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