Carina Furåker

Learning leadership through practice – healthcare managers' experience

Purpose – The aim of this study is to describe the experience of Swedish healthcare managers (HCMs) of learning leadership through practice.Design/methodology/approach – The study is based on a qualitative approach, and critical incident technique guided the data collection. Interviews with 22 hospital HCMs provided a total of 50 narratives. These narratives were categorised by classifying them according to their manifest content, and a latent content analysis resulted in categories with additional sub‐categories.Findings – Leadership learning occurred in relation to reorganisation, developmental work and conflicts. About 50 per cent of the narratives were classified as “managing conflicts”. The learning outcome in the classes was related to the categories “personal development”, “interpersonal leadership qualities” and “developing leadership strategies”. About 50 per cent of all learning outcome was a result of managing conflicts.Research limitations/implications – To be able to transfer the findings to ...

Primary healthcare in transition – a qualitative study of how managers perceived a system change

BackgroundPrimary healthcare in Sweden has undergone widespread reforms in recent years, including freedom of choice regarding provider, freedom of establishment and increased privatisation. The key aims of the reforms were to strengthen the role of the patient and improve performance in terms of access and responsiveness. The aim of this study was to explore how managers at publicly owned primary healthcare centres perceived the transition of the primary healthcare system and the impact it has had on their work.MethodsIn this qualitative study, 24 managers of publicly owned primary healthcare centres in the metropolitan region of Gothenburg were recruited. Semi-structured interviews were conducted and data were analysed using content analysis inspired by Silverman.ResultsThe analysis revealed two core themes: The transition is perceived as a rapid change, enforced mainly through financial incentives and Prioritisation conflicts arise between patient groups with different needs, demands and levels of empowerment. The transition has produced powerful and rapid effects that were considered to be both positive and negative. While the new financial incentives were seen as a driving force and a tool for change, they also became a stress factor due to uncertainty, competition with other primary healthcare centres and negative feelings associated with staff cutbacks. The shift in power towards the patient improved access and service but also led to more patients with unreasonable demands. Managers found it difficult to prioritise correctly between patient groups with different needs, demands and levels of empowerment and they were concerned about potentially negative effects on less empowered patients, e.g. multi-morbid patients. Managers also experienced shortcomings in their change management skills.ConclusionsThis qualitative study shows the complexity of the system change and describes the different effects and perceptions of the transition from a manager’s perspective. This suggests a need for improved follow-up and control in order to monitor and govern system changes and ensure development towards a more effective and sustainable primary healthcare system.

Age care managers in residential facilities – aspects of competence

Purpose – The purpose of the research project was to study aspects of the competence of age care managers, and how they develop their leadership in residential facilities.Design/methodology/approach – The participants comprised 13 age care managers (ACMs) from 13 different residential facilities. Ten of the residential facilities were located in a large municipality and three in small municipalities. On average they had 19 years of experience of caring for old people. The ages of the respondents varied from 40 to 63 years. Individual, semi‐structured interviews were chosen. The data were subjected to content analysis. Two main categories and six subcategories were generated.Findings – The ACMs had different educational backgrounds and very few had university courses in management, implying an insufficient theoretical knowledge of leadership. There are several ways of learning leadership, for example model learning, collective learning, learning by experience and through theoretical education. Model learni...