The purpose of this master's degree thesis was to develop an understanding of how hospital management, in the case studied, worked to achieve changes in an organization influenced by differing professional cultures. To gain insight into the conditions that may have contributed to nurses and physicians developing appropriate attitudes and behaviours, which may have affected the organization's ability to achieve the Swedish Quality Award 2012.  A qualitative single case study was conducted at Karlskoga Hospital, with focus groups as well as individual depth interviews.   The results of the case study showed the following conditions provided nurses and physicians the potential to develop appropriate attitudes and behaviours, which may have influenced the hospitals ability to achieve the Swedish Quality Award:   Responsibility and influence over the development processes. Participation in management teams and quality development groups as well as individual fields of responsibility. Training programs that have given insights and skills in quality management related to clinical practice. Nurses and physicians as key individuals gave legitimacy to development process, and served as management advisors. Collaboration between all kind of employees and responsibilities. Committed management.