Sociotechnical Systems and Middle Manager Practices: Improving Policy and Strategy Implementation

This article, situated within the strategy-as-practice field, explores how healthcare middle managers interpret, contextualize, and adapt sociotechnical systems to achieve strategic objectives. It begins by recognizing how formulation, implementation, and monitoring/evaluation are not separate steps in policy and strategy; rather they are entangled and working in concert to deliver outcomes that meet an intent based on principles and planning assumptions. Next it provides insights into the coevolution of middle manager practices and the sociotechnical systems that guide alignment and misalignment. It then concludes with four recommendations to improve middle manager practices in policy and strategy implementation.