| 1. |
- Berglund, Martina, 1963-, et al.
(author)
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HTO - a concept of humans, technology and organisation in interaction
- 2020
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Reports (other academic/artistic)abstract
- Working life of today faces challenges. There is a fast pace in technical and organisational development and continual demands for increased performance. In order to manage the increasing complexity in work systems, there is a need to take a holistic view on operations. One such view is the systems concept of Humans, Technology and Organisation (HTO). The aim of this report is to describe the HTO concept, how it was developed, and how it can be used to develop work and work systems, understand humans at work, and understand contributing factors to organisational performance and individual well-being. The core of the HTO model is human work activity and how it is carried out within a work system consisting of humans, technology and the organisation. Focussing on human work activity generates knowledge about work conditions, needed competences and collective interaction, but also understanding about outcomes of the activities – the systems performance. H, the Humans in the work system, can be understood from different perspectives, for example as biological systems, information processing systems, individuals with unique personal traits and experiences, or as members of social groups. The H can thus in itself be regarded as a sub-system within HTO. In a similar way, T, Technology, includes several facets, such as tangible tools and machinery, intangible IT systems and software, and environmental characteristics that are technologically designed. The same applies for O, Organisation, consisting of both formal aspects (e.g. written work instructions and follow-up systems) and informal aspects (e.g. organisational culture and informal work practice). Applying HTO in practice generates several types of outcomes: 1) HTO to design products shows that it can be beneficial for productivity, quality and individual safety; 2) HTO to analyse and understand complex work may shed light on complex work in practice, the influences between the individual and the work system, and gaps between prescribed, standard work and how it is carried out in practice; 3) HTO to understand safety shows that it is achieved through systems thinking, thus technology needs to be designed to match human capabilities, and HTO barriers should be in place to prevent accidents; and 4) HTO to improve health and productivity may result in workplace redesign, increased individual well-being and business productivity. HTO has several uses, such as a theoretical framework, an analytical tool, and a method for a holistic view on human work, but also as a tool for visualisation and design.
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| 2. |
- Forslund, Magnus, 1969-
(author)
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Ledarskap för ökad innovationsförmåga : exemplet Småland
- 2019
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Book (other academic/artistic)abstract
- Ordet innovation har nästan blivit det nya svarta. Fokus ligger på hur företag, offentliga organisationer och ideella föreningar kan bli mer innovativa. Boken presenterar teorier, modeller, metoder och verktyg som i projektet Ledarskap i Småland använts för att hjälpa ledare att öka organisationens innovationsförmåga. Citat och exempel från ledares vardag i framför allt små och medelstora organisationer används som illustrationer. Med begrepp som 0,5-steg och att tända många eldar riktar sig boken i första hand till praktiskt verksamma ledare – i och utanför Småland. Detta är projektets andra bok. Den första heter Småländskt ledarskap – inledande betraktelser.
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| 3. |
- Karlsson, Magnus, et al.
(author)
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Resilience through the daily work of first line managers
- 2020
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In: Contemporary EHF 2020.
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Conference paper (peer-reviewed)abstract
- Organisational resilience can be a source of competitiveness, enabling companies to respond and adapt to unexpected changes, ensuring that a company can thrive whilst dealing with the unexpected. The ability of first line managers (FLMs) to handle their daily work at the operational level in order to maintain a stable production output, while managing the many challenges in the complex industrial context, is key. The importance of how FLMs can handle their role has been confirmed by several researchers – and more research is needed. In this research, two manufacturing companies are participating as they wish to develop their FLMs’ abilities to handle their role as an intermediate position between workers, technical support staff and upper management. The study aims to produce knowledge of how the daily work in the role of FLMs is enacted in the manufacturing context and how resilient action strategies can be developed for both performance and wellbeing. The study follows a collaborative approach in which two manufacturing companies are participating. After an initial workshop and ten in-depth interviews with FLMs the preliminary results indicate that the disturbances of daily work per se were expected by many of the interviewees. Difficulties involved were diminished by developed routines, although the information about those sometimes were difficult to find. Improvement opportunities regarded for example clarification of the role, better collaboration with support functions, more time to spend with operators interacting at shop floor level and expanding proactive action strategies.
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| 4. |
- Karltun, Anette, 1956-, et al.
(author)
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Benefits of the Human-Technology-Organization Concept in Teaching Ergonomics – Students Perspective
- 2018
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In: Advances in Intelligent Systems and Computing. - Cham : Springer. - 9783319960791 - 9783319960807 ; , s. 627-636
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Conference paper (peer-reviewed)abstract
- The human-technology-organization (HTO) concept has been used for creating systems understanding of ergonomics in three engineering educations at the School of Engineering in Jönköping. Students from courses given in two undergraduate and one graduate program (n = 122) participated in the study, which involved a course evaluation questionnaire to assess the understanding of ergonomics as discipline and HTO as a means for creating systems understanding. The questionnaire included both ranking and personal comments to the questions. The results show that the students in general considered knowledge of ergonomics and HTO as beneficial for their future work and that the HTO concept did contribute to their understanding of workplace ergonomics. However, there was a significant difference between undergraduate and graduate students in all these aspects where undergraduates ranked all these aspects lower than graduates. This was also reflected in personal comments on the questions. Conclusions that can be drawn are that understanding systems is generally difficult and the HTO concept can assist in helping students to overcome these difficulties. However, the differences between the student groups must be explicitly considered as well as increasing students’ awareness of the relevance of ergonomics for engineers.
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| 5. |
- Karltun, Anette, 1956-, et al.
(author)
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HTO - a complementary ergonomics perspective
- 2014
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In: Proceedings of Human Factors in Organizational Design and Management – xi Nordic Ergonomics Society Annual Conference – 46, Copenhagen, August 17-20. - : Nordic Ergonomics Society.
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Conference paper (peer-reviewed)
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| 6. |
- Karltun, Anette, 1956-, et al.
(author)
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Interactive Oral Assessment Supporting Active Learning
- 2014
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In: Proceedings of the 10th International CDIO Conference, Universitat Politècnica de Catalunya, Barcelona, Spain, June 16-19, 2014.
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Conference paper (peer-reviewed)abstract
- The CDIO standards stress the importance of using a variety of examination methods for effective learning assessment as well as active learning methods to help the students develop skills in applying knowledge to new settings. Oral assessment methods in a more traditional form where students answer questions in oral form instead of in written seems to be underrepresented in practice as well as in the literature although it has many benefits in supporting active learning and reaching learning outcomes. The oral examination method has been used during ten years within the field of Industrial Engineering and Management at the School of Engineering at Jönköping University in Sweden. The aim of this paper is to show how the oral assessment method has been successfully used in contributing to active learning in engineering education and lessons learned from this experience. The experience shows that by having students undertaking the assessment in groups, an active learning occasion is created by interaction between students as well as students and teacher. Through the design of the assessment the teacher has the opportunity to help the students to make connections between detailed knowledge and system understanding as well as among key concepts and to the application of knowledge to new settings. The assessment procedure also supports the teacher to discern the learning outcomes from each student. Further, the interaction between the teacher and the students during the assessment helps the teacher to capture what improvements need to be made in teaching and learning.
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| 7. |
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| 8. |
- Karltun, Anette, 1956-, et al.
(author)
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The work of first line managers – A key to resilience in manufacturing
- 2023
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In: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 110
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Journal article (peer-reviewed)abstract
- First-line managers (FLMs) have a vital role in developing stable output and organizational competitiveness through their ability to manage front-line operations in daily work. It is also well known that FLMs are strong determinants of good ergonomics and well-being for front-line staff. However, research focusing on how FLMs deal with their important role is lacking particularly regarding empirical studies. The focus here is how they deal with uncertainties and disruptive interruptions and develop more resilient performance in daily work – introduced in this article as resilient action strategies.This research uses two conceptual frameworks on resilient engineering for analysis of FLM's actions in daily work in two manufacturing companies, to explore how resilient action strategies can be organizationally supported. The study combines analysis of front-line activities with multilevel organizational support based on 30 semi-structured in-depth interviews with FLMs and support functions, 21 workshops as well as policy documents of the two companies. The analysis exemplifies how resilience engineering was enabled in practice in the organizations.The study contributes to the empirical understanding of how resilience can be organizationally supported in daily front-line work. Our results show that a developed and consistent infrastructure in companies promotes the emergence of resilient action strategies in front-line work. We propose an extended model for resilient front-line performance enhancement by including coordination as a linking aspect between the earlier suggested resilient potentials – anticipate, monitor, respond and learn. This highlights the importance of both organizational support and coordination between system levels to enable the development of resilient action strategies by FLMs.
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| 9. |
- Karltun, Johan, 1954-, et al.
(author)
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Activity – The Core of Human-Technology-Organization
- 2021
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In: Proceedings of the 21st Congress of the International Ergonomics Association (IEA 2021). - Cham : Springer. - 9783030746018 - 9783030746025 ; , s. 704-711
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Conference paper (peer-reviewed)abstract
- Human work activities are at the core of value adding processes creating system performance. The concept of human, technology and organization (HTO) is used in different cases as it offers a framework for understanding and developing work. The aim of this paper is to elucidate the character of work activities and their significance in using the HTO concept. The aspects elaborated on are: the relation between the objectives of the organization and the activity, the organizational context of the activity, the variability of the individual and the work process, the influence of history, the relation between the individual and the activity and finally how activity can be studied. Looking at three short examples from different industries, it can be concluded that the HTO concept is beneficial to use in order to better understand the studied activities in the examples. However, there must be clearly identifiable tasks to really benefit from the HTO concept.
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| 10. |
- Karltun, Johan, 1954-, et al.
(author)
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Handbok för första linjens chefer
- 2022
-
Book (other academic/artistic)abstract
- Från inledningen: Den här handboken vänder sig framför allt till dig som är första linjens chef i tillverkande industri. Första linjens chef definieras här som den första chefsnivån som har personalansvar. Det är den vanligaste chefspositionen och finns i alla företag med minst en chefsnivå. Det är en oerhört viktig funktion! Även forskningen lyfter fram första linjens chef som en nyckelposition för att skapa en väl fungerande och hållbar produktion.Du kanske är helt ny i rollen som chef och då är det här en hjälp till att förstå uppgiften. Eller så är du erfaren chef men ny i företaget, och kan behöva lite tips för att förstå och lyckas i ditt nya jobb. Slutligen hoppas vi erbjuda några guldkorn även för dig som är erfaren chef i ett företag som du känner sedan länge.Handboken vänder sig också till dig som har en roll i samarbete med första linjens chefer. Du kanske jobbar i linjen eller är teamledare, dvs ledare utan personalansvar. Du kanske är andra linjens chef eller har en stödfunktion till produktionen med ansvar för skydd och säkerhet, planering, kvalitetsutveckling, tekniskt underhåll, teknikutveckling, produktutveckling, logistik eller HR-funktioner. Vi hoppas att ni alla kan hitta användbara råd och lärdomar i handboken.I handboken vill vi tydliggöra arbetsinnehållet för första linjens chefer och hur det kan utvecklas. Vi gör det genom att beskriva rollen och arbetet som första linjens chef. Vi lägger också stor vikt vid att beskriva dynamiken och problemlösningen som hela tiden är närvarande. Dessutom vill vi peka på möjligheterna att systematiskt utveckla förutsättningarna för och förmågan att arbeta som chef i första linjen – så att du kan fungera och må bra i uppgiften på ett hållbart sätt eller stötta den personsom har denna roll. En första linjens chef har stor inverkan på både arbetsmiljön och effektiviteten inom sitt område. Även chefens arbetsmiljö är därför av stor vikt för att nå bra resultat inom dessa områden.
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| 11. |
- Karltun, Johan, 1954-, et al.
(author)
-
Handbook for front line managers
- 2023
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Book (other academic/artistic)abstract
- From the introduction: This handbook is aimed primarily at front line managers (FLMs) in manufacturing industries. Frontline manager is defined here as the first management level with personnel responsibility. It is the most common managerial position and is found in all companies that have at least one management level. It is an extremely important role. Research also highlights the FLM as a key position in the creation of well-functioning and sustainable production.You may be new to the role of being a manager, if so this book will help you to understand your tasks. If you are an experienced manager but new to the company, you will find some suggestions on how to succeed in your new job. Finally, we hope that we can offer some pearls of wisdom for those of you who are experienced managers in a company you have known for a long time.The handbook is also for you who collaborate with FLMs. You may be working in the line or as a team leader, which is a leader without personnel responsibility. You may be a second line manager or have a production support role with responsibility for protection and safety, planning and scheduling, quality development, technical maintenance, technological development, product development, logistics, HR functions or something else. We hope that the handbook will provide you all with useful advice and information.This handbook is intended to clarify the content of FLM’s work and how it can be developed. We do this by describing the role and work of the FLM but also the ever-present dynamics and problem-solving foundin the role. We also want to underscore opportunities for systematically developing the potential for and ability to work as a FLM. To enable you to work and thrive in the role in the long term or support someone else in this role. FLMs have a major impact on both work environment and efficiency within their area. As such, the manager’s work environment is also of great importance for success.
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| 12. |
- Karltun, Johan, 1954-, et al.
(author)
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Positioning the study of first line managers’ resilient action strategies
- 2019
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In: 8th REA Symposium on Resilience Engineering: Scaling up and Speeding up. - : Lnu Press. - 9789188898951
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Conference paper (peer-reviewed)abstract
- This paper introduces a study on the action strategies of first line managers (FLMs) using a resilience perspective and the aim is to position the study in the theoretical field of resilience management and engineering. One important key to an organization's long-term competitiveness are the first line managers’ ability to handle the role as a leader in daily work. In the role of a FLM, there are a lot of conflicting objectives to manage, for example, regarding available resources, subordinates’ views versus superiors’, centralized and/or local control, optimization of cost and capability (quality and delivery). Moreover, at the operational level of detail, FLMs have to balance daily deliveries in relation to development activities, i.e. technical development, product development, implementation of new system and management concepts. Regardless of the complexity in work and organisational change over time, a FLM’s most important task is to contribute to a high and stable production output out of an input that is characterized by variability and disturbances. To do so in a sustainable way, the FLMs must develop action strategies about ways of working and problem solving that systematically facilitate coping with the situation and managing their own workload. We consider this as developing resilient actions strategies that allow the FLMs to handle the upcoming problems without getting problems on their own. In this paper we describe and develop the theoretical underpinnings of the study as well as how we position our own research in relation to the different theoretical strands of resilience management. We further suggest some methodological ideas on how to capture the work and nature of first line managers’ resilient action strategies. The focus in our work will thus be on how FLMs handle and can improve the more or less chaotic mix of activities in daily work in a resilient way.
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| 13. |
- Karltun, Johan, 1954-, et al.
(author)
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Studying resilient action strategies of first line managers [Protocol]
- 2021
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In: Social Science Protocols. - : University of Edinburgh. - 2516-8053. ; 4
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Journal article (peer-reviewed)abstract
- Background: One important key to an organization’s long-term competitiveness is the ability of first line managers (FLMs) to handle their role as a leader in daily work. FLMs main task is to contribute to a high and stable production output according to customer demands from an input that is characterized by instability and variability. To do so, FLMs must develop resilient action strategies – ways of working and daily problem solving that systematically facilitate to cope with instability. In this study protocol we present a methodological approach developed to evaluate and improve these.Methods/Design: The research approach is collaborative and developmental and performed together with two companies. The approach integrates and extends the theory and application of a model on interactive research and a framework on activity analysis. It will be applied using data collection techniques like interviews, diaries, observations, document analysis, and questionnaires. The analysis and development stages will be performed both separate and in collaboration in workshops and the result is planned to end up in the joint writing of a generic handbook on advantageous action strategies for FLMs’.Discussion: This study contributes with a new integration of two methodological approaches which provides a novel way to understand and develop dynamic on-the-job behaviour in work settings.
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| 14. |
- Vackerberg, Nicoline, et al.
(author)
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What is best for Esther? A simple question that moves mindsets and improves care
- 2023
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In: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1, s. 1-16
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Persons in need of services from different care providers in the health and welfare system often struggle when navigating between them. Connecting and coordinating different health and welfare providers is a common challenge for all involved. This study presents a long-term regional empirical example from Sweden-ESTHER, which has lasted for more than two decades-to show how some of those challenges could be met. The purpose of the study was to increase the understanding of how several care providers together could succeed in improving care by transforming a concept into daily practice, thus contributing with practical implications for other health and welfare contexts.METHODS: The study is a retrospective longitudinal case study with a qualitative mixed-methods approach. Individual interviews and focus groups were performed with staff members and persons in need of care, and document analyses were conducted. The data covers experiences from 1995 to 2020, analyzed using an open inductive thematic analysis.RESULTS: This study shows how co-production and person-centeredness could improve care for persons with multiple care needs involving more than one care provider through a well-established Quality Improvement strategy. Perseverance from a project to a mindset was shaped by promoting systems thinking in daily work and embracing the psychology of change during multidisciplinary, boundary-spanning improvement dialogues. Important areas were Incentives, Work in practice, and Integration, expressed through trust in frontline staff, simple rules, and continuous support from senior managers. A continuous learning approach including the development of local improvement coaches and co-production of care consolidated the integration in daily work.CONCLUSIONS: The development was facilitated by a simple question: "What is best for Esther?" This question unified people, flattened the hierarchy, and reminded all care providers why they needed to improve together. Continuously focusing on and co-producing with the person in need of care strengthened the concept. Important was engaging the people who know the most-frontline staff and persons in need of care-in combination with permissive leadership and embracing quality improvement dimensions. Those insights can be useful in other health and welfare settings wanting to improve care involving several care providers.
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| 15. |
- Anderson, Janet E., et al.
(author)
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Translating research on quality improvement in five European countries into a reflective guide for hospital leaders : the ‘QUASER Hospital Guide’
- 2019
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In: International Journal for Quality in Health Care. - : Oxford University Press. - 1353-4505 .- 1464-3677. ; 31:8, s. G87-G96
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Journal article (peer-reviewed)abstract
- Objective: The aim was to translate the findings of the QUASER study into a reflective, dialogic guide to help senior hospital leaders develop an organization wide QI strategy.Design: The QUASER study involved in depth ethnographic research into QI work and practices in two hospitals in each of five European countries. Three translational stakeholder workshops were held to review research findings and advise on the design of the Guide. An extended iterative process involving researchers from each participant country was then used to populate the Guide.Setting: The research was carried out in two hospitals in each of five European countries.Participants: In total, 389 interviews with healthcare practitioners and 803 hours of observations.Intervention: None.Main outcome measure: None.Results: The QUASER Hospital Guide was designed for leadership teams to diagnose their organization’s strengths and weaknesses in the eight QI challenges. The Guide supports organizational dialogue about QI challenges, enables leaders to share perspectives, and helps teams to develop solutions to their situated problems. The Guide includes extensive examples of QI strategies drawn from the data and is published online and on paper.Conclusion: The QUASER Hospital Guide is empirically based, draws on a dialogical approach to Organizational Development and complexity science and can facilitate hospital leadership teams to identify the best solutions for their organization.
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| 16. |
- Karltun, Anette, 1956-
(author)
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A novel approach to understand nested layers in quality improvement
- 2014
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In: Proceedings of Human Factors in Organizational Design and Management – xi Nordic Ergonomics Society Annual Conference – 46, Copenhagen, August 17-20. - : Nordic Ergonomics Society. ; , s. 343-348
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Conference paper (peer-reviewed)abstract
- Studies on healthcare quality improvement (QI) increasingly point at the importance of understanding multilevel organizational issues, especially interaction between national, hospital and clinical level. In a EU-study involving ten hospitals in five countries one hospital stood out in successful multilevel QI work, which is elaborated in this paper. It is suggested that there is a potential in using linkages and dependencies in terms of organisational development and resource support (O) and method, process and IT support (T) affecting the individual caregiver (H), to understand the nestedness and interaction between operational system levels in QI.
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| 17. |
- Karltun, Anette, 1956-, et al.
(author)
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Developing a sustainable infection control program in health care
- 2012
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In: In proceedings of the 6<sup>th</sup> NOVO symposium on Sustainable Health Care<em></em>.
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Conference paper (other academic/artistic)abstract
- IntroductionThe increasing threat of resistant bacteria has become a progressively more important issue and a major challenge to deal with in health care systems. In 1995 the Medical Society Reference Group for Antibiotics Questions (RAF) started a Strategic Program for rational use of antibiotics and reduced antibiotic resistance called Strama. In 2006 Strama received a commission from the government and a permanent financing and on July 2010 a national Strama council was formed as an advisory body to support the Swedish Institute for Communicable Disease Control in issues regarding 1) use of antibiotics and reduced antibiotic resistance and 2) efforts to promote cross-sectorial and locally established approach includings relevant authorities, county councils, municipalities and nonprofit organizations.In May 2011 a working group within Strama was formed in hospital A on behalf of The Director of Public Health and Healthcare in the county. The Urology Unit was chosen as a pilot department as urinary infections account for more than 30 percent of all hospital-acquired infections and contributes to the overuse of antibiotics. On behalf of The Director of Public Health and Healthcare in the county, the urology clinics at the three hospitals in the county during the past year merged into a common Urology Unit as a part of the process in gaining better control of infection spread when patients move between hospitals depending on the type of treatment that each hospital is specialized on. This merger involves in itself a number of major challenges. Materials and methodsA process in the Strama work related to the Urology Unit at the County Council was followed during autumn 2011 and spring 2012 by interviewing project leaders, members of the Strama group, clinicians, attending meetings, studying documents and by observations. Results and conclusionsThe Strama group has been working at obtaining uniform working methods and procedures as it has been varying between physicians and clinics. They have also developed methods to inform about the latest treatment guidelines to assist clinicians to work properly.A problem is the difficulty for clinicians to obtain feedback on their treatment results, since the current IT systems do not enable a convenient way to access measurement data over time, which also affects the motivation of staff documenting the measurements. The Strama team therefore work together with the IT unit at the hospital to develop a so-called E-portal to provide quick feedback on clinical measurement data and prescribing patterns for antibioticsDuring the spring 2012 Strama-responsible physicians and Department Care Developers from all clinics were invited to learning seminars. The aim was that each clinic would initiate mapping and improvement work at the clinical level of three important Strama areas: antibiotics, hospital acquired infections, epidemiology and resistance.The work performed by the Strama-team is perceived as a great support at the surgical department where the urological patients are cared for after surgery. So the Strama work is now beginning to take off in the county but there are many challenges to be solved e.g. the implementation takes time due to cultural differences, between units and personnel, inefficient and incompatible information systems, organizational boundaries and lack of time for improvement work for clinicians.
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| 18. |
- Karltun, Anette, 1956-, et al.
(author)
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Emphasizing the interactive systems view in a master’s programme in Ergonomics and HTO
- 2015
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In: Proceedings 19th Triennial Congress of the IEA, International Ergonomics Association. - : International Ergonomics Association.
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Conference paper (peer-reviewed)abstract
- Ergonomics spans over several disciplines and carries a strong potential in designing and improving systems performance. However, from an educational perspective, bringing forward the systems perspective may be challenging from different point of views e.g. what areas of Ergonomics should be taught and in what way and how should the systems perspective be realized in an educational setting. The aim of this paper is to highlight experiences and lessons learned when emphasizing and developing an interactive systems perspective within a master’s programme in Ergonomics and HTO (Human, Technology, Organization) at the Royal Institute of Technology (KTH), Sweden. The interactive systems perspective is conveyed through a separate HTO-course to emphasize the systems perspective and a developed interdisciplinary approach. It further pervades the programme from selection of students, pedagogical structure of the programme and the teachers’ multidisciplinary backgrounds. Although working with a full educational programme gives substantial room for room for manoeuvre, some experiences and ideas from this education may serve as inspiration in other ergonomics and human factors educational contexts.Practitioner Summary: Ergonomics is a multidisciplinary field, which contributes to developing a systems view to design products and systems. Bringing forward the systems view in an educational setting, however, may be challenging. This paper highlights experiences and lessons learned when emphasising and developing an interactive systems perspective within a master’s programme in Ergonomics and HTO (Human, Technology, Organization) at The Royal Institute of Technology (KTH), Sweden. The interactive systems perspective is developed through student and teachers with different academic backgrounds, linking between different courses in the programme, and an HTO-course, which emphasizes the systems perspective in Ergonomics.
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| 19. |
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| 20. |
- Karltun, Anette, 1956-, et al.
(author)
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Knowledge management infrastructure to support quality improvement : A qualitative study of maternity services in four European hospitals
- 2020
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In: Health Policy. - : Elsevier. - 0168-8510 .- 1872-6054. ; 124:2, s. 205-215
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Journal article (peer-reviewed)abstract
- The influence of multilevel healthcare system interactions on clinical quality improvement (QI) is still largely unexplored. Through the lens of knowledge management (KM) theory, this study explores how hospital managers can enhance the conditions for clinical QI given the specific multilevel and professional interactions in various healthcare systems.The research used an in-depth multilevel analysis in maternity departments in four purposively sampled European hospitals (Portugal, England, Norway and Sweden). The study combines analysis of macro-level policy documents and regulations with semi-structured interviews (96) and non-participant observations (193 hours) of hospital and clinical managers and clinical staff in maternity departments.There are four main conclusions: First, the unique multilevel configuration of national healthcare policy, hospital management and clinical professionals influence the development of clinical QI efforts. Second, these different configurations provide various and often insufficient support and guidance which affect professionals’ action strategies in QI efforts. Third, hospital managers’ opportunities and capabilities for developing a consistent KM infrastructure with reinforcing enabling conditions which merge national policies and guidelines with clinical reality is crucial for clinical QI. Fourth, understanding these interrelationships provides an opportunity for improvement of the KM infrastructure for hospital managers through tailored interventions.
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| 21. |
- Karltun, Anette, 1956-, et al.
(author)
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Supporting engineering innovation and design by a multidisciplinary master´s program
- 2013
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In: Proceedings of the 9th International CDIO Conference, Massachusetts Institute of Technology and Harvard University School of Engineering and Applied Sciences, Cambridge, Massachusetts, June 9 – 13, 2013. - : CDIO.
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Conference paper (peer-reviewed)abstract
- The aim of this paper is to reflect on lessons learned from a master's program with a multidisciplinary approach. The rapidly developing technology and specialization in society, business, industry and labor puts a demand on education to provide specialist skills in various technical fields. Paradoxically, the increasing complexity also demands skills from different disciplines, such as understanding human capabilities to handle technically complex systems and adapting technology to the design of organizational and individual working conditions in different workplaces and businesses. Therefore, knowledge and experience from engineers often need to be combined with skills and experience from the domain of behavioral and health scientists in order to obtain good usability and system performance. It is not, however, an easy task to combine experiences from different domains of expertise, as diverse traditions are deeply institutionalized by different approaches and research platforms and not easily adapted and integrated within engineering faculty. The master’s program reported on in this paper is an example of promoting a multidisciplinary approach contributing to an effective CDIO implementation. The design of the master’s program includes a combination of courses from a number of scientific disciplines with teachers who represent different theoretical areas, practical skills and in addition a careful mix of examination forms. Furthermore, the students' different backgrounds and learning traditions as engineers, behavioral and health scientists create a platform with excellent opportunities to learn from each other in order to develop new and innovative ways of thinking and approaching design and business development. It also offers opportunities to experience and reflect on the cultural contradictions between educational disciplines and practice.
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| 22. |
- Karltun Erlandsson, Anette, 1956-
(author)
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A Top-Down Rationalisation in Mail Delivery – Short-term Outcomes
- 2002
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In: Organization, Intensity of Work, Quality of Work, Paris, France 21-22 November 2002. - : Institutionen för ekonomisk och industriell utveckling. ; , s. 8-
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Journal article (peer-reviewed)abstract
- The Swedish Post Office is undergoing large-scale restructuring, including outsourcing of the mail service division to an independent market driven organisation. As a consequence of exposure to competition, the local delivery offices were rationalised by introducing a new working concept called “Best Method”. It was a top-down change process that included downsizing the personnel, more standardisation of working and formalisation of delivery time. The changes have influenced the postmen’s working conditions in several ways and they perceive a greater workload. This paper aims to identify the factors that contribute to the increased workload and work intensification due to the rationalisation inherent in the new working concept. The findings emerge from an evaluative investigation conducted during autumn 2001 at fifteen local delivery offices in different parts of Sweden. It was carried out by an independent research team in industrial ergonomics through participant observation, 60 in-depth interviews and a questionnaire answered by 524 postal personnel, mainly postmen. Several factors contributing to the increased workload and work intensification have been identified, such as a faster work pace and greater physical workload, less flexibility for the individual, insufficient participation, shortcomings and contradictions in the new working concept, deficient strategic planning and systems thinking, and a somewhat indistinct organisational philosophy. Further research activities are now taking place and an intervention study is in the planning stage.
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| 23. |
- Karltun Erlandsson, Anette, 1956-
(author)
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En utredning om brevbärarpersonalens arbetsförhållanden och införandet av Bästa Metod
- 2002
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Reports (other academic/artistic)abstract
- Utredningen har utförts på uppdrag av Servicenätet Posten vid Avdelningen för Industriell Arbetsvetenskap, inom forskningsområdet Kvalitet, Människa, Teknik vid Linköpings universitet. Syftet har varit: - dels att utvärdera den totala arbetssituationen för brevbärare med i huvudsak utdelning i flerfamiljshus, - dels att utvärdera hur införandet av den så kallade ”Bästa Metod” har fungerat, främst vad gäller införandeprocess, acceptans, delaktighet och manual. Utredningsarbetet har utförts under hösten 2001. Efter deltagande observation av brevbärare i flerfamiljshus under arbete, gjordes 60 djupintervjuer med såväl brevbärare, SEKO-ombud som postcenterchefer på femton av Posten utvalda utdelningskontor spridda över hela Sverige. Intervjumaterialet låg till grund för en enkät som distribuerades till samtlig personal på de femton utdelningskontoren. 525 enkäter har besvarats (en svarsfrekvens på 90 procent). Ergonomiska studier och fysiska mätningar har utförts på brevbärare under arbete för att identifiera belastningsergonomiska risker och prioritera mellan olika förbättringsförslag. Resultaten visar att brevbärarnas arbetsförhållanden i dag är krävande, framförallt i fysiskt avseende, något som understryks av en mycket hög besvärsfrekvens från rörelseorganen. Bästa Metod framstår som en principiellt bra arbetsmetod med stor utvecklingspotential. De flesta brevbärare bedömer metoden som arbetsbesparande och produktivitetsförbättrande men uttrycker farhågor för den fysiska arbetsbelastningen och framtida besvärsrisker samt kvalitetsbrister. Om utvecklingspotentialen skall kunna tas till vara för både verksamhetens och brevbärarnas bästa, erfordras en optimering av arbetssättet. Resultaten visar också att det finns stora skillnader i hur väl Bästa Metod fungerar vid de femton utdelningskontor som ingått i studien. Ett antal faktorer som försvårat införandet och tillämpningen av Bästa Metod har identifierats. Brist på delaktighet och lokal anpassning framträder särskilt. Arbetsledningens agerande på såväl lokal som central nivå har visat sig vara en kritisk faktor för hur väl arbetet med Bästa Metod har förlöpt. Vi bedömer att åtgärder som fokuserar på att öka brevbärarnas delaktighet och lokalt anpassa Bästa Metod, skulle resultera i bättre arbetsförhållanden för brevbärarna, en ökad effektivitet, bättre produktivitet och kvalitetsvinster. En infrastruktur som befrämjar god informationsspridning och kommunikation både horisontellt och vertikalt i organisationen är då avgörande. Med ett åtgärdsprogram och en plan för ständigt förbättringsarbete, skulle verksamheten med Bästa Metod och brevbärarnas arbetssituation på sikt kunna förbättras med åtgärder på såväl lokal som central nivå i organisationen. Utredningen har visat på ett antal önskvärda åtgärder och flera av dessa kan genomföras av Posten själva. De åtgärder som föreslås nedan genomförs av Posten i samarbete med Avdelningen för Industriell Arbetsvetenskap och de kan delas upp i två huvudkategorier: I. I rapporten preciserade förbättringsförslag som kan genomföras relativt omgående av Posten med stöd från Avdelningen för Industriell Arbetsvetenskap: KAMFACKEN • Förbättrad märkning av kamfacken och införande av kompletterande karta (prototyp finns redan klar), för att underlätta kamning på ny slinga samt förbättrad belysning vid kamfacken. • Justeringar och optimeringar av kamfacken där så är möjligt. • Förbättring av avlastningsytor vid kamfacken. SKOR • Införskaffande av lämpliga individuellt anpassade skor för både inomhus- och utomhusarbete. UTBILDNING • Utbildning i arbetsteknik av utvalda representanter från respektive utdelningskontor. ARBETSRUTINER • Fördelning av arbetsmoment, utveckling av arbetsrutiner som exempelvis slingors sammansättning och anpassad användning av cyklar och motordrivna fordon. UTRUSTNING • Utveckling av hjälpmedel och utrustning, som exempelvis centralpostfack. De ovanstående förändringarna testas på pilotkontor före breddinförande. II. Åtgärder som kräver ytterligare planering och utvärdering för att kunna genomföras och som innebär medverkan av Avdelningen för Industriell Arbetsvetenskap Lokala åtgärder genom utveckling av den lokala arbetsorganisationen mot välfungerande teambildningar på utdelningskontoren. Under sommaren 2001 började man på utdelningskontoren införandet av en teambaserad arbetsorganisation genom att tillsätta teamledare som ansvarar för den löpande verksamheten. En ytterligare utveckling av denna organisations-form föreslås. Man skulle därmed öka delaktigheten bland personalen, vilket på sikt skulle leda till bättre och effektivare arbetsformer med större påverkansmöjligheter över det dagliga arbetet, större ansvarskänsla, större arbetstillfredsställelse och högre yrkesstolthet. Denna arbetsform skulle kunna vidga synen på vad som är ”det egna distriktet” och skulle vidare minska känsligheten för störningar. I samband med detta skulle en plan för ”Ständiga Förbättringar” introduceras, för att bygga in ett kontinuerligt kvalitetstänkande och ökad delaktighet i det dagliga arbetet. Sammantaget skulle man kunna uppnå bättre lokal anpassning, högre produktivitet och bättre kvalitet. CENTRALA ÅTGÄRDER Utredningen har visat att det funnits kommunikationsglapp mellan de olika nivåerna i organisationen och att brevbärarpersonalen upplever bristande delaktighet, toppstyrning och otillräcklig flexibilitet i fråga om lokala anpassningar. Detta synes ha påverkat arbetet med Bästa Metod negativt. En analys behöver göras över hur kommunikationsglapp och delaktighets-brister uppstår, med syfte att utveckla åtgärdsförslag för att förbättra infrastrukturen och kommunikationen mellan de olika organisationsnivåerna. Därigenom skapas förutsättningar att från centralt håll öka delaktigheten och på så sätt skapa en bättre verksamhet. Resultaten matchas sedan mot erfaren-heterna på lokal nivå för vidare åtgärder. Framgången med Bästa Metod varierar på de femton utdelningskontor som ingått i studien. Rapporten visar att olika lokala förhållanden och förut-sättningar påverkat utfallet med Bästa Metod. Detta är något som kan utredas närmare. Behovet av lokala anpassningar måste vägas mot behovet av en standardisering av arbetet enligt Bästa Metod. Hur denna avvägning kan göras är förknippad med användningen av manualen för Bästa Metod och dess fortsatta nytta. Vi menar att en manual bör tydliggöra vad som är kärnan i det nya systemet och därmed ska gälla överallt, men manualen bör också tydliggöra vad som kan anpassas lokalt, och ge ett stöd för hur detta kan ske. Manualen behöver vidareutvecklas och omarbetas för detta syfte. Utredningen visar att det i vissa avseenden finns en bristande överens-stämmelse mellan den bärande tanken bakom Bästa Metod och den ökade flexibilitet som krävs av brevbärarna i praktiken. Det gäller bland annat hur snabbt nyanställda eller ovana brevbärare kommer upp i arbetstakt när man kammar upp post på en ny slinga, hur introduktion av nyanställda sker, vilka kvalifikationer brevbärare bör ha och vilka effekter detta har på yrkes-stoltheten. Den höga medelåldern på brevbärarna i dag kommer att medföra många nyanställningar inom en 10-15-årsperiod. Dessa frågor är då viktiga att utreda inte minst ur produktivitets- och kvalitetshänseende. Mot bakgrund av ovanstående föreslås följande åtgärder som hänför sig till punkt II ovan: • Att identifiera kommunikationsglapp och delaktighetsbrister för att skapa förbättringsförslag och ledningsstrategier i syfte att förbättra verksamheten. • Utbildning i Människa-Teknik-Organisation (MTO) och Life Cycle Cost analyser (LCC), för ökad systemsyn och möjligheter att analysera och utvärdera teknikval och alternativa åtgärder, utifrån konsekvenser för systemprestanda, ekonomi och människorna i systemet. Det finns ett flertal möjliga åtgärder som kan få positiv effekt på inte bara belastnings-situationen för brevbärarna utan också på produktivitet och kvalitet. • Att starta en tidsbegränsad kampanj som bygger på delaktighet genom brevbärarnas förslag till och utveckling av hjälpmedel och produkter med syfte att underlätta arbetet. • Utveckling av arbetsorganisationen med inriktning mot flexibla team med ansvar för sitt specifika område med syfte att: • öka delaktigheten hos personalen, • förbättra informationsspridning och kommunikation, • skapa utrymme för lokala anpassningar, • öka arbetstillfredsställelsen, • skapa förutsättningar för ökad yrkesstolthet, • minska den fysiska belastningsproblematiken samt stressrelaterade faktorer, • förbättra den arbetsrelaterade hälsan, • förbättra kompetensen genom att utveckla en kompetensutvecklingstrappa, • optimera förutsättningarna för nyanställda, vikarier och brevbärare som arbetar på nya slingor, • utbilda instruktörer i varje team både ergonomiskt och för handledning av nybörjare, • minska känslighet för störningar i systemet, • öka produktiviteten och kvaliteten i verksamheten.
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| 24. |
- Karltun Erlandsson, Anette, 1956-
(author)
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Evaluation of intervention measures : a methodological approach
- 2006
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In: 16th World Congress on Ergonomics, Maastricht, the Netherlands 10-14 July. - : Institutionen för ekonomisk och industriell utveckling.
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Conference paper (peer-reviewed)abstract
- It is common for researchers to evaluate interventions by having the participants answer standardized questions before and after, and measuring the effect of the intervention as a statistical difference between the two. There is a risk that the results of such a calculation will be misleading due to the subject interpreting the response scales differently on each occasion. This risk has previously been observed by Golembiewski et al, who indicated that we are dealing with a psychometric problem set that is especially evident in interventions. The question is whether the individual’s own yardstick for assessing or valuing a certain circumstance/area is the same before and after the intervention, or whether the yardstick has changed due to the subject gaining new experience within the conceptual framework. Golembiewski calls this phenomenon beta change. The purpose of this paper is to illustrate empirically the occurrence of beta change and its possible consequences for the interpretation of the results, with the aid of a model devised by Terborg et al. The material is taken from a health-promoting intervention project in the mail distribution division of the Swedish Post Office.
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| 25. |
- Karltun Erlandsson, Anette, 1956-
(author)
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Forskarstött förändringsarbete i själva verket : Att förbättra arbetssituationen för 15 000 brevbärare
- 2007
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Doctoral thesis (other academic/artistic)abstract
- Denna avhandling belyser forskarstött förändringsarbete, inom ”Servicenätet Posten”, den division inom Posten Sverige AB som ansvarar för postdistribution till kunderna. Förändringsarbetet har handlat om att förbättra arbetssituationen för 15 000 brevbärare.Den teoretiska grunden utgörs av ett systemtänkande där konceptet ”Människa-Teknik-Organisation” (MTO), används för att granska interventionsprocessen.Det övergripande syftet med denna avhandling är att bidra till kunskapsutveckling-en om forskarstött förändringsarbete utifrån följande delsyften: 1) att illustrera hur ett systemtänkande i förändringsarbete påverkar förståelsen för hur systemkomponenterna Människa, Teknik och Organisation (MTO) interagerar i praktiken, 2) att exemplifiera hur den kunskapen kan omsättas i praktiken genom utveckling och implementering av MTO-anpassade lösningar i samverkan mellan forskare och praktiker, 3) att empiriskt exemplifiera hur former för participation kan bidra till framgångsrikt förändringsarbete genom analys och syntes av process och resultat.Forskningsprojektet har bedrivits med en interaktiv ansats. Den interaktiva ansatsen har gjort det möjligt att belysa samverkan mellan forskare och praktiker på ett verklig-hetsnära och realistiskt sätt under fyra projektfaser fördelade över en femårsperiod.Den inledande projektfasen innebar en diagnostisering av problematiken. Ett antal åtgärdsförslag presenterades av forskargruppen och ledde vidare till ett forskarstött ut-vecklingsarbete under en andra projektfas då ett underlag till olika förbättringsåtgärder arbetades fram. Detta inbegrep utveckling av såväl teknisk som arbetsorganisatorisk ka-raktär för att åstadkomma effektiva och hälsosamma arbetsprocesser för brevbärare inom postutdelningsverksamheten. I en tredje projektfas testades och utvärderades hela åtgärdspaketet genom implementering på ett pilotkontor. I en fjärde och sista projektfas implementerades förbättringsåtgärderna på samtliga 602 postutdelningskontor i landet och forskarna gjorde en utvärdering.Resultaten visar hur man genom att anlägga ett MTO-perspektiv i förändringsarbete ökar möjligheterna att få klarhet i vilka faktorer som påverkar effektiviteten i ett pro-duktionssystem i sin helhet. Den tvärvetenskapliga forskningssatsningen i kombination med samverkan forskare/praktiker visade sig vara en förutsättning för att skapa förståel-se för interaktionen mellan M-T-O-komponenterna. Avhandlingen visar vidare hur olika former för participation i praktiken kan bidra till framgångsrikt förändringsarbete både vad gäller process och resultat. Den utförliga redogörelsen för interventionsprocessen, forskarrollens skiftande karaktär samt hindrande och främjande faktorer för forskarstött förändringsarbete, utgör andra viktiga kunskapsbidrag.
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