The Materialization of Changes - How Built Spaces Drive, Prevent and Modify Organizational Changes

Public healthcare is facing a strong pressure for change due to rapid technological, demographic and economic changes in society. This has resulted in an increased use of different types of management models in hospital management. A common strategy is to try to change healthcare professions’ practices and norms by making changes in the physical hospital environment. However, research has rarely investigated how built space influence organizational change. The purpose of this project is therefore to contribute with new knowledge about how managerial interventions in built spaces influence working practices among employees.

The project carries out ethnographic studies at two of Sweden's largest university hospitals, Nya Karolinska Solna in Stockholm and Norrlands universitetssjukhus in Umeå. Both of these university hospitals have undergone profound changes in the physical hospital environment in recent years, but they have chosen to do this in different ways. Through the construction of a new, top-modern, hospital building, the political leadership of Nya Karolinska Solna chose a radical strategy for change aimed at changing working methods and professional standards throughout the whole Stockholm region. Norrlands universitetssjukhus, on the other hand, chose a more incremental change strategy that involved changing working methods through renovation of existing premises.

The project contributes theoretically to organization research by comparatively studying the material conditions for organizational change, as well as to an public discussion about the need to find effective and sustainable ways to change public healthcare practices in order to meet future healthcare needs.