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Related Experiment Video

Updated: Jul 9, 2026

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
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Published on: February 19, 2021

Sociotechnical Systems and Middle Manager Practices: Improving Policy and Strategy Implementation.

Michael Morrison1

  • 1Faculty of Management, Royal Roads University, Victoria, British Columbia, Canada.

Healthcare Management Forum
|March 4, 2026
PubMed
Summary

Healthcare middle managers strategically adapt sociotechnical systems, integrating policy formulation, implementation, and evaluation. Understanding the coevolution of management practices and systems is key for effective strategy execution and improved outcomes.

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Last Updated: Jul 9, 2026

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
06:05

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

Published on: February 19, 2021

Area of Science:

  • Healthcare Management
  • Strategy-as-Practice
  • Sociotechnical Systems Theory

Background:

  • Policy and strategy are not linear processes but interconnected, involving formulation, implementation, and monitoring.
  • Middle managers play a crucial role in translating strategic objectives into actionable practices within healthcare settings.
  • Sociotechnical systems influence and are influenced by management practices, leading to alignment or misalignment.

Purpose of the Study:

  • To explore how healthcare middle managers interpret, contextualize, and adapt sociotechnical systems.
  • To understand the entanglement of policy formulation, implementation, and monitoring/evaluation.
  • To provide recommendations for enhancing middle manager practices in strategy implementation.

Main Methods:

  • The study is situated within the strategy-as-practice field.
  • It examines the interplay between middle manager practices and sociotechnical systems.
  • Analysis focuses on how managers navigate and adapt these systems to achieve strategic goals.

Main Results:

  • Policy and strategy processes are entangled, not sequential steps.
  • Middle manager practices and sociotechnical systems coevolve, impacting alignment.
  • Managers actively interpret and adapt systems to meet strategic objectives.

Conclusions:

  • Middle managers are central to effective strategy implementation in healthcare.
  • The coevolution of practices and systems requires careful management for alignment.
  • Four recommendations are proposed to improve middle manager contributions to policy and strategy execution.