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The purpose of this paper is to empirically examine developmental trends in healthcare organisation management practice and improvement work.

Primary healthcare centre (n=1,031) and clinical hospital department (n=1,542) managers were surveyed in spring 2007 (response rate 46 per cent). This article compares results from this survey with a study in 2003. A theoretical framework based on organisational inner context, organisational outer context, external environment and outcomes form the analytical base. Comparisons were made using independent two‐sample t‐tests.

A general aspect, identified empirically, is the tendency toward increased external pressure on leaders in their improvement work. Higher management decisions, patient pressure and decisions made by policymakers increasingly influence and shape the choices made by healthcare managers about where to focus improvement efforts. Three different trends are empirically identified and elaborated: take‐control logic; practice‐based improvement; and patient‐centeredness.

Healthcare leaders should carefully design new management control systems that support healthcare micro systems. Findings support the general assumption that staff increasingly tend to focus organisational changes on management control.

This study extends management research with a unique survey. Through two measurements made in 2003 and 2007, several important trends about how healthcare organisations are managed and developed are identified.

The purpose of this paper is to contribute to the understanding of how statistical process control (SPC) methodology can be implemented and used in organizational settings.

An action research model was used. Data were collected through formal meeting protocols, interviews and participant observation.

Based on the results of an action research project, the paper emphasizes the need for: top management support with respect to roles such as infrastructural assistance, mentor, critic, financer; creating system validity through the involvement of people with experiential knowledge about the “world” in which SPC should be applied; keeping a small, highly knowledgeable development team with appropriate expertise together during the whole process from beginning to end; keeping the various end‐users in focus but separate and prioritising between their different needs; and working with iterative design methodology.

The paper provides the research field with a unique case of implementing SPC using a computerized administrative data system.

Organizations are given guidelines to use when implementing SPC.

The paper contributes knowledge in an underdeveloped field of research. It may provide a basis for further research and scholarly analysis.