Competing forms of fit in a professional bureaucracy: IT management dilemmas

Abstract

Organisational and role conflicts within a large Australian public hospital are examined, with a focus on information technology (IT) management issues. Two different fit configurations, similar to Mintzberg's professional and machine bureaucracies, are found to compete for dominance in the hospital, each with different design corequisites, and requiring incompatible forms of IT management. The paper highlights IT management dilemmas experienced by many health systems facing extreme budgetary pressures and conflicting priorities. Rather than attempting to resolve symptoms within individual functions, the underlying dynamics of the problem are analysed at the level of competing organisational configurations, and the outline of a possible integrative solution is discussed.