| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
- Jarebrant, Caroline, et al.
(författare)
-
Development of a tool for integrating Value Stream Mapping and ergonomics in healthcare - A Nordic Multicenter study.
- 2014
-
Ingår i: The 7th Nordic Working Life Conference. Book of Abstracts and Programme. - 9789198119558 ; , s. 123-124
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To present the most recent draft Nordic version of the ErgoVSM tool for healthcare and some contextual factors influencing the intended impact of the tool. Material and Methods: The ErgoVSM tool is tested at 7 wards on 4 different hospitals in Denmark, Iceland and Sweden. The tests include assessment of tool usability and main factors facilitating or inhibiting the intended impact of the tool. On the basis of these trials a final version of the ErgoVSM is developed. The ErgoVSM tool: According to common VSM procedure the Current State is mapped (visualized) followed by a similar procedure regarding a wanted Future State. The Ergo-module includes assessments of physical exposures (posture, forces, variation, porosity) and psychosocial exposures (demands, control, variation, communication, porosity). It focuses task as well as values stream level. The exposures are assessed by ratings scales with verbally defined end points. The analysis includes discussion of solutions and establishment of an Action Plan needed to realize the wanted Future State. Main contextual factors influencing the intended impact of the tool seem to be previous Lean experience, management style, volume of competing projects and type of value stream analysed.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Jarebrant, Caroline, et al.
(författare)
-
ERGONOVA Workbook. Ergonomic Value Stream Mapping in health care
- 2013
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Preface to the present English edition: This edition has been translated and printed as part of the Nordic Multicenter Study "A Nordic work environment complement to Value Stream Mapping (VSM) for more sustainable patient flows at hospitals – A NOVO Multicenter study", funded by the Nordic Council of Ministers. The present prototype version of the Workbook is now evaluated at 14 hospital wards in Denmark, Iceland and Sweden. We aim to deliver a revised Workbook for intervention processes towards increased sustainability of patient flows based on our specific Nordic opportunities with our strong tradition of agreement between the parties (cf. ‘the Nordic Model’).Jörgen WinkelProject leader of the Nordic Multicenter StudyCaroline JarebrantProject leader of the Swedish project
|
|
| 9. |
- Jarebrant, Caroline, et al.
(författare)
-
Previous experiences of Value Stream Mapping (VSM) at the hospital units included in the Swedish part of the NOVO Multicenter Study
- 2012
-
Ingår i: Abstract book. 6th NOVO symposium. - 9789163723803
-
Konferensbidrag (refereegranskat)abstract
- Within the county councils of Sweden (hospitals, elderly care, etc.) two waves of introduction of Lean Production (Lean) have occurred. The first occurred during the 1990s and was unsuccessful mainly due to dramatic and negative impact on the employees (Härenstam et al, 1999). The 2nd wave started after the turn of the millennium. In 2011 about 80% of the county councils were running Lean projects (SKL, 2012). Now more emphasis was put on leadership and teamwork as well as knowledge on methodology. Successful projects creating e.g. more efficient patient flows are supposed to save time. A key issue is, however, that no general agreement seems to occur on how these saved resources should be reprioritized (cf. the “50/50-basis” in Denmark). Due to this, Lean projects are often perceived as “saving projects” where staff will eventually be phased out leading to further “work intensification”. VSM is a main Lean tool used to reduce waste in production flows. Our present case studies show differences between hospitals in Lean and VSM experiences. At one hospital Lean has been developed from "below" in the organization since 2004 through successive education (SkaS-guiden 2008). In our 2 cases from this hospital the initial steps of VSM were guided by internal Lean educated stakeholders. No resistance was met from any employee. However, the writing of action plans and the following actions were integrated in parallel rationalization processes. In contrast, our 2 other cases at another hospital had only been marginally influenced by Lean. The VSM processes were guided by an external Lean educated stakeholder (one of the authors). Especially one of the cases had significant difficulties in achieving consensus on an action plan including work environment issues. The required time for the VSM analyses became considerably prolonged, partly related to lack of Lean and VSM experience. Conclusions: The duration of the VSM process seems to depend on previous Lean experiences. Problems in the assessment of an action plan, an essential part in the VSM procedure, seems partly due to employee uncertainty regarding the consequences for the individual and parallel rationalization processes.
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
- Johansson Hanse, Jan, 1954, et al.
(författare)
-
Lean och arbetsmiljö inom sjukvården: Proaktivt förändringsarbete för hållbara arbetsprocesser inom vården
- 2013
-
Ingår i: FALF Abstracts. Arbetslivets föränderlighet. FALF 17-19 juni 2013, Stockholm. ; , s. 15-16
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Det övergripande syftet med projektet (som finansieras av AFA Försäkring) är att skapa bättre förutsättningar för att kombinera effektiva patientflöden och en god arbetsmiljö bland anställda inom sjukvården. Ett delsyfte är att utveckla ett ergonomiskt integrerat komplement till LEAN-verktyget värdeflödesanalys (VFA). Ett annat delsyfte är att studera vilka faktorer som har betydelse i selektionsprocessen av lösningsförslag. Inom Lean är VFA ett etablerat verktyg för att effektivisera flöden. När ett flöde kartläggs så är huvudsyftet att reducera icke värdeskapande aktiviteter, dvs. den tid/aktiviteter som inte tillför varan eller tjänsten något värde. Genom visualisering av olika arbetsuppgifter i flödet (med hjälp av post it-lappar) och dialog tar man sig från ett nuläge till ett önskat framtida läge. Vid VFA finns dock en risk för arbetsintensifiering och därmed en risk för försämrad fysisk och/eller psykosocial arbetsmiljö. Därför är verktyget ERGONOVA (ergonomisk värdeflödesanalys) framtaget som ett integrerat komplement till VFA. Med ERGONOVA beaktas arbetsmiljöaspekter i ett flöde. De arbetsmiljöaspekter som beaktas är fysisk belastning(arbetsställningar, lyft av föremål mm) och arbetsinnehåll (krav, kontroll, kommunikation). Här görs bedömningar på arbetsuppgiftsnivå, flödesnivå och jobbnivå. Utifrån en nulägeskarta för flödet identifieras problem/hinder för arbetets utförande och arbetsmiljöbrister. Analysprocessen resulterar i konkreta lösningsförslag och en preliminär handlingsplan vad gäller ett framtida flöde. Förslagen exponeras sedan på avdelningen, där alla medarbetare ges tillfälle att lämna synpunkter. Slutligen fastställs en handlingsplan med de aktiviteter och åtgärder som krävs för att förändringarna ska kunna genomföras och implementeringen påbörjas. Resultat från tre vårdenheter inom Västra Götalandsregionen visar att de anställda blir delaktiga i förändringsarbetet, där analys av arbetssätt blir i centrum. Fördelen med att använda post it-lappar (olika färger för olika yrkeskategorier) är att de anställda får arbetsuppgifter och flödet ”framför ögonen”. Därmed förskjuts fokus från person till arbetssätt och flöde. De preliminära resultaten visar att den anställde ofta får en bättre förståelse för vad de gör i ett flöde och vad andra yrkeskategorier gör. Ergonomisk värdeflödesanalys genererar en betydande idérikedom vad gäller förslag till förändringar. Resultaten indikerar att de anställda får en tvärfunktionell dialog där man diskuterar och föreslår förändringar som ofta leder till både ökad effektivitet och bättre arbetsmiljö.
|
|
| 14. |
- Winkel, Jörgen, 1946, et al.
(författare)
-
A Nordic work environment complement to Value Stream Mapping (VSM) for sustainable patient flows at hospitals – A NOVO Multicenter study
- 2012
-
Ingår i: Abstract book. 6th NOVO Symposium. - 9789163723803 ; , s. 57-
-
Konferensbidrag (refereegranskat)abstract
- The Nordic Council of Ministers (NCM) granted 2007-09 a project with the aim to establish and develop a Nordic Network for scientists regarding research on work environment and efficiency in the health care sector (‘the NOVO network’). The vision is a “Nordic Model for sustainable systems” in health care. A “Sustainable system” is here defined as the joint consideration of competitive performance and working conditions in a long-term perspective (Westgaard & Winkel, 2009, 2011). A preliminary project plan for a Nordic Multicenter project focusing a specific aspect of the vision was developed as part of the above mentioned NCM project. This was entitled: “A Nordic work environment complement to Value Stream Mapping (VSM) for sustainable patient flows at hospitals – A NOVO Multicenter study”.Development of production systems in healthcare is at present to an increasing extent based on Lean Production ideas. In the Lean terminology “value-adding work” (VAW) represents the portion of process time that employees spend on actions that create value as perceived by the customer (Liker 2004). The complementary part is “non-VAW” or “waste” as the general Lean term of non-value-adding activities.In healthcare VSM is a common Lean tool used to identify and minimize waste (Keyte & Locher, 2004). It is a participatory tool, i.e. those affected by this type of rationalization are performing the analyses and subsequently suggesting the interventions. Participation has been shown to be crucial to obtain ownership of the suggested interventions and thereby increase impact. In addition, VSM has been shown to be a powerful rationalization tool. However, the resulting interventions may imply physical work intensification and impaired psychosocial work environment if the proportion of VAW is increased and management issues are not properly considered. In the rationalization process both physical and psychosocial working conditions should therefore be integrated to obtain a competitive performance in a long term perspective. In practice, this is rarely done. Thus, health of the employees and system performance goals often end up on a collision course with short-term performance demands as the winner (e.g. Winkel & Westgaard 1996, Westgaard & Winkel 2011).
|
|
| 15. |
- Winkel, Jörgen, 1946, et al.
(författare)
-
Ergonomic Value stream Mapping (ErgoVSM) – potential for integrating work environment issues in a Lean rationalization process at two Swedish Hospitals
- 2013
-
Ingår i: 7th NOVO Symposium: A Nordic Model for Sustainable Systems in the Health Care Sector, Helsinki 25 – 26 November, 2013. - 2323-363X. - 9789523020580
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Lean is used in healthcare as a tool for business development and rationalization. Lean aims at contributing value from a holistic perspective including reduction of waste. Previous research indicates that this often creates work intensification with possible negative implications for the working environment (WE). WE considerations generally take a back seat on the rationalization process and are most often introduced later in a separate process. This paper reports findings from the Swedish part of a Nordic Multicenter Study where WE considerations have been integrated into a rationalization process based on Value Stream Mapping (VSM). ErgoVSM incorporates aspects of the physical and psychosocial WE into the VSM process. The abstract presents pros and cons for using ErgoVSM in relation to VSM at 2 wards at 2 different hospitals based on some of our preliminary data. Material and Methods: The case ward (“Ca”) used the ErgoVSM tool and the control ward (“Co”) the VSM tool. The resulting Action Plans were analyzed regarding number of suggested interventions and expected impact on performance (P) and WE. The expected WE impact was finally categorized according to impact at “Task”, “Work Content” and “Work Situation” (Westlander 1993). Two of the present researchers made these assessments independent of each other followed by a consensus procedure. Results: The Action Plan from Ca comprised 37 and Co 22 interventions. For both wards 65% of the interventions were expected to improve both P and WE. However, for Ca none of the interventions were expected to imply negative or no impact on WE, while this was 23% for Co. For Ca 16% of the interventions concerned Tasks, 46% Work Content and 38% Work Situation. The corresponding results for Co were 55%, 36% and 9% respectively. Conclusions: The Ca ward suggested more interventions, none of these with expected negative impact on WE and the suggestions were more often at a system rather than task level. The present preliminary data suggest that the ErgoVSM tool facilitate development of an Action Plan that may result in higher organizational sustainability compared with VSM.
|
|
| 16. |
- Winkel, Jörgen, 1946, et al.
(författare)
-
Factors facilitating and inhibiting Value Stream Mapping processes at hospital units in three Nordic countries - A Nordic Multicenter study
- 2014
-
Ingår i: O. Broberg, N. Fallentin, P. Hasle, P.L. Jensen, A. Kabel, M.E. Larsen, T.Weller (Editors). 11th International Symposium on Human Factors in Organisational Design and Management 46th Annual Nordic Ergonomics Society Conference. - 9788793130135
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- 1.Conceptual framework and Purpose In healthcare Value Stream Mapping (VSM) is a common Lean tool used to improve the efficiency of patient flows by identifying and minimizing waste (Keyte & Locher, 2004). It is a participatory tool, i.e. those affected by this type of rationalization are performing the analyses and subsequently suggesting appropriate interventions. Participation has been shown to be crucial to obtain ownership of the suggested interventions and thereby increase impact. VSM has been shown to be a powerful rationalization tool. However, the resulting interventions may imply physical work intensification and impaired psychosocial work environment. Due to this, Lean is often perceived as a “threat” by employees at hospitals (Härenstam et al 2000, personal communications). Physical and psychosocial working conditions should therefore be taken into account in the rationalization process to obtain sustainable solutions, i.e. solutions that allow for competitive performance and acceptable work environment in a long term perspective. On this background we have complemented the VSM tool by an ergonomic module assisting the users to consider also physical and psychosocial implications of the suggested interventions. This ErgoVSM tool is now evaluated in a Nordic Multicenter Study including Denmark, Iceland and Sweden (Winkel et al, 2012). The aim of this paper is to present observations that may indicate facilitating and inhibiting factors for the VSM process. 2.Methods Seven wards have used the ErgoVSM and seven the traditional VSM. Information was obtained by screening key hospital documents and interviewing participants in the VSM processes. 3.Results In Sweden one out of three wards using VSM decided not to fulfil the VSM process. On Iceland the only ward using VSM also decided not to fulfil their VSM process. The hospitals of the investigated wards using VSM in Sweden and Iceland had a strong primary focus on financial balance of the business according to key documents. Decisions on when and which value stream to analyse were made by management with little/no dialog with the employees. Work environment issues were not discussed as part of this. In addition, Iceland had a short experience of Lean, mainly based on support from McKinsey, an American global management consulting firm that focuses on solving issues of concern to senior management (http://en.wikipedia.org/wiki/McKinsey_%26_Company). Thus, they had no attention to the wellbeing to the employees and their work environment when introducing Lean. In general, the Icelandic Lean coaches had problems motivating the employees. However, they perceived a facilitated VSM process at the investigated ErgoVSM ward. Due to this, the main Lean coach decided to include work environment aspects in the VSM processes performed at other wards not part of the present Multicenter Study. Positive effects on those VSM processes were reported back to the researchers. In Denmark all three wards using VSM fulfilled their VSM process. This hospital had a long Lean experience. The main Lean coach reported process problems during their 3 initial years when using a top-down approach. Before the present project was initiated they had turned to a bottom-up initiation of the VSM processes. The Lean coach also expressed that work environment issues might be articulated as part of the VSM process. All seven wards using ErgoVSM in the 3 countries fulfilled the process. 4.Conclusion When using the Lean tool “Value Stream Mapping” it seems to be important not only to focus on efficiency but also on issues that are perceived important for the well-being of the individual employee. 5.Financial support The Nordic Council of Ministers and national grants. 6.References Härenstam A, Bejerot E, Johansson K, Leijon O, Schéele P. “Mager och god” eller ”Lean and mean”? Samband mellan organisationsförändringar och arbetsförhållanden. In: Barllöf K (Ed.) Smärtgränsen? En antologi om hälsokonsekvenser I magra organisationer. Rådet för arbetslivsforskning, pp 2000 Keyte, B., Locher, D., 2004. The Complete Lean Enterprise. Value Stream Mapping for Administrative and Office Processes. Productivity Press, New York. Winkel J, Birgisdóttir B D, Dudas K, Edwards K, Gunnarsdóttir S, Jarebrant C, Johansson Hanse J (2012). A Nordic work environment complement to Value Stream Mapping (VSM) for sustainable patient flows at hospitals – A NOVO Multicenter study. 6th NOVO Symposium: Sustainable Health Care: Continuous Improvement of Processes and Systems. Karolinska Institute, Stockholm Sweden. November 15-16, 2012, pp 58-59. ISBN: 978-91-637-2380-3
|
|
| 17. |
- Winkel, Jörgen, 1946, et al.
(författare)
-
Introduction of Lean/Value Stream Mapping at hospital units in three Nordic countries and expected impact on the working environment - A Nordic Multicenter study
- 2013
-
Ingår i: International HELIX Conference 2013.
-
Konferensbidrag (refereegranskat)abstract
- Conceptual framework and Purpose A recent review has documented mostly negative effects of rationalization on musculoskeletal and mental health and corresponding risk factors. This goes in particular for the healthcare sector (Westgaard & Winkel, 2011). Lean Practices are increasingly used in healthcare and Value Stream Mapping (VSM) seems to be a commonly used tool to identify and minimize waste (Keyte & Locher, 2004). The health impact of Lean varies considerably between investigations. This may to a large extend be due to differences in the operationalization of Lean (Brännmark et al, 2012). VSM is a participatory tool, i.e. those affected by this type of rationalization are performing the analyses and subsequently suggesting the interventions. Participation has been shown to be crucial to obtain ownership of the suggested interventions and thereby increased impact. On this background rationalizations based on VSM may offer a procedure that also includes working environment issues. In addition, workplaces in the Nordic countries seem to offer good opportunities for realizing a true participatory approach considering also working environment issues when rationalizing a value stream (Guðmundsson, 1993; Westgaard & Winkel, 2011). VSM has been shown to be a powerful rationalization tool in the elimination of non-value-adding tasks (non-VAT). Several studies show that non-VAT generally offer less risky physical and mental exposures (e.g. Kazmierczak et al, 2005; Østensvik et al, 2008; Palmerud et al, 2012; Jonker et al, 2013). According to this, non-VAT is usually named “the porosity of the working day” (Marx, 1867; Westgaard & Winkel, 2011; Winkel & Westgaard, 2001). Strong political demands to maximize efficiency in healthcare may thus potentially result in an excessive rationalization causing a too large reduction in porosity and thus too risky work intensification. In practice Lean is often perceived as a “threat” by employees at hospitals (Härenstam et al, 2000; many personal communications). In contrast, most Lean consultants generally describe Lean as an opportunity for improvements also in terms of the working environment (numerous personal communications). On this background an ergonomic complement to VSM, the ErgoVSM, has been developed based on existing scientific evidence and in close co-operation with Swedish industry and the healthcare sector (Jarebrant et al, 2013). The ErgoVSM also considers health issues, i.e. risk factors for musculoskeletal and mental health in addition to reduction of waste (Jarebrant et al, 2004; 2009). In this paper we present some preliminary data based on 1st line managers’ assessments of expected impact of action plans based on VSM and ErgoVSM. The presented data are retrieved from a larger NOVO Multicenter Study (Winkel et al, 2012). Design/Methodology Fourteen hospital wards in Denmark, Iceland and Sweden are investigated. Seven of these are using VSM and the remaining the ErgoVSM to improve the efficiency of their patient flows. Current and future states are assessed and action plans presented. 1st line managers are then interviewed and asked to assess expected impact of each suggested intervention in the action plan in terms of efficiency, treatment quality, physical and psychosocial working environment. So far five of the fourteen 1st line managers have been interviewed. Two of the wards have used the VSM tool and 3 the ErgoVSM tool. Results and Discussion All together 103 amendments for improved performance have been assessed in the five action plans. Eighty-one of these were assessed also to imply improvements in the working environment. Three suggestions were expected to imply a negative impact and four no impact on the working environment. Fifteen suggestions were not rated as they were decided not to be realized. Using VSM or ErgoVSM did not influence the assessment of expected impact of amendments in the action plan. The dominance of expected positive impact on the working environment of the amendments will be discussed in terms of potential bias and real opportunities. The Multicenter Study includes follow-up investigations of realized impact on the working environment as well as potential national differences between the three investigated countries (cf. Birna & Gunnarsdóttir, 2012; Edwards & Winkel, 2012; Jarebrant et al, 2012).
|
|
| 18. |
|
|
| 19. |
- Edwards, K, et al.
(författare)
-
Using Chronicle Workshop to quantify impact of context in case studies
- 2014
-
Ingår i: In: Kasper Edwards & Jørgen Winkel (Eds.) Abstract book, The 8th Novo symposium: Sustainable Health Care Production Systems, Copenhagen, November 6 - 7, 2014, Technical University of Denmark..
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)
|
|
| 20. |
|
|
| 21. |
|
|
| 22. |
- Jarebrant, Caroline, et al.
(författare)
-
Framtidens VårdArbete. Proaktivt förändringsarbete för hållbart arbetsliv
- 2014
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektets övergripande hypotes utgår från att riskfaktorer för mental och fysisk ohälsa kan minskas, genom att arbetsmiljöarbetet integreras i utvecklings- och effektiviseringsarbetet. Verktyget Ergonomisk VärdeFlödesAnalys (ErgoVFA) har vidareutvecklats för att stödja förändringsprocessen. Tre vårdenheter arbetade med ErgoVFA (värdeflödesanalys med arbetsmiljöperspektiv) och två använde traditionell värdeflödesanalys (VFA). Ett gemensamt tillvägagångssätt tillämpades men där förändringsprocessen utgick från respektive vårdenhets behov och förutsättningar. Handlingsplanerna (central del i processen) innehöll mellan åtta och 39 förändringsförslag. Handlingsplanerna tyder på att ErgoVFA genererar fler förslag än traditionell VFA. Effektivitet beaktas i lika omfattning. ErgoVFA tenderar att i högre grad fokusera den psykosociala arbetsmiljön. När endast patientkvalitet prioriteras, noteras risker för försämringar i arbetsmiljön. Resultaten tyder på att ErgoVFA jämfört med VFA medför effekter på förändringsarbetet som skulle kunna leda till högre grad av organisatorisk hållbarhet. Beträffande upplevd förändring under projekttiden visade resultaten att ErgoVFA-enheterna upplevde den ”psykosociala arbetsmiljön” som signifikant bättre jämfört med VFA-enheterna. I projektet framkommer att ErgoVFA skapar engagemang och ger möjlighet till helhetslösningar. En arena för kommunikation skapas, där kontinuitet i analysarbetet över tid möjliggörs. ErgoVFA har vidareutvecklats där arbetsgången förtydligats och verktyget som ett processinstrument betonas. I vidareutvecklingen har förenkling av handledningstext och bedömningsmallar eftersträvats.
|
|
| 23. |
- Johansson Hanse, Jan, 1954, et al.
(författare)
-
Leader-Member Exchange (LMX) and Psychosocial Factors at Work Among Healthcare Professionals
- 2014
-
Ingår i: Journal of Nursing and Care. - : OMICS Publishing Group. - 2167-1168. ; 3:5
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The study aims to examine the associations between leader–member exchange (LMX) and psychosocial factors at work. Methods: A questionnaire-based cross-sectional study was undertaken at four units in two not-for-profit hospitals in southwestern Sweden. The study sample included 240 employees. Results: Significant correlations were found between LMX items and most of the psychosocial domains and dimensions. The strongest correlations were found between the LMX item affect and rewards/recognition, role clarity and predictability, and the LMX item loyalty and rewards/recognition. In sum, high-quality LMX was associated with good psychosocial work conditions experienced by the employees. Conclusions: The results support possible ways for managers and employees to strengthen their relationships and this may in turn lead to more sustainable systems in health care.
|
|
| 24. |
- Johansson Hanse, Jan, 1954, et al.
(författare)
-
Optimering av handlingsplaner för utveckling av hållbara arbetsprocesser inom vården
- 2014
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det övergripande syftet med projektet var att skapa bättre förutsättningar för att kombinera effektiva flöden och en god arbetsmiljö bland anställda inom sjukvården. I projektet studerades vad som har betydelse i selektionsprocessen av lösningsförslag fram till handlingsplan vid användning av Ergonomisk VärdeFlödesAnalys (ErgoVFA), dvs. värdeflödesanalys med integrerat arbetsmiljöperspektiv. Tre vårdenheter ingick i projektet. Tillvägagångssättet vid vårdenheterna var att identifiera ett flöde i sin verksamhet, genomföra analys av det valda flödet med hjälp av ErgoVFA, ta fram lösningsförslag och upprätta en handlingsplan och implementera. Datainsamling skedde med hjälp av intervjuer med vårdenhetschefer och analysgrupper. Syftet med intervjuerna var att få en förståelse för val av flöde, problemidentifiering samt eventuella selektionsmekanismer från lösningsförslag fram till handlingsplan. Dessutom ställdes intervjufrågor utifrån ledarskapsteorin ”servant leadership” när det gäller dialogen och samspelet mellan vårdenhetschefen och medarbetarna under förändringsprocessen. Resultaten indikerar, när det gäller den initiala selektionsprocessen av lösningsförslag, att det är viktigt att det finns en öppenhet och delaktighet på vårdenheten där ledningen uppmuntrar sina medarbetare att komma med nya idéer (”empowerment”). När det gäller faktorer som har betydelse för hur goda idéer på bästa möjliga sätt når fram till handlingsplanen visar resultaten att det är viktigt med en förankring hos ledningen. Med ErgoVFA visualiseras problem för olika yrkeskategorier och på så vis skapas transparens i organisationen. Resultat från vårdenheterna vittnar också om betydelsen av att ha en långsiktig vision (”stewardship”) för att medarbetarnas idéer ska nå fram till handlingsplaner.
|
|
| 25. |
- Johansson Hanse, Jan, 1954, et al.
(författare)
-
The impact of servant leadership dimensions on leader–member exchange among health care professionals
- 2016
-
Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 24:2, s. 228-234
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of the current study was to investigate the impact of servant leadership dimensions on leader–member exchange (LMX) among health-care professionals. Background: Leadership support and the quality of the dyadic relationship between the leader and the employee are essential regarding the work environment and turnover intentions in health care. Method: A questionnaire-based cross-sectional study was undertaken at four hospital units in Sweden. The study sample included 240 employees. Results: Significant bivariate correlations were found between all servant leadership dimensions and LMX. The strongest correlations were found between ‘humility’ and LMX (r = 0.69, P < 0.001), and ‘empowerment’ and LMX (r = 0.67, P < 0.001). The hierarchical regression analyses indicated that ‘empowerment’, ‘humility’ and ‘stewardship’ explained about 55% of the variance in LMX. Conclusion: In our study servant leadership dimensions were strongly related to LMX. Implications for nursing management: The results identify specific servant leadership dimensions that are likely to be useful for developing a stronger exchange relationship between the leader (e.g. nursing manager) and individual subordinates in health care.
|
|
| 26. |
- Winkel, Jörgen, 1946, et al.
(författare)
-
A Nordic evaluation of a work environment complement to Value Stream Mapping for increased sustainability of patient flows at hospitals - The NOVO Multicentre Study I
- 2015
-
Ingår i: Abstract book, The 9th Novo symposium: Sustainable Health Care Production Systems. ; , s. 34-36
-
Konferensbidrag (refereegranskat)abstract
- Conclusions: •Both the ErgoVSM and VSM tools seem mostly to result in intervention proposals causing improved or no change in the work environment without impaired performance. •Based on Swedish data only the use of ErgoVSM may result in some improvement of the work environment compared with VSM. Such an effect is weakly supported by the Icelandic data and not by the Danish data. Thus, only under some conditions the ErgoVSM tool may be used in favour of the VSM tool. •Most proposals were assessed to cause ergonomic improvements at system level (‘job content’ and ‘work situation’). This is in contrast to intervention proposals investigated in the ergonomic intervention literature mainly focusing task level and the individual (cf. Westgaard and Winkel, 2011).
|
|
| 27. |
- Winkel, Jörgen, 1946, et al.
(författare)
-
Effect modifiers in intervention research at hospitals in three Nordic countries
- 2016
-
Ingår i: Abstract book of the 10th NOVO symposium, Reykjavík, 10 – 11 November, 2016. s. 33. - 9789935926555
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The impact of ergonomic interventions may be offset by other changes at the work place, primarily rationalizations. These have previously been shown to imply a dominant negative effect on health and risk factors, thus causing effect modification (Westgaard & Winkel 2011). The present paper aims to present assessment of potential effect modifiers in intervention studies at hospital wards in Denmark, Iceland and Sweden. Material and methods: The effect modifiers were assessed by a newly developed method (the EMA method; Edwards & Winkel 2016). It is a type of group interview including 3-6 participants representing all occupational groups in the investigated organization. The group is asked to write down significant changes at the workplace during the investigated period. The method also includes a semi-qualitative assessment of the potential Work Environment (WE) impact of each modifier. It aims to capture both the individual and collective account of all significant events that may have caused a significant impact in relation to the specific aim of the investigated intervention. Thirteen hospital wards went through interventions based on either the lean tool VSM (Value Stream Mapping) (6 wards) or the ErgoVSM method (Jarebrant et al, 2010) where additional focus is on ergonomic issues (7 wards). Results: In total 120 interventions were implemented. However, 322 significant modifiers were assessed to have occurred during the intervention period. Of these, 120 were assessed to imply impaired WE, 166 a positive impact, 33 no impact and 3 were not assessable. The number of significant modifier events varied between wards from 8-48, while the number of implemented interventions varied from 0-28. The semi-qualitative assessments suggested a major impact on WE due to modifiers. At seven wards the dominating impact of the modifiers was estimated to improve WE; at two wards the modifiers were estimated mainly to impair WE while four wards showed a mixture of modifiers, some estimated to improve and other to impair WE. Conclusion: Numerous effect modifiers occurred parallel to the investigated interventions. This jeopardizes any inference regarding impact of the investigated interventions on WE. The study thereby highlights the significance of considering effect modifiers in ergonomic intervention research.
|
|
| 28. |
- Winkel, Jörgen, 1946, et al.
(författare)
-
May sustainability of patient flows at hospitals be increased by adding a work environment module to Value Stream Mapping (VSM)? - A NOVO Multicenter study in Denmark, Iceland and Sweden
- 2014
-
Ingår i: In: Kasper Edwards & Jørgen Winkel (Eds.) Abstract book, The 8th Novo symposium: Sustainable Health Care Production Systems, Copenhagen, November 6 - 7, 2014, Technical University of Denmark. ; , s. 23-24
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)
|
|
| 29. |
- Fasth Berglund, Åsa, 1978, et al.
(författare)
-
CREATING A STRUCTURED MEETING ARENA FOR KNOWLEDGE SHARING
- 2014
-
Ingår i: The sixth Swedish Production Symposium. - 9789198097412
-
Konferensbidrag (refereegranskat)abstract
- This paper aims to describe how to create and structure a meeting arena by combining organisation structure and information structure; this will be used in order to create an innovative and creative arena for knowledge sharing and problem solving within the company. The model is exemplified by four industrial case-studies. Results reveal that most of the companies do not have any standards for information- or knowledge sharing, most improvement potentials are seen in structuring and storing the right information (IS), aiming from tacit towards explicit knowledge (OS) and this could be done by structuring the questions in the OS-M-IS model and by creating innovative and creative meeting arenas.
|
|
| 30. |
- Fasth Berglund, Åsa, 1978, et al.
(författare)
-
Digitalisation of MEETings - from White-boards to SMART-boards
- 2016
-
Ingår i: Procedia CIRP. - : Elsevier BV. - 2212-8271. ; 41, s. 1125-1130
-
Konferensbidrag (refereegranskat)abstract
- Information is a vital resource in development activities of any business. These systems also play a very important role in the knowledge sharing of an organisation. In order to properly bridge over from the information system to the organisation system, the transformation process from data, via information, to knowledge becomes important to understand. A challenge is to create appropriate conditions in both the organization system and in the information system enhancing knowledge sharing among employees, and promote organizational learning. This paper will analyse an industrial example of weekly planning meetings for preventative maintenance, this will be illustrated in the OS-M-IS model i.e. were the information sharing exist in a current situation (whiteboards). A future situation of the same case will be tested and evaluated in a lab environment (with SMART boards and iObeya) as a first step.
|
|
| 31. |
- Fasth Berglund, Åsa, 1978, et al.
(författare)
-
SMARTARE MÖTEN MEET-MODELLEN
- 2016
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- MEET-modellen bidrar till ett mer strukturerat arbete gällande organisations- och informationsstruktur när olika former av möten skall planeras. Målet är effektivare möten, bättre vägval gällande organisatoriska och informatoriska frågor, ökat informations- och kunskapsspridande i organisationen samt att gå från individuellt till organisatoriskt lärande.
|
|
| 32. |
- FJÄLLSTRÖM, SABINA, 1975, et al.
(författare)
-
Information enabling production ramp-up
- 2009
-
Ingår i: Journal of Manufacturing Technology Management. - Bingley : Emerald. - 1741-038X .- 1758-7786. ; 20:2, s. 178-196
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose – This paper seeks to identify information enabling and supporting production ramp-up processes, by exploring critical events and the role of information in such events.Design/methodology/approach – The research approach was based on empirical and theoretical investigations. A selection of 30 events, considered the most critical for production ramp-up realization and/or performance at one Swedish automotive company, were categorized and constituted the base for the analysis which focused information types and sources enabling event handling.Findings – Information enabling event handling is a balanced combination of problem and domain information, regardless of event category. However, a differentiation concerning preference and usage of information types between experienced and less experienced personnel is identified. Problem-solving information has the character of pragmatic information, composed of complementary parts of confirmation and novelty in terms of domain and problem information. The preferred information source in all event categories was “other people”.Research limitations/implications – The study focuses on the application of information in relation to critical events during production ramp-up. General information theory is not addressed in depth.Practical implications – Information type and information source are not dependent on certain event categories, which allows a general information strategy enabling production ramp-up. To facilitate production ramp-up and event handling managers and key personnel need to apply a holistic perspective and need to be updated on domain information of the products, the equipment, and the production process during production ramp-up.Originality/value – The originality is in the focus and role of information to achieve an efficient production ramp-up performance. A supporting model is developed which describes the structure of pragmatic information for personnel with various levels of experience, regardless of event category.
|
|
| 33. |
- Gullander, Per, 1968, et al.
(författare)
-
MEETINGS – THE INNOVATIVE GLUE BETWEEN THE ORGANISATION SYSTEM AND INFORMATION SYSTEM
- 2014
-
Ingår i: The sixth Swedish Production Symposium. - 9789198097412
-
Konferensbidrag (refereegranskat)abstract
- The research presented aims for enhanced utilization of human skills,collaboration, and information sharing. This paper concerns the production context,and the needs and challenges of people striving for high-quality, innovative, andefficient work. The paper presents a model of the information system (IS) andorganisations system (OS) and their integration. Main conclusions are that thesesystems overlap, and create an innovative working arena for the different workingprocesses. People with knowledge gather into meetings held for different purposessupported by technical systems. These meetings provide a core element for efficientand innovative collaboration, requiring parallel development of IS and OS.
|
|
| 34. |
- Gullander, Per, et al.
(författare)
-
Towards a Production Complexity Model that Supports Operation, Re-balancing and Man-hour Planning
- 2011
-
Ingår i: Proceedings of the 4th Swedish Production Symposium (SPS): Lund, Sweden.
-
Konferensbidrag (refereegranskat)abstract
- Mass customization and more variants, components, and frequent changes increase productioncomplexity. This paper presents research project aimed at developing a feasibledefinition of complexity, a method for measuring complexity, which supports line rebalancing,man-hour planning, and complexity management, competence, and informationsupport. The project is done in collaboration between Swerea IVF, Chalmers, Volvo Cars,Electrolux, Stoneridge, Electronics, and AB Volvo. Industrial studies were carried out tounderstand the needs for handling complexity. In parallel, a literature study was conductedover research on definitions, models and methods for complexity. In literature, complexityis commonly modelled by information and entropy of the system (randomness); and categorizedinto static/dynamic and subjective/objective. The research further concludes: unknownevents increase with complexity, making management of uncertainty increasinglyimportant, not only reducing but also coping with complexities; the role of humans andtechnology in work systems is crucial for coping with uncertainties; complexity models andmethods must be easy to understand and use; and must take a holistic view of production;and include different user’s perspective and the subjective complexity.
|
|
| 35. |
- Kurdve, Martin, 1971, et al.
(författare)
-
Considerations when Modelling EV Battery Circularity Systems
- 2019
-
Ingår i: Batteries. - : MDPI AG. - 2313-0105. ; 5:2
-
Tidskriftsartikel (refereegranskat)abstract
- The electric vehicle market is expected to grow substantially in the coming years, which puts new requirements on the end-of-life phase and on the recycling systems. To a larger extent, the environmental footprint from these vehicles is related to raw material extraction and production, and, consequently, a material- and energy-efficient 3R system (reuse, remanufacturing, recycling) is urgently needed. The ability to understand and model the design and development of such a system therefore becomes important. This study contributes to this by identifying factors that affect 3R system design and performance, relating these factors to the various actors and processes of the system and categorising them according to time from implementation to impact. The above is achieved by applying a PEST analysis (political, economic, social and technological factors), differentiating between political, economic, social and technological factors. Data were gathered from literature, by interviews and by a number of workshops in the automotive industry and the 3R system and observations at meetings, etc. The study confirms some previous results on how vehicle battery 3R systems work and adds knowledge about the influencing factors, especially the timeframes and dynamics of the system, necessary for modelling the system and the influencing factors. For practitioners, the results indicate how to use appropriate models and which factors are most relevant to them.
|
|
| 36. |
- Kurdve, Martin, 1971, et al.
(författare)
-
Implementation of daily visual management at five small and medium sized enterprises in Produktionslyftet compared to six larger Swedish companies
- 2016
-
Ingår i: Swedish Production Symposium 2016.
-
Konferensbidrag (refereegranskat)abstract
- This paper compares the implementation of daily visual management (DVM) in five SMEs (small and medium sized enterprises), with practice in six large Swedish companies, considering the challenge to include sustainability aspects. With method definition from Produktionslyftet (PL), a Swedish development programme, DVM includes daily meetings around key performance indices (KPIs) and visualised information on boards. The SMEs were studied within PL while the large companies were studied in the research project SuReBPMS (Sustainable and resource efficient Business Performance Measurement Systems). The empirical result from SMEs shows that KPIs often cover few areas (most common: delivery, safety and quality) while the larger companies have wider range of areas. In some SMEs the meeting agendas, KPIs and pulse-boards are standardised while in others there are differences between teams or operations. The larger companies were mainly standardised. Both SMEs and larger companies mostly include all employees in DVM, in line with PL-DVM methodology. The general tendency is to focus on short term rather than follow-up of strategic challenges in the DVM. Furthermore, environmental issues, such as climate impact, are rarely found on boards, while often reflected in company policy. However, many KPIs have a strong, indirect, connection to sustainability and environment.
|
|
| 37. |
- Mattsson, Sandra, 1984, et al.
(författare)
-
Testing Complexity Index – a Method for Measuring Perceived Production Complexity
- 2012
-
Ingår i: Procedia CIRP. - : Elsevier BV. - 2212-8271. ; 3:1, s. 394-399, s. 394-399
-
Konferensbidrag (refereegranskat)abstract
- Complexcity Index (CXI) is a method developed to help manufacturing companies to describe complexity as experienced and to assist in reducing the effects it has on operator performance. The method is targeting the perceived complexity and was tested at Volvo Cars Corporation. Reproducibility of the method could be seen between respondents and was considered a valuable tool for visualizing problem-areas at the stations. It is suggested that objective data could be one way to identify which stations should be tested in-depth with the CXI method, and that CXI could be used for suggesting improvements or appropriate support tools.
|
|
| 38. |
|
|
| 39. |
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
- Ny Harlin, Ulrika, 1963, et al.
(författare)
-
Towards an assessment approach promoting flexible value-adding meetings in industry
- 2016
-
Ingår i: Swedish Production Symposium.
-
Konferensbidrag (refereegranskat)abstract
- Assessment approaches in manufacturing companies has the potential of providing improvement potential issues. The purpose of this paper is to investigate potentials of an initial assessment approach of meetings in production. The assessment approach is based on a model regarding organization and information system structures, tested and validated in an industrial company in Sweden. Results show that the assessment approach could be used in order to evaluate what area to improve and what the company are strong within. The assessment approach also implies if the company are information-oriented or more organizational-oriented in their approach when creating meeting arenas. This could be used in future meeting strategies to improve the flexibility and value of the meetings. In further research, the next step is to develop, test, and validate a process for continuous improvement of meetings, as well as to apply the model for development of organization and information system structures in new scenarios such as ‘Personnel changes of positions and roles’, ‘Training and workplace learning’, and ‘Automation/digitalization’.
|
|
| 43. |
- Ny Harlin, Ulrika, 1963, et al.
(författare)
-
Towards efficent automation implementation
- 2006
-
Ingår i: 9th symposium IFAC on "Automated Systems Based on Human Skills and Knowledge" / edited by Frédérique Mayer.
-
Konferensbidrag (refereegranskat)
|
|
| 44. |
|
|
| 45. |
- Wallo, Andreas, 1978-, et al.
(författare)
-
Charting the path to a sustainable, competitive and green industry in an era of rapid change: proposing a research agenda
- 2024
-
Ingår i: Cogent Business and Management. - : Taylor & Francis. - 2331-1975. ; 11:1
-
Tidskriftsartikel (refereegranskat)abstract
- Global labor market shifts have spurred the need for innovations and adaptations in workplace norms. This evolution demands a workforce with technical and soft skills to meet sustainability and industry advancements. The paper aims to elucidate the complex challenges related to the ambition to develop a socially sustainable, competitive, and green industry subjected to an accelerating pace of change. It outlines the findings of a Delphi study conducted in Sweden, which integrated workshops, interviews, and surveys with experts from various sectors to identify 14 key challenges. These challenges were synthesized into five themes: innovative competence supply management practices, resilient organizations and production systems, analytics for improvement and learning, socially sustainable work, and green transformation practices. The study provides a set of propositions within these themes, offering a strategic roadmap for future research to foster the growth of industries that are socially responsible, competitive, and committed to environmental sustainability. A practical implication of the study is the recognition of the larger competence ecosystem of which industrial companies are a part. This community must work together to create the knowledge needed to manage the shift to a green, sustainable, and digital working life.
|
|
| 46. |
|
|
