Strategy transformation and change : changing paradigms in Australian Catholic health and aged care

Abstract

When I was younger I always conceived of a room where all these (strategic) concepts were worked out for the whole, company. Later I didn't find any such room .... The strategy (of the company) may not even exist in the mind of one man. I certainly don't know where it is written down. It is simply transmitted in the series of decisions made (Quinn 1978: 7). How do organisations in the Australian Catholic Health and Aged Care sector transform shared strategic thinking into formulated strategy? This research has investigated strategy formation, which can be defined as the process whereby the insights and thoughts of the key players in Catholic health and aged care are converted into formulated strategies. Specifically, the research analysed a major strategic amalgamation of the health and aged care operations of the Catholic Church in Australia, identified as Integration 2000. The concept of social constructs of meaning for the key actors is the fundamental perspective of this research. This required a constructivist ontology. The epistemology is interpretivist, and set out to provide a description of perceptions of the key actors as they engage in the formation of strategy. Defenders of interpretivism argued that the human sciences aim to understand human action (Schwandt, 2000:191). A qualitative methodology has been used to provide a plausible interpretation of the conversion process commonly referred to as strategy formation.A purposive sample was obtained. The data collection methods included qualitative interviews, attendance as an observer at two of the three day National Conferences of Catholic Health Australia and document analysis (see Chapter Three).A key focus of the research was the identification of planning models used to set the strategic context of organisations in Catholic health. The research showed that the prescriptive design and planning models were not used to plan broad strategy, but to implement strategies already formed by an emergent/learning process which, in Mintzberg et al's (1998) terms, would fit the learning, cultural and environmental schools of thought. Pinpointing a strategy school may not be a particularly fruitful exercise in this particular arena. It assumes that the distinctive act of deciding the future shape and the strategic management context of organisations charged with fulfilling a sacred mission can be classified into one school or another. The research also explored the perceptions of the Integration 2000 process, including the compatibility between the espoused philosophies and values of Catholic health and aged care and the behaviours evidenced during the Integration 2000 process. A diagnostic model was used to perform this evaluation. Rather than uncovering major discrepancies, this revealed some differences and some potential challenges.The espoused philosophies and values of Catholic health and aged care are those of compassion, collaboration, sense of community and, of course, financial viability. Pre-Integration 2000, particularly in health care, theories of organising and practices reflected values of independence and competitiveness, both between and even within religious orders. The findings from post-Integration 2000 suggested that theories of organising and practices were becoming more aligned with the original and continuing values, at the same time as responsibility for sustaining these values was being handed over from religious to lay trusteeship. There are still some outstanding issues before the Integration 2000 process achieves its objectives. The progress to date in bringing together so many components of such a disparate sector attests to the strength of the underlying value systems of Catholic health and aged care.