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Organizing principles and management climate in high-performing municipal elderly care

Petri Kajonius (Department of Psychology, University of Gothenburg, Göteborg, Sweden and School of Health and Education, University of Skövde, Skövde, Sweden)
Ali Kazemi (University of Skövde)
Stefan Tengblad (School of Business, University of Skövde, Skövde, Sweden)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 1 February 2016




Previous research has shown that user-oriented care predicts older persons’ satisfaction with care. What is yet to be researched is how senior management facilitates the implementation of user-oriented care. The purpose of this study is to investigate the organizing principles and management climate characterizing successful elderly care.


The department in one highly ranked municipality was selected and compared with a more average municipality. On-site in-depth semi-structured interviews with department managers and participatory observations at managers’ meetings were conducted in both municipalities.


Results revealed three key principles for successful elderly care: organizing care from the viewpoint of the older person; recruiting and training competent and autonomous employees; instilling a vision for the mission that guides operations at all levels in the organization. Furthermore, using climate theory to interpret the empirical material, in the highly successful municipality the management climate was characterized by affective support and cognitive autonomy, in contrast to a more instrumental work climate primarily focusing on organizational structure and doing the right things characterizing the more average municipality.


The authors suggest that guiding organizing principles are intertwined with management climate and that there are multiple perspectives that must be considered by the management, that is, the views of the older persons, the co-workers and the mission. These results can guide future care quality developments, and increase the understanding of the importance of organizational climate at the senior management level.



This research was financially supported by grant 2012-1200 to Ali Kazemi from the Swedish Research Council for Health, Working Life and Welfare (FORTE, previously FAS). The authors would like to thank Professor Boo Johansson at the Department of Psychology, University of Gothenburg, for valuable advice.


Kajonius, P., Kazemi, A. and Tengblad, S. (2016), "Organizing principles and management climate in high-performing municipal elderly care", Leadership in Health Services, Vol. 29 No. 1, pp. 82-94.



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