Search results

In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.

Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.

Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people – leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.

Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.

Prior research has emphasised the importance of the early phases of construction projects, as well as the difficulties of procuring engineering services – especially due to the uncertainties. Despite that, studies on the public procurement of engineering services are scarce. Although scholars have shown that uncertainty may affect the choice of control modes, the level of uncertainty that characterises services is not addressed by the two task characteristics: knowledge of the transformation process and output measurability. The purpose is to investigate organisational control in public procurement of engineering services.

The existing control model was adjusted in this study by conceptually adding uncertainty as a third aspect to the two task characteristics. A single case study of the Swedish Transport Administration was used. The empirical data, comprising 14 interviews with managers from the client and engineering consulting companies, were analysed using flexible pattern matching and visual mapping approaches and then illustrated using the model.

The public client did not base its choice of control modes on uncertainty, but rather on the other two task characteristics. Consequently, the service providers argued that the chosen control modes reduced their creativity, increased their financial risks and caused unclear responsibilities. This study therefore shows that uncertainty is an important factor to consider in the choice of control modes, both from a theoretical perspective and from the service providers' point of view. The developed model may therefore be useful for researchers as well as practitioners.

This study is the first attempt to add uncertainty as a task characteristic when choosing control modes. The results contribute to the scarce control literature regarding the procurement of engineering services for construction projects and the procurement of other services with high uncertainty.

Prefabricated products are continually entering the building construction market; yet, the decision to use prefabricated products in a construction project is based mostly on personal preferences and the evaluation of direct costs. Researchers and practitioners have debated appropriate measurement systems for evaluating the impacts of prefabricated products and for comparing them with conventional on-site construction practices. The more advanced, cost–benefit approach to evaluating prefabricated products often inspires controversy because it may generate inaccurate results when converting non-monetary effects into costs. As prefabrication may affect multiple organisations and product subsystems, the method used to decide on production methods should consider multiple direct and indirect impacts, including nonmonetary ones. Thus, this study aims to develop a multi-criteria method to evaluate both the monetary and non-monetary impacts of prefabrication solutions to facilitate decision-making on whether to use prefabricated products.

Drawing upon a literature review, this research suggests a multi-criteria method that combines the choosing-by-advantage approach with a cost–benefit analysis. The method was presented for validation in focus group discussions and tested in a case involving a prefabricated bathroom.

The analysis indicates that the method helps a project’s stakeholders communicate about the relative merits of prefabrication and conventional construction while facilitating the final decision of whether to use prefabrication.

This research contributes a method of evaluating the monetary and non-monetary impacts of prefabricated products. The research underlines the need to evaluate the diverse benefits and sacrifices that stakeholder face when considering production methods in construction.