Balancing Conflicting Interests -A Case Study of the Sahlgrenska University Hospital

Abstract

Problem background: The Swedish health care system is experiencing increases in demand at the same time as funds and resources remains at a static level. Consequently, efficiency has become a vital part of hospital management and aims at maintaining the same level of quality and accessibility of healthcare services while minimising the use of resources. Hospital management is, however, made out of a strong medical profession and exposed to conflicting interests related to the process of improving efficiency. We have therefore chosen to study how the medical profession and conflicting interests affect the process of improving efficiency at a specific hospital, the Sahlgrenska University Hospital. Aim of study: The aim of this thesis is to investigate how managers at the Sahlgrenska University Hospital handles conflicting interests that arise from the pressures of creating a more efficient organisation. Furthermore, we aim to study how the presence of the medical profession affects the process of creating better efficiency. Limitations: Our thesis was conducted as a case study of the Sahlgrenska University Hospital. A significant drawback to the scientific credibility of the thesis is that only three clinic managers have been interviewed. Method: The thesis has taken the form of a case study that has been conducted with a qualitative research approach. The empirical study consists of five personal interviews and has together with the theoretical framework been the basis for the analysis of the thesis. Conclusion: The medical profession does not oppose the process of making the hospital more efficient as long it is beneficial to the individual patients. However, we have identified that the present management control system has failed to balance conflicting interests and those have become amplified through a focus on cost reduction. We have, therefore, recognised that a management control system that successfully achieves to balance conflicting interests is needed in order to create a sustainable hospital management and avoid opposition from the medical profession concerning the process of making the Sahlgrenska University Hospital more efficient.