Emerging pathways of colonization in healthcare from participative approaches to management accounting

This paper analyses, through the Laughlin and Broadbent framework, the interaction between Management Accounting (MA) (as a design archetype) and clinicians’ interpretative schemes in the change of healthcare organizations, started by reforms introduced by government. Unlike previous research, this paper focuses on the process of MA change and in particular (1) the role played by the government and internal actors in MA change and (2) the implication of MA change for clinicians’ interpretative scheme and for organizational change. We found that the interaction between the government and internal actors determines MA change and that an integrative-interactive approach to MA change can be developed. This approach is based on a collaboration between clinicians and controllers in the revision of MA tools. The integrative-interactive approach underlines a new change pathway of reciprocal colonization, where the interpretative schemes and the design archetypes influence each other in the organizational change triggered by the government.