| 1. |
- Hellman, Stefan, et al.
(author)
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Lean och processer i hälso- och sjukvården
- 2019
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Book (other academic/artistic)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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| 2. |
- Kastberg Weichselberger, Gustaf, 1976, et al.
(author)
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Activity based financing of health care - experiences from Sweden
- 2007
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In: International Journal of Health Planning and Management. - : John Wiley & Sons, Ltd. ; 22:1, s. 25-44
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Journal article (peer-reviewed)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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| 3. |
- Kastberg Weichselberger, Gustaf, 1976, et al.
(author)
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Lean and process-orienting health care : linking and disentangling activities
- 2017
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In: Qualitative Research in Accounting & Management/Emerald. - 1176-6093 .- 1758-7654. ; 4:4, s. 390-406
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Journal article (peer-reviewed)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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| 4. |
- Kastberg Weichselberger, Gustaf, 1976, et al.
(author)
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The role of management accounting and control in making professional organizations horizontal
- 2016
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In: Accounting Auditing & Accountability Journal. - : Emerald. - 0951-3574. ; 29:3, s. 428-451
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Journal article (peer-reviewed)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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| 5. |
- Siverbo, Sven, 1970, et al.
(author)
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Activity based financing of health care – experiences from Sweden
- 2005
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Reports (other academic/artistic)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 the public health services in many countries. Market-inspired control models are still being used and have strong advocates. The difference now is that there are fewer who believe that NPM is a universal solution to the problems of effectiveness in public health services. The purpose of this article is two-fold. The first purpose is to describe what impacts activity-based financing has had in Sweden’s public health service. This analysis has been guided by Pollit’s (2000) general observations that NPM reforms have effects on productivity, finances/savings, work processes, administrative capacity/flexibility and effectiveness. The second purpose is to explain why the application of the payment model has been gradually changed. Within the framework of both purposes it is appropriate to compare Sweden’s experience with some international observations.
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| 6. |
- Siverbo, Sven, 1970, et al.
(author)
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The impossible split? A Study of the Creation of a Market Actor
- 2008
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In: International Advances in Economic Research. - : Springer. - 1083-0898. ; 14, s. 65-75
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Journal article (peer-reviewed)abstract
- Quasi-markets have been created within the health care sector in many countries. One commonly used market model is the purchaser–provider split, which implies that purchasers use contracts to control the providers. A hierarchical organizational solution is replaced by a contractual relation. This article shows that creating quasi-markets in public organizations is complicated by the need to balance the market actors’ (the sub-units) autonomy and the efficiency of the entire public organization. The market actors have limited opportunities to work as autonomous units. The initial aim when creating market actors is to reduce their complexity by giving them distinct responsibilities and authorities. Reducing complexity in some parts of the organization, however, seems to cause problems in other parts. In the article, this effect is called quasi-market externalities or “overflows.” The overflows result in less autonomy for the market actor because the market frame has to be changed. Fiscal pressures, volatile political actors and strong professions are sources of overflow and subsequent changes in the market frame. The conclusion is that it is difficult, perhaps impossible, to create and maintain contractual relationships when both parties are dependent on the same principal.
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