| 1. |
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| 2. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Institutional Work Through Interaction in Healthcare
- 2017
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Ingår i: Academy of Management Proceedings. - : Academy of Management.
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Konferensbidrag (refereegranskat)abstract
- This study examines how interactions between individual actors can form institutional work in a highly institutionalized setting. Recent progress within the institutional logics perspective has directed focus to the roles of individual actors, their strategic actions, and how institutional logics may be interpreted and rebalanced. However, these contributions are founded on individual actors’ identity processes, but not on how institutional work can be performed through interactions among individual actors adhering to different institutional logics. We performed a qualitative case study, based on observations and interviews, with a focus on quality-improvement work performed in a hospital. The study affirmed that institutional work primarily maintains and upholds the rigidity of healthcare organizations, by interactions that either preserve the distance between different institutional logics or prevent their mutual influence on each other. However, when institutional work transcends maintaining – towards creating or disrupting – the interaction is characterized both by acts of claiming influence and acts of granting influence between actors adhering to different institutional logics. Nonetheless, these interactions are dependent upon the approaches of the physicians; such interactions start with the physicians either being granted influence or granting influence – influence that can later be claimed by the other actor. As such, although the coexistence of different institutional logics is currently an established phenomenon in healthcare, we illustrate how institutional work is contingent upon the dominating professional logic of physicians.
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| 3. |
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| 4. |
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| 5. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Understanding institutional work through social interaction in highly institutionalized settings : Lessons from public healthcare organizations
- 2020
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Ingår i: Scandinavian Journal of Management. - : Elsevier BV. - 0956-5221 .- 1873-3387. ; 36:2
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Tidskriftsartikel (refereegranskat)abstract
- The present study describes and analyses how social interactions between individual actors form institutional work in the highly institutionalized setting of healthcare organizations. Based on a qualitative case study, we affirm that social interactions mainly form maintaining institutional work, thus primarily upholding the rigidity of healthcare organizations. Social interactions either preserve distance between different actors or prevent their mutual influence, which decreases the effects of institutional complexity. However, when institutional work goes beyond maintaining, social interaction is characterized by processes of claiming influence and granting influence between individual actors who adhere to different institutional logics, which allows effects of institutional complexity. Such institutional work is contingent upon physicians' strong power position, and granting influence is likely to precede claiming influence.
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| 6. |
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| 7. |
- Eklund, Annika, 1981-, et al.
(författare)
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Samverkanskompetens
- 2023
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Ingår i: Samverkan i vården. - : Liber. - 9789147145416 ; , s. 196-208
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
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| 9. |
- Eriksson, Erik, 1977-, et al.
(författare)
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Collaborative Public Management : Coordinated Value Propositions among Public Service Organisations
- 2020
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Ingår i: Public Management Review. - : Taylor & Francis. - 1471-9037 .- 1471-9045. ; 22:6, s. 791-812
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Tidskriftsartikel (refereegranskat)abstract
- Drawing from collaborative public management, this article seeks to contribute topublic service logic by focusing on what precedes the public service user’s realizationof value: the value proposition. A new care model for elderly people with multiplechronic diseases shows that coordinators with an inter-organizational mission, ver-tical and horizontal supporting structures, trust established through relationships,and recognition of service systems’embeddedness in social systems are pivotal forthe ability of public service organizations to develop coordinated value propositions.The contribution to policy and practice is an increased understanding of a coherent,rather than fragmented, welfare system for users/citizens.
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| 10. |
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| 11. |
- Eriksson, Erik, 1977, et al.
(författare)
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One-size fits-all-lösningar fungerar sällan i vården
- 2019
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Ingår i: Dagens medicin. - 1104-7488.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- ”Låt oss diskutera hur de olika vetenskapliga traditionerna kan bidra till att förbättra vården”, det skriver Erik Eriksson och Christian Gadolin.
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| 12. |
- Eriksson, Erik, 1977, et al.
(författare)
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Post-New Public Management in Public Healthcare: Recycled, Hybridized, Paradigmatic?
- 2019
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Ingår i: British Academy of Management (BAM) 2019 Conference. - : British Academy of Management.
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Konferensbidrag (refereegranskat)abstract
- New Public Management (NPM) is increasingly used pejoratively and claimed unfit for the complex challenges in contemporary societies, for example aging population structures and, as a result, increased number of cancer patients. Consequently, post-NPM gains increased attention. Drawing from a longitudinal case in Swedish cancer care, the present article seeks to pinpoint post-NPM in public healthcare practice. It is revealed that some post-NPM aspects are recycled by combining traditional public administration (pre-NPM) and NPM aspects: the former’s re-professionalisation is combined with the latter’s foci on performance measures, decentralisation, and accountability. Other post-NPM aspects are hybridizing typical NPM aspects with new (post-NPM) aspects: for instance, customer-focus is taken further to include the patient’s active participation in co-designing services, and standardization is reinterpreted to concern meeting-places rather than efficiency. Yet other aspects are replacing NPM shortcomings: for instance, trust is replacing control, and a systems approach is replacing the intra-organisational focus
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| 13. |
- Eriksson, Erik, 1977-, et al.
(författare)
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Public management in turbulent times : COVID-19 as an ecosystem disruptor
- 2021
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Ingår i: Australian journal of public administration. - : John Wiley and Sons Inc. - 0313-6647 .- 1467-8500. ; 80:4, s. 732-747
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Tidskriftsartikel (refereegranskat)abstract
- The decentralisation of Swedish healthcare closer to citizens has been slow. Drawing from empirical material of the reform prior and amidst the COVID-19 pandemic, this paper argues that the pandemic has disrupted the healthcare ecosystem. Consequently, citizen-centred collaborations have accelerated integration of resources (such as knowledge and skills) across organisational, hierarchical and professional borders. However, collaborations have been delimited to traditional healthcare providers, neglecting the resources of citizens and other actors to be used to improve service delivery. The pandemic has revealed strengths and weaknesses with the prevailing healthcare ecosystem that post-COVID-19 public management must address, both theoretically and practically. Theoretically, the paper contributes to the development of a public service logic, addressing both strengths and difficulties with the logic in turbulent times. Practically, the empirical descriptions contribute to improved understanding of public service delivery reform and how it is impacted during the pandemic. © 2021 The Authors. Australian Journal of Public Administration published by John Wiley & Sons Australia, Ltd on behalf of Institute of Public Administration Australia.
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| 14. |
- Eriksson, Erik, 1977, et al.
(författare)
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Value Propositions in Public Collaborations : Regaining Organizational Focus Through Value Configurations
- 2022
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Ingår i: British Journal of Management. - : John Wiley & Sons. - 1045-3172 .- 1467-8551. ; 33:4, s. 2070-2085
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Tidskriftsartikel (refereegranskat)abstract
- There is consensus that complex problems of contemporary society call for public service collaborations. So-called public service logic (PSL) focuses on joint value creation among a multiplicity of actors in service ecosystems. Despite recognizing various actors, this logic is essentially user-centric, with the service user being the one realizing the value. Consequently, single and collaborating organizations cannot deliver value, only potential value, or so-called value propositions. The elusive public service logic takes a network value conguration for granted and as a starting point. Drawing from two cases in Swedish healthcare, this paper argues that two other value congurations (chain and shop) are also relevant for understanding the development of value propositions – and that these may be related to both intra- and inter-organizational processes. Theoretically, we conclude that just like public service logic, other collaborative public management theories need to recognize the importance of a multiplicity of value congurations and that these are often related to both intra- and inter-organizational processes. We conclude that managers should not adopt the latest network trends without first reflecting on the relevance of existing internal processes.
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| 15. |
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| 16. |
- Gadolin, Christian, 1987-
(författare)
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Att ge oss mer skam räddar inte klimatet
- 2019
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Ingår i: Aftonbladet. - : Aftonbladet Hierta AB. - 1103-9000 .- 1403-9656. ; :2019-09-12, s. 8-8
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 17. |
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| 18. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Barriers and enablers of coordination across healthcare system levels
- 2023
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Ingår i: Journal of Public Affairs. - : John Wiley & Sons. - 1472-3891 .- 1479-1854. ; 23:4, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Coordination across healthcare system levels is a global imperative to ensure efficient resource utilization and provide high-quality care. The substantial body of research on coordination in healthcare mainly concerns coordination across professional and organizational domains. Consequently, there is a dearth of empirical research aimed at delineating the determinants of coordination across healthcare system levels. This paper describes and analyses the barriers and enablers of healthcare coordination across national, regional, and local system levels in a populous Swedish region. Individual interviews and focus group discussions, encompassing a total of 63 individuals, were conducted with managers, administrators, and politicians. The findings of the paper underscore that the barriers identified were most often of a structural or institutional character, whereas the enablers of the studied cross-level coordination were mostly relational. Therefore, we propose that future research should aim to further delineate the prerequisites for personal relationships to emerge, as well as how they may act as enablers of coordination across healthcare system levels.
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| 19. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Complexity Leadership in a Public Sector Context : Exploring Adaptive Leadership Practices
- 2023
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Ingår i: Change Management. - : Common Ground Research Networks. - 2327-798X .- 2327-9176. ; 23:2, s. 63-81
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Tidskriftsartikel (refereegranskat)abstract
- The public sector is becoming increasingly complex. As complexity leadership theory has been formulated in order to understand leadership in such a context, it thus seems appropriate that it should inform public leadership research. However, the applicability of complexity leadership theory and the concomitant adaptive leadership practices have thus far been underexplored empirically in a public sector context. To address this omission, this article uses a qualitative case study to exemplify how adaptive leadership practices may manifest themselves in a public sector context. The article’s findings indicate that adaptive leadership practices that reduce, rather than induce, tension within the dynamics of actors’ interactions may be a more viable route to handle challenges within a public sector context. Future research could beneficially pay greater attention to the public sector context when studying how adaptive leadership practices might manifest themselves in public sector organizations, as well as when assessing the merits of complexity leadership theory in informing public leadership.
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| 20. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Complexity Leadership in a Public Sector Context : Exploring Adaptive Leadership Practices
- 2023
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Ingår i: Change Management. - 2327-798X .- 2327-9176. ; 23:2, s. 63-81
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Tidskriftsartikel (refereegranskat)abstract
- The public sector is becoming increasingly complex. As complexity leadership theory has been formulated in order to understand leadership in such a context, it thus seems appropriate that it should inform public leadership research. However, the applicability of complexity leadership theory and the concomitant adaptive leadership practices have thus far been underexplored empirically in a public sector context. To address this omission, this article uses a qualitative case study to exemplify how adaptive leadership practices may manifest themselves in a public sector context. The article’s findings indicate that adaptive leadership practices that reduce, rather than induce, tension within the dynamics of actors’ interactions may be a more viable route to handle challenges within a public sector context. Future research could beneficially pay greater attention to the public sector context when studying how adaptive leadership practices might manifest themselves in public sector organizations, as well as when assessing the merits of complexity leadership theory in informing public leadership.
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| 21. |
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| 22. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Därför avstår forskarna från offentlig debatt
- 2019
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Ingår i: Göteborgs-Posten. - Göteborg : Tidningsaktiebolaget Stampen. - 1103-9345. ; :2019-06-28
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 23. |
- Gadolin, Christian, 1987, et al.
(författare)
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Därför avstår forskarna från offentlig debatt
- 2019
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Ingår i: Göteborgs-Posten (GP). - 1103-9345. ; , s. 5-6
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Varför deltar forskare så sällan i den offentliga debatten? Det beror troligen på tre orsaker, skriver Christian Gadolin och Erik Eriksson.
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| 24. |
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| 25. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Healthcare quality improvement work : a professional employee perspective
- 2017
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald Publishing Limited. - 0952-6862 .- 1758-6542. ; 30:5, s. 410-423
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work.Design/methodology/approachQualitative case study based on interviews (n=27) and observations (n=10).FindingsThe main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute.Practical implicationsUnderstanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed.Originality/valueHealthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.
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| 26. |
- Gadolin, Christian, 1987-, et al.
(författare)
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How do healthcare unit managers promote nurses' perceived organizational support, and which working conditions enable them to do so? : A mixed methods approach
- 2022
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Ingår i: Scandinavian Journal of Psychology. - : John Wiley & Sons. - 0036-5564 .- 1467-9450. ; 63:6, s. 648-657
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Tidskriftsartikel (refereegranskat)abstract
- Healthcare unit managers are pivotal to promote nurses' Perceived Organizational Support and hence to ensure nurses' health and well-being, as well as high-quality care. Despite this fact, there is a dearth of studies addressing how healthcare unit managers act and organize their work to promote nurses' Perceived Organizational Support and which working conditions enable them to do so. Through a mixed methods approach, comprising qualitative interviews and quantitative surveys among healthcare unit managers and nurses, this paper underscores that healthcare unit managers' availability to their nursing staff was essential for their ability to promote nurses' Perceived Organizational Support, and that responsive support from the care unit managers' superior management, administration, and managerial colleagues constituted enabling working conditions. Superior manager support strongly promoted the care unit manager's own Perceived Organizational Support, which, in turn, was positively correlated with nurses' organizational climate of Perceived Organizational Support.
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| 27. |
- Gadolin, Christian, 1987-
(författare)
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Hur följer vi råden från staten?
- 2020
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Ingår i: Norrländska Socialdemokraten.
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 28. |
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| 29. |
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| 30. |
- Gadolin, Christian, 1987-
(författare)
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Kollegialt ledarskap är viktigt i vården
- 2018
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Ingår i: Dagens Samhälle. - Stockholm : Dagens Samhälle. - 1652-6511. ; :2018-11-27
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 31. |
- Gadolin, Christian, 1987-
(författare)
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Kompetens
- 2019
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Ingår i: Moderna policies. - Stockholm : Leading Health Care. - 9789198016987 ; , s. 56-79
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Bokkapitel (populärvet., debatt m.m.)
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| 32. |
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| 33. |
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| 34. |
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| 35. |
- Gadolin, Christian, 1987, et al.
(författare)
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Managing health care under heavy stress: Effects of the COVID-19 pandemic on care unit managers’ ability to support the nurses—A mixed-methods approach
- 2022
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 30:8, s. 4080-4089
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Tidskriftsartikel (refereegranskat)abstract
- Aim(s): This study aims to investigate care unit managers’ perceptions of how the COVID-19 pandemic influenced their ability to support the nurses. Background: The COVID-19 pandemic placed extreme pressure on health care organizations. More knowledge regarding how the pandemic influenced care unit managers’ ability to support nurses is central to ensuring high-quality health care in future crises. Method(s): A mixed-methods study in Swedish hospitals with a survey (n = 128) and interviews (n = 20) with care unit managers. Results: Approximately half of the managers reported having spent more time available to and supporting the nurses. Availability was positively predicted by their perceived organizational support while negatively by their job demands. These job demands concerned meeting staff anxiety and managing organizational restructuring. Full focus on direct patient care and strong professional and social support were important job resources. Conclusion(s): For care unit managers to effectively support the nurses during a crisis, they need proficient job resources and moderate job demands. Managers’ perceived organizational support positively affects the quality of their crisis leadership. Creating arenas in which staff collegiality can form and develop is beneficial for the ability to meet future crises. Implications for Nursing Management: This study specifies important job resources that should be acknowledged and reinforced to strengthen the ability of care unit managers to actively support the nurses during a crisis.
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| 36. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Managing Healthcare under Heavy Stress : Effects of the COVID-19 Pandemic on Care Unit Managers' Ability to Support the Nurses - A Mixed Methods Approach.
- 2022
-
Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 30:8, s. 4080-4089
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Investigate care unit managers' perceptions of how the COVID-19 pandemic influenced their ability to support the nurses.BACKGROUND: The COVID-19 pandemic placed extreme pressure on healthcare organizations. More knowledge regarding how the pandemic influenced care unit managers' ability to support nurses is central to ensuring high-quality healthcare in future crises.METHOD: A mixed-methods study in Swedish hospitals with a survey (n=128) and interviews (n=20) with care unit managers.RESULTS: Approximately half of the managers reported having spent more time available to and supporting the nurses. Availability was positively predicted by their perceived organizational support while negatively by their job demands. These job demands concerned meeting staff anxiety and managing organizational restructuring. Full focus on direct patient care, and strong professional and social support were important job resources.CONCLUSION: For care unit managers to effectively support the nurses during a crisis, they need proficient job resources and moderate job demands. Managers' perceived organizational support positively affects the quality of their crisis leadership. Creating arenas in which staff collegiality can form and develop is beneficial for the ability to meet future crises. Implications for Nursing Management This study specifies important job resources that should be acknowledged and reinforced to strengthen the ability of care unit managers to actively support the nurses during a crisis.
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| 37. |
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| 38. |
- Gadolin, Christian, 1987-
(författare)
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Olika styrningsideal behöver genomsyra och integreras i vården
- 2019
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Ingår i: Skaraborgs Allehanda. - Skövde : NWT-Gruppen. - 1403-3739. ; :2019-03-14, s. 2-
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Svensk sjukvård präglas av olika synsätt på hur verksamheten ska bedrivas. För att möta dagens och framtidens utmaningar måste chefer och medarbetare hitta större förståelse för varandras perspektiv.
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| 39. |
- Gadolin, Christian, 1987-
(författare)
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Orimligt att man tvingas ringa för att säga upp en tjänst
- 2022
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Ingår i: Göteborgs-Posten. - 1103-9345. ; :2022-11-05
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Debatt Att säga upp en betaltjänst ska vara lätt. Trots det så blir vi konsumenter ofta hänvisade att ringa kundtjänst när vi vill säga upp en tjänst, exempelvis ett telefonabonnemang. Att skapa hinder som gör uppsägning krångligt utgör inte bara en inskränkning av konsuments rättigheter utan kan dessutom utgöra en ordentlig olägenhet, skriver Christian Gadolin, docent i företagsekonomi.
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| 40. |
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| 41. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Preconditions for nurses' perceived organizational support in healthcare : a qualitative explorative study
- 2021
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Ingår i: Journal of Health Organization & Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 35:9, s. 281-297
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this paper is to inductively explore the context-specific preconditions for nurses' perceived organizational support (POS) in healthcare organizations. Design/methodology/approach: A qualitative interview study was performed, based on the critical incident technique (CIT), with 24 registered nurses in different specialities of hospital care. Findings: The nurses perceived three actors as essential for their POS: the first-line manager, the overarching organization and their college. The preconditions affecting the nurses’ perceptions of organizational support were supportive structuring and structures at work, as well as individual recognition and professional acknowledgement. Originality/value: Previous studies of POS have mostly had a quantitative outset. In this paper, context-specific preconditions for nurses' POS are described in depth, enabled by the qualitative approach of the study. The findings may be used to guide healthcare organizations and managers aiming to foster nurses' POS, and thereby, benefit nurses' well-being and retention, as well as healthcare quality and efficiency.
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| 42. |
- Gadolin, Christian, 1987-
(författare)
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Professional employees’ strategic employment of the managerial logic in healthcare
- 2018
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Ingår i: Qualitative research in organization and management. - : Emerald Group Publishing Limited. - 1746-5648 .- 1746-5656. ; 13:2, s. 126-143
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – The purpose of this paper is to describe and analyze how physicians and nurses strategicallyemploy the managerial logic.Design/methodology/approach – A qualitative case study incorporating interviews and observations.Findings – Neither physicians nor nurses were prone to strategically employing the managerial logic.However, when doing so nurses were able to acknowledge the legitimacy of managerial impact on practice,whereas the physicians were not. Consequently, physicians might find other, more subtle, ways tostrategically employ the managerial logic.Originality/value – This paper argues for and makes explicit the applicability of qualitative methods inorder to delineate actors’ strategic use of available and accessible institutional logics, the conditions for suchusage, as well as the multiplicity of actors’ interactions that needs to be taken into account when conductingqualitative data analysis of such occurrences. By the merits of the qualitative research approach utilized inthis study, novel insights concerning the strategic use of the managerial logic in the everyday work ofphysicians and nurses were obtainable. These insights emphasize the necessity of acknowledging situational,organizational and institutional context, incorporating inter-professional power discrepancies and relationsvis-à-vis managers.
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| 43. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Providing healthcare through “value shops” : impact on professional fulfilment for physicians and nurses
- 2020
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Ingår i: International Journal of Health Governance. - : Emerald Group Publishing Limited. - 2059-4631 .- 2059-464X. ; 25:2, s. 127-136
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this paper is to empirically explore and demonstrate the ability of healthcare professionals to attain professional fulfilment when providing healthcare inspired by “value shops”. Design/methodology/approach: A qualitative case study incorporating interviews and observations was conducted. Findings: The empirical data suggest that the professional fulfilment of both physicians and nurses is facilitated when care is organized through “value shops”. Both groups of professionals state that they are able to return to their “professional core”. Originality/value: The beneficial outcomes of organizing healthcare inspired by the “value shop” have previously been explored in terms of efficiency and quality. However, the professional fulfilment of healthcare professionals when providing such care has not been explicitly addressed. Professional fulfilment is vital in order to safeguard high-quality care, as well as healthcare professionals' involvement and engagement in implementing quality improvements. This paper highlights the fact that care provision inspired by the “value shop” may facilitate professional fulfilment, which further strengthens the potential positive outcomes of the “value shop” when utilized in a healthcare setting.
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| 44. |
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| 45. |
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| 46. |
- Gadolin, Christian, 1987-
(författare)
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Samhällets normer för styrning av vården
- 2022. - 2
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Ingår i: Jämlik vård. - Lund : Studentlitteratur AB. - 9789144151069 ; , s. 241-259
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 47. |
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| 48. |
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| 49. |
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| 50. |
- Gadolin, Christian, 1987-
(författare)
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The Influence of Policy Makers over Lean Implementations in Healthcare
- 2019
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Ingår i: International Journal of Health Governance. - : Emerald Group Publishing Limited. - 2059-4631. ; 24:3, s. 222-229
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – It is often argued that Lean enables the challenges of contemporary healthcare delivery to be tackled in relation to consistently high-quality care, while utilizing the full potential of available resources. Nevertheless, system-wide implementations of Lean are notoriously difficult and the desired results are often not achieved. Policy makers play a pivotal role in enabling healthcare organizations to enact more precise strategies and frameworks through steering professionals toward both adopting guidelines and becoming more comfortable with Lean as an improvement technique. However, the difficulties in achieving system-wide implementations of Lean indicate their shortcomings in this respect. The purpose of this paper is to outline how these shortcomings may be manifested empirically. Design/methodology/approach – A qualitative content analysis of Swedish counties’ annual reports with regard to how the implementation of Lean is presented and promoted. Findings – The study shows that policy makers have vague and divergent perceptions of what Lean is, and that they often reduce Lean to a means of achieving cost reductions and savings, while relying on the education of managers as the primary factor to ensure implementation. Originality/value – In order for policy makers to facilitate system-wide implementations of Lean, this study indicates that they need to rectify their simplistic perception of Lean while elaborating on why and how Lean should be implemented in healthcare.
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