Studies on Innovative Practices
Edited by Mattias Elg, Per- Erik Ellström, Magnus Klofsten and Malin Tillmar
Chapter 5: Towards the collaborative hospital – harnessing the potential of enabling care processes and structures
Growing patient demands and financial, clinical and quality challenges increasingly force hospitals into continuous restructuring (Bohmer, 2009; Vos et al., 2011). Wards and hospitals are merged to create economies of scale and scope (Kristensen et al., 2010). New public management (Ferlie et al., 1996), total quality management (Douglas and Judge, 2001) and accreditation (Shaw et al., 2010) are implemented to improve hospital performance. Lean, clinical guidelines and other management tools are used to rationalize processes (Bohmer, 2009; Poksinska, 2010). However, further gains from this traditional top-down restructuring appear limited (Radnor et al., 2012). Healthcare professionals also often perceive organizational restructuring as hampering work, professional autonomy and job satisfaction (Pearson et al., 1995; Every et al., 2000; Obling, 2013), although their buy-in is a key for positive outcome (Bohmer, 2012). In this chapter we propose the concept of the collaborative hospital as an organizational form that will allow hospitals to meet demands for patient treatment, quality, innovation, efficiency and financial performance and still secure high levels of professionalism and autonomy.
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