Reforms and clinical managers' responses: a study in Norwegian hospitals

Abstract

Purpose

This paper seeks to explore the legitimacy of budgets as management control processes in hospitals after comprehensive reforms were implemented in the Norwegian hospital sector in 2002.

Design/methodology/approach

The paper employs qualitative interviews with top level clinical managers in three large hospitals.

Findings

The study shows a variety of practices among the clinical managers as to management control adjustments. The managers use different strategies in order to cope with the budget frames.

Research limitations/implications

This paper contributes to the current debate and research relating to the budgeting and performance management practices in hospital settings.

Practical implications

These findings contribute to contextual knowledge that is relevant in understanding the diverse practices of clinical managers in hospitals as complex service producing organizations.

Social implications

The findings give information to decision makers as to the diversity in management practices within knowledge intensive organizations.

Originality/value

The paper challenges the idea that the strategies used by managers can be understood by the concepts of the means‐end rationality prescribed in most of the reforms introduced into the hospital sector.

Citation

Johanne Pettersen, I. and Nyland, K. (2012), "Reforms and clinical managers' responses: a study in Norwegian hospitals", Journal of Health Organization and Management, Vol. 26 No. 1, pp. 15-31. https://doi.org/10.1108/14777261211211070