Strategies for change: adaptation
to new accounting conditions
Eric D. Carlstro
¨
m
Department of Health & Science, University West, Trollha
¨
ttan, Sweden and
Sahlgrenska Academy, Institute of Health and Care Sciences,
University of Gothenburg, Gothenburg, Sweden
Abstract
Purpose – The purpose of this paper is to identify middle managers’ strategies during changed
accounting conditions.
Design/methodology/approach – Middle managers from hospitals, primary care and community
care were interviewed about their strategies during change processes. Each middle manager selected
changes that had played the greatest part in a ten-year period.
Findings – Each change was dominated by one strategy that corresponded to the tactics of middle
managers during change. They questioned new control models, they experimented with smart budget
strategies and they implemented new IT technology. These strategies formed transitions in a
continuous circular change model based on Hinings and Malholtra. The study points to two key
findings. First, strategies that can be perceived as irrational are organised within a context of plausible
explanations; and second, middle managers in public organisations are likely to adopt innovations
supported by management policy voluntarily and to question or even reject those prohibited.
Research limitations/implications – Criticism may be directed towards the fact that the
theoretical model presented in the analysis has an element of determinism. In the model, the managers’
control strategies are given limited influence. The theoretical model’s strength is that it measures the
development in slow-to-change public organisations with long histories and deeply rooted practices.
Practical implications – The results can be used to understand the motives of the middle
managers’ strategies for change. It provides support to management that hesitates between defending
a well-established but criticised organisational model, and implementing new and untested
approaches.
Originality/value – Theoretical change models frequently originate from a management
perspective or differentiate between “top-down” and “bottom up” change. In this paper, change is
regarded as a generalised process where different phenomena are connected. This forms a circular
model that moves between stable phases without change and transformative phases of major change.
Keywords Sweden, Health services sector, Organizational change, Accounting, Middle managers,
Management strategy
Paper type Research paper
1. Introduction
This article discusses how middle managers in public healthcare alter their strategies
during transformationalchange. It identifies threedifferent strategies practiced by middle
managers during major change processes. The result is a matter of interest because
middle managers in public organisations have been characterised as bound by tradition
and resistance to change (Haveman, 1992). This phenomenon can be seen especially in old
coherent public healthcare systems, as the one in Sweden, from where the examples in this
study have been drawn (Axelsson, 2000; Bergman, 1998; Gustafsson, 1989).
The purpose is to identify middle managers’ strategies during changed accounting
conditions. It is based on the assumption that changes originate from the management
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Strategies
for change
41
Received 21 July 2010
Revised 31 October 2010,
15 January 2011,
30 March 2011,
29 May 2011,
17 July 2011
Accepted 1 August 2011
Journal of Accounting
& Organizational Change
Vol. 8 No. 1, 2012
pp. 41-61
q Emerald Group Publishing Limited
1832-5912
DOI 10.1108/18325911211205739