Purpose - In the last decade, greater attention has been paid to the role of management accounting and control (MAC) in making professional organizations more horizontal. The authors argue that earlier research has not shown how the interrelatedness between professional identities and MAC influences attempts to make organizations more horizontal. In this paper the authors respond to the call for more research on the relationship between horizontalization and accounting and control. The purpose of this paper is to contribute to the emerging literature on the relationship between accountability arrangements and professional identities. Design/methodology/approach - Theoretically the authors have an actor-network theory (ANT) approach. Empirically, the authors followed two episodes where actors at top management levels in two Swedish health care organizations introduced horizontalization. Findings - The two episodes support the view that the role of MAC when making professional organizations more horizontal is limited. Professionals dominate what happens at the operational level and they do not act on MAC rules and performance targets in opposition of their professional identity. However, in alliance with other interessement devices MAC may have a role in creating overflows, that is, pointing out imperfections in the existing frame. The authors noticed no signs that professionals developed hybrid identities as in previous research. Originality/value - The authors apply ANT to move beyond the commonly used contingency and new institutional sociology perspectives.

Purpose – In order to improve cooperation and collaboration between units, clinics and departments, many health care organizations (HCOs) have introduced process orientation. Several studies indicate problems in realizing these ambitions. The purpose of this paper is to explain and understand the success and failure of process orientation in HCOs.

Design/methodology/approach – The authors conducted three case studies and applied Actor-Network Theory as an analytic lens.

Findings – The realization of process orientation is hindered by neglect or resistance from physicians, who find the process targets to be of low medical priority. However, the authors also see that medical priorities are no stable entities but are susceptible to negotiations. Over time, process organization, process mapping, process measurement activities and the acting of enroled actors may have impact on medical priorities.

Originality/value – Contrary to previous research, the findings indicate that New Public Management may not be the main obstacle against processes, that accounting figures may not be hard to disregard and that the role of leadership is not paramount.

Trenden i många välfärdsstater är att konkurrensutsättning och privata utförare är ett tydligt alternativ till egenregiproduktion för att leverera service och välfärd till medborgare. Sverige är inget undantag. Förklaringen är ideologiska strömningar men också en vilja att effektivisera och skapa nytänkande inom offentligt finansierade verksamheter. För att ambitionerna med konkurrensutsättning ska kunna realiseras måste de offentliga huvudmännen styra sina privata utförare. För närvarande vet vi dock väldigt lite om hur styrningen av privata utförare i offentlig sektor utformas, vad som förklarar utformningen och vilken betydelse den har för olika verksamheter i olika situationer. Trots det debatteras frågan livligt i politik och media. I den här rapporten utgår vi från teori om styrning av samarbete och samordning när en organisation ska styra en annan. Genom att studera upphandlad verksamhet i svenska kommuner söker vi förklaringar till hur, varför och med vilket utfall offentliga huvudmän styr sina privata utförare. Det empiriska materialet är insamlat med enkäter skickade till privata utförare inom äldreomsorg och teknisk verksamhet.

Recent research emphasizes technocratic controls to support the self-management aspect of empowerment. Strategic alignment is ascribed to socio-ideological controls. However, the indirect nature of socio-ideological controls pose a question regarding monitoring of strategic alignment in organizations with empowerment-oriented controls. We adopt a holistic approach in exploring the role of and interaction between organization structure, socio-ideological control and technocratic control through a qualitative case study. Our study confirms the essential role of socio-ideological controls in ensuring strategic alignment, but highlights the role of trust in experienced-based advice-giving from superiors to subordinates. Technocratic controls contain information that provide visibility of local actions and are used in hierarchical communication. The interrelationship between socio-ideological and technocratic controls is dependent on the organization structure design through time and proximity. A high capacity to communicate is thereby established, enabling monitoring without impairing empowerment.

In the public sector, budget deviations are an important performance dimension. Because of political and institutional pressures, it is crucial that public sector organizations neither overspend, nor underspend. Budget deviations actualize the issue of tight budget control. In this article we hypothesize that when public sector organizations face budget turbulence, the implementation of tight budget control is a functional response that increases the likelihood of meeting budget targets. Our study, combining survey and archival data from 196 Swedish municipalities, confirms our hypothesis. If budget turbulence is substantial, public sector organizations benefit from tight budget control as they seek to control budget deviations, but if turbulence is only marginal, they can conduct activities in the same manner as last year and additional direction from tight controls has no effect on budget deviations. A more general contribution of the paper is the evaluation of the effect of environment and tight budgetary control fit on budgetary performance.

Benchmarking is a management accounting innovation (MAI) that can be used for performance measurement and management in both the private and the public sectors. Although public sector accounting researchers have reported some success with the use of benchmarking, it is frequently charged problems exist in implementing and using this management technique. To look beyond the technical and institutional explanations, this paper takes a translation approach and presents a case study of a local government benchmarking network. We conclude that there is a link between benchmarking implementation problems and initiators’ failure to build a strong network of benchmarking allies. Implementation is facilitated if actors other than the initiators recognize the possibility of making benchmarking more relevant and less cost focused. However, even when a network of actors has a favourable attitude towards benchmarking, benchmarking may still appear as an unruly ‘actant’. Furthermore, the perception of implementation failure and success is heterogeneous and connected to various actors’ adoption of benchmarking. We also conclude that there is a connection between the use of benchmarking and 1) actors’ possibilities to use benchmarking in the struggle for resources and 2) the perception of benchmarking information as ‘factual’ or ‘factual enough’. However, the perception of benchmarking information as ‘factual’ or ‘factual enough’ seems not only a matter of correct or incorrect ratios but also of whether such information serves actors’ interests. A final conclusion is that the use of benchmarking increases when actors other than the initiators complement the original idea and ‘counter interest’ the initiators.

Process orientation has made its entrance in Health Care Organizations (HCOs). The purpose is to improve patients’ journeys through the health care system. One factor that potentially affects process orientation is the design and use of Management Accounting Systems (MAS). In the literature there are worries that process orientation often is not supported by a well designed and used MAS but, on the contrary, is counteracted by a MAS designed for other purposes than supporting processes. This study contributes to the existing knowledge in that it shows how the introduction of process orientation within health care is accompanied by the development of horizontally oriented MAS (HMAS) which is used in different ways and by different actors. Generally, the use of HMAS for diagnostic control is limited. The main use of HMAS is for the purpose of mastering the events and interactive control, and the main users are the persons connected to the processes. The observation in earlier research that the existence of vertically oriented MAS may be a threat to process orientation is to some extent corroborated in the paper.