| 1. |
- Olsson, Jesper, et al.
(författare)
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System characteristics of healthcare organizations conducting successful improvements
- 2007
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Ingår i: Journal of Health Organization & Management. - : Emerald. - 1477-7266 .- 1758-7247. ; 21:3, s. 283-296
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Tidskriftsartikel (refereegranskat)abstract
- Purpose - In a previous study, based on a survey to all clinical department and primary care center managers in Sweden, it was concluded that the prevailing general improvement strategy is characterized by: drivers for improvement are staff needs, patients and data are not as important, improvements mainly focus on administrative routines and stress management, improvements are mainly reached, by writing guidelines, and conducting meetings, the majority of managers perceive outcomes from this strategy as successful. The purpose of current research in this paper is to investigate whether there is any other improvement strategy at play in Swedish health care. Design/methodology/approach - Data from the study of all Swedish managers were stratified into two populations based on an instrument predicting successful improvement. One population represented organizations with exceptionally high probability of successful imrpovement and remaining organizations represented the general improvement strategy. Findings - The paper finds that organizations with high probability for successful change differed from the comparison population at the p=0.05 level in many of the surveyed characteristics. They put emphasis on patient focus, measuring outcomes, feedback of data, interorganizational collaboration, learning and knowledge, communication/ information, culture, and development of administration and management. Thus these organizations center their attention towards behavioral changes supported by data. Practical implications - Organizations predicted to conduct successful improvement apply comprehensive improvement strategies as suggested in the literature. Such actions are part of the Patient Centered Task Alignment strategy and it is suggested that this concept has managerial implications as well, as it might be useful in further studies on improvement work in health care. Originality/value - This paper provides empirically based findings on a successful improvement strategy that can aid research-informed policy decisions on organizational improvement strategies. © Emerald Group Publishing Limited.
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| 2. |
- Böling, Susanna, et al.
(författare)
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No ordinary consultation : a qualitative inquiry of hospital palliative care consultation services
- 2020
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Ingår i: Journal of Health Organization and Management. - : Emerald Group Publishing Limited. - 1477-7266. ; 34:6, s. 621-638
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – Considering the great need for palliative care in hospitals, it is essential for hospital staff to havepalliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care.However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need forfurther knowledge about the process of palliative consultations. The purpose of this study therefore was toexamine how palliative consultations in hospitals are practised, as perceived by consultants and health careprofessionals on receiving wards.Design/methodology/approach – Focus groups with palliative care consultation services, health carepersonnel from receiving wards and managers of consultation services. Interpretive description and constantcomparative method guided the analysis.No ordinaryconsultationThe authors would like to thank participating colleagues for sharing their knowledge and experiencesabout palliative consultations.Ethics approval and consent to participate: The project received ethical approval from the SwedishEthical Review Authority, No. 809–16. Informed consent preceded participation for all of the participants.Consent for publication: Not applicable.Availability of data and material: The datasets generated and analysed during the current study are notpublicly available due to the inclusion of potentially sensitive individual data about health status. Theethical approval includes a statement that the data will be kept in a private repository but are availablefromthe corresponding author on reasonable request.Funding: Sahlgrenska Academy at the University of Gothenburg.Authors' contributions: JO, HB and JB planned the study. All authors conducted focus group €interviews. Analysis and interpretation of focus group data was performed by SB with support from JO, €HB and JB. SB wrote the first draft of the manuscript, JO, HB and JB commented on the manuscript and €contributed to the final version. The final manuscript was read and approved by all authors.Competing interests: The authors declare that they have no competing interests.The current issue and full text archive of this journal is available on Emerald Insight at:https://www.emerald.com/insight/1477-7266.htmReceived 14 April 2020Revised 24 June 2020Accepted 2 July 2020Journal of Health Organization andManagement© Emerald Publishing Limited1477-7266DOI 10.1108/JHOM-04-2020-0130Findings – Variations were seen in several aspects of practice, including approach to practice and representedprofessions. The palliative consultants were perceived to contribute by creating space for palliative care,adding palliative knowledge and approach, enhancing cooperation and creating opportunity to amelioratetransition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultationservices utilised proactive practices that took the initiative in relation to the receiving wards.Originality/value – A lack of policy and divergent views on how to conceptualise palliative care appeared tobe associated with variations in consultation practices, tentative approaches and a bottom-up drivendevelopment. This study adds knowledge, implying theoretical transferability as to how palliative careconsultations can be practised, which is useful when designing and starting new consultation services.
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| 3. |
- Andersson, Johanna, et al.
(författare)
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Actor or arena : Contrasting translations of a law on interorganizational integration
- 2012
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Ingår i: Journal of Health Organization & Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 26:6, s. 778-793
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – A Swedish framework law has enabled integration between public agencies in vocational rehabilitation. With the support of this law, coordination associations can be formed to fund and organize joint activities. The purpose of this study is to describe and analyze how the law has been interpreted and translated into local coordination associations and how local institutional logics have developed to guide the organization of these associations. Design/methodology/approach – Data was collected through observations of meetings within two coordination associations and supplemented with documents. The material was analyzed by compilation and examination of data from field notes, whereupon the most important aspects were crystallized and framed with institutional organization theory. Findings – Two different translations of the law were seen in the associations studied: the association as an independent actor, and as an arena for its member organizations. Two subsequent institutional logics have developed, influencing decisions on autonomy, objectives and rationality for initiating and organizing in the two associations and their activities. The institutional logics are circular, further enhancing the different translations creating different forms of integration. Research implications/limitations – Both forms of integration are legitimate, but the different translations have created integration with different degrees of autonomy in relation to the member organizations. Only a long-term analysis can show whether one form of integration is more functional than the other. Originality/value – This article is based on an extensive material providing insights into a form of interorganizational integration which has been scarcely researched. The findings show how different translations can influence the integration of welfare services.
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| 4. |
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| 5. |
- Andersson, Johanna, 1981, et al.
(författare)
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Constructing accountability in inter-organisational collaboration: the implications of a narrow performance-based focus
- 2014
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Ingår i: Journal of Health Organization and Management. - 1477-7266. ; 28:5, s. 619-634
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Purpose – The purpose of this paper is to analyse how accounts of collaboration practice were made and used to construct accountability in the empirical context of coordination associations, a Swedish form of collaboration between four authorities in health and social care. They feature pooled budgets, joint leadership and joint reporting systems, intended to facilitate both collaboration and (shared) accountability. Design/methodology/approach – Empirical data were collected in field observations in local, regional and national settings. In addition, the study is based on analysis of local association documents such as evaluations and annual reports, and analysis of national agency reports. Findings – Accountability is constructed hierarchically with a narrow focus on performance, and horizontal (shared) accountability as well as outcomes are de-emphasised. Through this narrow construction of accountability the coordination associations are re-created as hierarchical and accountability is delegated rather than shared. Research limitations/implications – Features such as pooled budgets, joint leadership and joint reporting systems can support collaboration but do not necessarily translate into shared accountability if accountability is interpreted and constructed hierarchically. Practical implications – When practice conforms to what is counted and accounted for, using the hierarchical and narrow construction of acco untability, the result may be that the associations become an additional authority. That would increase rather than decrease fragmentation in the field. Originality/value – This research derives from first-hand observations of actor-to-actor episodes complemented with the analysis of documents and reports. It provides critical analysis of the construction and evaluation of accounts and accountability related to practice and performance in collaboration. The main contribution is the finding that despite the conditions intended to facilitate inter-organisational collaboration and horizontal accountability, the hierarchical accountability persisted.
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| 6. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Clinicians' psychological empowerment to engage in management as part of their daily work
- 2022
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Ingår i: Journal of Health Organization & Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 36:9, s. 272-287
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of the article is to analyze how physicians and nurses, as the two major health care professions, experience psychological empowerment for managerial work. Design/methodology/approach: The study was designed as a qualitative interview study at four primary care centers (PCCs) in Sweden. In total, 47 interviews were conducted, mainly with physicians and nurses. The first inductive analysis led us to the concept of psychological empowerment, which was used in the next deductive step of the analysis. Findings: The study showed that both professions experienced self-determination for managerial work, but that nurses were more dependent on structural empowerment. Nurses experienced that they had competence for managerial work, whereas physicians were more ignorant of such competence. Nurses used managerial work to create impact on the conditions for their clinical work, whereas physicians experienced impact independently. Both nurses and physicians experienced managerial work as meaningful, but less meaningful than nurses and physicians' clinical work. Practical implications: For an effective health care system, structural changes in terms of positions, roles, and responsibilities can be an important route for especially nurses' psychological empowerment. Originality/value: The qualitative method provided a complementary understanding of psychological empowerment on how psychological empowerment interacted with other factors. One such aspect was nurses' higher dependence on structural empowerment, but the most important aspect was that both physicians and nurses experienced that managerial work was less meaningful than clinical work. This implies that psychological empowerment for managerial work may only make a difference if psychological empowerment does not compete with physicians' and nurses' clinical work.
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| 7. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Nurturing innovative culture in a healthcare organisation : Lessons from a Swedish case study
- 2022
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Ingår i: Journal of Health Organization & Management. - : Emerald Publishing. - 1477-7266 .- 1758-7247. ; 37:9, s. 17-33
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Healthcare organisations are often described as less innovative than other organisations, since organisational culture works against innovations. In this paper, the authors ask whether it has to be that way or whether is possible to nurture an innovative culture in a healthcare organisation. The aim of this paper is to describe and analyse nurturing an innovative culture within a healthcare organisation and how culture can support innovations in such a healthcare organisation. Design/methodology/approach: Based on a qualitative case study of a healthcare unit that changed, within a few years, from having no innovations to repeatedly generating innovations, the authors describe important aspects of how innovative culture can be nurtured in healthcare. Data were analysed using inductive and deductive analysis steps. Findings: The study shows that it is possible to nurture an innovative culture in a healthcare organisation. Relationships and competences beyond healthcare, empowering structures and signalling the importance of innovation work with resources all proved to be important. All are aspects that a manager can influence. In this case, the manager's role in nurturing innovative culture was very important. Practical implications: This study highlights that an innovative culture can be nurtured in healthcare organisations and that managers can play a key role in such a process. Originality/value: The paper describes and analyses an innovative culture in a healthcare unit and identifies important conditions and strategies for nurturing innovative culture in healthcare organisations.
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| 8. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Patients' perceptions of quality in Swedish primary care - a study of differences between private and public ownership
- 2021
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Ingår i: Journal of Health Organization & Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 35:9, s. 85-100
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of the paper is to describe and analyze differences in patients' quality perceptions of private and public primary care centers in Sweden.DESIGN/METHODOLOGY/APPROACH: The article explores the differences in quality perceptions between patients of public and private primary care centers based on data from a large patient survey in Sweden. The survey covers seven dimensions, and in this paper the measure Overall impression was used for the comparison. With more than 80,000 valid responses, the survey covers all primary care centers in Sweden which allowed for a detailed analysis of differences in quality perceptions among patients from the different categories of owners.FINDINGS: The article contributes with a detailed description of different types of private owners: not-for-profit and for profit, as well as corporate groups and independent care centers. The results show a higher quality perception for independent centers compared to both public and corporate groups.RESEARCH LIMITATIONS/IMPLICATIONS: The small number of not-for-profit centers (21 out of 1,117 centers) does not allow for clear conclusions for this group. The results, however, indicate an even higher patient quality perception for not-for-profit centers. The study focus on describing differences in quality perceptions between the owner categories. Future research can contribute with explanations to why independent care centers receive higher patient satisfaction.SOCIAL IMPLICATIONS: The results from the study have policy implications both in a Swedish as well as international perspective. The differentiation between different types of private owners made in this paper opens up for interesting discussions on privatization of healthcare and how it affects patient satisfaction.ORIGINALITY/VALUE: The main contribution of the paper is the detailed comparison of different categories of private owners and the public owners.
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| 9. |
- Anell, Anders
(författare)
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Reconsidering performance management to support innovative changes in health care services
- 2024
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Ingår i: Journal of Health Organization and Management. - 1477-7266. ; 38:9, s. 125-142
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Tidskriftsartikel (refereegranskat)abstract
- PurposeA large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional consequences. The purpose of this article is to discuss new approaches to performance management in health care services when the purpose is to support innovative changes in the delivery of services.Design/methodology/approachThe article represents cross-boundary work as the theoretical and empirical material used to discuss and reconsider performance management comes from several relevant research disciplines, including systematic reviews of audit and feedback interventions in health care and extant theories of human motivation and organizational control.FindingsAn enabling approach to performance management in health care services can potentially contribute to innovative changes. Key design elements to operationalize such an approach are a formative and learning-oriented use of performance measures, an appeal to self- and social-approval mechanisms when providing feedback and support for local goals and action plans that fit specific conditions and challenges.Originality/valueThe article suggests how to operationalize an enabling approach to performance management in health care services. The framework is consistent with new governance and managerial approaches emerging in public sector organizations more generally, supporting a higher degree of professional autonomy and the use of nonfinancial incentives.
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| 10. |
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