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  • 1. Andersson, Johanna
    et al.
    Löfström, Mikael
    University of Borås, School of Business and IT.
    Bihari Axelsson, Susanna
    Axelsson, Runo
    Actor or arena: Contrasting translations of a law on interorganizational integration2012In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 26, no 6, p. 778-793Article in journal (Refereed)
    Abstract [en]

    Purpose – A Swedish framework law has enabled integration between public agencies in vocational rehabilitation. With the support of this law, coordination associations can be formed to fund and organize joint activities. The purpose of this study is to describe and analyze how the law has been interpreted and translated into local coordination associations and how local institutional logics have developed to guide the organization of these associations. Design/methodology/approach – Data was collected through observations of meetings within two coordination associations and supplemented with documents. The material was analyzed by compilation and examination of data from field notes, whereupon the most important aspects were crystallized and framed with institutional organization theory. Findings – Two different translations of the law were seen in the associations studied: the association as an independent actor, and as an arena for its member organizations. Two subsequent institutional logics have developed, influencing decisions on autonomy, objectives and rationality for initiating and organizing in the two associations and their activities. The institutional logics are circular, further enhancing the different translations creating different forms of integration. Research implications/limitations – Both forms of integration are legitimate, but the different translations have created integration with different degrees of autonomy in relation to the member organizations. Only a long-term analysis can show whether one form of integration is more functional than the other. Originality/value – This article is based on an extensive material providing insights into a form of interorganizational integration which has been scarcely researched. The findings show how different translations can influence the integration of welfare services.

  • 2.
    Dellve, Lotta
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wikström, E
    Contemporary leadership in healthcare organizations: Fragmented or concurrent leadership2009In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, ISSN 1477-7266, Vol. 23, no 4, p. 411-428Article in journal (Refereed)
    Abstract [en]

    Purpose – The purpose of this paper is to gain a deeper understanding of the main contemporary challenges for healthcare leaders in their everyday work practice, and the support they need to master their experienced dilemmas. Design/methodology/approach – Qualitative in-depth interviews (n=52), and focus-group interviews (n=6) with 31 first-line and 45 second-line healthcare leaders are analysed in line with constructivist grounded theory. Findings – In this paper, two leadership models are proposed for defining and differentiating ways of meeting different logics and demands made on leaders in the healthcare sector. The first model is leadership by separating different logics and fragmentation of time. Here, leaders express a desire for support in defining, structuring, dividing, and allocating tasks. The second model is leadership by integrating different logics and currentness of solutions. In this case, leaders want support in strengthening proactive leadership and shaping the basis for participative employeeship. Research limitations/implications – This research is designed to describe what people experience rather than to assess the frequency of that experience in the studied settings. However, it would be interesting to elaborate on the findings of this study using other research methodologies. Practical implications – The findings contribute to contextual knowledge that is of relevance in supporting healthcare leaders. This is helpful in identifying important conditions that support the establishment of leadership and employeeship, leading to improvements in healthcare practice. Originality/value – The paper describes how contemporary leadership in the healthcare sector is constituted through different strategies for meeting multiple logics.

  • 3. Wikström, E
    et al.
    Tengelin, E
    Arman, R
    Dellve, Lotta
    [external].
    Regulating time commitments in healthcare organizations: managers’ boundary approaches at work and in life2011In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 25, no 5, p. 578-599Article in journal (Refereed)
    Abstract [en]

    The purpose of this paper is to explore managers' boundary setting in order to better understand their handling of time commitment to work activities, stress, and recovery during everyday work and at home. DESIGN/METHODOLOGY/APPROACH: The paper has qualitatively-driven, mixed method design including observational data, individual interviews, and focus group discussions. Data were analyzed according to Charmaz' view on constructivist grounded theory. FINDINGS: A first step in boundary setting was to recognize areas with conflicting expectations and inexhaustible needs. Second, strategies were formed through negotiating the handling of managerial time commitment, resulting in boundary-setting, but also boundary-dissolving, approaches. The continuous process of individual recognition and negotiation could work as a form of proactive coping, provided that it was acknowledged and questioned. RESEARCH LIMITATIONS/IMPLICATIONS: These findings suggest that recognition of perceived boundary challenges can affect stress and coping. It would therefore be interesting to more accurately assess stress, coping, and health status among managers by means of other methodologies (e.g. physiological assessments). PRACTICAL IMPLICATIONS: In regulating managers' work assignments, work-related stress and recovery, it seems important to: acknowledge boundary work as an ever-present dilemma requiring continuous negotiation; and encourage individuals and organizations to recognize conflicting perspectives inherent in the leadership assignment, in order to decrease harmful negotiations between them. Such awareness would benefit more sustainable management of healthcare practice. ORIGINALITY/VALUE: This paper highlights how managers can handle ever-present boundary dilemmas in the healthcare sector by regulating their time commitments in various ways.

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