The Unexpected Role of Materiality in Strategic Implementation. A case study of value based care

Abstract: Abstract In this article we dedicate attention to how a general strategy as Value Based Care (VBC), is implemented and legitimated in a local context. The aim of this study is to contribute to further understandings of the dynamics in institutional work, with regards to both humans and materials, when a new strategy is implemented. To gain understanding in this, we undertook a qualitative research method, including interviews, semi-structured observations, and document analysis. First of all, we detected that an essential part of the strategy of VBC has been materialized, and by using theories of institutional work and materiality, we have been able to identify that both humans and material objects participate in the institutional work in the initial phase of the implementation. This study shows that humans and materials collaborate in the creation of institutions, and that the dynamics of materiality can result in different effects on institutional work, more specifically, reinforcing effects, and hampering effects. Further, we argue that a deeper understanding of these roles, and an extended collaboration between these actors, can overcome several of the difficulties that may occur in initial phase of an implementation of a new strategic management model. Finally, this article emphasize that a strategic implementation, that succeeds to create reinforcing effects of materiality, is more likely to become successful.