Jansson, K., Tuunainen, J. and Mainela, T. (2021), "Concealing paradoxes in decision-making during hospital hybridization – a systems theoretical analysis", Journal of Health Organization and Management, Vol. 35 No. 2, pp. 195-211. https://doi.org/10.1108/JHOM-08-2020-0334
Concealing paradoxes in decision-making during hospital hybridization : a systems theoretical analysis
|Author:||Jansson, Kaisu1; Tuunainen, Juha1; Mainela, Tuija1|
1Department of Marketing, Management and International Business,University of Oulu Business School, Oulu, Finland
|Online Access:||PDF Full Text (PDF, 0.3 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2021062840220
|Publish Date:|| 2021-06-28
Purpose: While previous health-care-related hybridity research has focused on macro- and micro-level investigations, this paper aims to study hybridization at the organizational level, with a specific focus on decision-making. The authors investigate how new politico-economic expectations toward a university hospital as a hybrid organization become internalized via organizational decision-making, resulting in the establishment of a new business collaboration and innovation-oriented unit.
Design/methodology/approach: The authors employed a social systems theoretical framework to explore organizational decision-making processes involved in the establishment of the new hybrid hospital unit. Drawing on 15 interviews and nine organizational documents, the authors describe and analyze three decision-making cycles using the concepts of complexity, decision and justification.
Findings: The findings reveal the challenging nature of decision-making during hybridization, as decisions regarding unprecedented organizational structures and activities cannot be justified by traditional decision premises. The authors show that decision-makers use a combination of novel justification strategies, namely, justification by problems, by examples and by obligations, to legitimize decisions oriented at non-traditional activities. Further, the analysis reveals how expectations of several societal systems, i.e. health care, education, science, law, economy and politics, are considered in decision-making taking place in hybrid organizations.
Originality/value: The study draws attention to the complexity of decision-making in a hybrid context and highlights the role of justification strategies in partially reducing complexity by concealing the paradoxical nature of decision-making and ensuring the credibility of resulting decisions. Also, the study presents a move beyond the dualism inherent in many previous hybridity studies by illustrating the involvement of several societal systems in hybridization.
Journal of health organization and management
|Pages:||195 - 211|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
512 Business and management
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