| 1. |
- Quist, Johan, 1971-
(författare)
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Att översätta TQM : - en longitudinell studie kring reflekterande aktörer
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This doctoral thesis focuses on translating Total Quality Management (TQM). The reason for this focus is that ideas such as TQM rarely or never contain a complete description of how the idea is to be “installed” in an organisation if it is to achieve the intended result. This often has the consequence that the result the idea is expected to produce in the organisation is only achieved in part, if at all. In Sweden there has been a great interest in working with the SIQ Model for Performance Excellence. In the thesis the model is viewed as an operationalisation of the TQM concept.The theoretical perspective of sensemaking is applied to understand what happens when organisations begin to use the model. This work is in the thesis seen as a translation process and contrasts the rational view of implementation. The sensemaking perspective rests on a social constructionist viewpoint, which distinguishes it from the view that TQM has on organisations. The study is placed in the interpretative paradigm and two service organisations in public sector have been studied with a longitudinal design.The main contribution of the study is a new way of looking at the work with the model. Thus, the interpretations could be seen as aspects, which together present a detailed description of the translation process. These aspects are, in summary, a way of looking upon and understanding:• the translation process as a number of parallel and reciprocal processes• the role of the translators• the relationship between translators and top management• the contextual prerequisites of the translation process.In addition to this, the thesis can work as a driving force towards a more constructive and critical attitude among practitioner of TQM. The somewhat seductive rhetoric and the risk to work with the model without an apparent intention are highlighted in the study. It seems that the model in itself can lead to collective sensemaking that gets the work done without discussing the intention. In light of the interpretations it becomes clear that working with the model is a relatively complicated process. Many of the failed attempts to reach excellence could be explained by unrealistic expectations of the character and requirement of the work. In the thesis, the translator has been introduced as a counterbalance that possibly could help dealing with the complexity of TQM.
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| 2. |
- Lilja, Johan
(författare)
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The Realization of Attractive Quality : Conceptual and practical perspectives within the TQM system
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Within the quality community, quality management is often pictured as and referred to as rapidly evolving and continuously learning by interaction with the surrounding world. In general, an ability to evolve and transform is also seen as most desirable and the only choice for long term survival. In line with this picture, quality scholars, consultants, and practitioners strongly accentuate the necessity and great benefits from continuous improvement as well as systematic collection and usage of facts about what customers really value, to guide such improvement. This is reflected in the exhortations “improve continuously”, “focus on the customer” and “base decisions on facts”, found with minor variations in most modern quality literature. Strong exhortations mainly directed outwards, towards the many leaders and organizations out there. Towards leaders and organizations that still have not grasped the necessity and great winnings from continuous improvement, that are still not fully applying modern quality initiatives like Total Quality Management (TQM). However, while seemingly being busy exhorting others, doubts have been increasingly raised concerning whether TQM, as currently applied, actually lives up to these exhortations. Does TQM itself continuously improve and evolve? Is the current application of TQM really taking into account facts in the surrounding world about what customers value? When viewing TQM as a system, as now is commonly done, the problem implied is a lack of system goal fulfillment, questioning if the current TQM system’s structure and processes are really purposeful. More specifically the critics highlight the inadequacy of the current reactive one-sided defect avoidance focus, stressing that defects do not matter much if you are making a product no one wants to buy. What can be referred to as “an obsession with error avoidance” is in fact shown to stifle both innovation and value creation. As for what the TQM system currently is missing, the shortcoming is often referred to as a lack of focus on Attractive Quality. That is, a lack of focus on a different kind of quality elements, often described as being unrelated to the dissatisfaction expressed, but strongly contributing to the customer’s positive emotions, such as delight. The inclusion and realization of Attractive Quality has been widely emphasized as important and urgent for more than 20 years. However, a more systematic inclusion and realization within the TQM system has remained no more than merely “a vision”. A situation seemingly supporting the argument that TQM really has failed in terms of continuously evolving and improving. An inability to learn and adapt that in the long term will jeopardize the survival of the entire TQM system. This thesis then aims to move “from a vision to reality” both in terms of exploring the realization of Aattractive Qquality within TQM, and in a wider sense towards realizing the desired state of TQM as truly evolving and alive. In doing so the thesis addresses the three questions of what, why and how the vision of a more systematic creation of Aattractive Qquality creation actually should and could be realized within the system of TQM. Among the results presented in this thesis are a new two-dimensional perspective on Attractive Quality and a re-understanding of the TQM system. The thesis also introduces a new methodology called Attraction Detection Study (ADS) as part of the concluding suggestions about how Attractive Quality could be more systematically created within the system of TQM.
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| 3. |
- Neubeck, Truls
(författare)
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Quality improvement within nonprofit social service providers
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- As a relatively new phenomenon in 2009, Swedish nonprofit social service providers proposed quality improvement as a way to reduce mistakes, use resources more effectively and meet the needs and expectations of clients in a better way. Although similar experiences have been studied in health care, the transfer of quality improvement to nonprofit social services gives a possibility for more knowledge on what enables, and constrains, systematic quality improvement in this specific context.This thesis is based on five years of supporting quality improvement in the Swedish nonprofit welfare sector. Specifically, it builds knowledge on which active mechanisms and enabling or constraining structures exist for nonprofit social service quality improvement. By studying quality improvement projects that have been conducted in the development program Forum for Values, critical cases and broad overviews are found valuable. These cases have resulted in four papers on quality improvement in nonprofit social services. The papers include: critical cases from a nursing home for elderly and a daycare for disabled children (Paper I); a critical case from a sheltered housing (Paper II); an overview of performance measurements in 127 quality improvement projects (Paper III); and an analytical model of how improvement policy and practice are bridged by intermediaries (Paper IV). In this thesis, enabled or constrained events and activities related to Deming's system of profound knowledge are identified from the papers and elaborated upon. As a basis for transforming practice into continuous improvement, profound knowledge includes the four knowledge domains: appreciation of a system, theory of knowledge, understanding of variation and psychology of change. From a realist perspective, the identified events are seen as enabled or constrained by mechanisms and underlying regularities, or structures, in the context of nonprofit social services.The emerging mechanisms found in this thesis are: describing and reflecting upon project relations; forming and testing a theory of action; collecting and displaying measurable results over time; and engaging and participating in a development program. The structures that enable these mechanisms are: connecting projects to shared values such as client needs; local ownership of what should be measured; and translating quality improvement into a single practice. Constraining structures identified are: a lack of generalizable scientific knowledge and inappropriate or missing infrastructure for measurements.Reflecting upon the emergent structures of nonprofit social services, the role of political macro structures, reflective practice, competence in statistical methods and areas of expertise becomes important. From this discussion and the findings some hypotheses for future work can be formulated. First, the identified mechanisms and structures form a framework that helps explain why intended actions of quality improvement occur or not. This frameworkcan be part of formulating a program theory of quality improvement in nonprofit social services. With this theory, quality improvement can be evaluated, reflected upon and further developed in future interventions. Second,new quality improvement interventions can be reproduced more regularly by active work with known enablers and constraints from this program theory. This means that long-lasting interventions can be performed and studied in a second generation of improvement efforts. Third, if organizations integrate quality improvement as a part of their everyday practice they also develop context-specific knowledge about their services. This context-specific knowledge can be adopted and further developed through dedicated management and understanding of variation.Thus, if enabling structures are invoked and constraining structures handled, systematic quality improvement could be one way to integrate generalizable scientific knowledge as part of an evidence-creating practice.
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| 4. |
- Asadi, Narges
(författare)
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Supporting flexibility in an assembly system through product design
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Increasing customer demands for product variety in conjunction with the short lifecycle of products has caused manufacturing companies to introduce a wide range of products by accommodating flexibility. An assembly system is an essential part of the manufacturing system from both cost and time perspectives. Hence, the shift towards flexibility in manufacturing companies highlights the significance of establishing flexible assembly systems and designing products that are closely aligned with them. Despite its significance, however, the flexible assembly system concept and its requirements for product design have not been clearly defined in research and from a practical point of view. Most research on flexible assembly systems has mainly approached either the design or the balancing and scheduling issues of these systems, whereas only a few studies have briefly defined the flexible assembly system they focused on, without further specifying the characteristics of a flexible assembly system and its requirements for product design.Taking that into account, the objective of this work is to provide a framework to contribute to the understanding of the concept of flexibility in an assembly system and its requirements for product design. In order to fulfil the objective, four empirical studies combined with literature reviews have been conducted. The empirical studies, a multiple case study and three single case studies, investigate the definition of flexibility in an assembly system as well as the requirements that a flexible assembly system imposes on product design.Through its findings, this research provides a definition of flexibility in assembly systems that mainly revolves around volume, mix and new product flexibility. In addition, six constituents of a flexible assembly system have been identified: adaptable material supply, versatile workforce, increased commonality, standardised work content, integrated product properties and strategic planning. Furthermore, three requirements of a flexible assembly system for product design are defined, which, if fulfilled, reduce the complexity created by product variety and consequently support flexibility in the assembly system. Accordingly, to increase the understanding of the concept of flexibility in an assembly system and its requirements for product design, a four-staged framework is suggested. The proposed framework deals with the activities related to the concept and the development of a flexible assembly system and is expected to be received by assembly practitioners as a link between assembly and product design teams in the product realisation process. Future research can further validate the framework in practice.
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| 5. |
- Holmström, Stefan, 1970-
(författare)
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Workplace stress measured by Job Stress Survey and relationships to musculoskeletal complaints
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main purpose of this thesis was to evaluate and test the Job Stress Survey (JSS, Spielberger, 1991; Spielberger & Vagg, 1999), a self-report instrument which assesses workplace stress. In the thesis a thorough evaluation is made of JSS scales and items, and the relations to health, particularly musculoskeletal complaints. The aim of Study I was to evaluate the factor structure and the psychometric properties of a Swedish version of the JSS. The instrument was distributed to medical service personal and metal industry workers (n=1186). Factor analyses demonstrated a good resemblance between the present version and the American original version. The results also showed that the internal consistencies, as well as the test-retest reliabilities of the scales are high, and the concurrent validity are good. Study II examined work-related stress measured by JSS for the subgroups of gender, industry workers and medical service personnel, and special attention was given to the problem of differential item functioning (DIF) on these subgroups. The main findings were that both gender and occupation has a substantial impact on specific sources of work-related stress assessed by JSS scales and individual items. The result of the DIF analyses showed no item bias in the gender subgroup, but for the occupational subgroups there where items showing DIF in two of the scales. These items do not jeopardize the conclusions made on scale level since the number of items showing DIF are too few to make an impact on the overall result on the different scales. In Study III the relation between self-reported stress and health, particularly musculoskeletal problems were examined longitudinally in two metal industry factories. Results showed high levels of stress and musculoskeletal complaints in these factories and significant and strong relationships between the JSS scales and musculoskeletal, as well as psychosocial ratings. Lack of Organizational Support was found to be more related to musculoskeletal pain than Job Pressure. Longitudinal differences were found between the factories and between different types of musculoskeletal complaints. The general conclusions from the studies are that the present version of JSS shows a good resemblance with the American original, and that JSS is a useful instrument for studying relationships between stress and health.
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| 6. |
- Löfgren, Martin, 1975-
(författare)
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The Leader of the Pack : A Service Perspective on Packaging and Customer Satisfaction
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Almost everything we as consumers buy in a store has a package. Packages have many functions – some, if not all, present marketers with the opportunity to gain competitive advantages. The packaging influences the usage behavior long after it has influenced the purchase, therefore it is an interesting empirical context to study within the field of marketing. Nevertheless, academic attention to packaging has been sparse over the last two decades even though the industry focus on packaging as a strategic tool has grown over that same period. Exceptions in the marketing literature are investigations of packaging and brand communication, advertisement-package coordination, and packaging size and shape. In contrast to the traditional approach that views packaging as a complimenting non-product-related attribute, it is suggested in this thesis that packaging is a product-related attribute that does affect the customers’ experiences of products.The overall aim of this thesis is to develop and test theoretical models and provide empirical evidence of customer experiences in the context of packaging from a service perspective. To study packaging from a service perspective is relevant for several reasons. One reason is that packaging can have several functions, which include more than the physical package. Another reason is that packages are carriers of information that is interpreted by customers. The combination of function, information, the physical package, and its content creates the total customer experience.The results of this thesis provide increased knowledge about packaging and customer experiences from a service perspective. On an attribute level, quality attributes such as protection and usability are categorized according to Kano’s theory of attractive quality. The results show that customers’ evaluations of packages are multi-dimensional. On a comprehensive or an overall level, structural equation modeling is used to investigate the consumption process. We conclude that the quality attributes of packages need to be designed to display quality both on the shelf in a store and during usage and consumption at both the attribute and comprehensive level.
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| 7. |
- Rasmussen, Gunlög, 1973-
(författare)
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Staphylococcus aureus bacteremia, molecular epidemiology and host immune response
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Staphylococcus aureus is a major pathogen responsible for a considerable disease burden worldwide. It may cause a wide array of infections, from superficial skin infections to invasive bacteremia and complications such as infective endocarditis (IE) and osteomyelitis. This thesis aimed to investigate aspects of the molecular epidemiology of S. aureus and host immune response in relation to disease manifestation, severity, and over time during S. aureus bacteremia (SAB).Genotypic characteristics in isolates causing colonization, bacteremia, and bacteremia with IE were studied. The S. aureus population was genetically diverse and certain clones with their set of often lineage-specific virulence genes were associated with invasive disease. Characterization of the long-term molecular epidemiology of MSSA bacteremia showed an increased prevalence of CC5 and CC15, while CC8, CC25 and CC30 declined. Antibiotic resistance pattern was favorable and unaffected.Further, different aspects of host immune response were explored in patients with SAB during the acute phase of bacteremia. When investigating the NLRP3 inflammasome signaling, induced caspase-1 activity was found, with a great inter-individual variation between patients, and subsequent release of IL-18, indicating inflammasome activity. Finally, the dynamics of MHC class II related genes HLA-DRA and CD74 were analyzed as markers of immunosuppression. Patients with complicated SAB had significantly lower HLA-DRA expression than patients with uncomplicated bacteremia, demonstrating an association between complicated SAB and impaired immune function.In conclusion, the S. aureus genotype, as well as host factors reflected by inter-individual variations in inflammasome signaling and immune function, may all contribute to disease manifestation and outcome during SAB. An ability to measure the immune response early and continuously during the hospital stay and course of bacteremia could offer a way to tailor patient management and treatment in an individualized way.
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| 8. |
- Scheer, Vendela, 1967-
(författare)
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Perioperative Strategies to Prevent Surgical Site Infection After Shoulder Surgery
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In Sweden, about 18 000 patients undergo shoulder surgery each year. The current surgical site infection (SSI) rate after planned shoulder surgery is 0,3-5 %, which means that approximately 300 people are affected each year in Sweden. Treatment of deep SSIs always involves at least one reoperation followed by long-lasting treatment with antibiotics. In addition to pain and reduced mobility, an SSI can also have a negative effect on mental health. It is not possible to pinpoint exactly what causes an SSI. However, in today´s modern operating theatres with ultra clean air, tightly woven gowns, and surgical practice that strictly adheres to aseptic guidelines, SSIs after orthopaedic surgery are predominately caused by bacteria from the patient’s skin.The aim of this thesis was to evaluate perioperative strategies to prevent surgical site infection after shoulder surgery, focusing on bacterial burden on the skin. Cutibacterium acnes (C. acnes), a skin commensal, thrives in the sebaceous glands and causes most infections after shoulder surgery. Despite strict standardised preoperative preparation with 0.5% chlorhexidine solution in 70% ethanol, studies have shown that C. acnes are only partially eradicated. Topical treatment with benzoyl peroxide (BPO) over several months has been used to treat acne vulgaris for more than 50 years.In two randomised studies, we compared prophylactic topical treatment with BPO (applied five times over a period of 48 hours before surgery), with a control group with no BPO treatment. In the BPO group, the burden of C. acnes prior to incision and at the end of the surgery decreased significantly.When studying the effects of skin preparation, the technique and method used to capture the microbiome while maintaining the skin’s barrier, is crucial. In a pilot study, we developed a novel Pencil Eraser Swab-technique (PES) and compared this with two established swab techniques. The PES-technique was found to be significantly better, both in terms of sensitivity in detecting C. acnes and in quantification of viable bacteria.Following closure of a surgical incision, the wound is re-epithelialised within 24-72 hours. Choice of dressing is usually a question of personal preference and tradition rather than evidence based. The degree of colonisation of bacteria beneath wound dressings with different occlusive properties is not known. To investigate this, we compared three wound dressings of varying permeability on healthy skin. After 48 hours we found that recolonisation of bacteria was significantly higher beneath the semipermeable and occlusive wound dressings, than beneath the airy (gauze) dressing.Perioperative reduction of the bacterial burden on the skin is important in the fight against surgical site infection. A reliable technique to capture bacteria is essential when evaluating different methods.
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| 9. |
- Bergman, Johan, 1973-
(författare)
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Kulturfolk eller folkkultur? : 1968, kulturarbetarna och demokratin
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cultural folk or folk culture? 1968, cultural workers and democracy. In the early 1960’s it became clear that although Swedish citizens had experienced an overall increase in material well-being and political democracy, there were still severe shortages in terms of cultural democracy. The radicalisation of the 1960’s meant that students and leftist artists were to play an important part in attempts to rectify this — both as idea-bearers and policy-makers. Using the debates of cultural democracy as a starting point, this thesis focuses on how leftist radical “cultural workers” aimed at democratising culture during the 1960’s and the 1970’s. Demands were raised for a fundamental shift in focus from the context of cultural production (and, accordingly, the producers) to cultural consumption and the consumers. The study follows a cultural democratic tendency that expanded from established theatre institutions during the 1960’s over to the radical so-called “free” theatre groups, the progressive music movement and the textile collectives of the 1970’s. By comparing three organisations within the fields of theatre, music and textile respectively, both general and specific conditions and dilemmas that characterised these branches are analysed. The democratisation of culture during the 1970’s led to processes of professionalisation and politicisation. In these developments, authoritative criteria for what constituted “true” art were called upon. These measures can be understood both as a consequence of the actors’ ambition to reduce competition that resulted from producing culture on a market, but also as a way of gaining cultural status. Despite various revolutions within different cultural areas the agents agreed on one thing; the absolute right of an autonomous cultural field to exist. This meant that the battle of defining “true art” was about something real and precisely therefore a battle worth fighting.
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| 10. |
- Cronemyr, Peter, 1963-
(författare)
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Six Sigma management. Action research with some contributions to theories and methods.
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Many companies around the world have implemented Six Sigma as a problem solving methodology especially useful for dealing with recurring problems in business processes. Since the 1980s when it was developed at Motorola, many companies have tried to implement Six Sigma to fit their own company’s culture and goals. This thesis presents a longitudinal case study describing the evolution of ‘Six Sigma Management’ at Siemens in Sweden. The success of the programme was to a large degree built on previous failures, confirming Juran’s old saying ‘Failure is a gold mine’. From the case study, success factors for implementing Six Sigma at Siemens are identified and compared to those given in the literature. Some of the most critical success factors identified at Siemens had not been mentioned as such in the literature before. The main conclusion of the study is that, in order to succeed and get sustainable results from a Six Sigma programme, Six Sigma should be integrated with Process Management, instead of just running Six Sigma as a separate initiative in an organisation. Furthermore, the thesis includes papers presenting methods and tools to be used in a Six Sigma programme or in Six Sigma projects. They deal with: how to identify suitable Six Sigma projects, how to select which Six Sigma methodology to use, how to find hidden misunderstandings between people from different knowledge domains, and how to simulate the impact of improvements to iterative processes. All these methods and tools have been developed and tested at Siemens. This has been an action research project, where the author has been employed by the company under investigation for eleven years and has actively influenced the changes in the company based on knowledge gained at the company as well as on research studies conducted at universities. In action research the change initiative under investigation is conducted and analysed in a single context. The readers are invited to draw their own conclusions on the applicability of the results to their own specific cases. In addition to this, some conclusions derived using analytical generalisation, applicable to a more general case, are presented in the thesis.
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