Elina Viitanen

Reflection on Work Culture: The key to success

This paper reports on a development project carried out in a large hospital aiming to develop the expertise of the participating physiotherapists, and to discover cultural factors that promote and hinder change in organisations. The reflective and participatory educational intervention employed an action research framework and developed individual expertise and work orientation among the participants, but more extensive development of work in the physiotherapy unit was found difficult. Change and the spreading of change were obstructed by a host of factors associated with the professional and organisational cultures and hierarchical structures of a large hospital.

Leadership style profiles of middle‐level managers in social and health care

Purpose – The aim of this paper is to examine leadership styles among middle‐level managers in social and health care using the leadership role definitions developed by Robert Quinn et al..Design/methodology/approach – The data were obtained by means of a postal survey sent to middle‐line managers in social and health care services in municipalities and municipal federations within the responsibility area of one university hospital in Finland. The survey was sent to 703 managers, the response rate was 62 percent. Leadership styles differences were measured according to gender, professional background, activity sector, age, work experience and unit size. To determine statistical significance, t‐test was used.Findings – Leadership roles of middle‐level managers were evenly distributed on a relatively high level. Statistically significant differences found in leadership styles were related to gender, professional background, activity sector and unit size. Leadership styles stressed intra‐organizational activ...

Factors relating to effectiveness data use in healthcare management

Purpose - The aim of this study is to produce information concerning factors which may hamper or promote the use of effectiveness data in secondary health care middle and upper management. Additionally, the study aims to acquire knowledge of the ways in which the managers would generate effectiveness data for use in their own work. Design/methodology/approach - The study was conducted by interviewing department directors, chief medical officers and directors of nursing ( Findings - The use of effectiveness data in management was hampered by factors relating to research, managerial work and the organization. Factors relating to the production of effectiveness data, managerial behaviour and a universal demand for evidence-based operations were considered conducive to the use of such information. Managers would cultivate the use of effectiveness data by improving its accessibility, usability and visibility. Practical implications - The findings may help healthcare organizations in developing the use of effectiveness data in their decision-making. Originality/value - The paper addresses managers’ willingness to apply effectiveness data in decision-making although the present quality, reliability and accessibility of effectiveness data do not meet the managers’ needs. The use of effectiveness data in management can be influenced by enhancing organizational patterns of action and supporting managerial decision-making.

Characteristics of the Occupational Culture of Physiotherapy in Health Centres

The most typical creator of occupational culture is an occupational group with the rights and obligations that accompany an occupation within an organization. The work community shares values and norms characteristic of the job and has special knowledge provided by education to manage certain tasks. This article is a summary of an academic dissertation aimed at describing the occupational culture of physiotherapy units in health centres and its connections with other activities in health centres as well as with other physiotherapy services in the commune. An additional aim was to analyse the direction of the culture from the viewpoint of the functioning and development of the services. The occupational culture of physiotherapy units is integrated and compact, but also contradictory with regard to service goals and actual work practices.

Learning to Manage Welfare and Health Services Evaluating a Three-Year Academic Training Programme in Professional Development

In recent years, several training programmes in professional development (PD) have emerged to complement academic further education in Finland. These programmes, a novelty due to their long duration and often processlike nature, are organized by universities for university graduates and others with sufficient study skills, to promote professional development Iy complementing the degree system. Evaluation data on the outcome of these courses are still sparse. Evaluation is always connected with the idea of change and with the guidance and development required by it. Evaluation should thus lead to utilizing knowledge in decision making and planning. This article summarizes the evaluation of a programme in welfare and health care services management, which was an integral component of the training process.

Coordination of a complex welfare system case: rehabilitation entity in Finland

The main purpose of this article is to analyse the institutional and political structures of the Finnish rehabilitation entity and the governmental efforts to improve the governance of the rehabilitation policy. Rehabilitation in Finland is a complex welfare system which has undergone several coordination attempts during the last two decades. The centrality of the coordination of this welfare system is obvious. Based on the content analysis of three Governments rehabilitation reports from 1994 to 2002 and their background papers, this article provides two main findings. First, the rehabilitation entity seems to be based on different funding strategies, different governing and different coordination models between the rehabilitation subsystems. Second, the governance discourse in the reports seems to be unchanging with a predominantly hierarchical mode. The article concludes with a discussion on the challenges to coordinate this kind of a complex welfare system as an entity and also how to overcome those challenges.

Threat of mass resignation as a window of opportunity for questioning hospital service production structures in Finland.

Background Service production structures of public health care, once established, have proved extremely difficult to change. For this study, we reviewed discussions that took place in management teams at a Finnish central hospital over a period of nine months. The aim of the research was to analyze whether the management team meetings brought forth new and radical alternatives as to how service production could be reorganized. In addition to this, we were also interested in any possible problems that could be solved using these alternative models of service production, and also how preconditions to the application of different alternatives came about and how they eventually concluded. Methods Our data were derived from 24 management team meetings that took place between August 2007 and May 2008, and were fully videotaped. Data were collected from eight different management teams; the meetings of each were videotaped three times. The management teams reviewed represented three different hierarchical levels, ie, top management, division management, and operational unit management. Data were analyzed according to theory-based content analysis. As a theoretical framework, we utilized Kingdon’s model to enable us to understand why some issues and problems are brought to the agenda of the change process and go on to become concrete policies while others fail to do so. Results During the study period, a threat of mass resignation of nursing staff caused a considerable change to the agenda of the management team meetings, introducing alternatives with the potential to renew the existing structures of operation in a radical manner. Conclusion According to our analysis, the threat of mass resignation acted as a window of opportunity, linking the lack of nursing staff (problem) to operational and structural changes (alternative solutions).