Implementing strategies in complex systems: lessons from Brazilian hospitals

Victor Meyer Junior,J Patrick Murphy,Lucilaine Pascucci

doi:10.1590/s1807-76922012000500003

Abstract

Abstract Hospitals, as social organizations, are seen as complex, surprising, ambiguous and paradoxical. The theoretical foundation finds its roots in organizational complexity, strategic management characterized by strategy implementation, and sensemaking especially in the context of complex adaptive systems. Managers frequently neglect elements of complexity when they develop models and implement management practices. The purpose of this study is to analyze the implementation of strategies in complex organizations. The focus of the study is two Brazilian nonprofit hospitals. This is a comparative, qualitative case study. Data were gathered from three main sources: interviews, non-participant observation, and documents. Two important aspects of the strategic approach are discussed: first, the implementation of strategies, and second, the influence of ambiguity, unpredictability and uncertainty in the way strategies are implemented. The analysis indicated that the implementation of strategies in the hospitals has to do with the practices and processes that are adopted (

Highlights

Social organizations are difficult to understand; they are complex, surprising, ambiguous and paradoxical
Understanding the special characteristics and complexities of social or nonprofit organizations is necessary in order to develop suitable management models or approaches
Strategic management has spread into institutions as varied as corporations, governments, social organizations, museums, universities and hospitals

Summary

Introduction

Social organizations are difficult to understand; they are complex, surprising, ambiguous and paradoxical. Organizational scholars such as Etzioni (1964), Perrow (1986), Bolman and Deal (2003) and Scott (2008) suggest that managers frequently overlook these distinctive characteristics when developing and implementing management models and practices. Understanding the special characteristics and complexities of social or nonprofit organizations is necessary in order to develop suitable management models or approaches. Scholars have questioned its effectiveness because strategic management relies on a form of management based on rational assumptions not usually found in most organizations and because it is a process requiring significant outlays of time and resources. The implementation of strategies is even more important in this approach to management

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