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Executive management in radical change--The case of the Karolinska University Hospital merger

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  • Choi, Soki
  • Holmberg, Ingalill
  • Löwstedt, Jan
  • Brommels, Mats

Abstract

Summary Based on the merger of two Swedish university hospitals, this paper examines top management's work in implementing radical change initiatives. Our case confirms the limitations of the classic top-down approach to radical change in professional organizations. We also identify an important paradox: contrary to contemporary change literature prescription, initial managerial success seems to impair the change process further down the organization. A key finding is that when mergers are used as tools to effect radical change in politically ambiguous environment, management appears to be limited to initiate change and to take the role of the scapegoat due to inherent factors in the change process. By elucidating management's difficult role vis-à-vis multiple stakeholders, this paper contributes to one aspect of managerial agency discourse that is rarely discussed in detail.

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  • Choi, Soki & Holmberg, Ingalill & Löwstedt, Jan & Brommels, Mats, 2011. "Executive management in radical change--The case of the Karolinska University Hospital merger," Scandinavian Journal of Management, Elsevier, vol. 27(1), pages 11-23, March.
    • Handle: RePEc:eee:scaman:v:27:y:2011:i:1:p:11-23
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    Cited by:

    1. Clark, Andrew E. & Milcent, Carine, 2018. "Ownership and hospital behaviour: Employment and local unemployment," Social Science & Medicine, Elsevier, vol. 202(C), pages 151-161.
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    3. Andrew E. Clark & Carine Milcent, 2015. "Hospital Employment and Local Unemployment: Evidence from French Health Reforms," Working Papers halshs-01183454, HAL.
    4. Mohammad Alharbi, 2018. "The Effect of Leadership Behaviours on the Change Process in Healthcare Organisations in Saudi Arabia," Global Journal of Health Science, Canadian Center of Science and Education, vol. 10(6), pages 1-77, June.
    5. Rohde, Tarald & Torvatn, Hans, 2017. "A strategic document as a tool for implementing change. Lessons from the merger creating the South-East Health region in Norway," Health Policy, Elsevier, vol. 121(5), pages 525-533.
    6. Ernst, Jette, 2019. "The curse of bureaucratisation or the blessings of professionalisation? Nurses’ engaged adoption of quality management in hybrid managerial positions," Scandinavian Journal of Management, Elsevier, vol. 35(3).
    7. Börjeson, Love & Löwstedt, Jan, 2017. "Accomplish change or causing hesitance – Developing practices in professional service firms," Scandinavian Journal of Management, Elsevier, vol. 33(3), pages 185-194.
    8. Thomas, Robyn & Hardy, Cynthia, 2011. "Reframing resistance to organizational change," Scandinavian Journal of Management, Elsevier, vol. 27(3), pages 322-331, September.
    9. Teerikangas, Satu & Colman, Helene Loe, 2020. "Theorizing in the qualitative study of mergers & acquisitions," Scandinavian Journal of Management, Elsevier, vol. 36(1).

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