Timeline – main events in the decision-making process regarding the organization of vascular treatments at the South Eastern Norway Regional Health Authority (RHA) from 2007–2018
| Year | Event | Participants | Decisions/actions | Consequences |
|---|---|---|---|---|
| 2007 | The merger of the South and the East RHA | The government, the Parliament | Realize medical and economic scale advantages | The old regional organizational models need to be modified |
| 2008 | A strategic plan for the merged regional authority is completed | The regional CEO, the regional board, consultation groups | “Centralize what needs to be centralized and decentralize what can be decentralized” | Merger and decommissioning processes initiated by “modernizers” |
| 2009 | The provision of vascular services is investigated | The regional board, various professional and expert groups, The Sillesen Committee | Reduce number of vascular centers and establish a strong regional vascular center in Oslo | The process is opened up (politicized), stirs up the local and “traditionalist” stakeholders |
| CEO resigns from regional vascular reorganizing process because she is married to manager of vascular surgical department at Aker hospital. Vice president is assigned | Regional board | The regional management aims to appear unbiased and qualified in managing the process | Some stakeholders still consider management to be biased and disqualified | |
| 2010 | Vice president resigns from process, MD from Central RHA is assigned | Regional board | The regional management aims to appear unbiased and qualified in managing the process | These changes indicate that the management had prepared poorly for the process and put the “modernizers” on the defensive side |
| Strong local resistance against the perceived decommissioning of vascular departments | Local professionals, citizens, patient groups, media and politicians | Inform the Minister about the critical regional situation concerning the regional provision of vascular treatments | The power configuration is altered in favor of the “traditionalists” | |
| Board meeting to comply with resistance and consultation responses | The regional board | Perform risk analysis for hospitals without vascular competence. Investigate the future need for vascular services | The decision-making process is extended | |
| 2011 | The Sæther report (risk assessment) | Seven committee members | Reduce number of vascular centers and establish a strong regional vascular center in Oslo | The board needs to review situation and power configuration between “traditionalists” and “modernizers” |
| Board meeting | The regional board | Revoke centralizing plans, require future resource and quality measures for vascular services | The board concludes the decision-making process | |
| 2012 | The public debate about vascular services fades out | The provision of vascular services continues with little central interference | ||
| 2013–2018 | The regional number of vascular departments remains unchanged | The regional board and management, management at local hospitals and vascular departments | Incomplete professional documentation and reasoning | The rationality of different degrees of centralization is difficult to investigate |
| Year | Event | Participants | Decisions/actions | Consequences |
|---|---|---|---|---|
| 2007 | The merger of the South and the East RHA | The government, the Parliament | Realize medical and economic scale advantages | The old regional organizational models need to be modified |
| 2008 | A strategic plan for the merged regional authority is completed | The regional CEO, the regional board, consultation groups | “Centralize what needs to be centralized and decentralize what can be decentralized” | Merger and decommissioning processes initiated by “modernizers” |
| 2009 | The provision of vascular services is investigated | The regional board, various professional and expert groups, The Sillesen Committee | Reduce number of vascular centers and establish a strong regional vascular center in Oslo | The process is opened up (politicized), stirs up the local and “traditionalist” stakeholders |
| CEO resigns from regional vascular reorganizing process because she is married to manager of vascular surgical department at Aker hospital. Vice president is assigned | Regional board | The regional management aims to appear unbiased and qualified in managing the process | Some stakeholders still consider management to be biased and disqualified | |
| 2010 | Vice president resigns from process, MD from Central RHA is assigned | Regional board | The regional management aims to appear unbiased and qualified in managing the process | These changes indicate that the management had prepared poorly for the process and put the “modernizers” on the defensive side |
| Strong local resistance against the perceived decommissioning of vascular departments | Local professionals, citizens, patient groups, media and politicians | Inform the Minister about the critical regional situation concerning the regional provision of vascular treatments | The power configuration is altered in favor of the “traditionalists” | |
| Board meeting to comply with resistance and consultation responses | The regional board | Perform risk analysis for hospitals without vascular competence. Investigate the future need for vascular services | The decision-making process is extended | |
| 2011 | The Sæther report (risk assessment) | Seven committee members | Reduce number of vascular centers and establish a strong regional vascular center in Oslo | The board needs to review situation and power configuration between “traditionalists” and “modernizers” |
| Board meeting | The regional board | Revoke centralizing plans, require future resource and quality measures for vascular services | The board concludes the decision-making process | |
| 2012 | The public debate about vascular services fades out | The provision of vascular services continues with little central interference | ||
| 2013–2018 | The regional number of vascular departments remains unchanged | The regional board and management, management at local hospitals and vascular departments | Incomplete professional documentation and reasoning | The rationality of different degrees of centralization is difficult to investigate |
Sharing content requires targeting cookies to be enabled. Please update your cookie preferences to use this feature.