Faculty of Business Administration and Social Sciences, Molde University College, Molde, Norway.
Faculty of Logistics, Molde University College, Molde, Norway.
J Health Organ Manag. 2024 Feb 29;38(9):72-88. doi: 10.1108/JHOM-06-2022-0175.
As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country's hospital clinics are tasked with constructing development plans. Using the development plan as a case, the paper analyzes how managers navigate and legitimize the planning process among central actors and deals with the contingency of decisions in such strategy work.
DESIGN/METHODOLOGY/APPROACH: This study applies a qualitative research design using a case study method. The material consists of public documents, observations and single interviews, covering the process of constructing a development plan at the clinical level.
The findings suggest that the development plan was shaped through a multilevel translation process consisting of different contending rationalities. At the clinical level, the management had difficulties in legitimizing the process. The underlying tension between top-down and bottom-up steering challenged involvement and made it difficult to manage the contingency of decisions.
The findings are relevant to public sector managers working on strategy documents and policymakers identifying challenges that might hinder the fulfillment of political intentions.
ORIGINALITY/VALUE: This paper draws on a case from Norway; however, the findings are of general interest. The study contributes to the academic discussion on how to consider both the health authorities' perspective and the organizational perspective to understand the manager's role in handling the contingency of decisions and managing paradoxes in the decision-making process.
作为挪威专业医疗保健机构的专业和组织发展管理国家计划的一部分，该国的医院诊所负责制定发展计划。本文以发展计划为例，分析了管理人员如何在核心参与者中规划和使规划过程合法化，并处理此类战略工作中决策的偶然性。
设计/方法/途径：本研究采用了定性研究设计，并使用案例研究方法。材料包括公共文件、观察和单一访谈，涵盖了临床层面制定发展计划的过程。
研究结果表明，发展计划是通过一个多层次的翻译过程形成的，其中包含不同的竞争理性。在临床层面，管理层难以使该过程合法化。自上而下和自下而上的管理之间的潜在紧张关系挑战了参与度，并使得难以管理决策的偶然性。
研究结果与从事战略文件工作的公共部门管理人员和政策制定者有关，他们可以识别可能阻碍政治意图实现的挑战。
原创性/价值：本文借鉴了挪威的一个案例，但研究结果具有普遍意义。该研究有助于学术讨论，即如何考虑卫生当局的观点和组织观点，以了解管理人员在处理决策的偶然性和管理决策过程中的悖论方面的作用。
