| 1. |
- Andreasson, Jörgen, et al.
(författare)
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Health care managers' views on and approaches to implementing models for improving care processes
- 2016
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 24:2, s. 219-227
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To develop a deeper understanding of health-care managers' views on and approaches to the implementation of models for improving care processes. Background: In health care, there are difficulties in implementing models for improving care processes that have been decided on by upper management. Leadership approaches to this implementation can affect the outcome. Method: In-depth interviews with first- and second-line managers in Swedish hospitals were conducted and analysed using grounded theory. Results: 'Coaching for participation' emerged as a central theme for managers in handling top-down initiated process development. The vertical approach in this coaching addresses how managers attempt to sustain unit integrity through adapting and translating orders from top management. The horizontal approach in the coaching refers to managers' strategies for motivating and engaging their employees in implementation work. Conclusion and implications for nursing management: Implementation models for improving care processes require a coaching leadership built on close manager-employee interaction, mindfulness regarding the pace of change at the unit level, managers with the competence to share responsibility with their teams and engaged employees with the competence to share responsibility for improving the care processes, and organisational structures that support process-oriented work. Implications for nursing management are the importance of giving nurse managers knowledge of change management.
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| 2. |
- Andreasson, Jörgen, et al.
(författare)
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The importance of healthcare managers’ organizational preconditions and support resources for their appraisal of planned change and its outcomes
- 2017
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Ingår i: Journal of Hospital Administration. - : Sciedu Press. - 1927-6990 .- 1927-7008. ; 6:1, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- Background: Healthcare managers are expected to lead and manage planned organizational change intended to improve healthcare process quality. However, their complex working conditions offer limited decision control, and healthcare managers often feel ill prepared and inadequately supported to perform their duties. Healthcare managers have previously described their need for organizational support, but we lack knowledge of the preconditions and resources that help managers implement planned change. Methods: This prospective cohort study examined healthcare managers at three Swedish hospitals implementing lean production and two Swedish hospitals implementing their own improvement model. Questionnaire data from 2012, 2103, and 2014 were used in following up. We used t-tests and a linear mixed model design in analysing the data. Results: Healthcare managers who perceived strong support from managers, employees, colleagues, and the organization and managers with the longest managerial experience had the least negative appraisal of change. Managers who perceived strong support from employees, management, and the organizational structure perceived higher levels of healthcare process quality. Conclusions: Long managerial experience and strong support from managers, employees, and the organization are important for managers’ appraisal of, work on, and successful implementation of planned change. Top management must therefore ensure that the healthcare managers have sufficient managerial experience and support before they delegate to them the responsibility to implement planned change.
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| 3. |
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| 4. |
- Bayati, Zahra, 1958, et al.
(författare)
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Nytt centrum mot rasism får fel vetenskaplig inriktning
- 2015
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Ingår i: Göteborgs Posten. - 1103-9345. ; :2015-06-14
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- När rasism ska förstås som något som kan lösas genom att lära ut tolerans undergrävs förtroendet för regeringens satsning. Dessutom saknas det etnisk/rasifierad mångfald bland forskargruppen.
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| 5. |
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| 6. |
- Dellve, Lotta, et al.
(författare)
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Health care clinicians' engagement in organizational redesign of care processes : Health care clinicians' engagement in organizational redesign of care processes
- 2018
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Ingår i: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 68, s. 249-257
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Tidskriftsartikel (refereegranskat)abstract
- The Swedish health care system is reorienting towards horizontal organization for care processes. A main challenge is to engage health care clinicians in the process. The aim of this study was to assess engagement (i.e. attitudes and beliefs, the cognitive state and clinical engagement behaviour) among health care clinicians, and to investigate how engagement was related to work resources and demands during organizational redesign. A cohort study was conducted, using a questionnaire distributed to clinicians at five hospitals working with care process improvement approaches, two of them having implemented Lean production. The results show that kinds of engagement are interlinked and contribute to clinical engagement behaviour in quality of care and patient safety. Increased work resources have importance for engagements in organizational improvements, especially in top-down implementations. An extended work engagement model during organizational improvements in health care was supported. The model contributes to knowledge about how and when clinicians are mobilized to engage in organizational changes.
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| 7. |
- Dellve, Lotta, 1965, et al.
(författare)
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Health-Promoting Managerial Work: A Theoretical Framework for a Leadership Program that Supports Knowledge and Capability to Craft Sustainable Work Practices in Daily Practice and During Organizational Change
- 2017
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Ingår i: Societies. - : MDPI AG. - 2075-4698. ; 7:2
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to describe a theoretical framework, i.e., theoretical underpinnings and pedagogical principles, for leadership programs that support managers' evidence-based knowledge of health-promoting psychosocial work conditions, as well as their capability to apply, adapt, and craft sustainable managerial work practices. First, the theoretical framing is introduced, i.e., a system theory that integrates key work conditions with a practical perspective on managerial work and organization. Second, pedagogical principles and measures for leaders' training in integrated handling across system levels are described. Last, we present summarized results from an intervention study applying the theoretical framework and pedagogical principles. The complexity of interactions among different factors in a work system, and the variety in possible implementation approaches, presents challenges for the capability of managers to craft sustainable and health-promoting conditions, as well as the evaluation of the program components. Nevertheless, the evaluation reveals the strength of the program, in providing holistic and context-sensitive approaches for how to train and apply an integrative approach for improving the work environment.
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| 8. |
- Dellve, Lotta, et al.
(författare)
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Hållbart ledarskap : i vardag och förändring
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten sammanfattar aktuella studier om hållbar och hälsofrämjande arbetsmiljö och hur en sådan miljö kan skapas genom ledarskap. De mest betydelsefulla aspekter som rör hur chefer genom ledarskap och organisering av arbete och arbetsförhållanden kan ha en avgörande betydelse för medarbetares hälsa och hållbarhet i vardagsarbete och under utvecklingsarbeten tas upp. Rapporten inleds med en genomgång av allmänna teorier och forskning om välbefinnande och hälsosamt arbetsengagemang. Därefter beskrivs forskning om hur ledarskap och chefskap påverkar välbefinnande och engagemang. Förhållanden i chefers arbete som kan vara stödjande för att hantera utmaningar i ledarskapet lyfts också. Rapporten fokuserar därutöver förutsättningar i arbetet som visat samband med hälsa samt hur hälsa och hållbarhet kan stärkas genom medarbetarskap, socialt kapital och team. Aspekter på förändringsledning som visat samband med hållbarhet beskrivs också. Rapporten avslutas med att belysa basstrukturer som ger förutsättningar för delaktighet, kontroll, inflytande, handlingsutrymme och socialt stöd bland så många som möjligt vid arbetsplatsen.
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| 9. |
- Dellve, Lotta, 1965-, et al.
(författare)
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Lean implementation at different levels in Swedish hospitals: the importance for working conditions and stress
- 2015
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Ingår i: International Journal of Human Factors and Ergonomics. - : InderScience Publishers. - 2045-7804 .- 2045-7812. ; 3:3-4, s. 235-253
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Tidskriftsartikel (refereegranskat)abstract
- Health care organizations in Sweden are recently reorienting toward horizontal organization around care processes. The aim was to investigate how implementation approaches for improvements of care processes in line with lean production (LP), at strategic and operative levels, in hospitals are associated with the consequences for working conditions and stress-related health among the employees. Five hospitals working with improvements to care processes were tracked: questionnaires to employees (n=1326) and interviews at strategic and operative levels at baseline and follow-up. The process redesign implementation strategies varied between the strategic and operative levels. There were associations between a higher degree of LP at operative level and increased work resources and decreased work demands. Physical, cognitive and mental stress-related symptoms were only weakly associated with strategic or operative LP initiatives. There was evidence of more beneficial or improved working conditions in relation to strategic or operative initiatives, approaches to degree of LP.
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| 10. |
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