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Andreasson, J., Ljungar, E., Linda, A., Jonas, H. & Dellve, L. (2018). Professional Bureaucracy and Health Care Managers’ Planned Change Strategies: Governance in Swedish Health Care. Nordic Journal of Working Life Studies, 8(1), 23-41
Open this publication in new window or tab >>Professional Bureaucracy and Health Care Managers’ Planned Change Strategies: Governance in Swedish Health Care
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2018 (English)In: Nordic Journal of Working Life Studies, ISSN 2245-0157, E-ISSN 2245-0157, Vol. 8, no 1, p. 23-41Article in journal (Refereed) Published
Abstract [en]

To increase efficiency and quality, process development has been implemented in many Swedish hospitals. These hospitals are usually organized as professional bureaucracies in which health care managers have limited decision control. The new governance principles has been implemented without removing bureaucratic elements. This study analyzes how managers implement planned change in these professional bureaucracies, considering if managers coaching style, organizational preconditions, implementation strategy, appraisal of change and clinic autonomy, is associated with health care process quality (HPQ). The study is based on interviews with health care managers and longitudinal assessments of HPQ. The results revealed significant differences between coaching style, organizational preconditions, and HPQ over time. The conclusion is that leadership and preconditions is of importance for the health care manager’s ability to work with planned change, as that the health care managers understand how management methods, governance principles, and professional bureaucracies work in practice.

Keywords
Bureaucracy, health care organizations, health care managers, implementation, lean management
National Category
Work Sciences
Identifiers
urn:nbn:se:hb:diva-15253 (URN)10.18291/njwls.v8i1.104849 (DOI)2-s2.0-85044859048 (Scopus ID)
Available from: 2018-10-26 Created: 2018-10-26 Last updated: 2018-12-07Bibliographically approved
Rydström, I., Dalheim Englund, A.-C., Dellve, L. & Ahlstrom, L. (2017). Importance of social capital at the workplace for return to work among women with a history of long-term sick leave: a cohort study.. BMC Nursing, 14(16)
Open this publication in new window or tab >>Importance of social capital at the workplace for return to work among women with a history of long-term sick leave: a cohort study.
2017 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, ISSN ISSN 1472-6955, Vol. 14, no 16Article in journal (Refereed) Published
Abstract [en]

Background

The workplace is an essential source of social capital for many people; it provides mutual support and gives meaning to life. However, few prospective studies have thoroughly investigated the importance of aspects of social capital in the workplace. The aim of this study was to investigate the associations between aspects of social capital (social support, sense of community, and quality of leadership) at the workplace, and work ability, working degree, and vitality among women with a history of long-term sick leave from human service organizations.

Methods

A longitudinal cohort study was performed among women with a history of long-term sick leave. The study started in 2005, and the women were followed up at 6 months, 1 year, and 6 years using self-reported questionnaires (baseline n = 283). Linear mixed models were used for longitudinal analysis of the repeated measurements of prospective degree of work ability, working degree, and vitality. Analyses were performed with different models; the explanatory variables for each model were social support, sense of community, and quality of leadership and time.

Results

Social capital in terms of quality of leadership (being good at solving conflicts and giving high priority to job satisfaction), sense of community (co-operation between colleagues) and social support (help and support from immediate superiors and colleagues) increased the women’s work ability score (WAS) as well as working degree over time. Additionally, social capital in terms of quality of leadership increased the women’s vitality score over time.

Conclusions

A sustainable return-to-work process among individuals with a history of long-term sick leave, going in and out of work participation, could be supported with social support, good quality of leadership, and a sense of community at the workplace. The responsibility for the rehabilitation process can not be reduced to an individual problem, but ought to include all stakeholders involved in the process, such as managers, colleagues, health care services, and the social security agency.

Keywords
Cohort, Sickness absence, Social attachment, Social capital, Vitality, Work ability, Quality of leadership
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-13258 (URN)10.1186/s12912-017-0234-2 (DOI)000405812500001 ()28725159 (PubMedID)2-s2.0-85023643292 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2017-12-18 Created: 2017-12-18 Last updated: 2018-08-20Bibliographically approved
Andreasson, J., Linda, A., Andrea, E. & Dellve, L. (2017). The importance of healthcare managers’ organizational preconditions and support resources fortheir appraisal of planned change and its outcomes. Journal of Hospital Administration, 6(1), 25-33
Open this publication in new window or tab >>The importance of healthcare managers’ organizational preconditions and support resources fortheir appraisal of planned change and its outcomes
2017 (English)In: Journal of Hospital Administration, ISSN 1927-6990, E-ISSN 1927-7008, Vol. 6, no 1, p. 25-33Article in journal (Refereed) Published
Abstract [en]

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 formanagers’ 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

Place, publisher, year, edition, pages
Sciedupress, 2017
Keywords
Healthcare managers, Preconditions, Support resources, Planned change, Healthcare process quality, Appraisal of change
National Category
Work Sciences
Identifiers
urn:nbn:se:hb:diva-15252 (URN)10.5430/jha.v6n1p25 (DOI)
Available from: 2018-10-26 Created: 2018-10-26 Last updated: 2018-11-01Bibliographically approved
Dellve, L., Wolmesjö, M. & Bremer, A. (2016). Chefers stödresurser och ledarutbildning. In: Lotta Dellve, Maria Wolmesjö (Ed.), Ledarskap i äldreomsorgen: Att leda integrerat värdeskapande i en röra av värden och förutsättningar (pp. 69-76). Borås: Högskolan i Borås
Open this publication in new window or tab >>Chefers stödresurser och ledarutbildning
2016 (Swedish)In: Ledarskap i äldreomsorgen: Att leda integrerat värdeskapande i en röra av värden och förutsättningar / [ed] Lotta Dellve, Maria Wolmesjö, Borås: Högskolan i Borås, 2016, , p. 9p. 69-76Chapter in book (Other academic)
Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2016. p. 9
Series
Vetenskap för profession: rapport, ISSN 1654-6520 ; 35
Keywords
Ledarskap, äldreomsorg, chefer, stödresurser, ledarutbildning
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-9553 (URN)978-91-88269-08-9 (ISRN)9789188269089 (ISBN)9789188269096 (ISBN)
Available from: 2016-04-06 Created: 2016-04-06 Last updated: 2016-05-20Bibliographically approved
Dellve, L., Wolmesjö, M. & Jutengren, G. (2016). Hållbara chefs- och ledarskapsstrategier som utvecklar integrerade värden. Borås: Högskolan i Borås
Open this publication in new window or tab >>Hållbara chefs- och ledarskapsstrategier som utvecklar integrerade värden
2016 (Swedish)Report (Refereed)
Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2016
Series
Vetenskap för profession: rapport, ISSN 1654-6520 ; 35
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-15260 (URN)
Available from: 2018-10-27 Created: 2018-10-27 Last updated: 2018-11-21Bibliographically approved
Dellve, L. & Eriksson, A. (2016). Hållbart ledarskap: i vardag och förändring. Borås: Högskolan i Borås
Open this publication in new window or tab >>Hållbart ledarskap: i vardag och förändring
2016 (Swedish)Report (Other academic)
Abstract [sv]

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.

Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2016. p. 59
Series
Styrning, Organisering och Ledning ; 2016:1
National Category
Business Administration
Research subject
Bussiness and IT
Identifiers
urn:nbn:se:hb:diva-10551 (URN)978-91-87525-94-0 (ISBN)
Available from: 2016-08-17 Created: 2016-08-17 Last updated: 2016-08-17Bibliographically approved
Bremer, A., Kullén Engström, A., Fredman, M., Jonasson, L.-L., Jutengren, G., Karlsson, P.-Å. & Sandman, L. (2016). Ledarskap i äldreomsorgen: att leda integrerat värdeskapande i en röra av värden och förutsättningar. Borås: Högskolan i Borås
Open this publication in new window or tab >>Ledarskap i äldreomsorgen: att leda integrerat värdeskapande i en röra av värden och förutsättningar
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2016 (Swedish)Report (Refereed)
Abstract [sv]

Det övergripande syftet med denna rapport är att beskriva chefers etiska värderingar, dilemman och organisatoriska förutsättningar för att bedriva ett värdebaserat ledarskap i såväl kommunal som privat äldreomsorg.

Det empiriska materialet består av en omfattande enkätstudie till nästan 500 studerande inom ramen för den nationella ledarutbildningen för chefer inom äldreomsorgen vid Högskolan i Borås under perioden 2013 till 2015. Utbildningen gavs på uppdrag av Socialstyrelsen och omfattade 30 högskolepoäng med två års studier på kvartsfart. Samtliga studerande var yrkesverksamma som chefer och ledare inom kommunal eller privat äldreomsorg i södra Sverige. Metoder som använts i bearbetning och analys av materialet är deskriptiva, jämförande och analytiska med regressionsmodeller och SEM-analys.

Resultatet visar på att cheferna – oavsett utbildningsbakgrund, värderade följande etiska värden högst: att inte skada, respekt för individen och rätten till konfidentialitet. Värdedilemman i chefsarbetet är dock vanligt och sammanlänkat med andra utmaningar i arbetet, särskilt med utmaningar som rör hantering över organisationsnivåer (buffertproblem och containerproblem) och av olika ansvarsområden (logikkonflikter). Inom privat verksamhet skattade de medverkande cheferna värdekonflikter och andra utmaningar i lägre grad än chefer inom kommunal verksamhet.

De flesta chefer var nöjda med hur de kunde fullfölja sitt ansvar för utveckling av verksamheten avseende värdegrund, kvalitet, processer, dagligt arbete, brukarmedverkan, brukarsäkerhet och arbetsmiljö. De flesta skattade också att de arbetade i mycket hög grad med strukturering och utveckling av dessa frågor.

Stödresurser minskade upplevelsen av värdekonflikter, men det fanns skillnad i betydelsen relaterat till chefers grundprofession. Det organisatoriska stödet var också tydligare för chefer inom privat verksamhet. Organiserade stödresurser hade stor betydelse för hållbart integrerat och värdeskapande ledarskap samt för aktiva ledningsstrategier. Även sambandet mellan hållbart ledarskap och aktiva ledarstrategier modererades av grundprofession, där sambandet var moderat negativt för chefer med social grundutbildning. Det tycks således finnas ett utbildningsbehov bland äldreomsorgens chefer och behov av ett utvecklat stöd från arbets- HÖGSKOLAN BORÅS HÖGSKOLAN BORÅS 15 givaren då det varierar avseende omfattning, inriktning och nivå mellan kommunal och privat verksamhet.

Sammanfattningsvis har chefer i äldreomsorgen många olika värden, på olika nivåer och utifrån olika perspektiv att förhålla sig till i sitt ledarskap. Att hantera och utveckla förståelse för dessa är utmanande i chefskapet och värdedilemman är vanliga. Majoriteten av cheferna i denna studie beskriver dock generellt en aktiv och god hantering och organisering av dessa. Konstateras att en integrerad förståelse och hantering, samt goda organisatoriska stödresurser tycks bidra till mer hållbart och värdeskapande ledarskap.

Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2016. p. 138
Series
Vetenskap för profession: rapport, ISSN 1654-6520 ; 35
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hb:diva-9333 (URN)978-91-88269-08-9 (ISBN)978-91-88269-09-6 (ISBN)
Available from: 2016-03-08 Created: 2016-03-08 Last updated: 2018-01-04Bibliographically approved
Dellve, L., Fallman, S. L. & Ahlstrom, L. (2016). Return to work from long-term sick leave: a six-year prospective study of the importance of adjustment latitudes at work and home.. International Archives of Occupational and Environmental Health, 89(1), 171-179
Open this publication in new window or tab >>Return to work from long-term sick leave: a six-year prospective study of the importance of adjustment latitudes at work and home.
2016 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 1, p. 171-179Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim was to investigate the long-term importance of adjustment latitude for increased work ability and return to work among female human service workers on long-term sick leave.

METHODS: A cohort of female human service workers on long-term sick leave (>60 days) was given a questionnaire four times (0, 6, 12, 60 months). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability and return to work.

RESULTS: Having a higher level of adjustment latitude was associated with both increased work ability and return to work. Adjustments related to work pace were strongly associated with increased work ability, as were adjustments to the work place. Having individual opportunities for taking short breaks and a general acceptance of taking short breaks were associated with increased work ability. At home, a higher level of responsibility for household work was related to increased work ability and return to work. Individuals with possibilities for adjustment latitude, especially pace and place at work, and an acceptance of taking breaks had greater increased work ability over time and a greater work ability compared with individuals who did not have such opportunities.

CONCLUSIONS: This study highlights the importance of opportunities for adjustment latitude at work to increase work ability and return to work among female human service workers who have been on long-term sick leave. The results support push and pull theories for individual decision-making on return to work.

Keywords
Human service, Return to work, Sickness absence, Work ability, Work adjustment
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-8593 (URN)10.1007/s00420-015-1061-y (DOI)000368807400016 ()26044671 (PubMedID)2-s2.0-84952987737 (Scopus ID)
Available from: 2016-01-15 Created: 2016-01-15 Last updated: 2017-11-30Bibliographically approved
Strömgren, M., Eriksson, A., Bergman, D. & Dellve, L. (2016). Social capital among healthcare professionals: A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements.. International Journal of Nursing Studies, 53
Open this publication in new window or tab >>Social capital among healthcare professionals: A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements.
2016 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 53Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Social capital can be an important resource to facilitate the needed improvements in quality of care and efficiency in hospitals.

OBJECTIVES: To assess the importance of social capital (recognition, vertical trust, horizontal trust and reciprocity) for job satisfaction, work engagement and engagement in clinical improvements.

DESIGN: A prospective cohort design was used.

SETTINGS: Intensive care units and emergency, surgical and medical units at five Swedish hospitals with ongoing development of their processes of care.

PARTICIPANTS: Healthcare professionals (physicians, registered nurses, assistant nurses) at five Swedish midsize hospitals.

METHODS: The participants answered a questionnaire at two occasions, NN=1602 at baseline and NN=1548 at one-year follow-up. Mean hospital response rate was 53% at baseline and 59% at follow-up. Univariate, multivariate and logistic regression analyses were performed, and the prospective analysis was based on 477 respondents.

RESULTS: Social capital was associated with healthcare professionals' general work engagement and job satisfaction. Analysis showed positive associations between all measured aspects of social capital and engagement in clinical improvements of patient safety and quality of care. The prospective analysis showed that increased social capital predicted increased job satisfaction, work engagement and engagement in clinical improvements of patient safety.

CONCLUSION: Social capital is strongly related to job satisfaction and active engagement with clinical improvements. The findings contribute to a deeper knowledge of social capital as a predictive factor that influences patient safety and health among healthcare staff.

National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-8592 (URN)10.1016/j.ijnurstu.2015.07.012 (DOI)000366873100012 ()26315780 (PubMedID)2-s2.0-84955377066 (Scopus ID)
Available from: 2016-01-15 Created: 2016-01-15 Last updated: 2018-12-07Bibliographically approved
Dalheim Englund, A.-C., Rydström, I., Dellve, L. & Åhlstrom, L. (2016). Social support outside work and return to work among women on long-term sick leave working within human service organizations. Applied Nursing Research, 30(May 2016), 187-193
Open this publication in new window or tab >>Social support outside work and return to work among women on long-term sick leave working within human service organizations
2016 (English)In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 30, no May 2016, p. 187-193Article in journal (Refereed) Published
Abstract [en]

AbstractAim To investigate the relationships between return to work and social support outside work among women on long-term sick leave from human service organizations. Background Work is an important part of life and is, in general, considered to be supportive of health and wellbeing. Few studies have thoroughly investigated the importance of aspects of social support outside work for return to work. Methods A cohort of women on long-term sick leave was followed with questionnaires from 2005 to 2012. Results The availability of social attachment increased the women's work ability, return to work, and vitality significantly more over time. There were positive relationships between return to work and seeking support in terms of emotional support and comfort and expressing unpleasant feelings. Conclusions Important resources to increase return to work can be found in factors outside work, such as close social relationships and support seeking. Thus, it is important to take the woman's whole life situation into account and not focus solely on aspects related to the workplace.

Keywords
Sickness absence, Social attachment, Social capital, Vitality, Work ability, Cohort
National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-8843 (URN)10.1016/j.apnr.2015.06.007 (DOI)000375340300034 ()27091277 (PubMedID)2-s2.0-84960948413 (Scopus ID)
Available from: 2016-02-12 Created: 2016-02-12 Last updated: 2018-12-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-0480-1895

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