Veien mot "Pasientens helsetjeneste"

Abstract

In this article, the focus is on the patient's role in the healthcare system, with "patient-centered healthcare" being presented as a health policy goal. The study aims to understand the meaning of this term and how it is being realized at Oslo University Hospital (OUS) from a leadership perspective. The study employs document analysis as a qualitative method, examining the OUS Development Plan 2040 and relevant public documents. The theoretical framework adopted is organizational theory, exploring the characteristics of governance and management of public organizations, alongside instrumental and institutional perspectives. The term "patient-centered healthcare" was first introduced in 2014 as a Central health policy goal. Central health authorities communicating in 2016 that OUS should adopt this goal. The aim is to change the patient's role from a passive recipient to an active participant in their healthcare journey. The OUS Development Plan 2040 serves as a management tool to achieve this goal, conveying the hospital's ambitions and objectives to its employees. The study recognizes OUS as an organization with both instrumental and institutional traits. The hospital's leadership is responsible for executing public health policies, broadcasting health policy standards and objectives throughout the organization. However, strong professional norms within the hospital have given the various professions a high degree of autonomy and professional legitimacy. This can result in goal complexity, potentially leading to disagreements within the organization. Excessive control and management can create mistrust and resistance between leadership and the rest of the organization. Therefore, leadership must employ institutional mechanisms to ensure compliance with health authority management objectives, while harmonizing instrumental and institutional mechanisms to achieve health policy goals at OUS HF.