| 1. |
- Gadolin, Christian, et al.
(författare)
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Organising Healthcare with Multi-Professional Teams : Activity Coordination as a Logistical Flow
- 2016
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Ingår i: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - : Göteborgs universitet. - 2000-8058 .- 2001-3310. ; 20:4, s. 53-72
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Tidskriftsartikel (refereegranskat)abstract
- Multi-professional teams are now common when organising healthcare. Such teams areconsidered to resolve fragmentation issues amongst units and their functions, facilitateefficient and high quality care and are also deemed to enable different professions to meetand exchange experience and knowledge. The expected consequence is superior decisionsand improved care. However, research suggests that the deployment of multi-professionalteams within healthcare organisations is problematic with regard to knowledge sharingand integration between different professional groups. While often recognised, the reasonfor this shortcoming has rarely been explored in depth. This study consequently elaborateson the factors hindering knowledge sharing through illustrating and discussing thelogics of different professional groups and the ensuing consequences when multiprofessionalteams interact. The finding is that the teams are being utilised by the medicalprofessions in accordance with their professional logic. This results in the coordination ofactivities, incorporating the patient flow logistics amongst the different professions; makingthe impact of multi-professional teams concrete in practice and illustrating their potentialpositive outcomes for professionals and patients, even though they are not operatingas forums for overt knowledge integration for the different professions.
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| 2. |
- Nordesjö, Kettil, 1981-, et al.
(författare)
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Special Issue Introduction : The Power of Evaluation
- 2021
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Ingår i: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - : Göteborgs universitet. - 2000-8058 .- 2001-3310 .- 2001-7413 .- 2001-7405. ; 25:3/4, s. 3-15
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this special issue is to invite scholars in public administration to address issues of power in relation to evaluation practices in the public sector. Power is one of those big, difficult, and inherently nebulous concepts that both scholars and practitioners appear to consciously or unconsciously avoid. Our ambition in this introduction is not to present a comprehensive conceptual review of power, let alone to present the many different aspects of evaluation. Rather, this is a humble attempt to foster a more explicit discussion of the relationship between power and evaluation. The aim of this introduction is, firstly, to introduce a few basic distinctions and conceptualisations of the relationship between power and evaluation. Secondly, we would like to highlight three themes where power may be an especially fruitful lens when analysing, or just trying to make sense of, evaluation procedures. These are themes found in evaluation research, but where power is not always acknowledged or accounted for. We call them (1) Evaluation and instrumental power, (2) Evaluation and contextual power, and (3) Evaluation and performative power.
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| 3. |
- Rämö, Hans, 1963-, et al.
(författare)
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Reform in Translation : The Swedish Transport Administration's Quest for a New Mission Statement
- 2022
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Ingår i: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - : University of Gothenburg. - 2000-8058 .- 2001-3310 .- 2001-7413 .- 2001-7405. ; 26:4, s. 19-46
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Tidskriftsartikel (refereegranskat)abstract
- The long-term outcomes of reform processes in the public sector remain understudied inthe literature. This study investigates the Swedish Transport Administration (STA)employees’ and managers’ translation and internalization of their new role as societaldevelopers. Since the STA’s founding in 2010 and until 2018, the STA head officeneither guided nor centrally determined how to define and understand the STA’s role as asocietal developer. We examine this internalization process through the lens ofCzarniawska’s translation model of the distribution of ideas as a collective creationthrough local translation and adaptation. The study shows that the ongoing friction thatoccurs when the concept and role of a societal developer are discussed and disseminatedwithin an organization is influenced by prevailing identities and local action nets. It alsoshows that the translation of this new role eventually failed, due to either it beingsubmerged within already-existing concepts or it having a perceived lack of relevance.We conducted this mixed-method study over six years (2016–2021) using documentaryanalysis, workshop participation, interviews and a survey.
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| 4. |
- Hedegaard, Joel, et al.
(författare)
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Communicative Construction of Native versus Non-Native Swedish Speaking Patients in Consultation Settings
- 2014
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Ingår i: Scandinavian Journal of Public Administration. - 2001-7405. ; 17:4, s. 21-47
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we examine patient-centered care through analyzing communicative constructions of patients, on the basis of their native language, in consultations with physicians. Whereas patient-centered care is of current interest in health care, research has not addressed its implications in this dimension. Previous studies indicate that non-native Swedish speaking patients, experience substandard interpersonal treatment far more than native Swedish speaking patients. Our findings show that the non-native Swedish speaking patients presented themselves as participating, whereas the native Swedish speaking patients presented themselves as amenable. The physicians responded in two different ways, argumentatively towards the non-native Swedish speaking patients and acknowledging vis-à-vis the native Swedish speaking patients. When decisions and conclusions were made by the patients and physicians, this resulted in preservation of the status quo in the consultations with the non-native Swedish speaking patients, while the corresponding result with the native Swedish speaking patients was monitoring of their health status. So, whereas the non-native Swedish speaking patients actually were model patient-centered care patients, physicians were more amenable towards the native Swedish speaking patients. We suggest that patient-centered care is desirable, but its practical application must be more thoroughly scrutinized from both a patient and a health care worker perspective.
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| 5. |
- Johansson, Kerstin, 1963-, et al.
(författare)
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After the NPM Wave : Evidence-based practice and the vanishing client
- 2015
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Ingår i: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - Götebrog : Göteborgs universitet. - 2000-8058 .- 2001-3310. ; 19:2, s. 69-88
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Tidskriftsartikel (refereegranskat)abstract
- Over the last two decades, a movement for Evidence-Based Management (EBM) has surfaced across the Atlantic world with pretensions of being a successor of New Public Management (NPM). In this paper, we focus on Swedish social welfare as an arena where persistent government attempts have been made to implement locally new evidence-based ideas, specifically evidence-based practice (EBP). In Swedish discourse, the meaning of “evidence-based” is contested. One interpretation maintains that best (and only acceptable) evidence comes from the use of randomized controlled trials (RCTs). Another interpretation maintains that evidence from research constitutes only one leg of a multi-factorial definition; that is, this view contends that RCT evidence should be considered along with experience of practitioners and clients (users). Although client participation was an important tenet in the incipient attempts to implement EBP, by using translation theory this article will show that later attempts have tended to ignore the client’s perspective. From this foundation, we address why client views and outlooks have been ignored in EBP implementation.
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| 6. |
- Arman, Rebecka, et al.
(författare)
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Structuration in Managerial Communication Processes
- 2012
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Ingår i: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - : Göteborgs universitet: School of Public Administration. - 2000-8058 .- 2001-3310. ; 16:2, s. 143-163
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to describe and analyse observed managerial communication. The research questions concerned: What characterizes managerial communication practices and the organizational consequences? We make use of structuration theory and view communication as a social interaction process in which temporary structures are negotiated. Ten first- and second-line managers were shadowed. The managers used a combination of structuration of caring, interdependency and accountability typical of health care organizations. The communication practices were related to how new norms of reputation management were institutionalized through structuration. The types of structuration were sometimes contradictory and productive communication was rare or non-existent. The managerial communication practices had consequences for the power and domination and for which issues were signified as part of the agenda. The conclusions can be generalizable to other professional organizations.
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| 7. |
- Belin, Mats-Åke, et al.
(författare)
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Vision Zero. How a policy innovation is dashed by interest conflicts, but may prevail in the end.
- 2013
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Ingår i: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - 2000-8058 .- 2001-3310. ; 16:3, s. 83-102
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- In October 1997 the Swedish Parliament adopted a new road safety policy – Vision Zero. Vision Zero entails a fundamentally new division of responsibility for traffic safety between road users and the so called system designers such as road administrations, municipalities, and professional transport companies among others. In this study the implementation of a formal responsibility for system designers to prevent serious injuries in road traffic between 1997 and 2009 is evaluated. Two main research questions have guided this study namely: How has the legislative process of formalizing the responsibility of system designers progressed? and What important factors might explain the implementation outcome? The main sources of information for this study were official key documents. Based on a goal attainment model, an important conclusion is that the goal to legally formalize a responsibility has only been minimally realized and therefore this might be an example of a classic implementation failure. In order to explain and discuss this low level of achievement a process evaluation approach has also been used. Built on this process evaluation approach, it can be questioned if this is an example of implementation failure after all.
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| 8. |
- Berg Nordstrand, Laila, et al.
(författare)
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Managers’ identities : Solid or affected by changes in institutional logics and organisational amendments?
- 2017
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Ingår i: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - 2000-8058 .- 2001-3310. ; 21:1, s. 81-101
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Tidskriftsartikel (refereegranskat)abstract
- This paper studies doctors in Norway and Finland to compare how identities among professionals in managerial positions were expressed after changes in management in the aftermath of ‘New Public Management’ (NPM) reforms. Studying shifting identities provides a basis for investigating how institutions have changed and illuminates how agents within an organisation have implemented NPM-inspired reforms. Data from both countries revealed three groups: the majority of doctors/managers, who had a strong managerial identity; a smaller group who mainly identified as doctors; and a few doctors who displayed hybrid identities. Work experiences have a strong effect on how identity is perceived. Doctors who hold on to their professional identities seemed uneasy with their skills and ability to perform the tasks related to their new position. Many of the doctors were found to have altered their identities due to organisational amendments and the expanded focus on management-related issues. Hence, this paper concludes that a strong intervention in the sector from central government, as seen in Norway, has resulted in implementing general management to a larger degree than in Finland, but in a more hybrid manner. This is expressed through a focus on management, the institutional logics at stake and doctors’ identity formation.
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| 9. |
- Berlin, Johan, 1975-, et al.
(författare)
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Trender som utmanar traditioner : En hälso- och sjukvård i metamorfos
- 2012
-
Ingår i: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - 2000-8058 .- 2001-3310. ; 16:2, s. 3-23
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Tidskriftsartikel (refereegranskat)abstract
- I artikeln ges en översikt över traditioner inom hälso- och sjukvården som utmanas av trender. Betydelsen av starka professioner, otydliga och motstridiga mål och otillräckliga resurser har gjort att verksamheten måste hantera motsägelsefulla krav. Ett sätt att komma tillrätta med detta har skett genom införande av valfrihetssystem, arbete över organisatoriska och professionella gränser och ökad flexibilitet. Trenderna har till stor del influerats av styrmodeller inspirerade av New Public Management. Uppblandningen mellan nya och traditionella styrmodeller har gjort att det utvecklats hybrider. Hybriderna har bidragit till en organisatorisk spänning, där gammalt och nytt blandas i en motsägelsefull, men förnyande process.
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| 10. |
- Bohlin, Magnus, et al.
(författare)
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The Development of Swedish Tourism Public Policy 1930-2010
- 2014
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Ingår i: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - Göteborg. - 2000-8058 .- 2001-3310. ; 18:1, s. 19-39
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Tidskriftsartikel (refereegranskat)abstract
- In this article, the development and changes in Swedish public policy relating to tourism from the 1930s to 2010 is described and interpreted from a political economy perspective. A case study, compiled from mainly secondary sources, is analyzed from a theoretical framework based on regulation theory. The purpose with this study is to increase the understanding of how the macro political economy context has influenced the policy-making in tourism in Sweden, but also to make a contribution to an area which seems to be quite neglected when it comes to research. The changes are analyzed according to the three periods denoted as pre-Fordism (mid-19th century-1930s), Fordism (1930s-1970s) and post-Fordism (1970s to present). It is observed how the general changes between these periods regarding aspects such as regulation and deregulation, and the degree of state involvement, have affected tourism policy making. The tourism policy making has changed from being insignificant, to a high degree of state involvement including planning, control and supervision, to a situation where the market rather than government regulation is considered as state of the art.
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