Abstract
This study examines the implementation of a hospital cost savings program in a Swedish county hospital to understand how and why a downsizing intervention works and what outcomes it produces. Data were gathered from interviews and documents. Substantial differences were found among the healthcare professionals’ perceptions of the downsizing process. These diverse perceptions likely limited the scope of staffs’ participation and innovations of new savings strategies. Our findings stress the need for impact analyses addressing both intended aims and unintended side effects. Full attention should be paid to communication processes required to establish a trustful and committed change climate.
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