Background and aims: In a country with a large public sector populated by professionals, management and implementation of change can be difficult. The underlying strong Weberian leadership is geared to change and develop according to the performance goals and understandings of the professionals in the sector. Political agenda’s overarching the professionals’ agenda’s such at user involvement, digitization and Digital Era Governance (DEG) is not necessarily readily accepted or perceived as meaningful by the frontline workers such as nurses and physicians. The change project of taking into use the new electronic health record system Sundhedsplatformen (SP) and the associated patient portal MinSundhedsplatform (MinSP) can be regarded as an example of apolitically mandated change agenda with DEG ideals. This project aims to explore 1) How leadership, understood as the production of direction, alignment and commitment was produced and affected by the leadership culture of the health care sector and 2) How insight into these beliefs may inform interventions to promote meaningful implementation.
Theory: Drath’s leadership ontology points to the importance of leadership beliefs and leadership culture in the production of the leadership effects: Direction, alignment and commitment. Weick stresses the importance of sensemaking in leadership and identifies seven key properties in the sensemaking process.
Methods: The study was situated in two departments at Copenhagen University Hospital: The Department of Rheumatology and the Department of Clinical Genetics. A method for virtual reflective team interviews was developed, allowing data collection to take place despite the Covid-19 situation. Interviews were done at both departments, each team consisting of four employees (doctors or nurses) and one patient. The interviews were transcribed and analyzed for examples of production of direction, alignment and commitment and for examples of sensemaking according to Weick’s seven properties of sensemaking. The findings from the interviews were fed back to the locally responsible for the implementation of SP and MinSP in a third virtual reflective team interview. This interview was transcribed and analyzed for leadership beliefs and changes in leadership beliefs following the first interviews.
Analysis and interpretation: Physicians and physician leaders regard direction as something they themselves produce if the change is considered meaningful. Once direction is produced, physicians believe it to be their own responsibility to produce alignment and commitment. While they do effectively produce commitment, they are less effective producing alignment and in general accept and appreciate alignment production by formal leaders.
|Uddannelser||Master of Public Governance , (Masteruddannelse) Afsluttende afhandling|