Search results

Medication errors are a significant cause of injury in Norwegian hospitals. The purpose of this study is to explore how Lean Six Sigma (LSS) has been used in the Norwegian public health-care context to reduce medication errors.

A mixed method approach was used to gather data from participants working in the four regions served by the Norway health authorities. A survey questionnaire was distributed to 38 health-care practitioners and semi-structured interviews were conducted with 12 health-care practitioners.

The study finds that the implementation of LSS in the Norwegian public health-care context is still in its infancy. This is amidst several challenges faced by Norwegian hospitals such as the lack of top-management support, lack of LSS training and coaching and a lack of awareness around the benefits of LSS in health care.

Because of the large geographical area, it was difficult to reach participants from all health regions in Norway. However, the study managed to assess the current status of LSS implementation through the participants’ perspectives. This is a fruitful area for future research whereby an action research methodology could be used.

To the best of the authors’ knowledge, this is the first empirical study into the use of LSS methodology in reducing medication errors. In addition, this study is valuable for health-care practitioners and professionals as a guideline to achieve the optimal benefit of LSS implementation to reduce medication errors.

This paper aims to explore how accrual accounting is translated into new accounting norms and what role change agents have had in that process. The main research question is: How were private sector accounting norms translated within the Norwegian public health sector?

This study uses framing theory to understand how the different actors involved in the translation frame their arguments. The field study considers the specific case of public health care. The main data sources are archival data combined with semi-structured interviews.

The empirical study uses framing theory to show how the Big Four consultants worked as change agents to impose a valuation based on a full accrual accounting logic. The first finding shows that there are two framing processes to valuate fixed assets. The central government has a pragmatic framing trying to get the budget in balance, while the Big Four consultants together with private sector accounting experts have an accrual accounting ideology framing. The second finding shows how the Big Four consultants become a change agent by forming alliances with accounting experts, health enterprises and politicians. These findings point to the need to focus explicitly on the role of change agents as drivers of public sector organizational change and the important role accounting as a tool can have.

The paper is likely to be useful for governments, practitioners and researchers to gain knowledge about the implementation of accrual accounting.

This paper contributes to our understanding of change agent's role in successfully introducing a new accounting logic in the public sector, especially within an inter-organizational setting.

Contemporary categorizations of western-style welfare states distinguish a particular pattern of organizing social security mainly found in Scandinavian countries, and sometimes labeled as a “social democratic welfare regime.” This is characterized by general access of the population to a social security system organized and administered by public authorities. This categorization is widely acknowledged, but the Scandinavian “social democratic” model is rarely ever analyzed in detail.

While most health services are provided by public actors, it is often overlooked that health services in Scandinavian countries in certain fields are delivered to a substantial part by private actors. In Norwegian rehabilitation specialist health care, these private actors stand for more than 30% of all service delivery.

Based on a content analysis of publications of the Norwegian Ministry of Health and Care Services we look into the relation between public and private actors in rehabilitation and relate our findings to classifications of Scandinavian welfare states into an institutional, social democratic model.

Given the premise of de facto universal standards for FM, this paper aims to investigate development of facilities management (FM) at an Albanian and a Norwegian university hospital through examination of two hypotheses: the university hospital has recognised FM and established a designated FM organisation (H1) and the university hospital provides adequate food and catering services at ward kitchens and buffets (H2).

This is an exploratory and descriptive comparative case study based on a diverse cases’ designs.

There is limited and strong support for H1 at the Albanian and Norwegian university hospitals, respectively. Both the Albanian and the Norwegian university hospitals rely on in-house production of facilities services, but the Albanian university hospital has outsourced food and catering services. FM and provision of facilities services are deeply integrated within the Norwegian university hospital’s core activities. There is also limited and strong support for H2 at the Albanian and Norwegian university hospitals, respectively. Hence, the Albanian Ministry of Health and the Albanian university hospital’s top management have a comprehensive, but not impossible, task, if the aim is to catch up with the Norwegian university hospital concerning FM.

This is an exploratory and descriptive comparative case study. Large N studies should be carried out both in Albania and Norway and preferably also in other countries to corroborate and develop the findings.

This is the first comparative study of FM at an Albanian and a Norwegian university hospital.

The Norwegian health care system is semi-decentralized. Primary care and long-term care (LTC) are the responsibilities of the municipalities. Specialist care is the responsibility of the central government and is organised through four Regional Health Authorities (RHA). Resource use, health outcomes and severity are the three main pillars for priority setting, regularly applied in reimbursement decisions for pharmaceuticals.

The sustainability of health care is challenged in Norway. The main factors are a growing elderly population with high need of complex, coordinated services, an increasing demand for newly approved drugs and advanced technology and a potential shortage of health care personnel.

We present recent trials and policy reforms in Norway aimed at improving care pathways combined with cost containment. Reforms in the pharmaceutical market, both with regard to market access and reimbursement (cost-effectiveness), and regulation of prices, have resulted in cost containment. The primary care sector awaits reform initiatives to recruit and retain physicians as general practitioners. No reform in the hospital sector has had cost containment as a main focus. The sector is characterized with low productivity growth, and expenditures that have increased more than the GDP growth. Waiting times are long, and coordination between sub-sectors of health care has been poor, although the Coordination reform of 2012 has alleviated some of the challenges related to intersectoral coordination. Still, the divided responsibility for health care between the central government and the municipalities creates tensions between national ambitions and local decisions in the financing and provision of health services.

The main aim of this article is to broaden the notion of strategic intent in public relations. It also develops an understanding of the social value of what can be defined as the first modern health communication campaign in Europe based on strategic intents and the development of modernity.

The study is based on both historical research and empirical material from the Norwegian tuberculosis campaign from 1889 up to 1913, when Norwegian women achieved suffrage. The campaign is analysed in the framework of modernity and social theory. The literature on lobbying and social movements is also used to develop a theoretical framework for the notion of strategic intent.

The study shows that strategic intent can be divided into two layers: (1) the implicit strategic intent is the real purpose behind the communication efforts, whereas (2) the explicit intent is found directly in the communication efforts. The explicit intent may be presented as a solution for the good of society at the right political moment, giving an organisation the possibility to mobilise for long-term social changes, in which could be the implicit intent.

The distinction between explicit and implicit strategic intent broadens our understanding on how to make long-term social changes as well as how social and political changes occur in modern societies. The article also gives a historical account of what is here defined as the first modern health communication campaign in Europe and its social value.

This chapter analyses and discusses local government health promotion in Norway.

Institutional theory indicates that political and administrative jurisdictions are path dependent in their policy formation and implementation. By using data from different sources this assumption is analysed and discussed according to health promotion in Norwegian municipalities. The main methodology is cross tabulations, bivariate correlations and regression is carried out to supplement analyses.

Municipalities are path dependent in their health promotion policies. They acknowledge and prioritize health behaviour independent of experienced socio-economic challenges, municipal capacity as size and income, and local government political profile. Competence devoted to health promotion can create changes in policies.

The rhetoric on determinants and social determinants in particular is new in Norway. Rhetoric on, and interventions, that highlight the social determinants of health need to be coordinated.

The chapter presents new knowledge on Norwegian local government health promotion and how this is implemented in relation to the challenges experienced.

High socioeconomic status (SES) is associated with better health and lower use of health care services in the general population. Among immigrants, the relationship appears less consistent. The purpose of this paper is to determine if the relationship between income level (a proxy for SES) and use of primary health care services for mental health problems differs for natives and five immigrant groups in Norway. It also explores the moderating effect of length of stay (LoS) among immigrants.

Using data from two registers with national-level coverage, logistic regression analyses with interactions were carried out to determine the association between income level and having used primary health care services for mental health problems.

For Norwegian men and women there was a clear negative relationship between income and service use. Interaction analyses suggested that the relationship differed for all immigrant groups compared with Norwegians. When stratifying by LoS, income was not associated with service use among recently arrived immigrants but was negatively associated among immigrants staying more than two years (with the exception of Pakistani and Iraqi women).

Country of origin and LoS should be considered when applying measures of SES in immigrant health research.

There may be an initial transition period for recently arrived immigrants where competing factors mask the association between SES and service use.

This study benefits from nationwide coverage, eliminating self-selection biases. It demonstrates the complexity of the relationship between SES and health care use.

Green care – the utilisation of farms as the basis for health services – is seen as a promising addition to other health services, and it is seen as a viable diversification strategy for many farm families. However, the number of such services is low both in Norway and in Europe in general. The development of green care seems to have stagnated. This paper seeks to analyze and discuss the case of Norwegian green care in order to reflect on the hindrances to the further development of a viable green care sector.

The paper analyzes the green care market, green care policies and the interaction of social worlds that are necessary to make the green care sector function smoothly.

The conclusion is that there is a sound basis for a green care market and that there are sufficient political support and political engagement for the development of green care in Norway. The problem with the green care sector is the interaction between the “social worlds” involved in the sector – the suppliers/farmers, the users, and the (public sector) buyers. It is argued that the development of a green care market is hampered by the lack of an institutional framework and a set of market devices capable of bringing key actors together.

The paper presents an analysis of the Norwegian green care sector. It shows that there are substantial cross‐national differences between health service systems, and therefore comparisons between nations are difficult. However, the principal challenges – diverse social groups, the lack of institutional frames, and immature markets – are shared. Therefore, the need for further research is evident and there are lessons to be learned from cross‐national comparison and case studies.

Within the green care research field, there have been few social science studies that address organisational issues and the governance of this new and emerging business. Theoretically oriented and analytical contributions on organisational aspects of green care services are therefore timely. This paper is such a contribution.

This study aims to explore the development in Norway from an awareness of the need for numbers to govern in the 70s to a statistical information system launched in 2006, called IPLOS, to respond to this need. The article seeks to discuss how this system was developed, what the Norwegian authorities attempted to achieve with the development, which goals they desired and how the statistics were intended to contribute to reach them.

This study has a multisite approach inspired by situational analysis, and draws on “governing by numbers” among other theoretical debates. It is based on original data (qualitative interviews) and secondary sources (policy and statistics development documents). The sources represent both top down and bottom up perspectives: authorities, municipalities, expertise involved in the development and disability activists.

The statistics development expresses three challenges in Norwegian health and care service policy: planning and governance, the growing complexity of the welfare state and changing welfare ideologies.

The study is limited to a Norwegian context and does not provide generalized conclusions about the sociohistorical context for developing statistics as technologies for governance purposes.

Statistics and numbers for governance purposes are most often talked about as ready‐made facts. This study explores a quantifying tool and its numbers in the making, with a methodological approach that extends the governing by numbers tradition.