Managing for high quality and cost-efficiency within elderly care - a case study of Ambea and Vardaga, a private equity-owned elderly care company
Sammanfattning: This paper aims to explore how managers in the welfare sector control an organization. This was examined by conducting an in-depth case study of a Swedish private-equity owned elderly care company where we investigated how strategies related to quality of care are balanced with strategies related to cost-efficiency. A revised version of Simons' (1995) Levers of Control framework, that also takes into account how verbal communication of the formally designed systems can be a means of control (Hall, 2010), constitutes the theoretical framework. Our findings indicate that although the formally designed systems were identical at the corporate level as well as at the two studied subunits, Alpha and Beta, the management control systems (MCS) in use differed. At the corporate level and at Alpha, verbal communication facilitated a balanced focus between cost-efficiency and quality of care. However, at Beta, verbal communication rather led to operating managers perceiving the focus as skewed towards cost-efficiency. This illustrates the importance of not solely having appropriately designed formal systems when controlling for a company's business strategies, but that also managers' use of verbal communication needs to support a balanced focus between all strategic dimensions. If not, no matter the design of the formal control systems, a misuse of verbal communication risks leading to a skewed strategic focus.
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