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  • 1. Jensen, Christian
    et al.
    Johansson, Staffan
    Löfström, Mikael
    University of Borås, School of Business and IT.
    The project organization as a policy tool in implementing welfare reforms in the public sector2012In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 28, no 1, p. 122-137Article in journal (Refereed)
    Abstract [en]

    Organizational design is considered in policy literature as a forceful policy tool to put policy to action. However, previous research has not analyzed the project organization as a specific form of organizational design and, hence, has not given much attention to such organizations as a strategic choice when selecting policy tools. The purpose of the article is to investigate the project as a policy tool; how do such temporary organizations function as a specific form of organization when public policy is implemented? The article is based on a framework of policy implementation and is illustrated with two welfare reforms in the Swedish public sector, which were organized and implemented as project organizations. The case studies and the analysis show that it is crucial that a project organization fits into the overall governance structure when used as a policy tool. If not, the project will remain encapsulated and will not have sufficient impact on the permanent organizational structure. The concept of encapsulation indicates a need to protect the project from a potential hostile environment. The implication of this is that organizational design as a policy tool is a matter that deserves more attention in the strategic discussion on implementing public policies and on the suitability of using certain policy tools.

  • 2.
    Kullén Engström, Agneta
    et al.
    [external].
    Axelsson, L
    The concept of effectiveness--a blind alley? A study of different interpretations in a Swedish county council2001In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 16, no 1, p. 61-71Article in journal (Refereed)
    Abstract [en]

    Swedish health care organizations are experiencing pressure to make ever greater efforts to rationalize and to increase effectiveness in the way they plan and provide services. In order to gain a better understanding of the current practice of the three groups of key actors in Swedish health care—politicians, senior civil servants and operational managers—and their perception of effectiveness, a study was carried out in a Swedish county council using both qualitative and quantitative methods. While in general the concept of effectiveness is thought of as crucial, it is not clearly or uniformly defined within the organization. Each of the three groups defines the concept in a way that reflects their own function, which may lead efforts to achieve effectiveness into a blind alley.

  • 3.
    Kullén Engström, Agneta
    et al.
    [external].
    Axelsson, R
    The double spiral of change: experiences of privatization in a Swedish hospital2010In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, ISSN ISSN 0749-6753, EISSN 1099-1751, Vol. 25, no 2, p. 156-168Article in journal (Refereed)
    Abstract [en]

    ObjectivesPrivatization is a trend in countries with a public health system. It involves organizational change, a cultural transformation and changes for the employees as well as a more strictly controlled work. The objective of this study is to describe, analyse and interpret how privatization is perceived by the employees of a health care organization in Sweden. Methodology In-depth interviews have been performed with physicians, paramedics, secretaries, nurses, assistant nurses and local managers, in all 14 respondents, after a private entrepreneur had taken over the management of a hospital. The interviews were tape-recorded and have been analysed and interpreted following a grounded theory approach. Findings The transcribed interviews show that trust is a core category and linked with emotions, commitment and security. The analysis shows that employees' experience of privatization within a health care organization differs and is full of nuances and complexities. Conclusion A simultaneous virtuous and a vicious circle of experiences and reactions may describe how employees experience privatization. It can also be concluded that leadership is an important factor in the success of organizational change.

  • 4. Lindgren, Åsa
    et al.
    Bååthe, Fredrik
    Dellve, Lotta
    University of Borås, School of Health Science.
    Why risk professional fulfilment: a grounded theory of physician engagement in healthcare development2013In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 28, no 2, p. 138-157Article in journal (Refereed)
    Abstract [en]

    The need for trans-professional collaboration when developing healthcare has been stressed by practitioners and researchers. Because physicians have considerable impact on this process, their willingness to become involved is central to this issue. OBJECTIVE: This study aims to gain a deeper understanding of how physicians view their engagement in healthcare development. METHOD: Using a grounded theory approach, the study developed a conceptual model based on empirical data from qualitative interviews with physicians working at a hospital (n = 25). RESULTS: A continual striving for experiences of usefulness and progress, conceptualized as 'striving for professional fulfilment' (the core category), emerged as a central motivational drive for physician engagement in healthcare development. Such experiences were gained when achieving meaningful results, having impact, learning to see the greater context and fulfilling the perceived doctor role. Reinforcing organizational preconditions that facilitated physician engagement in healthcare development were workplace continuity, effective strategies and procedures, role clarity regarding participation in development and opportunities to gain knowledge about organization and development. Two opposite role-taking tendencies emerged: upholding a traditional doctor role with high autonomy in relation to organization and management, clinical work serving as the main source of fulfilment, or approaching a more complete 'employeeship' role in which organizational engagement also provides a sense of fulfilment. CONCLUSION: Experiencing professional fulfilment from participation in healthcare development is crucial for sustainable physician engagement in such activities.

  • 5.
    Löfström, Mikael
    University of Borås, School of Business and IT.
    Inter-organizational collaboration projects in the public sector: a balance between integration and demarcation2010In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 25, no 2Article in journal (Refereed)
    Abstract [en]

    For several years, the development of the Swedish public sector has been accompanied by a discussion about inter-organizational collaboration, which has been examined in several national experiments. The experience, however, indicates significant difficulties in implementing collaboration in local authorities’ regular activities. This article argues that organizing inter-organizational collaboration in projects tends to be counterproductive, since the purpose of this collaboration is to increase the integration of local authorities. This article is based on case studies of three different collaboration projects. Each project is analyzed in relation to the way collaboration is organized within the project and how the relationship to the local authorities’ activities is designed. The outcome of these studies shows that while collaboration projects increase integration between the responsible authorities, the integration stays within the projects. This is due to the fact that the projects were designed as units separate from the responsible authorities. As a result, the collaboration that occurs in the projects is not implemented in the local authorities’ activities, and the viability of the increased integration of different responsible authorities does not extend beyond the projects.

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