Hospital-wide Process-oriented Organization of Care: The Case of Turku University Central Hospital

In reaction to the productivity challenges that hospitals around the world have faced, some hospitals have begun to move towards a process-oriented organization of care in order to enhance productivity. Existing research on process-oriented organization emphasizes severe challenges along the implementation process. However, the literature contains only a small number of documented cases of hospital-wide process-oriented reorganization. Against this background, in this case study, we explain how hospitals can successfully implement organization-wide process orientation. To do so, we conducted an exploratory single case study with semi-structured, face-to-face interviews and document analyses as our primary data-collection methods. We developed a theoretical framework of antecedents, interventions, enablers, barriers, and consequences that explain the trajectory of this successful hospital-reorganization project. We contribute a substantive theory on which other researchers can build and can extend in future studies. Further, in analyzing our unique case, we identify factors that the extant literature has not yet discussed, such as the blackboxing of diagnosis and treatment activities as an enabler. In line with existing literature, we also found that, even in this case, inflexible healthcare IT represented a barrier that hindered the case study in implementing process orientation.