Understanding ERP system implementation in a hospital by analysing stakeholders Albert Boonstra and Mark J.G. Govers Implementing enterprise resource planning (ERP) systems requires significant organisational, as well as technical, changes. These will affect stakeholders with varying perspec- tives and interests in the system. This is particularly the case in health care, as a feature of this sector is that responsibility of services is shared between many autonomous units. In these and similar settings, it is essential to analyse stakeholders and to understand their expectations and attitudes towards the system. Such an understanding will help implementers to address stakeholder interests and to encourage acceptance. Therefore, the purpose of this paper is to develop a theoretically based model to analyse how stakeholder attitudes and be- haviours in a hospital setting affect the outcome of ERP imple- mentation. This model is applied in an empirical study of a project to introduce an ERP system in medium-sized hospital in The Netherlands. The study shows how the ERP implemen- tation impacts the interests of stakeholders such as physicians and administrators, which caused tensions. The paper exam- ines the reasons of these tensions. In doing so, it contributes to our understanding of ERP implementation in health care and any other similar sectors from a stakeholder perspective, and it may help implementers to manage this more effectively. Albert Boonstra (albert.boonstra@rug.nl) is an associate professor in the Faculty of Economics and Business at the University of Groningen, The Netherlands. He researches the management issues raised by advanced information technologies, especially in health care environments. He has pub- lished in New Technology, Work and Employment, European Journal of Information Systems, International Journal of Project Management, International Journal of Information Management and Journal of Strategic Information Systems. Mark Govers (m.govers@beoz.unimaas.nl) is an assistant professor in the Faculty of Health, Medicine and Life Sciences at Maastricht University, The Netherlands. He specialises in the organisational issues surrounding enterprise IT, such as bureaucratic impact, strategic alignment and organisational flexibility. New Technology, Work and Employment 24:2 ISSN 0268-1072 © 2009 Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, OX4 2DQ, UK and 350 Main St, Malden, MA, 02148, USA ERP system implementation in a hospital 177