From theoretical concept to organizational tool for public sector improvement. Janus-faced social capital in a hospital department

• Date: 09 July 2018
• DOI: https://doi.org/10.1108/IJPSM-05-2017-0147
• Published date: 09 July 2018
• Pages: 638-652
• Author: Jette Ernst,Anette Lykke Hindhede,Vibeke Andersen
• Subject Matter: Public policy & environmental management,Politics,Public adminstration & management

From theoretical concept to

organizational tool for public

sector improvement

Janus-faced social capital in

a hospital department

Jette Ernst

Department of Language and Communication,

University of Southern Denmark, Odense, Denmark, and

Anette Lykke Hindhede and Vibeke Andersen

Department of Learning and Philosophy,

Aalborg University, Copenhagen, Denmark

Abstract

Purpose –The purpose of this paper is to examine, first, how social capital was crafted and transformed

from a theoretical concept to an organizational tool for public sector improvement that was adopted by a

Danish region and implemented in all regional hospitals. Second, the paper examines the application of social

capital in one of these hospitals and, further, in a department of the hospital with the purpose of showing how

it was applied by the managerial levels and responded to by the nurses of the department.

Design/methodology/approach –A Bourdieusian ethnograp hic approach was used for und erstanding

the local and subjective understandings of social capital as well as the wider context in which the new tool

was crafted.

Findings –Social capital as a tool fo r organizational improvement wa s constructed in a gray zone between

science and consultancy. The paper demonstrates that the application of social capital in practice is

connected with paradoxes because the concept is inherently ambiguous and Janus-faced in that its official

representation is “soft”and voluntary with a worki ng environment focus yet , it envelopes conceale d

steering intentions . These contrary working features of the concept produce a press ure on the department

management and the nurses .

Originality/value –The explanatory critical framework combined with the ethnographic approach is a

useful approach for theorizing and understanding social capital as an example of the emergence and

consequences of new managerial tools in public organizations.

Keywords Hospitals, Field theory, Social capital, Ethnography, Organizational change, Consultancy

Paper type Research paper

Introduction

The Danish healthcare sector undergoes sweeping reform in these years as is the case in

most Western countries. Through the 00s, the Danish health system attracted political and

public attention fueled by ranking lists produced by international organizations like the

World Health Organization (WHO) and the Organization for economic co-operation and

Development (OECD) pointing out problems related to quality and expenditure (Knudsen

et al., 2008; Andersen and Jensen, 2010). New Public Management (NPM) ideas inspired some

of the changes incorporated in The Danish health reform of 2007 and gave rise to new

steering ideologies in the sector together with a search for tools and solutions through which

quality and efficiency goals could be obtained (Triantafillou, 2007).

The hospital sector is the largest unit in the health sector and at the center of the health

reform. Perceived as in urgent need of change, a movement was initiated from a democratic

structure with a belief in de-centralized steering to a more centralized structure in which the

state attempted to gain more control with the services of the sector (Knudsen et al., 2008;

International Journal of Public

Sector Management

Vol. 31 No. 5, 2018

pp. 638-652

© Emerald PublishingLimited

0951-3558

DOI 10.1108/IJPSM-05-2017-0147

Received 29 May 2017

Revised 1 December 2017

21 February 2018

Accepted 26 February 2018

The current issue and full text archive of this journal is available on Emerald Insight at:

www.emeraldinsight.com/0951-3558.htm

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