Management accounting and organisational change: an institutional perspective

Purpose -The paper aims at understanding the potential role of management accounting during a public hospital organisational change within a developing country in transition, Egypt. Design/methodology/approach -The paper is based on in-depth interviews, an analysis of documents, and direct observations. It uses a framework informed by institutional theory together with Giddens' (1990) notion of 'elements of system contradiction' to analyse the empirical findings. The paper draws on both DiMaggio and Powell's (1983) notion of coercive, mimic and normative isomorphic mechanisms to link a changing hospital to the changes in the wider social and institutional context wherein public hospitals operate, while exploring the interlinkages between these changes and the hospital's processes of accounting change and institutionalisation (Burns and Scapens, 2000); and Giddens' (1990) notion of ` elements of system contradiction' in order to evaluate the role of management accounting. Findings - The paper concludes that both the institutional change and reform around management accounting together with the changes in accounting systems are entrepreneurial processes in order to trigger a public hospital to change. Research limitations/ implications -Although the empirical findings suggest resistance to management accounting change within the case study, a full investigation and explanation of such a resistance is an area of future research. Originality/value -In contrast to the technical role of accounting, the paper shows how management accounting is acted upon to disrupt the hospital's micro institutions and routines, challenge physicians' professional and bureaucratic power and therefore engendering the public hospital to change.