دانلود رایگان مقاله واکنش کارکنان به استفاده از سیستم های کنترل مدیریت در بیمارستان ها

abstract

Objective: Management control systems (such as budgets or balanced scorecards) are formal procedures used by managers to promote employee behavior aligned with organisational objectives. Employees may react to these control systems by either becoming more motivated or perceiving them as a threat. The aim of this paper is to determine the extent to which hospital ownership (public or private), professional group (physician, nurse, pharmacist or administrative employee), type of contract (fixed or temporary), gender and tenure can condition employee reaction to management control systems. Methods: We conducted the study in the three largest hospitals in the State of Santa Catarina (Brazil), two public (federal and state-owned) and one private (non-profit organisation). Physicians, nurses, pharmacists and administrative employees received a questionnaire between October 2013 and January 2014 concerning their currentperceptions.We obtained100 validresponses andconductedanANOVAvariance analysis. Results: Our results show that the effect of management control systems on employees differs according to hospital ownership, professional group and type of contract. However, no significant evidence was found concerning gender or tenure. Conclusions: The results obtained contribute to creating specific knowledge on the reactions of employees to the use of management control systems in hospitals. This information may be important in adapting management control systems to the characteristics of the hospital and its employees, which may in turn contribute to reducing dysfunctional worker behavior.

Conclusions

The effectiveness of MCS in terms of consequences on employee behavior is currently one of the major challenges to hospital organizations.13,20 In this line, drawing on a sample of 100 respondents,this study aims to determine the extentto whichorganizational factors (hospital ownership and professional group) and individual characteristics (type of contract, gender and tenure) can condition employee reaction (motivation or threat) to MCS. Our results present central questions that should be discussed within the context of the existing literature.

Regarding hospital ownership, we observed that employees from public hospitals show higher levels of threat than do employees from private hospitals. This finding falls in line with previous research suggesting public employees are less satisfied with their supervisors and hold weaker distributive and procedural justice perceptions.34 Therefore, this paper sheds some light on the conceptualization of the differences between public and private organizations, an issue still debated among researchers.35 Besides, and also related to organizational factors, results that we initially obtained by comparing the values of the four groups of employees seem to be consistent with those of previous literature that stress the differences among non-clinical and clinical staff based on their different individual backgrounds.36 However, when going deeper into our analysis and refining it, we observe that the significant differences are limited to those between physicians and nurses. The latter shows higher levels of motivation. One plausible argument is that physicians are intrinsically motivated professionals;20 thus MCS cannot perform all of its postulated features.