Putting the patient first? The story of a decoupled hospital management quality initiative

نویسندگان

چکیده

This paper depicts the progress of a hospital management quality pilot project through lens institutional theory. Nine departments were chosen to change their control system from strict top-down productivity focus locally developed performance measurement based on patient focus. Thus, was changed with aim enhancing social impact provided services by integrating The portrays three-year evolution narratives. Findings evidence initial embracement followed gradual operational discouragement due external pressures and internal data issues. Despite these challenges, regional highlighted as success expanded it remaining departments. we find that became decoupled rather than institutionalized sustained logic. Through theory, argue decoupling focused happens because surprisingly strong We suggest in this context coupling previous systems, organizations may paradoxically engage practices are intended support professional core but instead protect administrative logic efficiency productivity.

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ژورنال

عنوان ژورنال: Critical Perspectives on Accounting

سال: 2021

ISSN: ['1045-2354', '1095-9955']

DOI: https://doi.org/10.1016/j.cpa.2020.102233