| 1. |
- Hellman, Stefan, 1975-, et al.
(författare)
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Explaining process orientation failure and success in health care - three case studies
- 2015
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Ingår i: Journal of Health Organisation & Management. - : Emerald Group Publishing Limited. - 1758-7247 .- 1477-7266. ; 29:6, s. 638-653
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Tidskriftsartikel (refereegranskat)abstract
- Purpose - In order to improve cooperation and collaboration between units, clinics and departments, many health care organizations (HCOs) have introduced process orientation. Several studies indicate problems in realizing these ambitions. The purpose of this paper is to explain and understand the success and failure of process orientation in HCOs. Design/methodology/approach - The authors conducted three case studies and applied Actor-Network Theory as an analytic lens. Findings - The realization of process orientation is hindered by neglect or resistance from physicians, who find the process targets to be of low medical priority. However, the authors also see that medical priorities are no stable entities but are susceptible to negotiations. Over time, process organization, process mapping, process measurement activities and the acting of enroled actors may have impact on medical priorities. Originality/value - Contrary to previous research, the findings indicate that New Public Management may not be the main obstacle against processes, that accounting figures may not be hard to disregard and that the role of leadership is not paramount.
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| 2. |
- Hellman, Stefan, et al.
(författare)
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Lean och processer i hälso- och sjukvården
- 2019
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Lean och styrning av processer är allt vanligare styrmetoder i hälso- och sjukvården. Introducerandet sker med förhoppning om ökad effektivitet: inte genom att alla springer snabbare, utan genom ett mer väl genomtänkt och planerat arbete. På så sätt kan onödiga moment reduceras, misstag minskas och mer värde för patienter skapas. Lean har införts på olika sätt i olika organisationer men har en kärna i dess betoning av helhetssyn och processer. Ambitionen i denna bok är att utifrån hälso-och sjukvårdens förutsättningar ge en nyanserad bild av fenomenet.
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| 3. |
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| 4. |
- Kastberg, Gustaf, et al.
(författare)
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The design and use of management accounting systems in process oriented health care : an explorative study
- 2013
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Ingår i: Financial Accountability and Management. - : Wiley-Blackwell. - 0267-4424 .- 1468-0408. ; 29:3, s. 246-270
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Tidskriftsartikel (refereegranskat)abstract
- Process orientation has made its entrance in Health Care Organizations (HCOs). The purpose is to improve patients’ journeys through the health care system. One factor that potentially affects process orientation is the design and use of Management Accounting Systems (MAS). In the literature there are worries that process orientation often is not supported by a well designed and used MAS but, on the contrary, is counteracted by a MAS designed for other purposes than supporting processes. This study contributes to the existing knowledge in that it shows how the introduction of process orientation within health care is accompanied by the development of horizontally oriented MAS (HMAS) which is used in different ways and by different actors. Generally, the use of HMAS for diagnostic control is limited. The main use of HMAS is for the purpose of mastering the events and interactive control, and the main users are the persons connected to the processes. The observation in earlier research that the existence of vertically oriented MAS may be a threat to process orientation is to some extent corroborated in the paper.
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| 5. |
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| 6. |
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| 7. |
- Kastberg, Gustaf, et al.
(författare)
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The role of management accounting and control in making professional organizations horizontal
- 2016
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Ingår i: Accounting, Auditing & Accountability Journal. - 1368-0668 .- 1758-4205 .- 0951-3574. ; 29:3, s. 428-451
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Tidskriftsartikel (refereegranskat)abstract
- Purpose - In the last decade, greater attention has been paid to the role of management accounting and control (MAC) in making professional organizations more horizontal. The authors argue that earlier research has not shown how the interrelatedness between professional identities and MAC influences attempts to make organizations more horizontal. In this paper the authors respond to the call for more research on the relationship between horizontalization and accounting and control. The purpose of this paper is to contribute to the emerging literature on the relationship between accountability arrangements and professional identities. Design/methodology/approach - Theoretically the authors have an actor-network theory (ANT) approach. Empirically, the authors followed two episodes where actors at top management levels in two Swedish health care organizations introduced horizontalization. Findings - The two episodes support the view that the role of MAC when making professional organizations more horizontal is limited. Professionals dominate what happens at the operational level and they do not act on MAC rules and performance targets in opposition of their professional identity. However, in alliance with other interessement devices MAC may have a role in creating overflows, that is, pointing out imperfections in the existing frame. The authors noticed no signs that professionals developed hybrid identities as in previous research. Originality/value - The authors apply ANT to move beyond the commonly used contingency and new institutional sociology perspectives.
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| 8. |
- Kastberg Weichselberger, Gustaf, 1976, et al.
(författare)
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Activity based financing of health care - experiences from Sweden
- 2007
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Ingår i: International Journal of Health Planning and Management. - : John Wiley & Sons, Ltd. ; 22:1, s. 25-44
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Tidskriftsartikel (refereegranskat)abstract
- The market-inspired control models that go under the name of New Public Management (NPM) are no longer being debated in the arena of public health care as they once were, although there are still very clear signs of NPM in many countries. One manifestation of NPM in health care is activity-based financing. The first purpose of this paper is to describe what impacts activity-based financing has had in Sweden's public health service. The second purpose is to explain why the application of the payment model has been gradually changed. The basis for the paper comprises research done on activity-based financing. The review of the development within Swedish health care regarding activity-based financing shows that effects appear. But it also becomes evident that the models often are adjusted and that the adjustments, for example the introduction of a production ceiling, changes the effects. The fundamental dilemma appears to be finding a balance between production efficiency and total cost control.
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| 9. |
- Kastberg Weichselberger, Gustaf, 1976, et al.
(författare)
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Lean and process-orienting health care : linking and disentangling activities
- 2017
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Ingår i: Qualitative Research in Accounting & Management/Emerald. - 1176-6093 .- 1758-7654. ; 4:4, s. 390-406
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Tidskriftsartikel (refereegranskat)abstract
- PurposeOne of the latest trends within public administration and healthcare organizations (HCOs) is process orientation, often in the shape of Lean management. The purpose of this study is to expand our understanding of process orientation of HCOs and the more specific aim is to investigate what measures are taken to re-frame the HCOs to include the process dimension.Design/methodology/approachThis empirical study is based on 67 interviews and 20 meeting observations.FindingsThe main observation in this study is that introducing process-oriented management solutions is about disconnecting and cutting-off existing links. The authors see how attempts are made to cut-off links to the logic of functional specialization, the autonomy of the professional worker, equal treatment of patients and other objectives.Originality/valueThis study adds to and expands previous studies that have problematized the use of Lean-inspired ways of organizing in the public sector.
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| 10. |
- Kastberg Weichselberger, Gustaf, 1976, et al.
(författare)
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The role of management accounting and control in making professional organizations horizontal
- 2016
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Ingår i: Accounting Auditing & Accountability Journal. - : Emerald. - 0951-3574. ; 29:3, s. 428-451
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose - In the last decade, greater attention has been paid to the role of management accounting and control (MAC) in making professional organizations more horizontal. The authors argue that earlier research has not shown how the interrelatedness between professional identities and MAC influences attempts to make organizations more horizontal. In this paper the authors respond to the call for more research on the relationship between horizontalization and accounting and control. The purpose of this paper is to contribute to the emerging literature on the relationship between accountability arrangements and professional identities. Design/methodology/approach - Theoretically the authors have an actor-network theory (ANT) approach. Empirically, the authors followed two episodes where actors at top management levels in two Swedish health care organizations introduced horizontalization. Findings - The two episodes support the view that the role of MAC when making professional organizations more horizontal is limited. Professionals dominate what happens at the operational level and they do not act on MAC rules and performance targets in opposition of their professional identity. However, in alliance with other interessement devices MAC may have a role in creating overflows, that is, pointing out imperfections in the existing frame. The authors noticed no signs that professionals developed hybrid identities as in previous research. Originality/value - The authors apply ANT to move beyond the commonly used contingency and new institutional sociology perspectives.
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