Strategic Planning as a Managerialist Practice in Hospital Organizations
Name: ANANDA BARCELOS BISI
Publication date: 17/11/2016
Advisor:
Name |
Role |
|---|---|
| LUCILAINE MARIA PASCUCI | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| LUCILAINE MARIA PASCUCI | Advisor * |
Summary: Hospitals are described as Complex Adaptive Systems (CAS) for showing significative presence of peculiarities such as: nonlinearity, unpredictability, dynamicity of interactions and autonomous agents, which guarantee the learning and evolution of the system continuously, challenging their managers. Aiming at greater professionalization of management, these organizations have adopted management methodologies - such as the Strategic Planning (SP) - focusing, principally, on the financial performance, not always observing the organizational peculiarities, characterized as a practice recognized as managerialism. In this context, the question of this study: What are the implications of strategic planning in organizational performance of hospitals, as a Complex Adaptive Systems? Therefore, we investigated the characteristics and influence of factors such as interactions, nonlinearity and learning on strategic planning in two hospitals organizations in the Southeast Region. This study is based on Strategy Concepts in Organizations and Complexity Theory. It is a comparative case study, with traverse analysis and qualitative nature. Data were collected through in-depth interviews, non-participant observation and documents. Which were analyzed using narrative analysis techniques and documentary analysis. Results showed that the SP adopted in hospitals follows the traditional orientation, in other words, has managerialist features it has in financial performance its main focus. Failure to observe the organizational specificities has limited the effectiveness of SP in the hospitals investigated. The CAS features allowed us to understand the reasons for the difficulties encountered: 1) non-linearity is enhanced for the autonomy of agents and agent groups for being professional organization; 2) decisions are strongly influenced by the unpredictability of hospital, therefore, the dynamics of informal interactions becomes more effective than deliberate planning; 3) learning ability of agents shown to be essential to deal with the unexpected, contributing to the strategic management of organizations, not necessarily through the Strategic Planning. Thus, it is concluded that, although some planned strategies have been implemented, prevails in the strategic management of hospitals the emerging strategies, very influenced by the multiplicity and plurality of agents, divergent interests between groups (especially administrative and professional) and the constant need for adaptation of agents to promote changes. Since is a Hospital, the performance takes on a social dimension, which, together with the financial, besides not balanced becomes source of conflict for the internal public, especially with the professional experts. Strategic Planning showed accomplish a symbolic role, legitimizing the management of hospitals in the market.
