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Open Access
Article
Publication date: 11 May 2023

Robin Jonsson, Kerstin Nilsson, Lisa Björk and Agneta Lindegård

This study aims to describe and evaluate the impact of a participatory age-management intervention on the knowledge, awareness and engagement of line managers and their HR…

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Abstract

Purpose

This study aims to describe and evaluate the impact of a participatory age-management intervention on the knowledge, awareness and engagement of line managers and their HR partners from six health-care organizations in Sweden.

Design/methodology/approach

The learning workshops consisted of lectures, discussions, feedback and exchange of experiences with colleagues and invited experts. A total of 19 participants were interviewed six months after the final workshop, and qualitative thematic analysis was used to analyze the transcribed interviews.

Findings

The intervention design produced promising results in improving line managers’ and HR partners’ knowledge and increasing awareness and engagement. On some occasions, the participants also initiated changes in organizational policies and practices. However, the intervention primarily became a personal learning experience as participants lacked resources and mandates to initiate change in their daily work. To stimulate engagement and change at the organizational level, the authors believe that an intervention must receive support from higher managers, be anchored at the workplace and be aligned with the organization’s goals; moreover, participants must be provided with sufficient resources and mandates to coordinate the implementation of age-management strategies.

Practical implications

Prolonged working life policies and skill shortages are affecting organizations and societies, and for many employers, there are strong reasons for developing strategies to attract, recruit and retain older workers.

Originality/value

This study offers lessons and guidance for future workplace interventions to attract, recruit and retain older workers.

Details

Journal of Workplace Learning, vol. 35 no. 9
Type: Research Article
ISSN: 1366-5626

Keywords

Article
Publication date: 25 October 2017

Kerstin Nilsson, Fredrik Bååthe, Annette Erichsen Andersson and Mette Sandoff

The aim of this study has been to explore learning experiences from the two first years of the implementation of value-based healthcare (VBHC) at a large Swedish University…

1264

Abstract

Purpose

The aim of this study has been to explore learning experiences from the two first years of the implementation of value-based healthcare (VBHC) at a large Swedish University Hospital.

Design/methodology/approach

An explorative design was used in this study. Individual open-ended interviews were carried out with 19 members from four teams implementing VBHC. Qualitative analysis was used to analyse the verbatim transcripts of the interviews.

Findings

Three main themes pinpointing learning experiences emerged through the analysis: resource allocation to support implementation, anchoring to create engagement and dedicated, development-oriented leadership with power of decision. Resource allocation included the need to set aside time and administrative resources and also the need to adjust essential IT-systems. The work of anchoring to create engagement involved both patients and staff and was found to be a never-ending task calling for deep commitment. The hospital top management’s explicit decision to implement VBHC facilitated the implementation process, but the team leaders’ lack of explicit management mandate was experienced as obstructing the process. The development process contributed not only to single-loop learning but also to double-loop learning.

Originality/value

Learning experiences drawn from implementing VBHC have not been studied before, and thus the results of this study could be of importance to managers and administrators wanting to implement this concept in their respective organizations.

Details

Leadership in Health Services, vol. 31 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 1 September 2017

Kerstin Nilsson, Fredrik Bååthe, Annette Erichsen Andersson and Mette Sandoff

This study explores four pilot teams’ experiences of improvements resulting from the implementation of value-based healthcare (VBHC) at a Swedish University Hospital. The aim of…

2006

Abstract

Purpose

This study explores four pilot teams’ experiences of improvements resulting from the implementation of value-based healthcare (VBHC) at a Swedish University Hospital. The aim of this study is to gain a deeper understanding of VBHC when used as a management strategy to improve patients’ health outcomes.

Design/methodology/approach

An exploratory design was used and qualitative interviews were undertaken with 20 team members three times each, during a period of two years. The content of the interviews was qualitatively analysed.

Findings

VBHC worked as a trigger for initiating improvements related to processes, measurements and patients’ health outcomes. An example of improvements related to patients’ health outcomes was solving the problem of patients’ nausea. Improvement related to processes was developing care planning and increasing the number of contact nurses. Improvement related to measurements was increasing coverage ratio in the National Quality Registers used, and the development of a new coding system for measurements. VBHC contributed a structure for measurement and for identification of the need for improvements, but this structure on its own was not enough. To implement and sustain improvements, it is important to establish awareness of the need for improvements and to motivate changes not just among managers and clinical leaders directly involved in VBHC projects but also engage all other staff providing care.

Originality/value

This study shows that although the VBHC management strategy may serve as an initiator for improvements, it is not enough for the sustainable implementation of improvement initiatives. Regardless of strategy, managers and clinical leaders need to develop increased competence in change management.

Details

Leadership in Health Services, vol. 30 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 10 October 2016

Mette Sandoff and Kerstin Nilsson

This study aims to explore challenges arising from the development of teamwork in a new organizational structure, based on the experiences of the staff involved.

4212

Abstract

Purpose

This study aims to explore challenges arising from the development of teamwork in a new organizational structure, based on the experiences of the staff involved.

Design/methodology/approach

An explorative and qualitative approach was used, with individual interviews as the data collection method. These interviews were analyzed using qualitative and interpretative analysis with a modified editing style.

Findings

The results describe how the lack of essential organizational prerequisites for teamwork and the absence of the leadership qualities needed to facilitate teamwork contribute to difficulties in working in a team-orientated way. Shortage of information among the team members and few scheduled meetings signify insufficient coordination within the working team. Without a team leader who can keep things together, read the team members’ needs and support and guide them, team work is difficult to uphold because the members will need to seek support elsewhere. Assumed synergies from working together as team member experts will be thwarted.

Originality/value

This study contributes knowledge about the difficulties in creating team-orientated cooperation in a new organizational structure when leadership as well as structures and processes supporting team work are absent. The challenges described are drawn from the experiences of the staff concerned, providing insights to form a basis for theoretical and practical discussion.

Article
Publication date: 1 January 2016

Fredrik Bååthe, Gunnar Ahlborg Jr, Lars Edgren, Annica Lagström and Kerstin Nilsson

The purpose of this paper is to uncover paradoxes emerging from physicians’ experiences of a patient-centered and team-based ward round, in an internal medicine department.

Abstract

Purpose

The purpose of this paper is to uncover paradoxes emerging from physicians’ experiences of a patient-centered and team-based ward round, in an internal medicine department.

Design/methodology/approach

Abductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings.

Findings

This paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician’s professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician’s professional identity was centered. Physicians with more of an I-perspective experienced challenges with the new round, while physicians with more of a We-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered.

Practical implications

For change processes affecting physicians’ professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure.

Originality/value

This paper provides increased understanding about how physicians’ professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement.

Details

Leadership in Health Services, vol. 29 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 27 April 2012

Kerstin Nilsson and Carina Furåker

The aim of this study is to describe the experience of Swedish healthcare managers (HCMs) of learning leadership through practice.

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Abstract

Purpose

The aim of this study is to describe the experience of Swedish healthcare managers (HCMs) of learning leadership through practice.

Design/methodology/approach

The study is based on a qualitative approach, and critical incident technique guided the data collection. Interviews with 22 hospital HCMs provided a total of 50 narratives. These narratives were categorised by classifying them according to their manifest content, and a latent content analysis resulted in categories with additional sub‐categories.

Findings

Leadership learning occurred in relation to reorganisation, developmental work and conflicts. About 50 per cent of the narratives were classified as “managing conflicts”. The learning outcome in the classes was related to the categories “personal development”, “interpersonal leadership qualities” and “developing leadership strategies”. About 50 per cent of all learning outcome was a result of managing conflicts.

Research limitations/implications

To be able to transfer the findings to a wider context in healthcare, further research into experience‐based leadership learning in healthcare is needed.

Practical implications

A majority of the narratives as well as the learning outcomes are related to managing conflicts. This indicates that in management development programmes, as well as leadership courses, the focus on conflict management should be extended, and also that HCMs need support from their employer in their conflict management duties.

Originality/value

With its use of critical incident technique, this study contributes to an understanding of HCMs' experience‐based leadership learning – a field in which limited research has been conducted.

Details

Leadership in Health Services, vol. 25 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 5 May 2015

Kerstin Nilsson and Mette Sandoff

The purpose of this study is to gain better understanding of the roles and functions of process managers by describing Swedish process managers’ experiences of leading processes…

Abstract

Purpose

The purpose of this study is to gain better understanding of the roles and functions of process managers by describing Swedish process managers’ experiences of leading processes involving patient care and treatment when working in a hierarchical health-care organization.

Design/methodology/approach

This study is based on an explorative design. The data were gathered from interviews with 12 process managers at three Swedish hospitals. These data underwent qualitative and interpretative analysis with a modified editing style.

Findings

The process managers’ experiences of leading processes in a hierarchical health-care organization are described under three themes: having or not having a mandate, exposure to conflict situations and leading process development. The results indicate a need for clarity regarding process manager’s responsibility and work content, which need to be communicated to all managers and staff involved in the patient care and treatment process, irrespective of department. There also needs to be an emphasis on realistic expectations and orientation of the goals that are an intrinsic part of the task of being a process manager.

Research limitations/implications

Generalizations from the results of the qualitative interview studies are limited, but a deeper understanding of the phenomenon was reached, which, in turn, can be transferred to similar settings.

Originality/value

This study contributes qualitative descriptions of leading care and treatment processes in a functional, hierarchical health-care organization from process managers’ experiences, a subject that has not been investigated earlier.

Details

Leadership in Health Services, vol. 28 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 16 November 2015

Kerstin Nilsson and Mette Sandoff

The purpose of this paper is to establish a knowledge bank for the development of overall hospital processes. Description and analysis are used to show how process managers…

Abstract

Purpose

The purpose of this paper is to establish a knowledge bank for the development of overall hospital processes. Description and analysis are used to show how process managers experience their situation and the various possibilities it offers for active management in the context of managing processes of inpatient care and treatment at Swedish hospitals.

Design/methodology/approach

A qualitative and explorative design with open-ended interviews with 12 process managers at three Swedish hospitals was used. Transcribed interviews were analysed by means of latent content analysis.

Findings

The two main categories emerging from the analysis were characteristics of process leadership and prerequisites of process management. Quality, relational and knowledge dimensions, and structure, time and information dimensions emerged as their respective sub-categories. The overall theme describes the interdependence between leadership characteristics and the prerequisites necessary for effective process management.

Research limitations/implications

No generalizations could be made from the results of the qualitative interview studies but a deeper understanding of the phenomenon was reached, which in turn can be transferred to similar settings.

Originality/value

This study contributes qualitative descriptions of leadership characteristics and the prerequisites necessary for active process management in the context of managing processes of inpatient care and treatment at Swedish hospitals, a subject that has not been investigated earlier.

Details

Journal of Health Organization and Management, vol. 29 no. 7
Type: Research Article
ISSN: 1477-7266

Keywords

Content available
Article
Publication date: 27 April 2012

154

Abstract

Details

Leadership in Health Services, vol. 25 no. 2
Type: Research Article
ISSN: 1751-1879

Content available
Article
Publication date: 5 May 2015

Jennifer Bowerman

148

Abstract

Details

Leadership in Health Services, vol. 28 no. 2
Type: Research Article
ISSN: 1751-1879

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