This case highlights how analyzing normative systems holds promise to improve scholarly understanding of organizational technologies and to refine managerial tools for technological and organizational innovation.
Use of administrative and managerial tools like Programme Budgeting and Marginal Analysis, also termed as options appraisal, which also provides for inclusion of users perspectives in programme management are highly recommended.
In our study, we draw on a broad definition of 'control' (or 'clinical management' more generally) that includes a wide range of bureaucratic measurements and managerial tools, such as target setting and performance indicators, and also interventions where doctors have oversight, such as evidence-based guidelines and continuing professional development (CPD).
These developments nurture the 'rise of a new professionalism' that may be more inclusive [21], p. 221, Table 10.11 but it also may embody opportunities for doctors to transform and strategically use managerial tools, like evidence-based clinical guidelines and quality reports.
The head of the project does not do all this alone; he receives help from advisers, experts and managerial tools.
In this situation doctors are most powerful in the area of quality and increasingly integrate new managerial tools, while developments on the top level and in the area of cost control limit medical power and may instead support state or hospital actors.
In this connection, the efficient implementation of technology management necessarily implies a need for "managerial tools" that can be customized and adapted to each particular business case.
They see organizations, not as rational, neutral, and objective, but as managerial tools designed to fulfil the interests of one group at the expense of another.
In summary, the review of the literature reveals that 'ownership' of managerial tools is not naturally attached to management and managers, but can be used flexibly by different groups.
