Hospital management teams – reflections on organizational and medical specialization cultures

Abstract

Although hospital management is studied in several branches of science, scarcity of studies investigating management team work in hospitals exist. The purpose of this paper was to study managers’ understanding concerning the role of management team work in specialized health care, as well as management team work methods within the different activity areas in a hospital and in the operational units within their domain. A total of 54 interviews of activity area managers and operational unit managers in one Finnish hospital district in 2007-2008 was analyzed using data-driven content analysis. Work of all management teams focused on financial and operative issues. However, different management teams used different working methods, which implicates the existence of medical specialization-specific work subcultures within a shared organizational culture. The psychiatric activity area appeared the most active and the most future-oriented, whereas the activity area of operative specializations seemed the most defensive, and the activity area of conservative specializations was businesslike and unfocused as regards the future. These differences were portrayed in the teams’ inner dynamics and interaction practices. Activity area work methods did not directly transfer to those of the unit-level management teams. We conclude that management teams may not be optimally used as a forum for strategic issues or innovation throughout hospital organizations and more research is needed in order to better understand the connections between management team work, organizational culture and medical specialization culture.