Document Detail


Threat of mass resignation as a window of opportunity for questioning hospital service production structures in Finland.
MedLine Citation:
PMID:  22312230     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Service production structures of public health care, once established, have proved extremely difficult to change. For this study, we reviewed discussions that took place in management teams at a Finnish central hospital over a period of nine months. The aim of the research was to analyze whether the management team meetings brought forth new and radical alternatives as to how service production could be reorganized. In addition to this, we were also interested in any possible problems that could be solved using these alternative models of service production, and also how preconditions to the application of different alternatives came about and how they eventually concluded.
METHODS: Our data were derived from 24 management team meetings that took place between August 2007 and May 2008, and were fully videotaped. Data were collected from eight different management teams; the meetings of each were videotaped three times. The management teams reviewed represented three different hierarchical levels, ie, top management, division management, and operational unit management. Data were analyzed according to theory-based content analysis. As a theoretical framework, we utilized Kingdon's model to enable us to understand why some issues and problems are brought to the agenda of the change process and go on to become concrete policies while others fail to do so.
RESULTS: During the study period, a threat of mass resignation of nursing staff caused a considerable change to the agenda of the management team meetings, introducing alternatives with the potential to renew the existing structures of operation in a radical manner.
CONCLUSION: According to our analysis, the threat of mass resignation acted as a window of opportunity, linking the lack of nursing staff (problem) to operational and structural changes (alternative solutions).
Authors:
Lauri Kokkinen; Elina Viitanen
Publication Detail:
Type:  Journal Article     Date:  2011-07-07
Journal Detail:
Title:  Risk management and healthcare policy     Volume:  4     ISSN:  1179-1594     ISO Abbreviation:  Risk Manag Healthc Policy     Publication Date:  2011  
Date Detail:
Created Date:  2012-02-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101566264     Medline TA:  Risk Manag Healthc Policy     Country:  England    
Other Details:
Languages:  eng     Pagination:  81-7     Citation Subset:  -    
Affiliation:
School of Health Sciences, University of Tampere, Tampere.
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