Implementing an hospital accreditation programme in a context of NPM reforms: Pressures and conflicting logics

IMPACT

This article shows how the politics associated with the New Public Management movement impacts organizations and how these pressures can be internalized by organizations and employees and professionals’ resistance to management initiatives overcome. Accreditation programmes can bridge two very different logics (professional and business) that often conflict with each other. The key is not to interfere with the professional identity and autonomy of the main actors.

ABSTRACT

This article examines how an accreditation programme emerged and developed in a hospital in the context of New Public Management reforms. A case study demonstrates that healthcare organizations characterized as contested can self-transform into aligned ones. Accreditation programmes can provide the means to do this. Quality assurance practices and technical medical expertise coexisted as the initiative did not interfere with doctors’ independence and identity. Committed leadership was vital, particularly having a medical professional leading the project. As well, trust was an essential mechanism for effective collaboration between professionals, thus preventing resistance to change.

KEYWORDS:

• Collaboration
• health sector
• hospital accreditation
• institutional logics
• logics coexistence
• new public management

Disclosure statement

No potential conflict of interest was reported by the author(s).