| 1. |
- Larsson, Ida, 1977-
(författare)
-
Att översätta Lean till praktik i hälso- och sjukvården
- 2019
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Lean has been widely discussed and introduced in Sweden as well as internationally. This thesis deals with the question of how Lean has been translated from idea into practice in healthcare. It contributes to Scandinavian institutional theory, more specifically translation theory. The thesis shows how Lean is translated at the micro level, i.e. at two healthcare units that deal directly with patients. Lean is quite a broad and flexible management idea. In this thesis Lean has been specified into the central concepts of value and flow. The thesis focuses on how these concepts have been translated in healthcare, investigating the role of translators and arenas in local translation processes at the micro level. The thesis is based on a comparative case study of two healthcare units, at two different hospitals, within public healthcare. In 2009 the healthcare units started to implement Lean with the aim that they would improve patient flow and increase quality. The thesis includes a vast number of internal documents, interviews and observations. It also includes a follow-up of the two cases a few years after the initial interviews were carried out. The study presents a number of contributions. Analysis shows that the local translation process in each case resulted in a mutual adaptation between Lean and practice. Furthermore, the introduction of Lean didn´t change the work of the units completely. Lean was translated in a way that supported how the units were organized already before the introduction of Lean instead of changing them. The analysis also shows that the translation of Lean was not isolated within the healthcare units, but spilled over into and was influenced by the surrounding context, both to the private sphere and to other organizations. The findings indicate that translation is something that is going on everywhere, all the time and that the connection between the public and the private sphere, through conversations and small talk about Lean, can be a way of spreading and translating ideas. The introduction of Lean at the units started as a top-down process. But Lean was also translated horizontally to and from friends and family members who had met Lean in other contexts. The translators and arenas at the micro-level filled an important function in the way in which Lean was translated into practice in the operational core where small talk and discussions seemed to be important. But in addition to this the thesis also shows that an actor in a formal position is required to add energy and drive the work with Lean forward.
|
|
| 2. |
- Magnusson, Eva Maria, 1947-
(författare)
-
Vad händer i själva verket? : Om styrning och handlingsutrymme i Skolverket under åren 1991–2014
- 2018
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis deals with questions of governance, control and discretion in state agencies. It is grounded on a case study of the Swedish National Agency for Education (Skolverket), from its prelude in the late 1980s, to its start in 1991, through several governments, seven ministers and four direktor generals, up tp 2014.The empirical part of the thesis follows the periods of the four director generals. The study is based on a vast number of documents, supplemented with interviews. For the analysis, a model of governance and control was condensed from the literature. This model attempts to cover both the political governing of agencies and the internal organizational control of agencies. This model was furthermore developed into three ideal type control styles: Old public management/ Agency, New public management/ Actor, and New public governance/ Arena.Analysis showed that Skolverket started out as a new type of agency, resembling the ideal type of NPG/ Arena, but over time, with an increasing pressure from the political level, it gradually turned into a more “normal” state agency, at one period resembling the ideal type of NPM/ Actor but finally becoming more similar to the ideal type of OPM/ Agent, however with still strong internal traits of an Arena.Further analysis showed that the actual governance and control featured several crucial characteristics that proved to be of importance for the amount of discretion left for the directors and officials of the agency. These characteristics were the degree of 1) unified or plural value systems, 2) partial or comprehensive use of control “tools”, and 3) high or low degree of specificity. These three characteristics were combined into eight different types of roles, each with a specific type and level of discretion, from the most restricted (“Authoritarian”) to the most unrestricted (“Laissez-faire”) and six other roles in between. It is proposed that this scheme of roles form a novel way of analysing the level and distribution of discretion in agencies.
|
|
| 3. |
- Sjölander, Anders
(författare)
-
Den naturliga ordningen : Makt och intressen i de svenska sparbankerna 1882-1968
- 2003
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis has been to analyse how savings banks were integrated into the Swedish financial system from the end of the 19 th century until 1968. The study has focused on two questions. The fist deals with different viewpoints regarding the role of Savings banks in the credit market and which of these viewpoints had an impact on the regulation of savings banks. The second questions studied in this thesis concerns which actors had control over the savings banks and their regulation. In this thesis I have shown that the question of the role of savings banks in the financial system is complex. During the entire period being studied, savings banks were local organisations and the ideas that were put forward regarding their role on the credit market were greatly affected by how the credit market were organised on the local level. Sudden changes were rare within the savings banks' movement. As I have shown, during the period being studied, there were many different points of view regarding the role of savings banks in the financial system. Without outside pressure in the form of legislation, however, the savings banks themselves would hardly have succeeded in agreeing on and developing new operations. The slow but apparent changes in the position of savings banks on the Swedish financial market were closely connected to changes in power structures in Swedish society. Up until the inter-war period, the local elite - both economic and political - were closely involved with the development of savings banks. Gradually, however, national elite groups, that is political parties and the savings banks' central organisation, increased their control over local savings banks. At the same time as this change strengthened the role of savings banks as in some measure a public organisation, it also helped to expand their sphere of activity.
|
|
| 4. |
- Vähämäki, Janet, 1973-
(författare)
-
Matrixing Aid : The Rise and Fall of 'Results Initiatives' in Swedish Development Aid
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Reform ideas, such as results measurement and management, tend to come and go in different ‘tides of reforms’. The purpose of this thesis is to increase our understanding of tides of reforms by identifying and discussing mechanisms that drive the rise, as well as the fall, of management reforms. This is done by studying four so-called ‘results initiatives’ launched at Sida, the Swedish International Development Agency in 1971, 1981, 1998 and 2012. The thesis tries to understand what happened both in Sida’s external environment as well as within the agency prior to the initiation, during implementation and when the four results initiatives fell out of favor.The life of each of the four results initiatives can be understood as having taken place in five phases: 1) the pressure phase, 2) the launch, 3) implementation, 4) point of re-do or die, 5) phase of opening up for something new. During these five phases different internal and external mechanisms contributed to either further institutionalization or to de-institutionalization of the results measurement and management ideas and technologies.It is argued that the need to gain legitimacy can be seen as the main mechanism that has driven the initiation of the results initiatives. During implementation, problems and difficulties arise. It is argued that whilst resistance towards the initiatives, as well as changed external demands, accelerates de-institutionalization, these mechanisms do not explain why the initiatives fall. In turn, the failure to find a standardized reporting category for “results”, the non-use of the results information produced and the fact that the initiatives no longer fulfill the function of providing legitimacy, are mechanisms that lead to the final death of the initiatives.The study concludes that whilst different external pressures can be considered important in initiating reforms, it is mainly internal mechanisms, within the organization, that explain the reason why the initiatives fall. Earlier literature has argued that tides of reforms are driven by hope and optimism to be and to be seen as effective. The findings in this study show that also the solidarity rationale, i.e. the wish to do good for someone else, and the feeling of doing so, drives the reforms. It is moreover argued that the reforms are also driven by fear and other emotions. In general, the occurrence of tides of reforms can be understood by the tension between the two rationales in development aid: solidarity and effectiveness.The study contributes with insights to what happens within an organization and over a longer time perspective when public agencies are faced with conflicting demands. It provides a broader understanding of reasons behind the quest to report on results and also what happens when results are not reportable. Since new and similar reforms will most probably arise in the future, findings from this study ought to be interesting not only in development aid but in all public policy sectors, for any policy maker or practitioner involved in the implementation of such reforms.
|
|
| 5. |
- Jüriado, Rein
(författare)
-
Learning within and between public-private partnerships
- 2008
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Local and national governments face increasing demands for modern, high-quality public services. To meet these challenges, a growing number of public organisations has, in the past few decades, ventured into public-private partnerships (PPP), a novel approach to improving public services by using the expertise accumulated in the private sector. Given that PPPs are often established for complex infrastructure projects, which may last for several decades and involve considerable investment from the partners, learning both within and between public-private partnerships is of utmost importance.Triangulation is employed in this dissertation to explore who learns, what is learned and how learning occurs in PPPs. Three case studies from Estonia and Sweden provide the main empirical insight into the topic. In addition, findings from expert interviews carried out at the European Investment Bank and a pan-European database of over 800 PPPs are compared with the case study results.The dissertation finds that public-private partnerships challenge existing theories on organisational learning because learning dynamics in PPPs take a different form than that found in strategic alliances. Organisational learning in public-private partnerships can be understood as occurring on five interrelated levels, each of which is characterised by a specific set of indicators put forward in this dissertation. The indicators take into account the creation and development of routines, flexibility, absorption of new knowledge, and informal learning. A managerial implication of the study is that institutional support for learning is likely to remain in the shadow of private sector consultancies unless the role of the PPP knowledge centres is rethought.
|
|
