Mattias Elg

Co‐creation and learning in health‐care service development

Purpose - The purpose of this study is to develop and evaluate a model for patient co-creation and learning based on diaries for use in health-care service development. In particular, the study aim ...

The practice of the Balanced Scorecard in health care services

Purpose - The purpose of this paper is to identify the main characteristics of the Balanced Scorecard (BSC) practice in health care services Design/methodology/approach - The paper uses a case study approach focusing on three health care organisations in Sweden using the BSC. The focus is upon different management levels in a hierarchical branch in each organisation. Findings - The paper concludes that the BSC is used as a tool for improving internal capabilities and supporting organisational development. More specifically, the BSC is used as a tool by management and employees in discussions, information dissemination, knowledge creation, follow-up and reporting processes. Instead of using the BSC as a tool to implement and communicate strategy formulated by management it is used as a tool for opening up the organisation and providing a foundation for an improvement dialogue, which consequently increases the demands on management. Research limitations/implications - The paper contributes to changing the focus in existing research away from the design and construction of the BSC towards its use in managerial work. Practical implications - The paper emphasises important aspects in using the BSC in a health care context that will help managers in improving performance measurements. Originality/value - The paper shows that the use of the BSC includes several aspects, such as the purpose of the system, implementation process, actions taken and the expected contribution.

Performance measurement to drive improvements in healthcare practice

Purpose – The purpose of this study is to contribute to the knowledge base on how performance measurement drives improvements in healthcare practice.Design/methodology/approach – The study is based ...

The process of constructing performance measurement

Purpose – The purpose of this paper is to show how the present article illuminates the process of how information is constructed in performance measurement systems.Design/methodology/approach – The main argument for using performance measurement is that it creates possibilities for managers to gain knowledge about what is going on within the organization and direct future behaviour. The effectiveness of such a knowledge creation process is partly dependent on local circumstances of how information is being created.Findings – In large scale performance measurement systems we can expect that several people are involved in constructing information. These people are either directly involved or have indirect influence over the construction process. Different motives and cognition play an important role as information is shaped and reshaped from the collection of raw data until its final usage in management settings.Research limitations/implications – The research field is provided with an alternative view of w...

Swedish healthcare management practices and quality improvement work: development trends

PURPOSE The purpose of this paper is to empirically examine developmental trends in healthcare organisation management practice and improvement work. DESIGN/METHODOLOGY/APPROACH Primary healthcare centre (n = 1,031) and clinical hospital department (n = 1,542) managers were surveyed in spring 2007 (response rate 46 per cent). This article compares results from this survey with a study in 2003. A theoretical framework based on organisational inner context, organisational outer context, external environment and outcomes form the analytical base. Comparisons were made using independent two-sample t-tests. FINDINGS A general aspect, identified empirically, is the tendency toward increased external pressure on leaders in their improvement work. Higher management decisions, patient pressure and decisions made by policymakers increasingly influence and shape the choices made by healthcare managers about where to focus improvement efforts. Three different trends are empirically identified and elaborated: take-control logic; practice-based improvement; and patient-centeredness. RESEARCH LIMITATIONS/IMPLICATIONS Healthcare leaders should carefully design new management control systems that support healthcare micro systems. Findings support the general assumption that staff increasingly tend to focus organisational changes on management control. ORIGINALITY/VALUE This study extends management research with a unique survey. Through two measurements made in 2003 and 2007, several important trends about how healthcare organisations are managed and developed are identified.

Managing ideas for the development of new products

It is ideas that act as initiators of new product development projects. In the literature, ideas for the development of new products are found to originate from different sources both external and internal to an organisation. For example, formalised product development processes use customer surveys and technology development in order to find ideas for new products while integration with a lot of other idea sources is less evident. Some organisations have identified this weakness and created arenas where ideas can be discussed and exchanged between individuals. One example of an arena is idea management systems, which are formal ways of capturing, examining, nurturing, storing and developing ideas created in an organisation. In this paper, the role of idea management systems in three multinational Swedish organisations is studied. The findings suggest that idea management systems can be used to introduce and strengthen the innovation capability of an organisation.

Surveying improvement activities in health care on a national level--the Swedish internal collaborative strategy and its challenges.

In order to map improvement activities in Swedish health care, we surveyed the managers of all primary health care centers (n = 958) and clinical hospital departments (n = 1355), with a response rate of 46%. The majority reports that their staff view improvement work positively. The most common driver of improvement is work environment problems, whereas external drivers have less influence. Among 35 methods, the most commonly used are educational initiatives, stress management, guidelines, and leadership development, whereas accreditation is used the least. Respondents who report extensive improvement efforts indicate the greatest benefit from educational interventions, analysis of patient incidents, guidelines, and rapid cycle tests. Respondents claim that improvement initiatives yield positive results, in particular regarding the working environment, administrative routines, workflow, and communication, although only 15%–30% of respondents report having data to support their claims. Our findings indicate an introverted focus of most improvement efforts, starting with staff and administration needs. Further research is needed to understand how and why some centers and departments have managed to achieve strategic, measurable, patient-focused, systems improvements, whereas most have not.

A self-determination theory perspective on customer participation in service development

Purpose – The purpose of this paper is to explore what motivates patients to participate in service development and how participation may influence their well-being. Health-care providers are increasingly adopting practices of customer participation in such activities to improve their services. Design/methodology/approach – This paper builds on an analysis of data from a service development project in which lung cancer patients contributed by sharing their ideas and experiences through diaries. Out of the 86 lung cancer patients who were invited to participate, 20 agreed to participate and 14 fully completed the task. The study builds on participants’ contributions, in-depth interviews with six participants and the reasons patients gave for not participating. Findings – This paper identifies a number of motives: non-interest in participating, restitution after poor treatment, desire for contact with others, volunteerism, desire to make a contribution and the enjoyment of having a task to complete. A self-...

The role of quality managers in contemporary organisations

A key question for firms nowadays is how to organise work with quality management. This naturally includes the role of the quality managers and it appears as if the profession of quality managers is at a crossroads. Alternatives are that the role of a quality manager broadens to include quality at a strategic level in the firm and that Six Sigma specialists and Lean Production managers drive the development of quality management in the future. In this paper, we present the results from a survey of 212 quality managers in Swedish organisations. The purpose is to contribute to an understanding of how the management of quality is designed and practised in contemporary organisations. This study shows that a quality managers operational responsibility is quite narrowly defined. The agenda of the quality manager is mainly related to quality standards, such as ISO 9000 and environmental management systems. These programmes frame the work of the quality manager, which in many cases leaves other programmes, such as Six Sigma and Lean Production, to other departments or parallel improvement structures.

Solicited diaries as a means of involving patients in development of healthcare services

Purpose – The purpose of this paper is to develop an understanding of how patients experience their health problems and how they can generate innovative ideas about health care services. The research questions that guide the present study are: how can solicited diaries be used for capturing patient ideas? What type of data is generated from solicited diaries used for generating patient ideas? And what are the potential benefits and shortcomings of using patient diaries in generating ideas for improvement of health care services?Design/methodology/approach – The paper is based on an exploratory case study using patient diaries to solicit ideas about how health care services in Sweden can be improved. From the methodological viewpoint, the diaries are used as a tool for patient co‐creation of health care services.Findings – When analyzing dairies written by patients four different types of diaries emerged from the study: brief, reporting, descriptive and reflective diaries. Furthermore, 102 ideas for improv...