Abstract
This study aims to address difficulties reported by the nursing team during the process of changing the management model in a public hospital in Brazil. This qualitative study used thematic content analysis as proposed by Bardin, and data were analyzed using the theoretical framework of Bolman and Deal. The vertical implementation of Participatory Management contradicted its underlying philosophy and thereby negatively influenced employee acceptance of the change. The decentralized structure of the Participatory Management Model was implemented but shared decision-making was only partially utilized. Despite facilitation of the communication process within the unit, more significant difficulties arose from lack of communication inter-unit. Values and principals need to be shared by teams, however, that will happens only if managers restructure accountabilities changing job descriptions of all team members. Innovative management models that depart from the premise of decentralized decision-making and increased communication encourage accountability, increased motivation and satisfaction, and contribute to improving the quality of care. The contribution of the study is that it describes the complexity of implementing an innovative management model, examines dissent and intentionally acknowledges the difficulties faced by employees in the organization.
Highlights
The historical classical management roots of contemporary accounting are still embedded in theory and practice, even in hospitals[1]
The content analyses identified two major themes: difficulties experienced during the implementation process (Difficulties arising from the implementation process), and the return to centralized management (Returning to the Traditional Management Model)
The vertical implementation style and lack of information concerning changes were highlighted in participants’ reports as they identified that they did not know the responsibilities of each member in the group: What happened was chaos, because professionals got lost, didn’t understand what was happening or didn’t know whom to turn to in order to solve problems, and there was a very big mess regarding the role of the manager, which was not welldefined. (N3)
Summary
The historical classical management roots of contemporary accounting are still embedded in theory and practice, even in hospitals[1]. In Brazil, most hospitals still have a management system based on a functional model that emphasizes formal and vertical structures. Such traditional models no longer address the expectations of managers, workers and especially patients, since professional nurses working www.eerp.usp.br/rlae. In this context occasionally distance themselves from the care provided to patients. This can work against the nurses’ role as professional practitioners who interact directly with clients to affect better health outcomes for patients[2]. Thereby, the ability of nurses to affect better health outcomes is influenced by the management model adopted by an institution
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
