The implementation of process orientation at a Swedish hospital

During the last decade, as a response to the need for inter- as well as intra-organizational integration, management models initially developed for industry have been spread to health care organizations. Based on 62 in-depth interviews, this qualitative study aims at describing and analyzing the limited success of implementation of process orientation at a Swedish hospital and in doing so, the traditional and the critical approaches are combined. Applying a traditional approach, the limited success of the implementation of process orientation is explained in terms of difficulties to challenge deeply institutionalized organizational routines and the inter-disciplinary boundaries. This might be condensed to the dilemma of how to maintain and develop the specialization of the medical profession while focusing process rather than function and how to enhance inter-organizational integration without hampering intra-organizational collaboration. Applying a critical approach, the limited success is explained in terms of a differentiated translation process and in terms of separation of talk and practice. This means that process orientation, notwithstanding that it might be an efficient tool for the type of integration needed, might be regarded as part of a change discourse, aiming at conveying a picture of an efficient and modern organization.