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At the outbreak of the COVID-19 pandemic, health care was at the centre of the crisis. New demands made existing organizational practices and services obsolete. Primary health care had a great deal of responsibility for COVID-19-related care. The pandemic demanded effective leadership to manage the new difficulties. This paper aims to explore experiences and perceptions of managers in primary health care in relation to their efforts to manage the COVID-19 crisis in their everyday work.

The authors used a qualitative approach based on 14 semi-structured interviews with managers in primary health care from four regions in Sweden. The interviews were conducted during September to December 2020. Data were analysed using conventional qualitative content analysis.

Data analysis yielded three categories: lonely in decision-making; stretched to the limit; and proud to have coped. The participants felt lonely in their decision-making, and they were stretched to the limit of their own and the organization’s capacity. The psychosocial working conditions in primary care worsened considerably during the pandemic because demands on leaders increased while their ability to control the work situation decreased. However, they also expressed pride that they and their employees had managed the situation by being flexible and having a common focus.

Looking ahead and using lessons learnt, and apart from making wise decisions under pressure, an important implication for primary health-care leaders is to not underestimate the power of acknowledging the virtues of humanity and justice during a crisis. Continuing professional education for leaders focusing on crisis leadership could help prepare leaders for future crises.

In today’s complex society, there is an increasing demand to include a wider set of skills in engineering curricula, especially skills related to policy, society and sustainable development. Role-playing and gaming are active learning tools, which are useful for learning relationships between technology and society, problem solving in complex situations and communication. However, use of these learning methods in higher education, and in engineering particularly, is limited. The purpose of this study was to test the effectiveness of a role-playing game for learning about complexities related to sustainable water and sanitation management within a civil engineering curriculum.

The game has been used during three consecutive years in a Masters’ level course. Surveys and course evaluations were used to evaluate the effectiveness of this method from both teacher and student perspectives.

The results show that students gained knowledge on complex subjects, and both teachers and students had positive experiences. Better integration of the game within the rest of the course could strengthen its effectiveness.

The experiences gained from this study should assist others in the development and use of such active learning techniques in higher education.

Conducting research that is both practice- and theory-relevant is important for the service research community. Action research can be a fruitful approach for service researchers studying the transformative role of service research and wanting to make contributions to both the research community and to practical development. By exploring the current use of action research in service research, this study aims to make suggestions for enhancing the contribution to theory and practice development and to propose criteria for research quality for action research in service research.

This study builds on a systematic literature review of the use of action research approaches in service research.

The study makes three main contributions. First, it posits that any action research project needs to consider the four elements of problem identification, theorization, creating guiding concepts and intervention. Second, based on these elements mirrored in service action research, it outlines and analyzes three approaches to action research (i.e. theory-enhancing, concept developing and practice-enhancing). Third, it suggests a move from instrumental to a more conceptual relevance of the research and elaborates on the criteria for research quality.

This study contributes to the understanding of how action research may be applied for conducting high-quality collaborative research in services and proposes measures to enhance research quality in action research projects focusing services.

This study aims to investigate service modularization in a manufacturing firm, identifies service modularization processes and examines how these processes change the service module characteristics.

The study is based on a longitudinal case study (2008-2017) of a manufacturing firm. The development of six service modules was analyzed using data from interviews with key informants, informal meetings and internal documentation.

This study suggests five service modularization processes, and that service module characteristics, such as standardization and interconnectedness, change in different ways depending on the service modularization processes used. It further identifies two service modularization routes that each combine the service modularization processes in unique ways with replication as a key process to improve both standardization and customization.

This study elaborates a framework for service modularization, which can serve as a guideline for developing service modules. It also highlights the differences between product and service modularization, suggesting that the role of service module characteristics such as standardization and customization is specific for services.

This longitudinal case study (2008-2017) provides empirical evidence on service modularization and extends existing knowledge on service modularization processes and how they influence service module characteristics.

The purpose of this paper is to use competence theory to explore the fit between actual competencies of quality management (QM) practitioner and the perception of QM competence needs in organisations.

This paper is based on a cross-case quantitative study design featuring a survey of QM practitioners (n = 249) within eight large Swedish organisations. The research instrument was a questionnaire covering seven themes within QM. The analysis is based on descriptive statistics.

The results show that while the perception of formal QM competence may seem sufficient, the evolving nature of QM requires knowledge, skills and attitudes that are also apt for more external and explorative perspectives. There is a bias towards competence for exploitative QM rather than explorative QM. Organisational logics preserving and possibly reinforcing a perceived “competence lag” in organisations are identified and described.

Few empirical studies within QM explore the competencies required for QM practices. This paper contributes to QM research in providing arguments for adopting the competence theory as a foundation for organising current and future QM work.

This study aims to explore recent public sector trends, inter-organizational and cross-sector collaborations, and analyzes these in terms of implications for participative development of information systems (IS). These trends are understood as being part of emerging forms of e-government. Initial suggestions for how to develop IS in the new contexts are provided.

Three cases involving the trends described above, taking place in the Swedish emergency response system, are studied and used as basis for identified participative IS development challenges and suggested adaptation needs. Data collection involves semi-structured interviews, focus groups and future workshops.

The identified challenges concern balancing ideological versus practical needs, lack of resources, lack of know-how and design techniques and tool challenges. Some practical implications for participative IS development include more extensive focus on stakeholder and legal analysis, need for interdisciplinary design teams, merging of task and needs analysis for yet-undefined user tasks and using on-line alternatives for interacting with users.

The study is exploratory where the three cases are in different, but at the same time interrelated, collaboration contexts. The identified implications and challenges provide proposals that in future research can be applied, formalized and integrated when developing practically feasible participative IS development approaches.

It is argued that the results point toward a current emerging form of e-government initiatives directed toward certain demarcated groups of citizens actually carrying out certain tasks for their co-citizens and society rather than the broad masses, having far-reaching practical implications and complicating the issue of IS development.

Network configurations have been proposed as an efficient form of organisation and a promising area of research; however, a lack of conceptual clarity can be noted. The purpose of this review is to allow for a broad appreciation of network configurations and provide guidance for future studies of the concept.

A systematic literature review was conducted based on the PRISMA method; Scopus, Web of Science, PubMed and the Cochrane Library were searched for conference proceedings and journal articles describing organisational networks to integrate resources aimed at care delivery. Around 80 articles were included in the final review and analysed thematically and by use of bibliographic coupling.

The last decades have seen an increase in the frequency of articles describing networks for healthcare delivery. The most common contexts are care for multiple and/or long-term conditions. Three clusters of articles were found, corresponding to different conceptualisations of networks in healthcare: efficiency-enhancing cooperation, efficiency-enhancing integration and involvement for cocreation.

To increase conceptual clarity and allow the research on network configurations in healthcare to produce meta-learnings and guidance to practice, scholars are advised to provide ample descriptions of studied networks and relate them to established network classifications.

The current review has only included articles including networks as a key concept, which provides a focused overview of the use of network configurations but limits the insights into similar approaches not described explicitly as networks.

Over one million organisations have a quality management system (QMS) certified to the ISO 9001 standard; however, the system requires a lot of resources and its value has been questioned. This critique also leads to a questioning of the strategic relevance of quality management. The purpose of this paper is to explore how different types of uses of QMS correlate with management perceptions of quality management in terms of respect, cost and strategic importance.

The paper is based on a mixed method data collection strategy, quantitative data being collected from a survey in 8 organisations (n = 108) and qualitative data being collected from 12 interviews with quality managers in 12 different organisations.

The paper shows that a compliance-oriented QMS usage will more likely lead to a view of quality management as costly and of little respect, than a business or improvement-oriented QMS usage. Moreover, it nuances the view on compliance-oriented usage, showing that it is mainly documentation that negatively influences how management views quality management, whereas standardisation that is part of the compliance-oriented use is perceived as more value-adding.

This paper suggests three types of QMS use, namely, business management, improvement, and compliance-oriented use, and that a wise selection of how to use the QMS will affect the respect, strategic importance and cost that management associates with quality management.

This study aims to explore factors that contribute to auditee satisfaction in external audit fieldwork of ISO 9001, and relationships between these factors.

The purpose is addressed through a single case study and based upon data collected by a questionnaire. Data were analysed using probabilistic graphical models.

An auditor's knowledge of operations is shown to be the single most important factor contributing to auditee satisfaction in the study. Furthermore, establishing a co-operative audit atmosphere and focussing on business improvements support the co-creation of value in the interaction between auditor and auditee, while a focus on ISO compliance appears to be more of a hygiene factor.

This paper is based on a study of one company and its interactions with one of the certification bodies for external auditing. Hence, the generalisability of the findings is limited by the case study method.

This paper identifies that an auditor's knowledge of operations and a focus on improvements and co-creation of value can improve auditee satisfaction and appreciation of the audit process.

Previous research has concluded that audit fieldwork is a key attribute associated with auditee satisfaction. This paper adds to this body of knowledge by empirically examining the specific factors within audit fieldwork that contribute to auditee satisfaction and focuses on value-creation in the audit process. By understanding these factors and moving towards a service perspective on audits with value co-creation as focus, it is possible to enhance the value of external audits.

The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The purpose of this paper is to construct a taxonomy that supports the management of parallel IAs in healthcare.

Based on previous research, this paper proposes a taxonomy that includes the dimensions of view on value and organizational focus; three contemporary IAs – lean, value-based healthcare, and patient-centered care – are related to the taxonomy. An illustrative qualitative case study in the context of psychiatric (psychosis) care is then presented that contains data from 23 interviews and focuses on the value concept, IAs, and the proposed taxonomy.

Respondents recognized the dimensions of the proposed taxonomy and indicated its usefulness as support for choosing and combining different IAs into a coherent management model, and for facilitating dialog about IAs. The findings also suggested that the view of value as “health outcomes” is widespread, but healthcare professionals are less likely than managers to also view value as a process.

The conceptual contribution of this paper is to delineate some important characteristics of IAs in relation to the emerging “value era”. It also highlights the coexistence of different IAs in healthcare management practice. A taxonomy is proposed that can help managers choose, adapt, and combine IAs in local management models.