Værdibaseret Styring i sundhedsvæsenet: Hvordan påvirker indførelse af Værdibaseret Styring i det offentlige sundhedsvæsen ledernes motivation?

Abstract

This focus of this master thesis is on how the managers in the public health care system experience increased motivation in their leadership through value based management. Value based management is currently tested through pilot projects at various hospitals in Denmark. Value based management implies, that the management is targeted to the patients’ needs instead of being an activity based management tool, Diagnose Related Groups, (DRG) The thesis statement asks the question: How does value based management in public health care influence the manager’s motivation? Sub questions: 1.How does it influence the manager’s motivation? 2.How are the changes experienced? 3.How do they perceive the changes in relation to the DRG account The focus of this thesis is motivation, including formation of opinion /opinion based management and narratives. Hertzberg’s 2-factor motivation theory has served as inspiration supplemented by Tor Herne’s description of opinion-based management based on Karl E. Weick, and narratives defined and described by both Tor Hernes and Mikala Schnoor The project is empirical, related to the selected theory, which forms the basis of the analysis. As part of the project 4 semi-structured pilot interviews were conducted with managers at various levels in the public health care system. A result of the analysis is that the implementation of a new management system not necessarily has increased the managers’ motivation. The general opinion is: "this is what we already do". The implementation, however, of value-based management legitimates the prevalent aproach. Four interviews do not form the basis of an unequivocal conclusion, but the interviews indicate that the thought of value-based management is motivating, while at the same time the managers ask to see some action behind the words. The perception is that the new management system is just another initiative to be implemented, on top of everything else and without regard for what else is going on. The analyses at the same time shows that it is motivating not to have to consider a DRG budget and instead let the patient’s situation decide what to do and when. The interviewees at the same time request a necessary early involvement of the managers when implementing new systems. This would help create ownership, influence and recognition of the managers, who are the people to implement new initiatives. The conclusion of this thesis is that the implementation of value based management not necessarily increases motivation for managers in the public health care system