From discord to symphony? A case study of strategic reorientation

31. Annual EAIR Forum, Vilnius, 23.-26. August 2009

Dr. Jürgen Deeg

Kirsten Hoeper

Overview• Case Study Hannover Medical School

3 Stages:- State of discord

- Turnaround – Strategic Reorientation

- Results

• Key factors of strategic reorientation

Organisation Structure: Integrative ModelOrganisation Structure: Integrative Model- Hannover Medical School -- Hannover Medical School -

Supervisory Board

Executive Board

PresidentDepartment

Research and Teaching

18 Centres with 70 Clinics and Institutes

Academic Senate

Internal Clinical Advisory Board

Vice-presidentDepartment Patient

Care

Vice-presidentDepartment

Economics and Administration

Development of Crisis atHannover Medical School

Amount Mio €

t

SuccessfulTurnaround

Economical Crisis

2003

40 Mio

20 Mio

1997

0

Time frame?

Major causes

• Fulltime position of management without

structural independence

• Lack of profile in research and medical facility

• Lack of cost awareness, economic reasoning

and behaviour of staff

• No transparency between income, expenses,

and output due to an insufficient controlling

Turnaround – Strategic ReorientationProfessionalization of Management

Management Characteristics 2003 2008

Full Time Position Yes Yes

Focus exclusively on Management Yes Yes

Managerial expertise and leadership skills No Yes

Self-conception as a professional Yes Yes

Structural independence No Yes

6-year cycle with re-election Yes Yes

Based on Nickel, S. & Ziegele, F. (2006), pp. 2-7

Turnaround – Strategic ReorientationCultivation of a competitive profile

Characteristics of HEIs Hannover Medical School

Experts as Solists Experts as Team Players

Dominance of Disciplines Clusters of Excellence

Specializing of Knowledge Distinctive Profile

Loose Coupling Internal Networking

Characteristics of HEIs in contrast

Results (I)Development of Grant Acquisition and Impact Factor

0

50

100

150

200

250

300

350

2001 2002 2003 2004 2005 2006 2007

Year

%

MHH Drittmittel

Impactpunkte

Grant AquisitionImpact Factor

Results (II)Development of Net Profit of the year

Net Profit of the Year

-10

-5

0

5

10

15

2005 2006 2007

Year

Mio

€

JahrsüberschussNet Profit

• Key factors of strategic reorientation

Employee Attitude SurveyOverall Concept and Business Objective

Administrative staffPhysicianScientist

1

2

3

Question 1: I am informed about concept and business objective of the institutionQuestion 2: I am informed about concept and business objective of my DepartmentQuestion 3: In our Department, we regulary get information about concept and

business objective of the institution

Not true

true

Hierarchic StructureHospital and Research

Department Head(= Medical Director = Scientist)

Senior Physician(= Assistant Medical Director =

Scientist)

Resident Physician(= Scientist)

Hierarchy HospitalDepartment Level

Senior Physician

(= Scientist)

Resident Physician

(= Scientist)

Biologist

etc.

Hierarchy ResearchDepartment Level

Department Head

(= Medical Director = Scientist)

Impact of increased governance

I have too much tasks in the hospital to perfomadequately in research

I do not have enough time to perfom appropriately onall assignments

I have too many different activities at the same time

I have problems to subordinate to departmentheads/assistant department heads in the hospital

I appreciate precise instructions and structures in thehospital. That leaves more free time for research

I would appreciate more instructions and guidance in research

I have to work to some extent with contradictingguidelines and approaches

True Not true

mw = 4,00mw = 4,00

mw = 2,14mw = 2,00

mw = 2,00mw = 1,92

mw = 4,14mw = 4,33

mw = 3,14mw = 2,33

mw = 4,00mw = 2,42

mw = 4,14mw = 3,33

I have too much tasks in research to perfomadequately in the hospital

Senior Physician mw = 1,86Resident Physician mw = 2,42

•Conclusions

• Most important changes: professionalization of management with dual qualification and profiling

• Quick decision making process and adaptation to a changing environment

• Changing definition of HEIs

• Effects on academic freedom

Final NoteThe inevitability of changes

„I don‘t know, whether things get better if they change, but I know that things have to change in order to get better. “

Georg Christoph Lichtenberg (1742-1799)

German Philosopher

Thank you for your attention!