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1 – 10 of 10Rómulo Pinheiro, Lars Geschwind, Francisco O. Ramirez and Karsten Vrangbæk
Following the spirit of an earlier volume in the series focusing on ‘Comparative Approaches to Organizational Research’, the mandate of the current volume is to provide a…
Abstract
Following the spirit of an earlier volume in the series focusing on ‘Comparative Approaches to Organizational Research’, the mandate of the current volume is to provide a comparative account of dynamics across two organizational fields – health care and higher education – and, subsequently, two specific types of organizational forms – hospitals and universities. In so doing, we take a broader perspective encompassing various conceptual and theoretical points of departure emanating from, mostly, the institutional literature in the social sciences (and its various perspectives), but also from public policy and administration literatures – of relevance to scholars and the communities of practice working within either field. In this introductory paper to the volume, we provide a brief overview of developments across the two organizational fields and illuminate on the most important scholarly traditions underpinning the study of both system dynamics as a whole as well as universities and hospitals as organizations and institutions. We conclude by reflecting on the implication of the volume’s key findings in regards to comparative research within organizational studies.
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Viola Burau and Karsten Vrangbæk
The paper aims to account for the substance of non‐linear governance change by analysing the importance of sector‐specific institutions and the pathways of governing they create.
Abstract
Purpose
The paper aims to account for the substance of non‐linear governance change by analysing the importance of sector‐specific institutions and the pathways of governing they create.
Design/methodology/approach
The analysis uses recent reforms of the governance of medical performance in four European countries as a case, adopting an inductively oriented approach to comparison. The governance of medical performance is a good case as it is both, closely related to redistributive policies, where the influence of institutions tends to be pertinent, and is subject to considerable policy pressures.
Findings
The overall thrust of reforms is similar across countries, while there are important differences in relation to how individual forms of governance and the balance between different forms of governance are changing. More specifically, sector‐specific institutions can account for the specific ways in which reforms redefine hierarchy and professional self‐regulation and for the extent to which reforms strengthen hierarchy and affect the balance with other forms of governance.
Originality/value
The recent literature on governance mainly focuses on mapping out the substance of non‐linear change, whereas the development of explanations of the substance of governance change is less systematic. In the present paper, therefore, it is suggested coupling the notion of non‐linear change with an analysis of sector specific institutions inspired by the historical institutionalist tradition to better account for the substance of non‐linear governance change. Further, the analysis offers interesting insights into the complexity of redrawing boundaries between the public and the private in health care.
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The purpose of this paper is to investigate different types of patient involvement in Denmark, and to discuss the potential implications of pursuing several strategies for patient…
Abstract
Purpose
The purpose of this paper is to investigate different types of patient involvement in Denmark, and to discuss the potential implications of pursuing several strategies for patient involvement simultaneously.
Design/methodology/approach
The paper presents a preliminary framework for analysis of patient involvement in health care. This framework is used to analyze key governance features of patient involvement in Denmark based on previous research papers and reports describing patient involvement in Danish health care.
Findings
Patient involvement is important in Denmark at the rhetorical level, and many policies and initiatives have been introduced. All three governance forms (voice, choice and co-production) are used. However, there are important barriers and limitations in translating the rhetoric into practice, and potential synergy and negative synergy effects can be identified when pursuing the strategies at the same time.
Research limitations/implications
Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed framework further.
Practical implications
The paper includes implications for the development of patient involvement in health care.
Originality/value
This paper fulfills a need to study different types of patient involvement and to develop a theoretical framework for characterizing and analyzing such involvement strategies.
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Ulrika Winblad, Karsten Vrangbæk and Katarina Östergren
This paper aims to analyse waiting‐time guarantees in the three Scandinavian countries (Denmark, Norway, and Sweden) and to assess whether their current policy designs have…
Abstract
Purpose
This paper aims to analyse waiting‐time guarantees in the three Scandinavian countries (Denmark, Norway, and Sweden) and to assess whether their current policy designs have strengthened the role of patients in their healthcare systems.
Design/methodology/approach
The paper compares official documents and legislation in the three countries. The main findings are that waiting‐time guarantees have generally empowered patients in the Scandinavian health systems. This empowerment is stronger in Denmark and Norway, where formal waiting‐time guarantee rules are applied, than in Sweden, where the guarantee is based on the “softer” regulatory instrument of agreements. While patients are formally empowered in all three countries, and care providers are gradually adjusting to this situation, it is also clear that the practical conditions for empowering patients are not fully in place. The issue of information dissemination is particularly important.
Research limitations/implications
Assessments are based on current regulatory configurations in the three countries, where the process of adapting and implementing the policies is ongoing. These assessments are based on a comparative analysis of the institutional designs. There is no detailed information on how patients use the waiting‐time guarantee.
Practical implications
It is important to consider carefully the information that patients have available in exercising their right to choose healthcare as well as the incentives for providing such information to them.
Originality/value
This is the first systematic comparison of waiting‐time guarantees in the three countries. It is a starting‐point for further research on the introduction of waiting‐time guarantees in public health systems.
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Many changes taking place in the public sector raise value questions. Examples are New Public Management, mixed governance forms, globalised recipes on good governance…
Abstract
Many changes taking place in the public sector raise value questions. Examples are New Public Management, mixed governance forms, globalised recipes on good governance, transnationalisation of public organisations and clashes between Christian and Islamic values in most European states. How to deal with value confusion and value conflicts, thus, is an important challenge for the public manager. Stated in 10 normative prescriptions, various strategies are suggested in the paper. The basic questions addressed are two. How can public management distinguish the central values from those of lesser interest? And how can public management handle value conflicts and organisational design conflicts
Karsten Vrangbæk, John Appleby, Tanja Klenk and Sarah Gregory
Performance management (PM) has been developed to a central part of health care reforms. However, ideas of performance are traditionally contested in the health care sector and…
Abstract
Performance management (PM) has been developed to a central part of health care reforms. However, ideas of performance are traditionally contested in the health care sector and split up between a professional and a bureaucratic understanding of effective service delivery. With the rise of New Public Management, an additional layer of PM instruments has been put on the already existing structures. As a result, different PM regimes can be distinguished, which vary in the way they define performance, blame underperformance and design accountability instruments to ensure appropriate behaviour. The paper investigates the institutional design of PM schemes of three different cases – Denmark, Germany and England – which are representative for different PM regimes.
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Francisco O. Ramirez, Haldor Byrkjeflot and Rómulo Pinheiro
The paper sets forth and examines the assumptions underlying two global ideas – world class and best practices – and their application to (higher) education and health…
Abstract
The paper sets forth and examines the assumptions underlying two global ideas – world class and best practices – and their application to (higher) education and health organizations. Our basic (ex-ante) assumption is that both sectors are influenced by organizational fields that embody these ideas. However, we also assume that these sectors differ, and thus, that one should find between sector variations in the influence of such ideas. The findings suggest that both sectors have been affected by hegemonic ideas, yet in rather different ways, and that these ideas, particularly the metrics being used, pose different challenges in the two sectors.
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