“Money is not an issue!”: Hospital CFOs’ narratives about handling a sudden shift in managerial focus

Abstract

The sustained political and managerial focus on cost containment and efficiency in hospitals has been altered by COVID-19-related concerns about public health. Through a novel qualitative study in Denmark, we explore CFOs’ narratives of their experiences during a sudden shift in managerial logic. All of the CFOs describe engagement in key operational procedures and change management that was fostered by the constant search for stability that strongly depended on bottom-up decision-making and flexibility. During this process, the existing competing logics of managerialism and medical professionalism vanished. The CFOs describe new forms of dynamic and collaborative approaches. The possibility of adhering to the core logic of administrative accounting techniques combined with urgency and emotional encounters appears to enable this approach. Thus, we document a moment when well-known opposing logics were suspended by exogenous urgency. This finding suggests possibilities for moving beyond deep-rooted views on established public administration structures and logics.

Points for practitioners

Financial managers show administrative skills that are useful for public administration changes in both administration and daily operations. These managers appear to have a strong core identity and willingness to dynamically engage with and facilitate acute frontline operational issues. In an emergency situation such as COVID-19, we find co-dependency across subject fields (administration and medical professions) which enables collaborations.