Walking a Tightrope: Managing Paradoxes and Tensions between Care taking and Efficiency through IT-enabled Organizational Transformation in a Hospital Group

Klein Stefan, Schellhammer Stefan

Abstract
The healthcare sector in general and hospitals in particular are often portrayed as lagging behind in terms of organizational efficiency. Management is facing the challenge to introduce economic principles to guide the caregiving processes of their organization. In contrast to management, healthcare profes- sionals are primarily concerned with patient care and increasingly perceive economic constraints as compromising their work. Information and communi- cation technology has been heralded as a panaceum to improve the quality of healthcare and reduce cost at the same time. This paper aims for studying the role of management in accommodating the tensions caused by the conflicting logics of care taking and efficiency. It uses the introduction of a centralized pharmacy and electronic ordering system in a German hospital (group) as an illustrative case. In doing so this paper portrays the careful maneuvering of management in order to mitigate and overcome the tension between economic and medical logic. It shows how management translates regulatory con- straints into accepted rules and mechanisms that facilitate quality of care and productivity at the same time.