹

2021

Serb J Management

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The hospital represents a specific organisation, operating in a turbulent environment and financed to a large extent by public funds. The health sector is exposed to constant political and social pressure. This causes significant problems with maintaining its financial stability, which particularly affects hospitals in the SME sector. The aim of this paper is to examine the relationship between selected financial indicators and some environmental phenomena that affect the financial situation and future financial stability of a selected group of hospitals from the SME group. The results will also be compared to the situation of other SME entities. The research is based on descriptive analysis, descriptive statistics, and correlation analysis of selected data. The results indicate that the financial situation of hospitals belonging to the SME group differs significantly from the overall SME sector, and does not bode positively for their future development. The current financial situation presents particular challenges for managers in balancing financial streams and ensuring economic sustainability. At the same time, this situation should encourage decision-makers to ensure an adequate level of revenues for these public service providers, as well as face other challenges related to operational management.

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Strategic Management in Hospitals: Tensions between the Managerial and Institutional Lens

Cited by 11 publications

References 43 publications

Accountability in Ontario's Health Care System: The Role of Governance and Information in Managing Stakeholder Demands

Accountability in Ontario's Health Care System: The Role of Governance and Information in Managing Stakeholder Demands

Alinhamento Estratégico Em Contexto Pluralista: Impactos Da Capacitação De Lideranças Da Fiocruz

Financial situation and challenges for management of SME hospitals: Evidence from Poland

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