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- Berlin, Johan, 1975, et al.
(författare)
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How do street-level bureaucrats manage high workloads? Collegial mechanisms at the organisational level—experiences from public healthcare organisations
- 2022
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Ingår i: European Management Review. - : Wiley. - 1740-4754 .- 1740-4762. ; 19:2, s. 299-312
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to understand and explain how street-level bureaucrats manage high workloads in public healthcare organisations. Data was collected through observations, interviews and documents. The results show that high workloads are reduced through use of collegial mechanisms at the organisation level. The study shows that workloads are reduced in a two-step process, the first is a negotiation between professionals and the second in the meeting with patients. The two-step process explains the limitation problems in more detail and makes an important contribution by explaining how high workloads are reduced in public health services.
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| 3. |
- Kjellberg, Inger, 1959, et al.
(författare)
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Pursuing collaborative advantage in Swedish care for older people: stakeholders' views on trust
- 2020
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Ingår i: Journal of Integrated Care. - 1476-9018. ; 28:3, s. 231-241
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The purpose of this paper is to explore stakeholder views on the policy of integrated health and social care for older people with complex needs in Sweden and the issue of trust in implementing the policy. Design/methodology/approach The study used a qualitative interview design and interviews with nine strategically selected stakeholders. A thematic analysis focused on trust, as defined in the theory of collaborative advantage, was used. Findings This study of health and social care exposed a lack of trust on political, strategic and inter-professional levels. Two opposing lines of argument were identified in the interviews. One advocated a single government authority for health and social care. The other was in accordance with recently implemented national policies, which entailed more collaboration between local government authorities, obliging them to make joint local agreements. The Swedish experience is discussed in an international context, examining the need for collaboration in integrated care services for older people. Research limitations/implications Although the findings are important for the current adjustment in health and social care for older people, the number of interviewees are limited. Future studies will include more regions and longitudinal studies. Originality/value Sweden is currently undergoing an extensive adjustment in line with recent national government policy which involves more primary health care and a corresponding reduction in the number of hospital beds. The restructuring of the care system for older people with complex needs is a paradox, as it simultaneously increases the need for centralisation while also increasing coordination and collaboration on a local basis.
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| 5. |
- Liljegren, Andreas, 1970, et al.
(författare)
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The police and ‘the balance’— managing the workload within Swedish investigation units
- 2021
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Ingår i: Journal of Professions and Organizations. - : Oxford University Press (OUP). - 2051-8811 .- 2051-8803. ; 8:1, s. 70-85
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Tidskriftsartikel (refereegranskat)abstract
- Professionals within street-level organizations are essential for the delivery of public services to citizens. However, among a number of difficult dilemmas, they have to deal with an extensive workload. The police can be seen as a good example of this; they are expected to solve most crimes, including the so-called mass crimes and the more spectacular cases that make it into media headlines, and often on a continually decreasing budget. A key regulating mechanism for investigation departments in the Swedish police is the so-called balance. The balance can be described as a basket in which they put the cases that there is a desire and potential to work on but not in the immediate term. The purpose of this article is to analyse the balance as a way of rationing the workload within the Swedish police. Working with the balance consists of two processes: limiting and buffering the workload. Limiting is the practice of reducing the work in a situation. Buffering is the process of putting some work on hold to deal with later, of which the article identifies five kinds; functional, problematic, quasi, progressive, and symbolic buffering. The exploration of ‘the balance’ contributes to our understanding of how street level organizations attempt to defend their professional jurisdictions, their well-being, and their ability to complete their duties.
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| 7. |
- McKelvey, Maureen, 1965, et al.
(författare)
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Conceptualizing evolutionary governance routines: governance at the interface of science and technology with knowledge-intensive innovative entrepreneurship
- 2020
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Ingår i: Journal of Evolutionary Economics. - : Springer Science and Business Media LLC. - 0936-9937 .- 1432-1386. ; 30
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Tidskriftsartikel (refereegranskat)abstract
- © 2019, The Author(s). The two main purposes of this article are: 1) To propose a conceptual model for governance at the interface of science and technology with knowledge-intensive innovative entrepreneurship and 2) To develop propositions and propose a future research agenda on evolutionary governance routines. Our proposed conceptualization of governance depends upon an understanding of how different ways of developing rules and norms to interact and make decisions collectively are created and maintained, including two sub-processes. One process is to develop advanced knowledge and the second process is where entrepreneurs transform that knowledge developed as the public good and privatize it through value creation. We propose that a main task for this type of entrepreneur is to manage their engagement in the overall governance in such a way as to be perceived by others as continuing to contribute to the collective action problem. The article provides definitions and propositions in relation to the conceptualization, as well as interesting trajectories for future research.
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| 8. |
- Szücs, Stefan, 1964, et al.
(författare)
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Achieving sustainable governance of horizontal integration of care services: progress and democratic accountability of strategic coordination bodies for older people
- 2022
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Ingår i: Journal of Integrated Care. - 1476-9018. ; 30:5, s. 69-82
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The purpose is to analyse the relationship between democratic accountability and how sustainable governance is achieved by horizontally integrating care services for older people through collaboration in a coordination body of key leaders from across the health and social care system. Design/methodology/approach The data and measures come from two surveys with coordination body members in Sweden (politicians, administrators, professionals) from a sample of 73 bodies in 2015 (n = 549) and the same/corresponding 59 bodies in 2019 (n = 389). Findings The governance of integrating care scale and the accountability scales repeatedly show consistency among individual members. Systematic progress is found among large coordination bodies: the greater the average perception of governance of horizontally integrating care in 2015, the greater it was in 2019 – and regardless of the period, the stronger the internal administrative or political monitoring and reviewing of the coordination body, the greater its governance (while the relationship to the external monitoring and reviewing is weak). However, the growing importance of external accountability is indirect, shown by stronger correlations between the internal political and external monitoring and reviewing, regardless of size. Research limitations/implications The scales are based on self-reported perceptions that cannot be objectively verified, but they can be linked to changes in outcomes and user experiences in the later stages of the research. Originality/value Repeatedly verified scales of internal and external accountability for analysing and evaluating governance of integrating care services horizontally, which is useful for improving strategic coordination of integrated care.
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| 10. |
- Szücs, Stefan, 1964, et al.
(författare)
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Cooperation capacity and quality in ageing: A longitudinal study of integrated care
- 2021
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Ingår i: Nordiska kommunforskarkonferensen NORKOM XXX (30th Nordic Conference on Local and Regional Government) Eilert Sundts Hus, Blindern, ISV, University of Oslo, Nov. 25–26, 2021.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- During the last decade, a significant reduction in most of Sweden’s regions' and cooperating municipalities' quality of integrated care services for older persons has occurred, indicated by increasing proportions of unplanned hospital readmissions. Cooperation scope, size and time, may however, constitute important keys for the significant challenge of making integrated care equal and autonomous enough to generate the local-regional capacity needed to implement quality characterized by lower readmission rates. The purpose is to study the continuity and cooperation between health and care providers, which sustain and improve quality of integrated care services for older people, using readmission rates as a quality indicator. The research question is: How is capacity to cooperate related to quality of integrated care: when, where, how, and why does it succeed? We rely on The Swedish National Board of Health and Welfare's data on the proportion of unplanned hospital readmissions within 30 days among older persons living with multi-morbidity 2010-11 and 2018-19 in all 290 municipalities and 21 regions of Sweden, enabling search for systematic patterns of explanation across 60 cases of cooperation between health and care providers in coordination bodies previously surveyed on cooperation capacity in 17 of the 21 Swedish regions for the 2010-14 and 2014-18 terms of office. The aim is to make cooperation work again, after the 2019 decline in quality and after the pandemic.
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