Tonje Osmundsen

Fish farmers and regulators coping with the wickedness of aquaculture

ABSTRACT Managing and regulating aquaculture is a complicated issue. From the perspective of fish farmers as well as regulators managing aquaculture can be regarded as what political scientists refer to as a “wicked problem.” This is because there is a great extent of uncertainty and lack of firm knowledge with respect to the externalities of aquaculture production; e.g., diseases, environmental impacts, and conflicts with other user interests. Furthermore, the dynamic nature of the aquaculture sector contributes to the uncertainty as new solutions emerge, rendering established knowledge obsolete or irrelevant. Designing appropriate public regulations and policy measures is thus important, but difficult. Based on empirical data from Norway, we investigate what respondents from public agencies and the industry perceive to be challenges in governing aquaculture and what we may infer on the characteristics of a good governance approach. We propose that such an approach needs to focus on building competence, collaboration, and be adaptable. Furthermore, it needs to be flexible and cost efficient.

Care pathways as boundary objects between primary and secondary care: Experiences from Norwegian home care services.

The need for integration of healthcare services and collaboration across organisational boundaries is highlighted as a major challenge within healthcare in many countries. Care pathways are often presented as a solution to this challenge. In this article, we study a project of developing, introducing and using a care pathway across healthcare levels focusing on older home-dwelling patients in need of home care services after hospital discharge. In so doing, we use the concept of boundary object, as described by Star and Griesemer, to explore how care pathways can act as tools for translation between specialist healthcare services and home care services. Based on interviews with participants in the project, we find that response to existing needs, local tailoring, involvement and commitment are all crucial for the care pathway to function as a boundary object in this setting. Furthermore, the care pathway, as we argue, can be used to push boundaries just as much as it can be used as a tool for bridging across them, thus potentially contributing to a more equal relationship between specialist healthcare services and home care services.

Service innovation from the edges: enhanced by telemedicine decision support

Abstract Increased prevalence of diabetes creates a need for improved care. Diabetes, as a chronic disease in which the patient is a central asset for effective care, is relevant as an illustrative example for also other chronic diseases that are on the rise globally. Such diseases demand localised co-produced healthcare services that respond to the need for integrated health care. The aim of the current paper was to investigate how telemedicine may facilitate patient consultations that improve quality, efficiency and patient involvement. Patient consultations facilitated by telemedicine were evaluated by the means of qualitative questionnaires to specialist, general practitioner and patients. The questionnaires revealed that the patient consultations improved quality of health care and saved time and cost. Findings suggest that such tripartite consultations may lead to outcomes where patients are empowered to take a more active role, the general practitioner increases his knowledge and competence, and the specialist is able to have a more holistic approach grounded in an understanding of patient history and local context. The support of telemedicine strengthens the consultations in terms of synchronous communication with visual clues and reduces time spent on the consultation by the specialist and travel time and cost for the patient. The contribution of this paper is to demonstrate how telemedicine can provide improved patient consultations by altering the established system of healthcare delivery.

Sustainability indicators for salmon aquaculture

In this paper, we present and describe data comprising indicators of sustainability, collected from eight of the major certification schemes for salmon aquaculture and categorized according to the topics covered by each. These indicators cover most aspects of aquaculture production, including biotic and abiotic effects, feed, emission and waste, fish health and welfare, social assurance, and respect for native culture. In addition to being published in its entirety as supplementary material alongside this article, the data is available through a searchable database on the SustainFish project site: https://sustainfish.wixsite.com/sustainfishproject/search-indicator-database.

Strengthening patient safety in transitions of care: an emerging role for local medical centres in Norway

BackgroundPatient safety has gained less attention in primary care in comparison to specialised care. We explore how local medical centres (LMCs) can play a role in strengthening patient safety, both locally and in transitions between care levels. LMCs represent a form of intermediate care organisation in Norway that is increasingly used as a strategy for integrated care policies. The analysis is based on institutional theory and general safety theories.MethodsA qualitative design was applied, involving 20 interviews of nursing home managers, managers at local medical centres and administrative personnel.ResultsThe LMCs mediate important information between care levels, partly by means of workarounds, but also as a result of having access to the different information and communications technology (ICT) systems in use. Their knowledge of local conditions is found to be a key asset. LMCs are providers of competence and training for the local level, as well as serving as quality assurers.ConclusionsAs a growing organisational form in Norway, LMCs have to legitimise their role in the health care system. They represent an asset to the local level in terms of information, competence and quality assurance. As they have overlapping competencies, tasks and responsibilities with other parts of the health care system, they add to organisational redundancy and strengthen patient safety.

Going global – a trajectory of individual and organizational development

Purpose – This paper aims to show how the internationalization process of a multinational corporation (MNC) is shaped and formed by actors engaging in collaborative inquiry. Faced with a centralized strategy grounded in Scandinavian organizational solutions, leaders of foreign subsidiaries reinterpret their local institutional frameworks in creating new organizational practices. Their ability to create acceptance for these practices both locally and with the central management determines which practices prevail.Design/methodology/approach – The paper is based on a qualitative comparative study of organizational units in Norway, Sweden, Mexico, the USA, South Korea and Poland. Over a four‐year period, 165 interviews were conducted with both employees and management.Findings – Through a perspective on learning, it is possible to show how organizational members make use of their institutional environment as they mutually attempt to build shared ideologies for conducting their business. To view organizational...