This paper explores an initiative by a Swedish governmental agency to create a temporary arena fo... more This paper explores an initiative by a Swedish governmental agency to create a temporary arena for collaboration between management consultancies, researchers and representatives from the public se ...
Chefsuppdragets komplexitet i politiskt styrda organisationer : utmaningar, hantering och utveckl... more Chefsuppdragets komplexitet i politiskt styrda organisationer : utmaningar, hantering och utvecklingsmojligheter
Perspectives in Business Information Research-BIR'2007, 2007
Abstract. In this paper we discuss the fact that more and more patients are treated in their home... more Abstract. In this paper we discuss the fact that more and more patients are treated in their homes by a set of organizations, sometimes with different ownership, we explore how this poses new and heavy demands on health care and home service staff to communicate and to collaborate. We investigate the need for improved communication and collaboration on different managerial and operational levels. In particular we point to the need for managers in different organizations to agree on ways of communicating and collaborating between ...
The role of a change process facilitating function in a large org. development attempt in a healt... more The role of a change process facilitating function in a large org. development attempt in a healthcare organization
International Journal of Quality and Service Sciences, Mar 16, 2015
Purpose – The purpose of this paper was to investigate the role of an intra-organizational change... more Purpose – The purpose of this paper was to investigate the role of an intra-organizational change facilitating function (CFF) in relation to a multi-level development initiative in a health care organization. Involved actors’ views on factors in need of attention and how the CFF related to these factors were studied. Design/methodology/approach – A longitudinal case study design was used, combining data from questionnaires, process diaries and interviews with employees at the CFF, managers and clinic staff. Findings – Factors on micro, meso and macro levels, crucial to attend to, were highlighted by respondents at staff and managerial levels. The CFF related to some of these factors by acting upon them, or by developing plans to handle them, while other factors were unattended to. The CFF activities also had indirect influence on other factors. The CFF role and responsibilities were not clearly defined beforehand, and a need to clarify a division of roles and responsibilities is highlighted. Research limitations/implications – Our study contributes to current knowledge on facilitation of change by relating it to an organizational dimension of implementation. Practical implications – The description of important factors to handle during a large organizational change process and issues a CFF can encounter may aid others involved in designing and managing large organizational development initiatives. Originality/value – The study elaborates on less studied functions and roles of an intra-organizational CFF in relation to factors of vital importance for organizational change and development in health-care organizations.
Journal of Health Organisation and Management, Mar 21, 2016
The purpose of this paper is to investigate the obstacles and challenges associated with organiza... more The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development. A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years. The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found. A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization's measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks. Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor's view on important factors to consider when building a coherent organizational M & F strategy.
Traditional views on the spread of knowledge and learning in health care have been criticized as ... more Traditional views on the spread of knowledge and learning in health care have been criticized as being overly linear, simplified and rational, leading to a slow progress of clinical praxis. The pur ...
This paper reports an action research program designed to develop new approaches for a locally ba... more This paper reports an action research program designed to develop new approaches for a locally based Swedish R&D unit’s task to facilitate improvement in partner organizations, and to provide guidance on how to manage challenges in action research programs focusing on development in health and social care. Data were gathered from interviews with R&D members’, managers representing the two embedded pilot cases, as well as from the lead action researchers. Key findings were the need to continually monitor and revise the action research plan and that each step should be given specific weights based on the conditions at hand. As the action program evolved the participants were given autonomy to take action in the partner organizations and the role of the action researchers became advisory and consultative. These findings accentuate the emergent nature of action research and the need for flexible and dynamic intervention planning, especially when multiple level actors and several organizations are involved. Based on these findings we discuss some implications for the action researcher’s role and how similar programs can be designed to manage change in complex health and social care systems reaching various stakeholders at many levels.
For an intervention to be effective, it has to be implemented : Fidelity and process analysis of ... more For an intervention to be effective, it has to be implemented : Fidelity and process analysis of the LeanHealth project, an intervention using an integrated system approach.
The LeanHealth project: Merging occupational health, safety and health promotion with lean : An i... more The LeanHealth project: Merging occupational health, safety and health promotion with lean : An integrated systems approach
Separate silos or integrated processes? Merging occupational health, safety and health promotion ... more Separate silos or integrated processes? Merging occupational health, safety and health promotion with lean : The LeanHealth project
This paper explores an initiative by a Swedish governmental agency to create a temporary arena fo... more This paper explores an initiative by a Swedish governmental agency to create a temporary arena for collaboration between management consultancies, researchers and representatives from the public se ...
Chefsuppdragets komplexitet i politiskt styrda organisationer : utmaningar, hantering och utveckl... more Chefsuppdragets komplexitet i politiskt styrda organisationer : utmaningar, hantering och utvecklingsmojligheter
Perspectives in Business Information Research-BIR'2007, 2007
Abstract. In this paper we discuss the fact that more and more patients are treated in their home... more Abstract. In this paper we discuss the fact that more and more patients are treated in their homes by a set of organizations, sometimes with different ownership, we explore how this poses new and heavy demands on health care and home service staff to communicate and to collaborate. We investigate the need for improved communication and collaboration on different managerial and operational levels. In particular we point to the need for managers in different organizations to agree on ways of communicating and collaborating between ...
The role of a change process facilitating function in a large org. development attempt in a healt... more The role of a change process facilitating function in a large org. development attempt in a healthcare organization
International Journal of Quality and Service Sciences, Mar 16, 2015
Purpose – The purpose of this paper was to investigate the role of an intra-organizational change... more Purpose – The purpose of this paper was to investigate the role of an intra-organizational change facilitating function (CFF) in relation to a multi-level development initiative in a health care organization. Involved actors’ views on factors in need of attention and how the CFF related to these factors were studied. Design/methodology/approach – A longitudinal case study design was used, combining data from questionnaires, process diaries and interviews with employees at the CFF, managers and clinic staff. Findings – Factors on micro, meso and macro levels, crucial to attend to, were highlighted by respondents at staff and managerial levels. The CFF related to some of these factors by acting upon them, or by developing plans to handle them, while other factors were unattended to. The CFF activities also had indirect influence on other factors. The CFF role and responsibilities were not clearly defined beforehand, and a need to clarify a division of roles and responsibilities is highlighted. Research limitations/implications – Our study contributes to current knowledge on facilitation of change by relating it to an organizational dimension of implementation. Practical implications – The description of important factors to handle during a large organizational change process and issues a CFF can encounter may aid others involved in designing and managing large organizational development initiatives. Originality/value – The study elaborates on less studied functions and roles of an intra-organizational CFF in relation to factors of vital importance for organizational change and development in health-care organizations.
Journal of Health Organisation and Management, Mar 21, 2016
The purpose of this paper is to investigate the obstacles and challenges associated with organiza... more The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development. A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years. The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found. A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization's measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks. Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor's view on important factors to consider when building a coherent organizational M & F strategy.
Traditional views on the spread of knowledge and learning in health care have been criticized as ... more Traditional views on the spread of knowledge and learning in health care have been criticized as being overly linear, simplified and rational, leading to a slow progress of clinical praxis. The pur ...
This paper reports an action research program designed to develop new approaches for a locally ba... more This paper reports an action research program designed to develop new approaches for a locally based Swedish R&D unit’s task to facilitate improvement in partner organizations, and to provide guidance on how to manage challenges in action research programs focusing on development in health and social care. Data were gathered from interviews with R&D members’, managers representing the two embedded pilot cases, as well as from the lead action researchers. Key findings were the need to continually monitor and revise the action research plan and that each step should be given specific weights based on the conditions at hand. As the action program evolved the participants were given autonomy to take action in the partner organizations and the role of the action researchers became advisory and consultative. These findings accentuate the emergent nature of action research and the need for flexible and dynamic intervention planning, especially when multiple level actors and several organizations are involved. Based on these findings we discuss some implications for the action researcher’s role and how similar programs can be designed to manage change in complex health and social care systems reaching various stakeholders at many levels.
For an intervention to be effective, it has to be implemented : Fidelity and process analysis of ... more For an intervention to be effective, it has to be implemented : Fidelity and process analysis of the LeanHealth project, an intervention using an integrated system approach.
The LeanHealth project: Merging occupational health, safety and health promotion with lean : An i... more The LeanHealth project: Merging occupational health, safety and health promotion with lean : An integrated systems approach
Separate silos or integrated processes? Merging occupational health, safety and health promotion ... more Separate silos or integrated processes? Merging occupational health, safety and health promotion with lean : The LeanHealth project
Bowen et al highlight the trend towards partnership research to address the complex ... more Bowen et al highlight the trend towards partnership research to address the complex challenges currently facing healthcare systems and organizations world-wide. They focus on important strategic actors in partner organizations and their experiences, views and advice for sustainable collaboration, within a Canadian context. The authors call for a multi-system change to provide better conditions for research partnerships. They highlight needs to re-imagine research, to move beyond an ‘acute care’ and clinical focus in research, to re-think research funding, and to improve the academic preparation for research partnerships. In this commentary we provide input to the discussion on practical guidance for those involved in research partnerships based on our partnership experiences from ten research projects conducted within the Swedish healthcare system since 2007. We also highlight areas that need attention in future research in order to learn from approaches used for collaborative and partnership research.
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Papers by Monica Nyström