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  • 1.
    Andersson, Thomas
    et al.
    University of Skövde, School of Technology and Society.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Ujvari, Sandor
    University of Skövde, School of Technology and Society.
    Easier to trust managers than management?: The case of improvement work in healthcare2011Conference paper (Refereed)
    Abstract [en]

    Previously, improvement work in healthcare has mainly been medically related and driven by medical research, but NPM implies that management-initiated improvement work targeting organizing, productivity, efficiency, work flow etc. has become more and more common. Management-initiated improvement work has a high failure rate, and in general it seems difficult to motivate co-workers to actively participate. In all processes of organizational change, trust in the initiator of a change project is an important prerequisite to enable change take place. In this article, our purpose is to investigate how trust in management influences management-initiated improvement work. In a qualitative study we investigate improvement work at three Swedish hospitals. Our theoretical framework is based on a view of management as being both the people who manage and the system of management. This distinction is important since we can trust people and we can have confidence in a system, but these processes are different. Consequently, it is possible to trust individual managers, but as long as we do not trust management as a system, management-initiated improvement work will face considerable problems.  To analyze trust we use a model that identifies three important antecedents for one person (the trustor) to consider another person (the trustee) as trustworthy: ability, benevolence and integrity. Using social system theory, we extend this model to on the one hand describe trust in specific persons (specific managers), and on the other hand describe confidence in a system (management in general, which the system-specific managers are parts of). The results indicate that there in general is a lack of trust between healthcare personnel and healthcare management.

     

    We were able to find certain managers who were found trustworthy by the personnel, but despite these trust-relations the personnel did still not have confidence in management as a system. To the contrary, these managers were perceived as exceptions, and did not change the perception of management in general. The consequences for management-initiated improvement work were that most personnel at best were ignorant to it, and at worst resisted it openly. However, there were examples when trusted enthusiastic managers succeeded in initiating improvement work, but then the continuation and success was directly connected to this person, and if s/he left, the improvement work stopped. Furthermore, some work groups seemed to very clearly separate “real” improvement work, which they initiated themselves, from “phony” improvement work initiated by management, which only stole time from more important tasks.

  • 2.
    Andersson, Thomas
    et al.
    University of Skövde, School of Technology and Society.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Ujvari, Sandor
    University of Skövde, School of Technology and Society.
    Industriellt baserade modeller för kvalitetsutveckling2013In: Att utveckla vården: Erfarenheter av kvalitet, verksamhetsutveckling och förbättringsarbete / [ed] Nomie Eriksson, Kajsa-Mia Holgers, Tomas Müllern, Lund: Studentlitteratur, 2013, 1, p. 73-84Chapter in book (Refereed)
  • 3.
    Andersson, Thomas
    et al.
    University of Skövde, School of Technology and Society.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Ujvari, Sandor
    University of Skövde, School of Technology and Society.
    Organisering av förbättringsarbete inom vården med inspiration från industrin2011Conference paper (Refereed)
    Abstract [sv]

    I denna artikel fokuserar vi på användandet av industriellt baserade produktionssynsätt (IBP) inom vården i avsikt att arbeta systematiskt med förbättringsarbete. Tidigare forskning har visat att det är svårt att få nya arbetsmetoder att få genomslag i den dagliga praktiken. I denna artikel fokuserar vi på om det går att se indirekta effekter såsom hur förbättringsarbetet organiseras beroende på vilka IBP olika sjukhus väljer att arbeta med. Undersökning är genomförd genom fallstudier på tre sjukhus som har valt att arbeta med tre olika metoder: six sigma, processorientering och mikrosystem.

    Studien visar att de olika logikerna bakom de olika metoderna ger fundamentalt olika sätt att organisera förbättringsarbetet vid de tre sjukhusen. Six sigma-sjukhuset valde ett centraliserat förbättringsarbete i hög grad drivet av experter på förbättringsmetoder, processsjukhuset

    hade en expertavdelning som var mer av bollplank och utbildare för verksamhetens förbättringsarbete och mikrosystem-sjukhuset valde ett decentraliserat förbättringsarbete där förbättringsarbetet var både lokalt initierat och drivet.

  • 4.
    Andersson, Thomas
    et al.
    University of Skövde, School of Technology and Society.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Ujvari, Sandor
    University of Skövde, School of Technology and Society.
    System trust in healthcare: A prerequisite for improvement work?2011Conference paper (Refereed)
  • 5.
    Andersson, Thomas
    et al.
    University of Skövde, School of Technology and Society.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Ujvari, Sandor
    University of Skövde, School of Technology and Society.
    Trust in management-initiated improvement work2011Conference paper (Refereed)
  • 6.
    Brorström, Björn
    et al.
    Högskolan i Borås.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Jensen, Christian
    Handelshögskolan Göteborg univeristet.
    Nilsson, Viveka
    Kfi - Kommunforskning i Västsverige, Göteborgs universitet.
    Hållbar kommun: Att balansera konkurrerande värden2015Report (Other academic)
    Abstract [sv]

    Frågan ”Vad är en hållbar kommun?” är utgångspunkt i den studie som presenteras. Studien syftar till att belysa vad en hållbar kommun kan vara och behandlar frågan både ur ett teoretiskt och empiriskt perspektiv. Begreppet hållbarhet används flitigt i samhällsdebatten om hur vi ska ta oss an allehanda utmaningar på såväl global som lokal nivå. Hållbarhetsbegreppet används inte bara som ett attraktivt värdeomdöme och en retorisk tankefigur i samhällsdebatten, utan även som en strukturerande idé som håller på att finna sina organisatoriska uttrycksformer på såväl nationell som lokal nivå. Hållbarhetsbegreppet adresserar både ett tillstånd och ideal (hållbarhet) och en process och dynamik (hållbar utveckling).

    Vad händer då i ett redan komplext system när nya ideal adderas? Blir det ”lager på lager” och allt ska göras samtidigt? Blir det särkoppling, transformeras kommunen eller förändrar man där det är möjligt och ger det nya namn, men gör man det man alltid gjort? Inom forskning finns alla alternativ dokumenterade det tenderar nämligen att ske flera saker samtidigt när nya struktureringsidéer anammas.

    I den teoretiska referensramen identifierades tre konfliktytor; de kring ägande, resurser och utveckling. En förutsättning för all konfliktlösning är institutionella arrangemang för att hantera makt, intressen och möjligheter. Makt i form av vem som ingår överenskommelser, intressen i form av vad man är beredd att gå med på och möjligheter kring vad som kan åstadkommas. Det är således inte ”antingen eller”, utan snarare ”både och”, där flera avvägningar och bedömningar måste göras. Det kommunala självstyret är en god grund att vidareutveckla detta institutionella arrangemang för en hållbar kommun.

     Forskningsprojektet fortsätter där föreliggande rapport ger en god grund för fördjupade studier med mer precisa frågeställningar och intervjuer av fler aktörer. Kommunerna behöver organiseras, styras och ledas för att få fokus på hållbarhet. Hur det sker är en viktig fråga för fortsatt forskning. 

  • 7.
    Cregård, Anna
    et al.
    Förvaltningshögskolan, Göteborgs universitet.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    A critique on physicians as managers in the healthcare sector: coping with contradictions in managerial and medical logics2012Conference paper (Refereed)
    Abstract [en]

    In the healthcare sector the physicians more and more often become managers, in Sweden as well as in many other countries. This is a global trend, which is motivated by better quality, higher efficiency and an increased possibility to control professional actors in the organization. Managing professions are perceived as difficult for many reasons and the appointment of physicians as managers is supposed to solve this problem.

     

    Our aim is to critically discuss the appointment of physicians on traditional management positions in healthcare sector and what it might result in. We recognize that there are positive effects, but they do not align with the rhetoric concerning these appointments. We also discuss an alternative way of organizing the management of professionals in healthcare organizations.

     

    We use two theoretical concepts to discuss this phenomenon: principles of control and shift in trust. The concepts are used to categorize and analyze our empirical data, which consist of deep interviews with 15 physicians and nurses, five focus groups consisting of physicians (managers) and five texts on the relationship between politics, administration and professions, written by physicians (managers) in management training. We also develop the concepts of medical and managerial logics.

     

    Our respondents recognize the principles of control as rational, and they perceive them as important. But there are contradictions between medical and managerial logics. The management discourse alter the care and raises questions they themselves cannot answer, for example “Is it right to treat people who themselves are responsible for their sickness”? They also discuss medical concepts as being altered, for example the course of treatment being completed. Nowadays the concepts concern strictly medical issues, which is not necessarily good in a health perspective. The shift in trust concerns four levels: the trust between individuals, between professional groups, between organizational levels and between the whole society and the healthcare system. For example the respondents mean that the staff sometimes are questioning if the physician as a manager have enough medical day-to-day practice, and there are examples where the staff try to steer away complicated surgery from their superior. The staff also question if he or she is competent enough in management. Another example is that there is a risk of a decrease in trust in the healthcare system as a whole. Gains and losses are described in monetary terms, and the business language is not recognised as appropriate in this kind of organization.

     

    In our conclusions we discuss that there are a chance that appointing physicians on administrative assignments might bring the ears of the colleagues, increased transparency in the everyday care and perhaps a better understanding of overall decisions. But there are also some negative effects and risks – which we discuss using the concepts of medical and managerial logics. Appointing physicians as managers result in two contradicting logics pressed into one individual, who are supposed to handle the contradictions on an individual basis. For example, this means that the principles of ethics will collide with a different rhetoric – from the rationality of medical logics (with equivalence principle and loyalty to the patient) to the rationality of business logics (with cost minimization, production maximization and loyalty to the organization). We summarize the risks below.

     

    —Risk 1: When the physician loses skill, or perceived as less competent than earlier, there will be consequences for both the physician and the patient.

    —Risk 2: When trust in the physician manager decreases, he/she will not gain support by other physicians.

    —Risk 3: When the trust between different levels, groups and individuals in the organization decreases, it will also decrease for care in general.

    —Risk 4: When important values in the service domain are pushed aside, this will favour the values in the administrative domain (efficiency over quality).

     

                     

    Finally we discuss other ways of handling uncontrollable professional organizations, for example by refining administrative and medical roles, by establishing medical management as a speciality within medical education, and by re-strengthen the medical logic. Most important is to alter and nuance the discourse around physicians as managers.

  • 8.
    Cregård, Anna
    et al.
    Högskolan i Halmstad.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Chefskap i professionella organisationer: läkare som chefer2018In: Att leda i en komplex organisation: Utmaningar och nya perspektiv för chefer i offentlig verksamhet / [ed] Anna Cregård, Erik Berntson, Stefan Tengblad, Stockholm: Natur och kultur, 2018, 1, p. 71-82Chapter in book (Other academic)
    Abstract [sv]

    Komplexa organisationer är vanligen svåra att styra – och det gäller särskilt organisationer med starkt professionaliserade aktörer. Det beror på flera faktorer: att det är svårt att överblicka handlingars konsekvenser i sådana organisationer, att det inte är självklart att styrimpulser efterföljs eller att verksamhetens viktigaste procedurer ens går att följa upp. Dessutom kan det som sker på en hierarkisk nivå sakna koppling till det som händer på en annan – och det gäller särskilt for kärnverksamhet i relation till ledning.

  • 9.
    Cregård, Anna
    et al.
    School of Public Administration, University of Gothenburg.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Educating in field visits: Creating images of work2013In: NFF 2013, Reykjavik, Track 2: Engaged scholarship, 2013Conference paper (Refereed)
    Abstract [en]

    The private sector as well as the public sector seeks qualified personnel who are motivated to work in the areas of administration and management. For example, students who have been educated as controllers, purchasing agents and managers are much sought after. Thus, public and private sector organizations are interested in connecting to students who want to study business administration, management and public administration. One goal of such organizations is to encourage students to study particular business areas, especially financial and administrative areas. In this paper, we discuss the possibilities for bridging the gap between education’s theoretical knowledge and management’s practical knowing. As the locus for this discussion, we use the field visit in which students meet with managers at work and acquire images of work. Our empirical data were obtained from field visits that students from two Swedish university programs took. We present this data as two case studies. As part of the experience, the students’ classroom lecturer and several representatives from the visited organizations made presentations to the students. The students in the first case made a series of field visits to retail stores. The students in the second case visited the accounting department at local government offices. We found that students generally enjoy seeing and discussing actual work sites away from the university. They are interested in learning about organizations where they might work after graduation. The visited organizations also find these field visits of value. These visits, through the translation process of the student-manager interaction, attempt to bridge theory and practice. One consequence of such visits, not examined closely in the literature, is that this interaction significantly influences the students’ images of work. Students become familiar with image-creating words such as enthusiasm, personnel issues, responsibility and an opportunity to influence.

  • 10.
    Cregård, Anna
    et al.
    Förvaltningshögskolan, Göteborgs universitet.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Medicinare som managers2011In: School of Business - NFF 2011 August 20-24, 2011Conference paper (Refereed)
    Abstract [sv]

    Sjukvårdspersonalen har ett stort inflytande på sitt arbete. I en tid när NPM fått en stark inverkan på offentliga organisationer förskjuts det som tidigare varit den offentliga sektorns kännetecken som: demokrati, öppenhet, yttrandefrihet, samverkan, helhetssyn och rättssäkerhet, till mer ekonomistiska och managementlika sådana, som produktivitet, kostnadseffektivitet, kundorientering, resultatkrav och avtal.

    Syftet i denna artikel är att kritiskt diskutera tillsättningen av medicinare på traditionella managementtjänster i hälso- och sjukvården och vad det kan medföra. Dessa tillsättningar motiveras vanligen av förbättrad effektivitet, men också av kvalitet och säkerhet för verksamheten. Skälen är svåra att argumentera emot, och därför har de fått stark genomslagskraft. Vi vill just peka på riskerna, som ofta negligeras och förespråkarna har en slagkraftig retorik. Positiva effekter saknas inte men de måste vägas mot de negativa effekterna.

    Metoden är intervjuer med 15 sjuksköterskor och läkare som har chefsuppdrag. Därtill har vi 5 fokusgrupper som består av verksamhetsansvariga sjuksköterskor och läkare under managementutbildning.

    Resultaten visar på att det främst är fyra risker förknippat med tillsättning av medicinare på traditionella managementtjänster: läkarens professionella kompetens minskar, förtroendet för läkaren som medicinsk kunnig minskar, liksom för organisationen och vården i stort. Därtill trängs viktiga värden inom servicedomänen undan till förmån för administrativa värden.

  • 11.
    Cregård, Anna
    et al.
    Förvaltningshögskolan Göteborgs universitet, School of Public Administration, University of Gothenburg, Göteborg, Sweden.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Perceptions of trust in physician-managers2015In: Leadership in Health Services, ISSN 1751-1879, E-ISSN 1751-1887, Vol. 28, no 4, p. 281-297Article in journal (Refereed)
    Abstract [en]

    Purpose – The purpose of this paper is to explore the dual role of physician-managers through an examination of perceptions of trust and distrust in physician-managers. The healthcare sector needs physicians to lead. Physicians in part-time managerial positions who continue their medical practice are called part-time physician-managers. This paper explores this dual role through an examination of perceptions of trust and distrust in physician-managers. Design/methodology/approach – The study takes a qualitative research approach in which interviews and focus group discussions with physician-managers and nurse-managers provide the empirical data. An analytical model, with the three elements of ability, benevolence and integrity, was used in the analysis of trust and distrust in physician-managers. Findings – The respondents (physician-managers and nurse-managers) perceived both an increase and a decrease in physicians’ trust in the physician-managers. Because elements of distrust were more numerous and more severe than elements of trust, the physician-managers received negative perceptions of their role. Research limitations/implications – This paper’s findings are based on perceptions of perceptions. The physicians were not interviewed on their trust and distrust of physician-managers. Practical implications – The healthcare sector must pay attention to the diverse expectations of the physician-manager role that is based on both managerial and medical logics. Hospital management should provide proper support to physician-managers in their dual role to ensure their willingness to continue to assume managerial responsibilities. Originality/value – The paper takes an original approach in its research into the dual role of physician-managers who work under two conflicting logics: the medical logic and the managerial logic. The focus on perceived trust and distrust in physician-managers is a new perspective on this complicated role.

  • 12.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Challenges in Hospitals Digitalization – Physicians’ and Nurses’ Outlook2017Conference paper (Refereed)
    Abstract [en]

    Digitalization is sweeping every organization. Also in hospitals patients’ records go through a digitization process to become electronic healthcare record, (EHR).

    Purpose – This study describe physicians and nurses perceptions towards digitization of their work practices. The overall questions is: What are the professionals’ perceptions on how to work with digitalized information systems?

    Design/methodology/approach –The sample consisted of physicians (n=64) and nurses (n=261) working in a Swedish regional hospital. A standardized questionnaire was coupled with free-text options as well. The professionals’ perceptions of EHR were compared with the traditional paper-based records.

    Findings – The professionals reacted with resistance and need more time and more well-developed systems to exercise their new skills. Competence to document in itself is not the problem. The problem is how to perform their new EHR work in daily practise. Communication problems between different systems become obvious. The study shows that performability is important when working with digitization in every day’s practises.

    Practical implications – There are still shortcomings in the quality of the documentation in EHR. Redundant documentations have to be minimized. The communication between systems and information to patient have to be developed. It also important to have more and better work places for professionals’ possibility to perform their skills. Additionally, to increase their knowledge of digitization in healthcare the professionals need continuous training and time to discuss pros and cons with the digitization.

  • 13.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Ekonomicheferna får ökad betydelse för kommunens ekonomiska ställning och utveckling2010In: Nästan som det brukar vara: kommunal utveckling under ansträngda förhållanden / [ed] Brorström, Björn & Nilsson, Viveka, Göteborg: Kommunforskning i Västsverige (KFi) , 2010, p. 43-46Chapter in book (Refereed)
  • 14.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    En hållbar balansakt över tiden2013In: Spår av Björn - Nio texter om Björn Brorström och hans forskargärning / [ed] Viveka Nilsson, Göteborg: KFi – Kommunforskning i Västsverige , 2013, , p. 28p. 15-16Chapter in book (Other academic)
    Abstract [sv]

    Med anledning av Björn Brorströms 60-årsdag bjöds alla hans gamla doktorander från Förvaltningshögskolan vid Göteborgs universitet in att skriva var sin text till denna festskrift. Björn var verksam som professor och senare även prefekt vid Förvaltningshögskolan mellan åren 1996 och 2006. Under denna tidsperiod handledde han tio doktorander mot sin examen. Sedan 2006 är Björn verksam vid högskolan i Borås, först som prorektor och nu som rektor. Detta har inte fått honom att släppa taget om forskningen då han fortfarande har uppdrag vid det forskningsinstitut han en gång grundade; Kommunforskning i Västsverige (KFi). Vi gamla doktorander har känt Björn olika länge och arbetat tillsammans med honom i olika utsträckning, men vi har en sak gemensamt och det är att Björn lämnat avtryck hos oss och i vår forskning. Dessa avtryck finns samlade i föreliggande skrift som innehåller nio texter som på olika sätt beskriver Björn och hans forskargärning. Några av texterna fokuserar på Björns avtryck i ett större sammanhang och därmed hans bidrag till forskarsamhället i stort. Andra texter fokuserar mer på Björns avtryck i det lilla hos den enskilde författaren. Texterna bjuder därmed på både personliga minnen från handledarmöten, seminarier och annat, men också på beskrivningar av spår som Björn lämnat i mer vetenskapliga sammanhang. Eller som man inom akademin brukar uttrycka det; hans bidrag till det vetenskapliga samtalet.

  • 15.
    Eriksson, Nomie
    Förvaltningshögskolan, Göteborgs universitet.
    En platt organisation i uppförsbacke: konsekvenser av en organisationsförändring för lokala och centrala ledare2001Licentiate thesis, monograph (Other academic)
  • 16.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Followership for Organizational Resilience in Health care2018In: The Resilience Framework: Organizing for Sustained Viability / [ed] Stefan Tengblad, Margareta Oudhuis, Singapore: Springer, 2018, p. 163-179Chapter in book (Refereed)
    Abstract [en]

    The resilient organization has the important capability of creating high reliability. In health care, professionals deal with major challenges in terms of new working methods. The chapter describes the introduction of a standardized working method in hospitals, utilizing Lean-oriented work processes. That is different from nurses’ and physicians’ traditional and flexible way of working. These differences in approaches are the subject of the study. The question is: How can followership create and maintain high reliability and resilience in health care? A comparative case study was performed using interviews and steering documents. To maintain and create high reliability, social resources such as followership are important. Followers’ ability to improve, cooperate, and learn turned out to be important characteristics. Organizational resilience depends on these professionals’ ability to manage change.

  • 17.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Förtroende för vårdens information2018In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 95, no 3, p. 311-320Article in journal (Refereed)
    Abstract [en]

    New technologies in health care shall provide more efficient information flows and contribute to treat patients more efficiently. The purpose describes and analyzes the professionals’ trust to the information in electronic healthcare records, compared to the former analogue. A survey of physicians’ (n = 65) and nurses’ (n = 262) (response rate of 84.7%) perceptions was performed about trust of the information regarding support, opportunities and challenges, and the professionals’ knowledge and ability to apply this information. The horizontal trust between professionals supports trust of the information. Digitized information, in itself, does not render the use of information more efficient. However, it is not digitalization that develops trust in the information without the trust between those working with the patients.

  • 18.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Har chefstjänstemän möjlighet att påverka kommunens ekonomi?2008In: Kapacitet att möta förändrade förutsättningar?: På väg in i krisen / [ed] Björn Brorström, Pierre Donatella, Göteborg: Kommunforskning i Västsverige (KFi) , 2008, 1, p. 54-59Chapter in book (Other academic)
  • 19.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Hospital management from a high reliability organizational change perspective: A Swedish case on Lean and Six Sigma2017In: International Journal of Public Sector Management, ISSN 0951-3558, E-ISSN 1758-6666, Vol. 30, no 1, p. 67-84Article in journal (Refereed)
    Abstract [en]

    Purpose – The purpose of this paper is to describe and analyze nurses’ perceptions and evaluations of healthcare developmental work after the introduction of Lean and Six Sigma and, how nurses aspire to maintain a high reliability organization (HRO).

    Design/methodology/approach – Nurses’ roles and the way they respond to new efficiency and quality working methods are crucial. Underlying themes were analyzed from in-depth, semi-structured interviews with (n 17) nurses at two Swedish hospitals.

    Findings – The nurses perceived that Lean worked better than Six Sigma, because of its bottom-up approach, and its similarities with nurses’ well-known work qualities. Nurses coordinate patients care, collaborate in teams and take leadership roles. To maintain high reliability and to become quality developers, nurses need stable resources. However, professional’s logic collides with management’s logic. Expert knowledge (top-down approach) without nurses’ local knowledge (bottom-up approach) can lead to problems. Healthcare quality methods are standardized but must be used with flexibility. However, HROs ensue not only from method quality but also from work attitudes, commitment and continuous work-improvement.

    Practical implications – Management can support personnel in developmental work with: continuous education, training, teamwork, knowledge sharing and cooperation. Authoritarian method structures that limit the healthcare professionals’ autonomy should be softened or abandoned.

    Originality/value – The study uses theoretical concepts from HROs, which were developed for unexpected events, to explain the consequences of implementing Lean and Six Sigma in healthcare.

  • 20.
    Eriksson, Nomie
    Förvaltningshögskolan vid Göteborgs universitet.
    Hur processer genomförs i sjukvården2006In: HEL: hälso- och sjukvårdens ekonomi och logistik / [ed] Björn Brorström, Olle Larkö, Göteborg: Sahlgrenska akademin vid Göteborgs universitet , 2006, p. 210-219Chapter in book (Refereed)
  • 21.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Kvalitet som styrning2011In: Mot svårare tider: om vikten av politiskt ledarskap och ekonomistyrning / [ed] Nilsson, Viveka, Göteborg: Kommunforskning i Västsverige (KFi) , 2011, p. 24-27Chapter in book (Refereed)
  • 22.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, The Virtual Systems Research Centre.
    Maintaining Healthcare Organizations’ Reliability in Times of Change2014In: British Academy of Management 2014: Track: Organizational Transformation, Change and Development / [ed] Catherine McCauley-Smith, London, 2014, p. 1-18Conference paper (Refereed)
    Abstract [en]

    Healthcare organizations should be reliable and resilient when unexpected events occur that create pressure for change. This paper discusses the importance of reliability and resilience when a decision is made to standardize the professionals’ work methods.

    The aim was to explain how healthcare organizations can maintain high reliability in the operations beyond an unexpected event.

    Two qualitative case studies at two hospitals are used to compare the work methods. Semi-structured interviews and follow-up questions were conducted with managers, nurses, and physicians in departments of cardiology and urology. Annual reports and operation plans also provide data.   

    High reliability healthcare organization is sufficiently resilient in times of change if providing quality care, encourages flexibility, individual responsibility, promotes good communication, develops learning processes and gives legitimacy.  

    Professionals need participate in decision-making processes and require time and opportunity to develop knowledge and skills.

  • 23.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Medarbetarskap för en resilient sjukvård2014In: Organisatorisk resiliens: Vad är det som gör företag och organisationer livskraftiga? / [ed] Stefan Tengblad & Margareta Oudhuis, Lund: Studentlitteratur AB, 2014, 1, p. 181-198Chapter in book (Other academic)
    Abstract [sv]

    En viktig förmåga som skapar resiliens i många slags organisationer är att den har hög tillförlitlighet. Organisatorisk tillförlitlighet innebär att det som produceras utvecklas över tid på ett sådant sätt att produkten eller tjänstens tillförlitlighet garanteras och behåller en hög nivå. I det här kapitlet beskrivs medarbetarskapets betydelse för att skapa en tillförlitlig och resilient sjukvård. Frågan som ställs är hur medarbetarskap kan medverka till att upprätthålla en god, tillförlitlig och resilient vård.

     

    Utveckling i sjukvården sker främst med hjälp av de sociala resurser som i studien beskrivs som medarbetarskap. Hur medarbetare, såsom sjuksköterskor och läkare, upprätthåller en god vård har stor betydelse, eftersom utvecklingen sker i en miljö där det finns stora risker för fel och misslyckanden. Utifrån två styrmodeller, standardiserade processer och flexibelt arbetssätt, undersöks möjligheten för en sjukhusorganisation att ha en hög tillförlitlighet när den utsätts för förändringsförsök.

     

    Med utgångspunkt från två fallstudier där en har anammat ett processorienterat arbetssätt och den andra behållit det flexibla arbetssätt som varit sedan tidigare, visar studien i båda fallen på en god och resilient vård. Oavsett arbetssätt var framgångsfaktorerna för en resilient och god vård med hög tillförlitlighet ett medarbetarskap där sjuksköterskor, läkare och övrig vårdpersonal kännetecknades av en vilja att utveckla verksamheten genom att vara lyhörda för den och att själva utvecklas genom att följa och respektera experterna inom sjukvården; samarbeta genom sin ovilja att förenkla vården och i stället utveckla en helhet oavsett om vården skär genom organisatoriska barriärer; lära av varandra genom att vara engagerade för en resilient och god verksamhet.

     

    Vårdens behov och kontext måste därmed styra hur sjukvården ska utövas. Ibland förs diskussioner om att det ena arbetssättet är bättre eller sämre än det andra. I sjukvården är det dock inte ett antingen eller som gäller när nya arbetssätt ska bestämmas. Utveckling som inte anses hållbar och tillförlitlig av medarbetarna bör förekomma mycket sparsamt, om ens alls. Standardisering som trend i sjukvården behöver därför kontextualiseras. I vilka fall den ena eller andra modellen ska användas måste vara upp till respektive medicinsk expertis att avgöra.

     

    För en sjukhusledning är det därför viktigt att stödja engagerade experter. Det finns ett behov av en dialogorienterad ledarstil, som uppmuntrar medarbetarnas initiativ och som kan bidra till att utveckla vårdverksamhet där hög tillförlitlighet är minst lika viktigt som en effektiv hushållning av resurser.

  • 24.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Nurses’ perceptions of healthcare development work in a high reliability organisation: A study of Lean and Six Sigma in hospital management2015In: BAM2015. The Value of Pluralism in Advancing Management research, Education and Practice, London, 2015, Vol. 1, p. 1-17Conference paper (Refereed)
    Abstract [en]

    Most nurses are deeply involved in healthcare development work. Nurses are required to participate as they coordinate processes with other health professionals in the entire hospital care chain.

    To investigate how nurses perceive and evaluate healthcare development work when Lean and Six Sigma are introduced in clinical practises, in-depth, semi-structured interviews with seventeen nurses at two hospitals were used.

    The nurses mean that quality healthcare is more dependent on hospital personnel than on the use of Lean and Six Sigma. Lean can be used in some healthcare areas but not in all. Six Sigma can be used only if some precautions are taken and personnel participate in the decision-making. Furthermore nurses do stress the importance of education and training, teamwork, and cooperation as ways to improve healthcare.

  • 25.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Organizing for Development Work in Healthcare Organizations: A study of Quality Methods for Reliable Care2015In: 23rd Nordic Academy of Management Conference: 12-14 August 2015, 2015, p. 138-138Conference paper (Refereed)
    Abstract [en]

    Healthcare professionals are involved in development work that is always present in healthcare organisations. They are required to participate when quality methods such as Lean and Six Sigma are introduced in hospitals’ clinical practises.

     

    The purpose of this paper is to explore how development work in terms of providing reliable care are perceived by nurses and physicians when quality methods are implemented in clinical practises.

     

    The data consist from in-depth, semi-structured interviews with seventeen nurses and ten physicians at two hospitals in western Sweden. A qualitative research method was used. The interviews were analysed in the search for underlying themes that reflect their perception and evaluation of the quality methods and their possibility to increase the reliability in healthcare.

     

    The confidence between nurses and physicians was essential for creating and maintaining supportive relationships and reliable systems. Reliable care seemed to be more of the result of the dedication and professionalism than the result of the applied quality methods. Reliability in healthcare seemed to flow from work attitudes, commitment and continuous development work as much as from quality methods. In general, the professionals more emphasized the importance of teamwork and cooperation as ways to develop healthcare.

  • 26.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Politiker och tjänstemäns betydelse för kommunerna i den finansiella krisens spår2009In: Krisen som kom av sig? - om att hantera sämre tider / [ed] Nilsson, Viveka, Göteborg: Kommunforskning i Västsverige (KFi) , 2009, 1, p. 50-54Chapter in book (Other academic)
  • 27.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Reformer för kvalitetsstyrning och processtyrning får inte fäste i kommunerna2009In: Krisen som kom av sig? - om att hantera sämre tider / [ed] Nilsson, Viveka, Göteborg: Kommunforskning i Västsverige (KFi) , 2009, 1, p. 37-41Chapter in book (Other academic)
  • 28.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Tigerekonomi i gungning2011In: Mot svårare tider: om vikten av politiskt ledarskap och ekonomistyrning / [ed] Nilsson, Viveka, Göteborg: Kommunforskning i Västsverige (KFi) , 2011, p. 35-39Chapter in book (Refereed)
  • 29.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Tilltro till kommunala förvaltningschefers betydelse2007In: Ekonomi i fokus : om sämre tider, ekonomistyrning och avgiftshöjningar / [ed] Donatella, Pierre & Johansson, Tobias, Göteborg: Kommunforskning i Västsverige (KFi) , 2007, p. 37-40Chapter in book (Other academic)
  • 30.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Tillämpningen av ett processinriktat arbetssätt2007In: Demokratisk och effektiv styrning : En antologi om forskning i offentlig förvaltning / [ed] Sven Siverbo, Lena Andersson-Felé, David Karlsson, Viveka Nilsson, Studentlitteratur, 2007, 1, p. 551-570Chapter in book (Other academic)
  • 31.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Tillämpningen av kvalitetsstyrning och processtyrning ökar2010In: Nästan som det brukar vara: kommunal utveckling under ansträngda förhållanden / [ed] Brorström, Björn & Nilsson, Viveka, Göteborg: Kommunforskning i Västsverige (KFi) , 2010, p. 32-34Chapter in book (Refereed)
  • 32.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Vad händer när läkare genomför verksamhetsutveckling och förbättringsarbete?2013In: Att utveckla vården: Erfarenheter av kvalitet, verksamhetsutveckling och förbättringsarbete / [ed] Nomie Eriksson, Kajsa-Mia Holgers, Tomas Müllern, Lund: Studentlitteratur, 2013, 1, p. 167-185Chapter in book (Refereed)
  • 33.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Överallt finns Rolf!2013In: 800 ord till Rolf Solli / [ed] Anna Cregård och Ulla Eriksson-Zetterquist, Göteborg: Gothenburg Research Institute , 2013, , p. 61p. 42-43Chapter in book (Other academic)
    Abstract [sv]

    I samband med Rolf Sollis 60-årsdag har vi bjudit in våra kollegor till att delta i en mindre festskrift till vår vän och kollega. Rolf har som vi alla vet många strängar på sin lyra: undervisning, forskning, prefektskap, föreståndarskap med mera. Han är även verksam inom en rad olika organisationer: Förvaltningshögskolan, KFI, GRI, Högskolan i Borås för att nämna några. I denna skrift blandas därför personliga och forskningsmässiga texter och bilder. För att få någon riktning på texten har vi tagit utgångspunkt i en av Rolfs produktivitetsnormer, nämligen idén om de 800 orden. Bakgrunden till idén om skriften blir därmed hans idé om hur forskning kan genomföras i vardagen.

  • 34.
    Eriksson, Nomie
    et al.
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Gadolin, Christian
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    The professional logic in welfare organizations: implications for change2017Conference paper (Refereed)
  • 35.
    Eriksson, Nomie
    et al.
    University of Skövde, School of Technology and Society.
    Holgers, Kajsa-MiaHälso- och sjukvårdsnämndernas kansli, Västra Götalandsregionen / Centre for Healthcare Improvement, Chalmers.Müllern, TomasInternationella handelshögskolan, Jönköping.
    Att utveckla vården: Erfarenheter av kvalitet, verksamhetsutveckling och förbättringsarbete2013Collection (editor) (Other academic)
  • 36.
    Eriksson, Nomie
    et al.
    University of Skövde, School of Technology and Society.
    Holgers, Kajsa-Mia
    Hälso- och sjukvårdsnämndernas kansli, Västra Götalandsregionen / Centre for Healthcare Improvement, Chalmers.
    Müllern, Tomas
    Internationella handelshögskolan, Jönköping.
    Avslutning2013In: Att utveckla vården: Erfarenheter av kvalitet, verksamhetsutveckling och förbättringsarbete / [ed] Nomie Eriksson, Kajsa-Mia Holgers, Tomas Müllern, Lund: Studentlitteratur, 2013, 1, p. 249-260Chapter in book (Refereed)
  • 37.
    Eriksson, Nomie
    et al.
    University of Skövde, School of Technology and Society.
    Holgers, Kajsa-Mia
    Hälso- och sjukvårdsnämndernas kansli, Västra Götalandsregionen / Centre for Healthcare Improvement, Chalmers.
    Müllern, Tomas
    Internationella handelshögskolan, Jönköping.
    Introduktion2013In: Att utveckla vården: Erfarenheter av kvalitet, verksamhetsutveckling och förbättringsarbete / [ed] Nomie Eriksson, Kajsa-Mia Holgers, Tomas Müllern, Lund: Studentlitteratur, 2013, 1, p. 17-40Chapter in book (Refereed)
  • 38.
    Eriksson, Nomie
    et al.
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Müllern, Tomas
    Jönköping International Business School, Jönköping, Sweden.
    Interprofessional Barriers: A Study of Quality Improvement Work Among Nurses and Physicians2017In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 26, no 2, p. 63-69Article in journal (Refereed)
    Abstract [en]

    This article studies interprofessional barriers between nurses and physicians in the context of quality improvementwork. A total of 17 nurses and 10 physicians were interviewed at 2 hospitals in Sweden. The study uncovered anumber of barriers relating to both the relative status of each group and their defined areas of responsibility.

  • 39.
    Eriksson, Nomie
    et al.
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Müllern, Tomas
    Jönköping International Business School.
    Andersson, Thomas
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Gadolin, Christian
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Tengblad, Stefan
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Ujvari, Sandor
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Involvement Drivers: A Study of Nurses and Physicians in Improvement Work2016In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 25, no 2, p. 85-91Article in journal (Refereed)
    Abstract [en]

    This article reports on the involvement of nurses and physicians in improvement work, with a special focus on the drivers. The purpose was to describe how the nurse and physician groups understand involvement drivers for improvement work and to explain the differences in how they understand involvement. The study was conducted at 2 Swedish hospitals, and a total of 20 nurses and 10 physicians were interviewed. The theoretical framework, developed by an interpretative approach, identifies and describes a number of involvement drivers. On clustering the drivers into larger involvement factors, the study shows clear differences and profiles in terms of the 2 groups' perception and understanding of the involvement—drivers. Each group's profile was then analyzed on the basis of concept of professional culture.

  • 40.
    Eriksson, Nomie
    et al.
    University of Skövde, School of Business.
    Tengblad, Stefan
    University of Skövde, School of Business.
    Låt professionerna leda vårdens utveckling!2014In: Jordemodern, ISSN 0021-7468, Vol. 127, no 1-2, p. 5p. 4-9Article in journal (Other (popular science, discussion, etc.))
  • 41.
    Eriksson, Nomie
    et al.
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Ujvari, Sandor
    University of Skövde, Enterprises for the Future. University of Skövde, School of Business.
    Fiery Spirits in the context of institutional entrepreneurship in Swedish healthcare2015In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 29, no 4, p. 515-531Article in journal (Refereed)
    Abstract [en]

    Purpose – Clinical governance and leadership concepts can lead to more or less successfulimplementations of new clinical practice. The purpose of this paper is to examine how Fiery Spirits, asinstitutional entrepreneurs can, working in a team, implement sustained change in hospital clinicalpractice.Design/methodology/approach – This paper describes two case studies, conducted at two Swedishhospitals over a period of two years, in which changes in clinical practice were implemented. In bothcases, key-actors, termed Fiery Spirits, played critical roles in these changes. The authors use aqualitative approach and take an intra-organizational perspective with semi-structured in-depthinterviews and document analysis.Findings – The new clinical practices were successfully implemented with a considerable influenceof the Fiery Spirits who played a pivotal role in the change efforts. The Fiery Spirits persuasively,based on their structural and normative legitimacy and the adoption of learning processes, advocated,and supported change.Practical implications – Fiery Spirits, given flexibility and opportunity, can be powerful forcesfor change outside the trajectory of management-inspired and management-directed change.Team members, when inspired and encouraged by Fiery Spirits, are less resistant to change and morewilling to test new clinical practices.Originality/value – The paper complements literature on how the Fiery Spirit concept aligns withconcepts of clinical governance and leadership and how change can be achieved. Additionally, thefindings show the effects of legitimacy and learning processes on change in clinical practice.

  • 42.
    Gadolin, Christian
    et al.
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Achieving Change in Professional Organizations: An Institutional Logics Perspective2015Conference paper (Refereed)
  • 43.
    Söderström, Eva
    et al.
    University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Åhlfeldt, Rose-Mharie
    University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre.
    Managing healthcare information: analyzing trust2016In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 29, no 7, p. 786-800Article in journal (Refereed)
    Abstract [en]

    Purpose– The purpose of this paper is to analyze two case studies with a trust matrix tool, to identify trust issues related to electronic health records. Design/methodology/approach– A qualitative research approach is applied using two case studies. The data analysis of these studies generated a problem list, which was mapped to a trust matrix. Findings– Results demonstrate flaws in current practices and point to achieving balance between organizational, person and technology trust perspectives. The analysis revealed three challenge areas, to: achieve higher trust in patient-focussed healthcare; improve communication between patients and healthcare professionals; and establish clear terminology. By taking trust into account, a more holistic perspective on healthcare can be achieved, where trust can be obtained and optimized. Research limitations/implications– A trust matrix is tested and shown to identify trust problems on different levels and relating to trusting beliefs. Future research should elaborate and more fully address issues within three identified challenge areas. Practical implications– The trust matrix’s usefulness as a tool for organizations to analyze trust problems and issues is demonstrated. Originality/value– Healthcare trust issues are captured to a greater extent and from previously unchartered perspectives.

  • 44.
    Söderström, Eva
    et al.
    University of Skövde, School of Humanities and Informatics.
    Åhlfeldt, Rose-Mharie
    University of Skövde, School of Humanities and Informatics.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Standardisation as a Means to Improve Information Security in Process-Oriented Distributed Healthcare2008In: Proceedings of the 13th EURAS Workshop on Standardisation (EURAS2008) / [ed] Jakobs, Kai & Söderström, Eva, Aachen: Mainz , 2008, p. 233-244Conference paper (Refereed)
    Abstract [en]

     

     

    Regardless of who we are, where we are, and when we get sick, we expect the healthcare sectors to take care of us. And we expect it to treat us with respect. Not the least, this concerns treating our personal information with care. However, the reality is that most healthcare institutions work separately, and that the flow of patient information therefore is less than optimal. This paper aims to investigate how current standards map against the concept of information security, and how process-orientation can be used in conjunction with standards to create secure information flows in healthcare. It does so by describing information security and process-orientation, and investigates how standards for information security apply in a process-oriented, distributed healthcare sector. The result shows that a dual focus is needed,on document and process standardisation, and that healthcare is facing great challenges in order to make this work.

     

     

  • 45.
    Söderström, Eva
    et al.
    University of Skövde, School of Humanities and Informatics. University of Skövde, The Informatics Research Centre.
    Åhlfeldt, Rose-Mharie
    University of Skövde, School of Humanities and Informatics. University of Skövde, The Informatics Research Centre.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Standards for information security and processes in healthcare2009In: Journal of Systems and Information Technology, ISSN 1328-7265, E-ISSN 1758-8847, Vol. 11, no 3, p. 295-308Article in journal (Refereed)
    Abstract [en]

    Purpose - Regardless of who or where we are and when we get sick, we expect healthcare to make us well and to handle us and our information with care and respect. Today, most healthcare institutions work separately, making the flow of patient information sub-optimal and the use of common standards practically unheard of. The purpose of this paper is to emphasise the use of standards to improve information security in process-oriented distributed healthcare. Design/methodology/approach - The paper introduces a real-life case which is analysed to highlight how and where standards can and should be used in order to improve information security in process-oriented distributed healthcare. Findings - In total, 11 flaws or problems in information security and process-orientation are identified. From these, six changes are suggested which address how information is handled, and how organizational routines should be standardized. Research limitations/implications - The case setting is Swedish healthcare, but problems can be shared across international borders. The purpose is to highlight the issues at hand. Practical implications - If suggested changes are implemented, healthcare processes will be more streamlined and focused on patients. Routines will be standardized and uncertainties thus removed in terms of how to act in certain situations. Originality/value - Healthcare and academia has yet to address both document and process issues concerning standardization in distributed healthcare. There are also few actual cases from a patient perspective. This paper provides lessons learned from a real-life case, where results may impact how standardization is addressed in healthcare organizations.

  • 46.
    Söderström, Eva
    et al.
    University of Skövde, School of Humanities and Informatics. University of Skövde, The Informatics Research Centre.
    Åhlfeldt, Rose-Mharie
    University of Skövde, School of Humanities and Informatics. University of Skövde, The Informatics Research Centre.
    Eriksson, Nomie
    University of Skövde, School of Technology and Society.
    Trusting Digitized Patient-Related Information: The Need for a New Approach2011In: Proceedings of the 5th International Symposium on Human Aspects of Information Security and Assurance (HAISA 2011) / [ed] Steven Furnell, Nathan Clarke, Plymouth Center for Security, Comunications & Network Research, University of Plymouth , 2011, p. 119-129Conference paper (Refereed)
    Abstract [en]

    Trust the receiving increasing attention nowadays, particularly since new technology enables communication and collaboration like it has never been seen before. However, trust is a fuzzy concept that needs further examination and attention from multiple levels. For examples, security is very important from a user's point of view in trusting that technology will function in accordance with the user's intended and requested function. This paper reviews the concept of patient safety, which thus far has been discussed and defined from a narrow technical perspective. We demonstrate that it is much more complex, and that it is not primarily the technical issues that are problematic, but rather the cultural, process-related and personnel issues. Our results point to a need for a new approach, which takes the patient's view of healthcare and the patient-related digital information as its focus. The discussion is made from a Swedish perspective, but the issues are international. The needs for information and knowledge in healthcare are obvious. Without clear definitions of concepts and roles, a good information flow or process cannot be designed. Our discussion shows that trusted digital patient information gives an opportunity for a patient-focused healthcare. Multidimensional trust must be addressed on all levels; organization, person and technology. More empirical research into trust in digital patient-related information is necessary, to develop a model for patient safety from a trust perspective that encompasses all levels of trust.

  • 47.
    Åhlfeldt, Rose-Mharie
    et al.
    University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre.
    Andersén, Annelie
    University of Skövde, School of Health and Education.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Nohlberg, Marcus
    University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre.
    Bergström, Erik
    University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre.
    Fischer Hübner, Simone
    Karlstads universitet.
    Kompetensbehov och kompetensförsörjning inom informationssäkerhet från ett samhällsperspektiv2015Report (Other academic)
    Abstract [sv]

    På uppdrag av Myndigheten för samhällsskydd och beredskap (MSB) har en studie genomförts med syftet att komplettera resultatet från en tidigare genomförd förstudie (Åhlfeldt m.fl., 2014) med en analys av kompetensförsörjning och kompetensbehov på informations­säkerhetsområdet från ett samhällsperspektiv. Arbetet har genomförts av forskare från två lärosäten, Högskolan i Skövde och Karlstad Universitet, samt inom tre forskningsdiscipliner: pedagogik, informationssäkerhet och företagsekonomi.

    Uppdraget har varit att besvara följande frågeställningar:

    • Vilka är kompetensbehoven för att ha en god och balanserad informationssäkerhet som bidrar till samhällets informationssäkerhet?
      • Samtida kompetensbehov (nuläget)
      • Framtida kompetensbehov
      • Hur ska nödvändig kompetens erhållas och på vem ligger ansvaret?
      • Utifrån ovanstående frågeställningar, vilka är de viktigaste framgångsfaktorerna?

    Arbetet har genomförts i form av fokusgrupper med representanter från myndigheter och företag som har en nära verksamhetskoppling till samhällets informationssäkerhet och som är viktiga för att samhällets informationssäkerhet ska fungera.

    Resultatet visar att det finns stora brister avseende informationssäkerhetskompetens på alla nivåer i samhället. Tre tydliga områden pekas ut 1) nationellt - ökat behov av starkare styrning och ledning samt kravställning 2) organisation - ökat behov av kompetens från ledning till medarbetare men med starkt fokus på kompetenshöjande åtgärder på ledningsnivå samt vid upphandling och 3) medborgarperspektivet där framförallt skolområdet lyfts fram som ett viktigt insatsområde för kompetenshöjande åtgärder.

    För att uppnå nödvändig kompetens krävs utbildningsinsatser på alla ovan angivna områden. Dels utbildningar på akademisk nivå för informationssäkerhetsexperter men även övriga utbildningar inom t ex juridik och ekonomi. Även yrkesverksamma på organisationsnivå behöver riktade kompetenshöjande åtgärder som sätter informationssäkerhet i fokus utifrån organisationens verksamhetsbehov, allt ifrån ledningsnivå till medarbetarnivå.

    Resultatet visar även att ansvaret för samhällets kompetensförsörjning för informationssäkerhet ligger även den på alla ovan nämnda tre områden men med tydlig betoning på nationell nivå. Här betonas behovet av nationella krav för att medvetandegöra och lyfta informations­säkerheten i samhällsviktig verksamhet för att nå så många medborgare som möjligt.  

    Förslag på framtida arbete avseende utveckling av metoder för framtida studier av kompetensförsörjningen pekar främst på metoder för att angripa bristen på helhetssyn samt kompetensförsörjning för management och medborgare.

  • 48.
    Åhlfeldt, Rose-Mharie
    et al.
    University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre.
    Fischer Hübner, Simone
    Karlstad University.
    Carlén, Urban
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Andersén, Annelie
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Björck, Fredrik
    Stockholms Universitet.
    Nohlberg, Marcus
    University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre.
    Förstudie kompetensbehov informationssäkerhet2014Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    På uppdrag av Myndigheten för samhällsskydd och beredskap (MSB) har en förstudie genomförts med syftet att sammanställa forskningsresultat om kompetenshöjande åtgärder inom informationssäkerhetsområdet för att kartlägga utbildningsbehov och identifierade nyttoeffekter. Arbetet har genomförts av forskare från tre olika lärosäten, Högskolan Skövde, Karlstad Universitet och Stockholms Universitet, samt inom tre forskningsdiscipliner nämligen pedagogik, informationssäkerhet och företagsekonomi.

    Förstudien har haft i uppdrag att besvara följande frågeställningar:

    • Hur definieras kompetens?

    • Hur mäter man kompetens?

    • Hur skiljer sig olika typer av utbildningsinsatser avseende nyttoeffekter? Vilka erfarenheter,

      utvärderingar förklaringsfaktorer kan identifieras?

    • Hur och i vilken utsträckning tillgodogörs olika typer av utbildningar?

    • Vad kännetecknar framgångsrika utbildningsinsatser?

      Resultatet visar att kompetensbegreppet är svårdefinierat och det finns ingen tydlig definition av begreppet. Ett försök till en sammanfattande beskrivning av kompetensbegreppet utifrån granskningen är att kompetens innebär en viss uppsättning kunskaper, färdigheter, etik och attityder i en viss kontext. Kompetens innefattar både egenskaper och intentioner där egenskap inkluderar kunskap och färdighet, och intentioner innefattar etik och attityder. Allt måste dock relatera till en kontext och alltid ses i sitt sammanhang.

      Ytterst få studier har fokus på mätning av kompetens både generellt och inom informationssäkerhetsområdet. De studier som genomfört någon form av mätning mäter främst kompetens utifrån det akademiska fältet och då i första hand utifrån ett kunskapsperspektiv. Forskning av mätning på yrkesverksamma är minimal inom de sökområden som granskats i denna förstudie.

      Avseende kompetensbehov, nyttoeffekter, erfarenheter och framgångsfaktorer visar granskningen att framgångsfaktorer generellt är när utbildningsinsatserna för yrkesverksamma har ett praktiknära fokus. Motivationen och engagemanget hos de som går en utbildning är av avgörande betydelse. Det går inte direkt att avgöra vilka utbildningstyper eller aktiviteter som är av störst betydelse utan granskningen visar att en kombination av olika utbildningsformer och aktiviteter är att föredra. Vidare är dialog och diskussion i den dagliga verksamheten av stor betydelse för att bygga upp en hållbar säkerhetskultur i organisationen. Den s k tysta kunskapen ska inte underskattas utan behöver tas i beaktande och stödjas.

      Ytterligare är ledningens engagemang, delaktighet och stöd för utbildningens genomförande av avgörande betydelse om en utbildning ska uppnå en tydlig effekt i verksamheten.

      Granskningen visar att det finns behov av ytterligare forskning avseende kompetensbehov och på vilket sätt olika utbildningsinsatser ger effekt i organisationer. Förslag på ett diskussionsunderlag för framtida arbete har tagits fram. Förslagen innefattar bl a behov av kompetensanalyser, metoder och verktyg för att mäta utbildningseffekter, riktade kompetenshöjande insatser för managementnivån, longitudinella studier för uppföljning av effekter samt utveckling av metoder och verktyg för ett situerat lärande.

    Granskningen har genomförts inom olika disciplinområden vilket har uppfattats mycket positivt av de deltagande forskarna. Eftersom informationssäkerhet är ett interdisciplinärt område krävs också att bredare perspektiv och ytterligare discipliner bör ingå i framtida fördjupade analyser i området. Exempel på tillkommande discipliner är beteendevetenskap, psykologi och juridik. Behovet av kompetens inom informationssäkerhetsområdet lär inte minska i framtiden och ytterligare forskning behövs för att rätt utbildning ska nå rätt person vid rätt tidpunkt och på rätt plats.

    Skövde i mars 2014

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