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Promoting cooperation in health care: creating endogenous institutions

Journal article
Authors Roy Liff
Published in Qualitative Research in Organizations and Management: An International Journal
Volume 6
Issue 1
Pages 46-63
ISSN 1746-5648
Publication year 2011
Published at Gothenburg Research Institute (GRI)
Pages 46-63
Language en
Links www.emeraldinsight.com.ezproxy.ub.g...
Keywords Health care, Organizational culture, Sweden, Team working
Subject categories Business Administration

Abstract

Purpose – The purpose of this paper is to investigate if a rational perspective can be used to interpret cooperation problems in a health care organisation. This perspective is proposed as a complementary perspective to the cultural perspective that dominates as an explanation of cooperation problems. The focus of the research is multiprofessional teamwork in contemporary Swedish health care. Design/methodology/approach – Four cases studies, in which the cooperation in daily work is described, are used to test the two perspectives. The cases concern the cooperative methods health care professionals use when work conditions depend upon an internal norm of mutual cooperation. Although the research is not designed to evaluate the two perspectives, it permits the rational explanations of cooperation problems to be compared with possibly cultural explanations. Findings – The investigation concludes that health care cooperation problems may be primarily explained by the rational perspective, and only secondarily by the cultural perspective. The actors can be seen as underinstitutionalised in the sense they have not yet developed the intra-organisational norms of cooperation needed for the provision of customised health care. Originality/value – The paper provides a complementary explanatory framework of cooperation problems based on actors' perceptions of their self-interests as producers. The examples of uncooperative behaviour reflect two forms of the free rider problem that Ostrom describes as a Common Pool Resource Problem. Management has to prove that cooperation is beneficial to the team members and has to promote a cooperative team spirit by instilling a common understanding of the concept of cooperation.

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