'Money is not an issue!': hospital CFOs' narratives about handling a sudden shift in managerial focus

TY - JOUR

T1 - 'Money is not an issue!': hospital CFOs' narratives about handling a sudden shift in managerial focus

AU - Malmmose, Margit

AU - Pedersen, Lars Dahl

PY - 2024/6

Y1 - 2024/6

N2 - The sustained political and managerial focus on cost containment and efficiency in hospitals has been altered by COVID-19-related concerns about public health. Through a novel qualitative study in Denmark, we explore CFOs’ narratives of their experiences during a sudden shift in managerial logic. All of the CFOs describe engagement in key operational procedures and change management that was fostered by the constant search for stability that strongly depended on bottom-up decision-making and flexibility. During this process, the existing competing logics of managerialism and medical professionalism vanished. The CFOs describe new forms of dynamic and collaborative approaches. The possibility of adhering to the core logic of administrative accounting techniques combined with urgency and emotional encounters appears to enable this approach. Thus, we document a moment when well-known opposing logics were suspended by exogenous urgency. This finding suggests possibilities for moving beyond deep-rooted views on established public administration structures and logics. Points for practitioners: Financial managers show administrative skills that are useful for public administration changes in both administration and daily operations. These managers appear to have a strong core identity and willingness to dynamically engage with and facilitate acute frontline operational issues. In an emergency situation such as COVID-19, we find co-dependency across subject fields (administration and medical professions) which enables collaborations.

AB - The sustained political and managerial focus on cost containment and efficiency in hospitals has been altered by COVID-19-related concerns about public health. Through a novel qualitative study in Denmark, we explore CFOs’ narratives of their experiences during a sudden shift in managerial logic. All of the CFOs describe engagement in key operational procedures and change management that was fostered by the constant search for stability that strongly depended on bottom-up decision-making and flexibility. During this process, the existing competing logics of managerialism and medical professionalism vanished. The CFOs describe new forms of dynamic and collaborative approaches. The possibility of adhering to the core logic of administrative accounting techniques combined with urgency and emotional encounters appears to enable this approach. Thus, we document a moment when well-known opposing logics were suspended by exogenous urgency. This finding suggests possibilities for moving beyond deep-rooted views on established public administration structures and logics. Points for practitioners: Financial managers show administrative skills that are useful for public administration changes in both administration and daily operations. These managers appear to have a strong core identity and willingness to dynamically engage with and facilitate acute frontline operational issues. In an emergency situation such as COVID-19, we find co-dependency across subject fields (administration and medical professions) which enables collaborations.

KW - financial managers

KW - hospital management

KW - managerial logics and managerial identity

UR - http://www.scopus.com/inward/record.url?scp=85159053974&partnerID=8YFLogxK

U2 - 10.1177/00208523231169913

DO - 10.1177/00208523231169913

M3 - Journal article

SN - 0020-8523

VL - 90

SP - 419

EP - 436

JO - International Review of Administrative Sciences

JF - International Review of Administrative Sciences

IS - 2

ER -