The purpose of this paper is to clarify the process of the role of middle management towards “Accountingization” (Power and Laughlin 1992, p.133) in healthcare organizations through an in-depth case study.
Accountingization is defined as a situation which frontline operations are distorted as a result of accounting control. There are two roles of middle management in Accountingization in a healthcare organization, which are “Absorption”(Laughlin et.al. 1994ab; Broadbent and Laughlin, 1998) and “Two-way windows”(Llewellyn 2001)
“Absorption” means that middle management absorbs accounting influence indicated by top management; separating accounting and frontline activities. “Two-way windows” means that while middle management translates accounting information indicated by top management to frontline operations, they also work as consolidating opinions from the frontline and communicate with top management to reflect these opinions into strategy and planning, connecting accounting and frontline operations.
Research question is as follows; how middle management functions as “Absorption” or “Two-way windows” towards Accountingization in frontline operations. This paper conducts interviews and on-site observations in a middle-sized hospital in an ordinance-designated city. Three findings are clarified through in-depth case study.
(1) Middle management act as “Absorption” in order to protect frontline operations from accounting pressure by the top management. In this situation, management accounting systems and frontline operations are maintained in loose coupling or decoupling.
(2) Middle management switches from “Absorption” to “Two-way windows” triggered by failing financial performances. In this situation, management accounting systems and frontline operations are connected.
(3) Middle management could switch from “Absorption” to “Two-way windows” if executive office provides a fine grain accounting information including each clinical department’s profit data to frontline staffs.
This paper contributes to existing literatures in terms of expansion of a concept of Accountingization and adding these process -based knowledge to Accountingizaiton discussion.
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