Search results

The purpose of this paper is to empirically examine developmental trends in healthcare organisation management practice and improvement work.

Primary healthcare centre (n=1,031) and clinical hospital department (n=1,542) managers were surveyed in spring 2007 (response rate 46 per cent). This article compares results from this survey with a study in 2003. A theoretical framework based on organisational inner context, organisational outer context, external environment and outcomes form the analytical base. Comparisons were made using independent two‐sample t‐tests.

A general aspect, identified empirically, is the tendency toward increased external pressure on leaders in their improvement work. Higher management decisions, patient pressure and decisions made by policymakers increasingly influence and shape the choices made by healthcare managers about where to focus improvement efforts. Three different trends are empirically identified and elaborated: take‐control logic; practice‐based improvement; and patient‐centeredness.

Healthcare leaders should carefully design new management control systems that support healthcare micro systems. Findings support the general assumption that staff increasingly tend to focus organisational changes on management control.

This study extends management research with a unique survey. Through two measurements made in 2003 and 2007, several important trends about how healthcare organisations are managed and developed are identified.

In a previous study, based on a survey to all clinical department and primary care center managers in Sweden, it was concluded that the prevailing general improvement strategy is characterized by: drivers for improvement are staff needs; patients and data are not as important; improvements mainly focus on administrative routines and stress management; improvements are mainly reached, by writing guidelines, and conducting meetings; the majority of managers perceive outcomes from this strategy as successful. The purpose of current research in this paper is to investigate whether there is any other improvement strategy at play in Swedish health care.

Data from the study of all Swedish managers were stratified into two populations based on an instrument predicting successful improvement. One population represented organizations with exceptionally high probability of successful imrpovement and remaining organizations represented the general improvement strategy.

The paper finds that organizations with high probability for successful change differed from the comparison population at the p=0.05 level in many of the surveyed characteristics. They put emphasis on patient focus, measuring outcomes, feedback of data, interorganizational collaboration, learning and knowledge, communication/information, culture, and development of administration and management. Thus these organizations center their attention towards behavioral changes supported by data.

Organizations predicted to conduct successful improvement apply comprehensive improvement strategies as suggested in the literature. Such actions are part of the Patient Centered Task Alignment strategy and it is suggested that this concept has managerial implications as well, as it might be useful in further studies on improvement work in health care.

This paper provides empirically based findings on a successful improvement strategy that can aid research‐informed policy decisions on organizational improvement strategies.

The purpose of this paper is to contribute to the understanding of how statistical process control (SPC) methodology can be implemented and used in organizational settings.

An action research model was used. Data were collected through formal meeting protocols, interviews and participant observation.

Based on the results of an action research project, the paper emphasizes the need for: top management support with respect to roles such as infrastructural assistance, mentor, critic, financer; creating system validity through the involvement of people with experiential knowledge about the “world” in which SPC should be applied; keeping a small, highly knowledgeable development team with appropriate expertise together during the whole process from beginning to end; keeping the various end‐users in focus but separate and prioritising between their different needs; and working with iterative design methodology.

The paper provides the research field with a unique case of implementing SPC using a computerized administrative data system.

Organizations are given guidelines to use when implementing SPC.

The paper contributes knowledge in an underdeveloped field of research. It may provide a basis for further research and scholarly analysis.

This study aims to investigate additive manufacturing of nickel-based superalloy IN718 made by powder bed fusion processes: powder bed fusion laser beam (PBF-LB) and powder bed fusion electron beam (PBF-EB).

This work has focused on the influence of building methods and post-fabrication processes on the final part properties, including microstructure, surface quality, residual stresses and mechanical properties.

PBF-LB produced a much smoother surface. Blasting and shot peening (SP) reduced the roughness even more but did not affect the PBF-EB surface finish as much. As-printed PBF-EB parts have low residual stresses in all directions, whereas it was much higher for PBF-LB. However, heat treatment removed the stresses and SP created compressive stresses for samples from both PBF processes. The standard Arcam process parameter for PBF-EB for IN718 is not fully optimized, which leads to porosity and inferior mechanical properties. However, impact toughness after hot isostatic pressing was surprisingly high.

The two processes gave different results and also responses to post-treatments, which could be of advantage or disadvantage for different applications. Suggestions for improving the properties of parts produced by each method are presented.