Amoeba Management and Enabling Control: A Field Study of Small and Medium-Sized Public Hospitals

Amoeba management is a cost management technique that entails an entrepreneurial thought process and is a leading system in management accounting in Japan. Its fields of application have expanded in recent years to include the medical and social welfare industries. However, few examples exist of its introduction in hospitals, and the factors leading to its adoption are yet to be explained. This chapter aims to clarify the organizational learning process necessary for the adoption of amoeba management by drawing on the perspective of the enabling control design principle, and takes Ohchi Municipal Hospital as a field study to examine its adoption of the technique. Results show that in order to establish amoeba management, the use of both coercive and enabling control afford each amoeba the opportunity to learn by trial and error, thus increasing motivation. In addition, in this study, hospital staff were not seconded from a central government office, but were instead almost exclusively employed by the hospital itself, thus suggesting that the accumulation of organizational memory is likely.