The importance of healthcare managers’ organizational preconditions and support resources for their appraisal of planned change and its outcomes

Abstract

Background: Healthcare managers are expected to lead and manage planned organizational change intended to improve healthcare process quality. However, their complex working conditions offer limited decision control, and healthcare managers often feel ill prepared and inadequately supported to perform their duties. Healthcare managers have previously described their need for organizational support, but we lack knowledge of the preconditions and resources that help managers implement planned change.Methods: This prospective cohort study examined healthcare managers at three Swedish hospitals implementing lean production and two Swedish hospitals implementing their own improvement model. Questionnaire data from 2012, 2103, and 2014 were used in following up. We used t-tests and a linear mixed model design in analysing the data. Results: Healthcare managers who perceived strong support from managers, employees, colleagues, and the organization and managers with the longest managerial experience had the least negative appraisal of change. Managers who perceived strong support from employees, management, and the organizational structure perceived higher levels of healthcare process quality. Conclusions: Long managerial experience and strong support from managers, employees, and the organization are important for managers' appraisal of, work on, and successful implementation of planned change. Top management must therefore ensure that the healthcare managers have sufficient managerial experience and support before they delegate to them the responsibility to implement planned change.

A Pre/Post Analysis of the Impact of the Covid-19 Pandemic on the Psychosocial Work Environment and Recovery among Healthcare Workers in a Large University Hospital in Sweden

“…15,16 These factors are relevant to discuss regardless of the ongoing crisis since the managers' situation within the public sector in Sweden, including the healthcare sector, has been in focus long before the pandemic. 17,18 The importance of supportive measures from managers and other functions during the pandemic has been raised by several authors. 19,20 The rapid conversion to COVID-19 care, including new routines, increased safety measures, adaptation of premises, transfer of staff, organisation of rapid training, and worries about infection among staff are some of many factors affecting the work situation for front-line managers and thus plausibly influencing the possibility for these managers to support their staff.…”

Implementing Organizational WHP Into Practice: Obstructing Paradoxes in the Alignment and Distribution of Empowerment

“…Firstly, organizational WHP programs need to consider the uncertainty a true distributed empowerment to all system levels may create , and also the variety of defensive mechanisms that are mobilized to curtail insight and influence over system levels, in terms of: managerialism, bureaucratism ( 7 ) and separated systems for documentation and follow-up ( 49 ). These increase the gap of knowledge and practice (alignment) between the organization's strategic and operative levels and is mainly described in large public organizations.…”

“…Dedicated engagement from top management is crucial for allocating resources in terms of time and competence ( 49 ). The allocation of time and priority was not the problem in this case from top-management's perspective.…”

Professional Bureaucracy and Health Care Managers’ Planned Change Strategies: Governance in Swedish Health Care

“…There are examples of Lean implementation in which the professional workers and employees actually perceived that their work quality improved in many respects due to their managers' better first-line leadership (Dellve et al, 2013). In these cases, a key success factor for the implementation was that the health care managers had a positive appraisal of addressing development issues in a substantial way (Andreasson et al, 2017).…”

“…Other factors demonstrated to be important for health care managers' ability to implement change are support from upper management and management colleagues, organizational resources, and support from the professional workers in the organization (Andreasson et al, 2017;Lachinger et al, 2006;Plsek & Wilson, 2001;Skytt, 2007). Also, positive support from managers and colleagues can motivate all those involved in the change process, increasing the chances of implementing actual change (Demerouti & Bakker, 2011).…”