MANAGEMENT ACCOUNTING TOOLS AS MEDIATORS OF A NEW ORGANISATIONAL CONSTRUCTION: A STUDY OF THE INTERACTION BETWEEN TOOLS AND 'PHYSICIAN-MANAGERS' IN A FRENCH PUBLIC HOSPITAL

Purpose - We utilise the actor-network theory (ANT) - based especially on Latour (2005) - to examine how management accounting tools affect physicians' representations and new managerial practices in French public hospitals currently undergoing reform. Design/methodology/approach - We conducted a longitudinal case study - based on interviews and observations - in a large French public hospital in which dashboards are diffused to physicians and nurses dealing with both medical and managerial activities. Findings - The case shows that head physicians and nurses are implicated in their new managerial tasks and spend time analysing dashboards. Management accounting tools thus play a role, as mediators, in organising new managerial practices, and dashboards are a means of materialising and giving structure to new managerial practices and enabling discussions and exchanges to take place between actors who were previously separated. Research implications - The case shows that management accounting tools are not necessarily useful because they help in decision-making or control - as in the dominant paradigm; rather, they are beneficial because they may help in changing representations and building a new collective organisation. Future research should therefore expand on the organisational and social roles of management accounting tools, especially in the healthcare field. Originality/value - Most ANT-inspired studies in management accounting focus on explaining changes in accounting practices, which are perceived as a consequence of an ANT process. This chapter, however, analyses the practices by which management accounting tools act as a vehicle to organisational change.