Is Self-management the Solution to a Strained Healthcare System? A Study of the Maternity Ward at Horsens Regional Hospital

Abstract

The objective of this master thesis is to investigate and analyze the possibilities and limitations of self-management in healthcare, with a specific focus on the maternity ward at Horsens Regional Hospital in Denmark. The empirical material of the study involves interviews with both managers and employees as well as the management strategy for the department.
The analysis is structured in three partial analyses. First, the department's self-narrative is investigated with inspiration from Niklas Luhmann's semantic analysis. The analysis shows that the department has a strong narrative about being equal, visionary and innovative compared to other birth departments. Second, the practice and communication of self-management is examined using Michel Foucault's governmentality analysis. The analysis investigates how an increased level of self-management is achieved through self-reflection and facilitating management. Finally, the implications of self-leadership for the department is explored based on the two previous analyses drawing on perspectives from among other Günther Teubner and Niklas Luhman. Three specific implications are identified as a result of increased self-management.
The study finds that the department practices self-leadership in various ways, including feedback culture, camps, delegating management tasks to employees, and eliminating the development midwife position. The study also finds that the department has a strong self-narrative of autonomy and equality, and communicates itself as a visionary and innovative birth department. The study concludes that an increased level of self-leadership has the potential to create more equal and responsible employees and leaders who are engaged and oriented towards development. However, and increased use of self-management also carries a risk of creating more complex situations for the employees, that might counterwork the ambitions of the strategy.