Reorganizing healthcare services: Sensemaking and organizational innovation
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The purpose of this thesis is to provide a rich account of organizational innovation processes in order to gain novel insights into such processes. The study is based on two longitudinal empirical case studies from a healthcare setting. One case is about the introduction and development of a new healthcare organization, called health arena, in which actors from different organizations and levels of care are co-located with the aim of achieving better collaboration. The second case is about a newly introduced rehabilitation unit, established to meet the demand for intensified rehabilitation services for the elderly. Both cases represent new ways of organizing healthcare services across organizational boundaries with the overall aim of improving service delivery. I have followed the cases over several years to capture the processes as they unfold. Methodologically, the thesis is based on an extensive qualitative fieldwork, mainly interviews and observations, conducted from 2012 to 2015. The overarching research question of the study is: How does the sensemaking of organizational innovation in a healthcare setting affect its emergence and development? Within this question, I seek to answer the following sub-questions: How do different narratives emerge around the organizational innovation, and how does this influence the sensemaking processes, and thus development of the organizational innovation? How do power relations and physical space influence the sensemaking of the new organizational innovation and its development? This study combines a process ontology with sensemaking theory to analyze how the involved actors in the innovation process construct meanings from the organizational innovation, why they do so, which actions are taken, and what effects these actions have on the innovation. Tsoukas and Chia (2002) argued that there is a need for a better understanding of how change is actually accomplished, and my study contributes to this understanding. The thesis has two main implications for theory. First, it contributes to innovation research by demonstrating how sensemaking theory, combined with a process view, holds the potential for providing understanding of the dynamics of innovation processes. Second, it advances sensemaking theory by treating sensemaking as a holistic and continuous process, by developing the notion of narrative, and by including the two contextual factors of power and physical space. This study has been an attempt to grasp some of the complexity involved in innovation processes. Restricted access: There are plans to publish the document or part of the document in a journal or through a publisher.