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The purpose of this paper is to empirically explore and demonstrate the ability of healthcare professionals to attain professional fulfilment when providing healthcare inspired by “value shops”.

A qualitative case study incorporating interviews and observations was conducted.

The empirical data suggest that the professional fulfilment of both physicians and nurses is facilitated when care is organized through “value shops”. Both groups of professionals state that they are able to return to their “professional core”.

The beneficial outcomes of organizing healthcare inspired by the “value shop” have previously been explored in terms of efficiency and quality. However, the professional fulfilment of healthcare professionals when providing such care has not been explicitly addressed. Professional fulfilment is vital in order to safeguard high-quality care, as well as healthcare professionals' involvement and engagement in implementing quality improvements. This paper highlights the fact that care provision inspired by the “value shop” may facilitate professional fulfilment, which further strengthens the potential positive outcomes of the “value shop” when utilized in a healthcare setting.

The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved.

A qualitative case study primarily consisting of interviews.

The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination.

The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability.

The purpose of this paper is to inductively explore the context-specific preconditions for nurses' perceived organizational support (POS) in healthcare organizations.

A qualitative interview study was performed, based on the critical incident technique (CIT), with 24 registered nurses in different specialities of hospital care.

The nurses perceived three actors as essential for their POS: the first-line manager, the overarching organization and their college. The preconditions affecting the nurses’ perceptions of organizational support were supportive structuring and structures at work, as well as individual recognition and professional acknowledgement.

Previous studies of POS have mostly had a quantitative outset. In this paper, context-specific preconditions for nurses' POS are described in depth, enabled by the qualitative approach of the study. The findings may be used to guide healthcare organizations and managers aiming to foster nurses' POS, and thereby, benefit nurses' well-being and retention, as well as healthcare quality and efficiency.

It is often argued that Lean enables the challenges of contemporary healthcare delivery to be tackled in relation to consistently high-quality care, while utilizing the full potential of available resources. Nevertheless, system-wide implementations of Lean are notoriously difficult and the desired results are often not achieved. Policy makers play a pivotal role in enabling healthcare organizations to enact more precise strategies and frameworks through steering professionals toward both adopting guidelines and becoming more comfortable with Lean as an improvement technique. However, the difficulties in achieving system-wide implementations of Lean indicate their shortcomings in this respect. The purpose of this paper is to outline how these shortcomings may be manifested empirically.

A qualitative content analysis of Swedish counties’ annual reports with regard to how the implementation of Lean is presented and promoted.

The study shows that policy makers have vague and divergent perceptions of what Lean is, and that they often reduce Lean to a means of achieving cost reductions and savings, while relying on the education of managers as the primary factor to ensure implementation.

In order for policy makers to facilitate system-wide implementations of Lean, this study indicates that they need to rectify their simplistic perception of Lean while elaborating on why and how Lean should be implemented in healthcare.

The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work.

Qualitative case study based on interviews (n=27) and observations (n=10).

The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute.

Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed.

Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.

The purpose of this paper is to describe and analyze how physicians and nurses strategically employ the managerial logic.

A qualitative case study incorporating interviews and observations.

Neither physicians nor nurses were prone to strategically employing the managerial logic. However, when doing so nurses were able to acknowledge the legitimacy of managerial impact on practice, whereas the physicians were not. Consequently, physicians might find other, more subtle, ways to strategically employ the managerial logic.

This paper argues for and makes explicit the applicability of qualitative methods in order to delineate actors’ strategic use of available and accessible institutional logics, the conditions for such usage, as well as the multiplicity of actors’ interactions that needs to be taken into account when conducting qualitative data analysis of such occurrences. By the merits of the qualitative research approach utilized in this study, novel insights concerning the strategic use of the managerial logic in the everyday work of physicians and nurses were obtainable. These insights emphasize the necessity of acknowledging situational, organizational and institutional context, incorporating inter-professional power discrepancies and relations vis-à-vis managers.

Nobody concerned with political economy can neglect the history of economic doctrines. Structural changes in the economy and society influence economic thinking and, conversely, innovative thought structures and attitudes have almost always forced economic institutions and modes of behaviour to adjust. We learn from the history of economic doctrines how a particular theory emerged and whether, and in which environment, it could take root. We can see how a school evolves out of a common methodological perception and similar techniques of analysis, and how it has to establish itself. The interaction between unresolved problems on the one hand, and the search for better solutions or explanations on the other, leads to a change in paradigma and to the formation of new lines of reasoning. As long as the real world is subject to progress and change scientific search for explanation must out of necessity continue.

In Canada, integrated care pilot projects are often implemented as a local reform strategy to improve the quality of patient care and system efficiencies. In the qualitative study reported here, the authors explored the experiences of healthcare professionals when first implementing integrated care pilot projects, bringing together physical and mental health services, in a community hospital setting.

Engaging a qualitative descriptive study design, semi-structured interviews were conducted with 24 healthcare professionals who discussed their experiences with implementing three integrated care pilot projects one year following project launch. The thematic analysis captured early implementation issues and was informed by an institutional logics framework.

Three themes highlight disruptions to established logics reported by healthcare professionals during the early implementation phase: (1) integrated care practices increased workload and impacted clinical workflows; (2) integrating mental and physical health services altered patient and healthcare provider relationships; and (3) the introduction of integrated care practices disrupted healthcare team relations.

Study findings highlight the importance of considering existing logics in healthcare settings when planning integrated care initiatives. While integrated care pilot projects can contribute to organizational, team and individual practice changes, the priorities of healthcare stakeholders, relational work required and limited project resources can create significant implementation barriers.