Organizational arrangements as a key to enhancing innovativeness and efficiency – analysis of a restructuring hospital in Finland

Abstract

Background Challenged to innovate and improve efficiency both at the policy level and in everyday work, many health care organizations are undergoing radical change. However, in many earlier studies, the significance of individuals’ perceptions of their organization and its innovativeness and efficiency during restructuring is not well acknowledged. Our study examines how various organizational arrangements; performance-, hierarchy-, tradition-, and leader-focused types, as well as collaborative and fragmented ones, connect to reaching innovativeness and efficiency in health care during restructuring. Method We built on previous organization and management research, innovation studies, and on research focusing in health care restructuring, and conducted an exploratory quantitative case study in a public sector hospital in Finland. Data comprising 447 responses from 19 professional groups across the hospital was analyzed using hierarchical regression analysis. Results Our results demonstrate that multiple, co-existing organizational arrangements can promote innovation and efficiency. The perceptions of the organizational members of the nature of their organization need to be generally positive and reflect future-orientation to show positive connections with efficiency and innovativeness; fragmentation in the members’ perceptions of the character of their organization and their inability to go beyond established organizational traditions pose risks of inefficiency and stagnation rather than fruitful exploration. Our study further shows, somewhat surprisingly, that while collaborative organizational arrangements are positively related to increases in perceived efficiency, the same does not apply to innovativeness. Conclusions Our study addresses understudied, yet inherently important aspects in providing high-quality health care: the relationships between different organizational arrangements and exploitation and exploration-related outcomes. In particular, examination of individuals’ perceptions (that may have even more weight for the subsequent developments than the actual situation) adds insight to the existing knowledge that has addressed more objective factors. Implications on how to support high levels of performance are drawn for management of professional and pluralistic organizations undergoing restructuring. Our findings also generate information that is useful for policy making concerned with public sector health care.

Decision-making processes in organizational arrangements: An analysis in the light of population ecology and resource dependence

“…Looking inside the organizational arrangements, it is possible to perceive the presence of the decision-making processes there. According to Kajamaa and Laukkanen (2022), organizational arrangements are a fertile environment for progress and innovation. The COVID-19 pandemic was a good example of this: with it came the need to review protocols, change policies, and establish requirements for training in various areas.…”

“…The need for change made the relationships between companies stronger and there was an exchange of knowledge between themorganizational arrangements played an important role in this environment. However, this context of challenge also made it clear that there is still a complex network of few professionals with specific knowledge and diverse power relations within the arrangements, which are the origin and end of a series of decisionmaking processes (KAJAMAA;LAUKKANEN, 2022).…”

“…The organizational arrangement is seen as an ally to increase performance levels and improve the achievement of goals, but each of them connects distinctly with efficiency and innovation (KAJAMAA;LAUKKANEN, 2022).…”