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Accounting for the influence of management devices in the evolution of public organizations practices: a sociomaterial perspective
Bérad, E., Saulpic, O., Zarlowski, P.

BERARD, E., SAULPIC, O., ZARLOWSKI P. (2013), "Accounting for the influence of management devices in the evolution of public organizations practices: a sociomaterial perspective"

Presented at the 9th International Management Control Conference, Breukelen, Netherlands, September 2013

 

Keywords: organizational change; public organizations; management devices; sociomateriality; practice studies; healthcare management.

 

Abstract

In France, new management devices and cybernetic control systems are currently being implemented in public hospitals, in line with New Public Management policies.

How do public organizations like hospitals respond to the implementation of such control systems? This question has already been addressed by management control research. Notably, previous studies have demonstrated that management control devices can be loosely coupled to the organization's core activities (Covaleski and Dirsmith 1983; Lapsley 1994; Pettersen 1995); that individual representations, norms and values are deeply influenced by management control devices, thus influencing the way work is performed on a daily basis (see for example Lowe 2000; Preston 1992; Chua and Degeling 1993); and that management control devices do have an influence on the organization itself (e.g. Kurunmäki, Lapsley, and Melia 2003; Lehtonen 2007). While these studies have brought meaningful contributions to our understanding of the processes that develop in public organizations when new management control systems are being implemented, organizing their results in a systematic way proves difficult. In effect, the conclusions drawn are often based on quite distinct conceptual frames and analyses; and the devices or systems' technical features under study are not always precisely described. Therefore, students are sometimes faced with problems when they want to compare the results of these studies and draw and build on previous work.

As a consequence, it remains difficult to assess the way public organizations and more particularly hospitals, respond to the implementation of new management control devices. To tackle this issue, in this paper we follow recent calls for giving more room to the technical dimension of management control devices in the study of their impact (Hopwood, 2007, 2008; Baldvinsdottir et al. 2010).

However, considering management devices as technical systems remains a debated choice: the design of management devices is often deemed to be a technical problem, rather than a theoretical one. Technical systems also are often considered as pertaining to a materialist approach. Therefore, dealing with management devices without being deterministic could prove  a difficult attempt (Leonardi and Barley 2008).

In our paper, we aim to analyze management control practices in a French public hospital from a sociomaterial perspective (Orlikowski and Scott 2008; Orlikowski 2010; Leonardi 2012). According to this perspective, human and material dimensions are considered to be deeply entangled in the current realization of activities. Therefore, they must be studied simultaneously, rather than being considered as alternatives. And considering the influence of material devices within the organization does not preclude from recognizing actors' voluntarism. In a nutshell, sociomateriality allows to consider that management devices shape and are shaped by their environment; and that management practices are not fully determined by instrumental constraints as for a single device, many different uses do remain possible.

Our paper is based on a longitudinal case study of a medium-size French public hospital.  We focus our study on the uses of  a new performance measurement system based on the production of  Department's Operating Income Statements (DOISs), designed for the newly created departments, which can be considered as Medical Business Units (MBU). Our field work has covered a 20 months period, from winter 2009 to summer 2011. We carried out 20 semi-structured interviews with administrative managers and medical managers so as to gather their interpretations about their work environment and the new system. One of the authors also stayed with the organization for a total of 12 weeks in 3 different sessions of participating observation (by the beginning, middle and end of the field work period) to collect information about actors' practices: 20 "DOIS meetings" between the administration and the medical staff have been attended, and rich observations of different practices have been witnessed as they emerged.

Our observations indicate that the DOISs appear to have influenced management control activity within the organization. DOISs were indeed perceived by actors as the core device for the management of medical business units. They were used by managers in the Finance department to monitor expenses at MBU and organizational levels. They also served as a vehicle for the institutionalization and legitimization of the hospital's new financial environment. However, DOISs were not used to assess MBUs' financial performance.  Neither were they used by MBU managers or managers in the Finance department as tools for decision making. In addition to that, they could not be used as a budgetary control device, considering the practical limitations of the DOISs production process (length of the production time and manipulation of the underlying accounting data).

In our paper, we illustrate how a sociomaterial perspective can enhance our interpretation of the interplay between DOIS devices and actors' practices, understandings and representations. Indeed, such a perspective is based on the comprehensive analysis of 1. the technological apparatus on which the DOISs rely and their enabling and constraining properties for action; 2. the net of relationships and control practices which are both previous to and contemporary of the implementation of DOIS in the organizational context in which actors have been embedded; and  3. the processes by which actors develop their understandings and make sense of the new  technology they have been encountering and growing familiar with.

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