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Article
Publication date: 18 February 2025

Suzana Holmér, Barbro Krevers, Kristin Thomas and Ann-Charlotte Nedlund

Publicly funded healthcare systems struggle to govern and determine how finite resources should be allocated in relation to political goals within a pre-determined budget. Primary…

22

Abstract

Purpose

Publicly funded healthcare systems struggle to govern and determine how finite resources should be allocated in relation to political goals within a pre-determined budget. Primary healthcare (PHC) has a central multipurpose function, not least in terms of political strategies, but PHC governance is still largely underexplored. The aim is to explore how politicians responsible for making decisions pertaining to healthcare coverage navigate the governance of public PHC and disentangle it in the form of narratives based on different types of underlying rationales.

Design/methodology/approach

Semi-structured interviews were conducted with 15 politicians from 3 Swedish regional healthcare authorities. The data were analysed abductively based on scientific, clinical and cultural rationales using thematic content analysis.

Findings

Our study provides insights into how PHC’s multipurpose function implicates tensions between politicians' different responsibilities regarding healthcare coverage. It shows how politicians navigate various coexisting rationales, with some being more dominant than others and where tensions also exist between them. In this balancing act, they create narratives addressing different stakeholders and priority-setting dilemmas, reflecting the diverse rationales. Our study reveals that politicians play a crucial role in PHC governance and priorities, balancing rationales that might otherwise become overly dominant.

Originality/value

This paper contributes new knowledge by displaying how politicians balance tensions within and between rationales through different narratives regarding goals/commissions, problematic situations and preferred solutions in PHC governance.

Details

Journal of Health Organization and Management, vol. 39 no. 9
Type: Research Article
ISSN: 1477-7266

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Book part
Publication date: 2 December 2024

Vítor Corado Simões, John Cantwell and Philippe Gugler

Abstract

Details

The History of EIBA: A Tale of the Co-evolution between International Business Issues and a Scholarly Community
Type: Book
ISBN: 978-1-83608-665-9

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Article
Publication date: 3 June 2014

Petra Dannapfel, Bozena Poksinska and Kristin Thomas

– The purpose of this paper is to contribute to knowledge about dissemination strategies for Lean thinking throughout multiple healthcare organisations.

2495

Abstract

Purpose

The purpose of this paper is to contribute to knowledge about dissemination strategies for Lean thinking throughout multiple healthcare organisations.

Design/methodology/approach

The Östergötland county council, Sweden (CCÖ) was chosen as a case study for an healthcare Lean-thinking dissemination strategies. Document analysis and interviews were used and results were compared with similar strategies employed by staff at the National Health Service Institute for Innovation (NHSI) and improvement in Great Britain and the Odense University Hospital in Denmark.

Findings

The Lean improvement programme was introduced to tackle challenges such as an ageing society, rising care expectations and budgetary and economic constraints. It was designed as a long-term programme to create added value for patients and employee involvement. The dissemination strategy was: forming clear visions and objectives; piloting; training potential adopters; and formal dissemination. The CCÖ strategy was focused primarily on managers and was not meant to involve all staff until the implementation stage. Staff at the NHSI attempted to address nurses’ needs during dissemination, which questioned whether the CCÖ managers’ dissemination strategy is sustainable.

Practical implications

This paper inspires healthcare managers and decision makers who aim to disseminate Lean production in their organisations.

Originality/value

There are many case studies describing Lean implementation in single healthcare organisations, but little is known about effective dissemination and implementation strategies in large healthcare systems. The authors, therefore, suggest activities for developing and implementing dissemination strategies in multiple healthcare organisations.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 5
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 April 2000

Stuart James

126

Abstract

Details

Reference Reviews, vol. 14 no. 4
Type: Research Article
ISSN: 0950-4125

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Book part
Publication date: 9 March 2021

Steven Cosares, Kristin Kalish, Thomas Maciura and Andrew C. Spieler

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Book part
Publication date: 8 October 2018

Kristin Reichborn-Kjennerud, Thomas Carrington, Kim Klarskov Jeppesen and Külli Taro

Since the 1970s the Supreme Audit Institutions (SAI) have gradually expanded their role as external controllers of the public administration. Instead of merely controlling whether…

Abstract

Since the 1970s the Supreme Audit Institutions (SAI) have gradually expanded their role as external controllers of the public administration. Instead of merely controlling whether accounts are according to standards they have taken on a role as evaluators with a mandate to assess whether the public administration works economically, efficiently and effectively. With this new regime of external control, the question arises whether the SAIs’ control, in practice, contributes to a more efficient and effective public sector. Whether this external control will be effective depends, in the end, on the extent to which the organisations learn from the control they are subjected to and make actual changes. The chapter uses theories of cultural differences and theories on control within public administration to understand civil servant perceptions of SAI results. Data on civil servants’ reactions to the SAIs’ performance audit in four countries are analysed to see whether performance audits have any impact on the audited entities. The research is based on 696 responses to questionnaires sent out to civil servants in three different Nordic countries plus one new democracy in northern Europe, Estonia.

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Book part
Publication date: 11 November 2016

Brook E. Sawyer, Patricia H. Manz, Kristin A. Martin, Thomas C. Hammond and Scott Garrigan

A pressing educational concern is how to provide effective education for the growing population of dual language learners (DLL) in early childhood settings. Given the robust…

Abstract

A pressing educational concern is how to provide effective education for the growing population of dual language learners (DLL) in early childhood settings. Given the robust findings that family involvement promotes children’s academic success as well as recognition of parents’ “funds of knowledge,” one pathway to provide a culturally and linguistically responsive classroom environment for DLLs is to form collaborative relationships between parents and teachers of DLLs. The purpose of this chapter is to describe Project TAPP (Teachers and Parents as Partners), a community of practice (CoP) composed of parents and teachers of preschool dual language learners. The chapter describes the framework of Project TAPP, findings related to participation, and lessons learned.

Details

Family Involvement in Early Education and Child Care
Type: Book
ISBN: 978-1-78635-408-2

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Article
Publication date: 3 June 2014

Keith Hurst

1252

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 5
Type: Research Article
ISSN: 0952-6862

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Book part
Publication date: 9 March 2021

H. Kent Baker, Ehsan Nikbakht and Sean Stein Smith

Blockchain is an emerging technology that started in the cryptocurrency sphere with bitcoin but expanded to include numerous applications. This chapter provides an overview of the…

Abstract

Blockchain is an emerging technology that started in the cryptocurrency sphere with bitcoin but expanded to include numerous applications. This chapter provides an overview of the book. It begins by identifying the three main components of a blockchain. Next, it discusses the book's purpose, distinguishing features, and its intended audience. The chapter then outlines the book's structure, consisting of 22 chapters divided into four main parts. It offers a brief synopsis of each section and chapter. Finally, it ends with a summary and conclusions.

Details

The Emerald Handbook of Blockchain for Business
Type: Book
ISBN: 978-1-83982-198-1

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Article
Publication date: 17 May 2013

Steve Oakes, Anthony Patterson and Helen Oakes

Despite the relatively low cultural status of department store music, it is proposed that music – the shopping soundtrack – is capable of transforming perceptions of the…

1628

Abstract

Purpose

Despite the relatively low cultural status of department store music, it is proposed that music – the shopping soundtrack – is capable of transforming perceptions of the environment in which it is heard, and eliciting immediate emotional and behavioural responses, thus underlining the influence of music, regardless of whether it is passively heard as a background element or actively listened to as a live performance in a dedicated venue.

Design/methodology/approach

This study addresses a gap in the marketing literature for introspective research evaluating the experience of music in service environments. It draws upon auto‐ethnographic data through which participants ponder their own consumption experience and provide detailed, subjective accounts of events and memories.

Findings

When considering the effects of music upon emotional, cognitive and behavioural responses, it highlights the importance of musicscape response moderators.

Practical implications

The service environment appears more exciting and attractive and may encourage increased spending when background music is congruous with other servicescape elements. Music with positive autobiographical resonance elicits pleasurably nostalgic emotions, positive evaluations and longer stay. However, the aural incongruity of unexpected silence in music‐free zones produces feelings of discomfort leading to negative store evaluation and departure.

Originality/value

Qualitative data are deliberately represented using typically positivist discourse to encourage resolution of the inherent tension between interpretivist and positivist perspectives and stimulate increased methodological integration (e.g. through future studies of music combining quantitative and qualitative data).

Details

Arts Marketing: An International Journal, vol. 3 no. 1
Type: Research Article
ISSN: 2044-2084

Keywords

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