Danish health care faces tremendous challenges in the near future due to rapid demographic changes, scarce resources, and new demands from citizens. In order to handle the challenges the health care system must develop new methods for innovation and improvement. This calls for new partnerships involving professionals across professions and sectorial borders and involving citizens. User centered innovation is one of the new methods that currently is introduced in Danish health care. However, to introduce user centered innovation raise a number of questions and dilemmas as is case of “The Citizens Plan”- the first large scale cross-sectoral user centered innovation project in the Zealand Region. The framework of this analysis is the strategic triangle by Mark Moore. By using the triangle, the analysis shows how a process inspired by New Public Governance meets a system dominated by the main management paradigms of the Danish health care system – New Weberian State and New Public Management. The thesis deals with the following research problem: That are the managerial dilemmas faced by regional decision makers when user centered innovation is introduced as at method to create public value – based on the case of “The Citizens Plan”? The analysis shows that the Weberian tradition is strong when it comes to the importance of formal legitimacy and it shows the importance of support from the clinical staff that continues to have autonomic status. The autonomy of the clinical staff is also support by the new public management paradigm that includes little incentives to work across organizational borders. Although managers on different levels consider the view of the citizen as a consumer as an ideal – another aspect for the new public management paradigm – it is far from the reality in the hospitals. This is one of the reasons why the user centered innovations project as ”The Citizens Plan” based on the New Public Governance paradigm poses challenges to the hospital managers. In this case, the managerial dilemmas become clear in the different views on whether the case may produce public value because the actors focus on different aspects of the value creating processes in Moore’s strategic triangle.The managers generally see the project of “The Citizens Plan” as a very relevant project and they consider the project to by well planned and well managed. At the same time, the analysis shows that the lack of experience with user centered innovation in the health care system cause problems to the project. One main problem is that the project 6 management underestimates the importance of facilitating project ownership in the organization and the role of the project management organization is unclear. This makes the transition from concept development to large-scale tests very difficult. Ideally, user centered innovation as a method of development is a way to create public value through citizen involvement. However, this learning process has only just begun in the Danish health care system.
|Uddannelser||Master i Offentlig Ledelse, (Masteruddannelse) Afsluttende afhandling|