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Open Access
Article
Publication date: 29 April 2020

Kjersti Wendt, Bjørn Erik Mørk, Ole Trond Berg and Erik Fosse

The purpose of this paper is to increase the understanding of organizational challenges when decision-makers try to comply with technological developments and increasing demands…

1307

Abstract

Purpose

The purpose of this paper is to increase the understanding of organizational challenges when decision-makers try to comply with technological developments and increasing demands for a more rational distribution of health care services. This paper explores two decision-making processes from 2007–2019 in the area of vascular surgery at a regional and a local level in Norway.

Design/methodology/approach

The study draws upon extensive document analyses, semi-structured interviews and field conversations. The empirical material was analyzed in several steps through an inductive approach and described and explained through a theoretical framework based on rational choice (i.e. bounded rationality), political behavior and institutionalism. These perspectives were used in a complementary way.

Findings

Both decision-making processes were resource-intensive, long-lasting and produced few organizational changes for the provision of vascular services. Stakeholders at both levels outmaneuvered the health care planners, though by different means. Regionally, the decision-making ended up in a political process, while locally the decision-making proceeded as a strategic game between different departments and professional fields.

Practical implications

Decision-makers need to prepare thoroughly for convincing others of the benefits of new ways of organizing clinical care. By providing meaningful opportunities for public involvement, by identifying and anticipating political agendas and by building alliances between stakeholders with divergent values and aims decision-makers may extend the realm of feasible solutions.

Originality/value

This paper contributes to the understanding of why decision-making processes can be particularly challenging in a field characterized by rapid technological development, new treatment options and increasing demands for more rational distribution of services.

Details

Journal of Health Organization and Management, vol. 34 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 11 September 2009

Craig Lowrie, Marc P.Y. Desmulliez, Lars Hoff, Ole Jakob Elle and Erik Fosse

The purpose of this paper is to review the design and fabrication of a micro‐accelerometer to be used to measure the heart wall motion of patients who have just undergone coronary…

Abstract

Purpose

The purpose of this paper is to review the design and fabrication of a micro‐accelerometer to be used to measure the heart wall motion of patients who have just undergone coronary artery bypass graft (CABG) surgery. The sensor will provide a means of early warning for the medical staff of associated complications with this surgery occurring.

Design/methodology/approach

A feasibility paper is carried out with the use of commercially available MEMS three‐axis accelerometers. The sensors are used in animal studies during which the sensor is stitched directly to the surface of a pig's heart. A need for smaller sensors is required and these are designed in‐house and fabricated using a MEMS process. The final dimensions of the sensors are 2.5×3.5×1.4 mm in width, length and height, respectively.

Findings

The results of the feasibility studies demonstrate the viability of this type of sensor for heart wall motion measurement. It is possible to detect abnormalities, which can indicate complications associated with CABG. The sensors presented here are fabricated within the tight overall size specifications deemed necessary for this application.

Research limitations/implications

This paper demonstrates an application of MEMS for implantable medical sensors.

Practical implications

In the UK, approximately 300,000 people have a heart attack each year. One of the most common surgeries that is used to treat this is CABG. This sensor is to be used by the medical staff in post‐surgery to provide “real‐time” monitoring of the heart and give early warning of regional cardiac ischemia which can save lives and reduce hospital waiting times and costs.

Originality/value

This paper demonstrates an original way of measuring heart wall motion. Results from the feasibility studies have proven that this can provide an invaluable way of providing early warning of complications after heart surgery.

Details

Sensor Review, vol. 29 no. 4
Type: Research Article
ISSN: 0260-2288

Keywords

Article
Publication date: 1 October 2006

Bjørn Erik Mørk, Thomas Hoholm and Margunn Aanestad

The purpose of this paper is to describe the knowledge generation in a cross‐disciplinary group in Norway that developed a new medical device. The aim is to shed light on how…

1458

Abstract

Purpose

The purpose of this paper is to describe the knowledge generation in a cross‐disciplinary group in Norway that developed a new medical device. The aim is to shed light on how knowledge was generated and how the relationships between different communities of practice were mediated. In particular, the paper seeks to examine how material objects and contextual conditions influenced the innovation process.

Design/methodology/approach

In this longitudinal case study an innovation process was followed for five years, and the research material was constructed through extensive observations, interviews and document analysis.

Findings

The innovation process exhibited different themes in varying degrees of blend throughout the process. First, the practices of constructing the device and ascertaining technical feasibility are described. Then the enacted nature of the work is outlined; how it was significantly dependent on circumstantial factors, but also strongly shaped by the need to ensure clinical usability of the device. Finally, the work to package the innovation and turn it into a commercial product is explored.

Originality/value

In contrast with many previous studies, this study follows large parts of the innovation process, and it emphasises how knowing and practice are a result of networked, and changing, relations between both human and non‐human actors. Rather than one community of practice emerging around the innovation work, what can be called an object‐centred assemblage of communities of practice was seen, which grew and changed according to the changing nature of knowledge needs for the project to continue and succeed. This has interesting implications for the understanding of cross‐disciplinary innovation processes.

Details

European Journal of Innovation Management, vol. 9 no. 4
Type: Research Article
ISSN: 1460-1060

Keywords

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