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Ingelsson, P., Bäckström, I. & Snyder, K. (2020). Adapting a Lean leadership-training program within a health care organization through cocreation. International Journal of Quality and Service Sciences, 12(1), 15-28
Open this publication in new window or tab >>Adapting a Lean leadership-training program within a health care organization through cocreation
2020 (English)In: International Journal of Quality and Service Sciences, ISSN 1756-669X, E-ISSN 1756-6703, Vol. 12, no 1, p. 15-28Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this paper is to describe and evaluate a Lean leadership-training program within the health-care sector. A training program developed through a cocreative process with the intent of enhancing the possibilities for a context-specific adaption of Lean. Design/methodology/approach: A cocreated leadership-training program, executed over a period of one year, is described both as a model development process and as the final training program. The program was evaluated through reflective discussions and feedback as well as a written final evaluation of the program from participants in the program. Findings: The evaluation shows that the objectives of the training program were met, at least among the participants who attended the whole program. Using a cocreative process when developing and realizing a leadership-training program enhances the possibilities for an organization to adapt Lean to its own context. One condition for this approach to be successful is that the expectations of both the organization and the university need to be in focus through the whole process. In addition, the executive team needs to be continuously engaged and create conditions for the organization to realize the potential benefits of the training program. Originality/value: This paper highlights the challenge when applying Lean in a health-care organization but also describes a way to address Lean training and learning in this context. 

Keywords
Cocreate, health care, Leadership-training program, Lean implementation, Lean leadership
National Category
Reliability and Maintenance
Identifiers
urn:nbn:se:miun:diva-38641 (URN)10.1108/IJQSS-09-2019-0107 (DOI)000512715100001 ()2-s2.0-85079559458 (Scopus ID)
Available from: 2020-03-16 Created: 2020-03-16 Last updated: 2020-03-17Bibliographically approved
Lilja, J., Ingelsson, P., Snyder, K., Bäckström, I. & Hedlund, C. (2020). Metaphors we manage and develop quality by. International Journal of Quality and Service Sciences
Open this publication in new window or tab >>Metaphors we manage and develop quality by
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2020 (English)In: International Journal of Quality and Service Sciences, ISSN 1756-669X, E-ISSN 1756-6703Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: Metaphors are a powerful and human way of understanding and experiencing one kind of thing in terms of another. In quality management (QM), several metaphors are used to describe and bring to life the often-abstract QM concepts and systems. These metaphors are of great importance for how QM is understood, communicated and practiced. However, the metaphors of QM have seldom been systematically screened or put in focus, neither the topic of a critical discussion. The purpose of this paper is hence to contribute with a screening of the metaphors currently used, within QM literature and in practice among QM leaders, and then elaborate on their potential for improvement and development. Design/methodology/approach: The paper is based on a literature review combined with interviews of QM leaders. Findings: The paper highlights that the current QM metaphors provide intuitive associations to properties such as stability, shelter, and structure, but not to the important dynamic properties of QM, such as learning, or to the critical role of people in QM. What can be seen as core properties of QM are communicated by texts or labels added on to metaphors with properties that often are in sharp contrast to them. The paper also provides suggestions for further improvements and development. Originality/value: The paper highlights the area of metaphors within QM as an important area for future research. It also provides insights concerning the successful use and selection of metaphors in future QM practice. 

Keywords
Appreciative inquiry, Change management, Communicative leadership, Generativity, Leadership, Lean leadership, Lean management, Metaphors, Quality management
National Category
Reliability and Maintenance
Identifiers
urn:nbn:se:miun:diva-39016 (URN)10.1108/IJQSS-04-2019-0060 (DOI)000529697800001 ()2-s2.0-85084202299 (Scopus ID)
Available from: 2020-05-13 Created: 2020-05-13 Last updated: 2020-05-15Bibliographically approved
Kahm, T. & Ingelsson, P. (2020). "Stuck in the middle” Healthcare first-line managers´ responsibilities and needs of support when applying Lean. International Journal of Quality and Service Sciences
Open this publication in new window or tab >>"Stuck in the middle” Healthcare first-line managers´ responsibilities and needs of support when applying Lean
2020 (English)In: International Journal of Quality and Service Sciences, ISSN 1756-669X, E-ISSN 1756-6703Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose - The purpose of this paper is to present the supportive conditions that the first-line health-care managers claim that they need from their own managers and what they experience as their own roles and responsibilities in relation to their coworkers when applying Lean principles and practices.

Design/methodology/approach - A survey with a Web-based questionnaire was designed and used in a Swedish health-care organization two years after the initiation of Lean to investigate the managers' views on their role, conditions and ability to create change according to Lean. The result from two of the questions will be presented where one focuses on the relationship to the first-line managers' own manager and the second on the relationship to their coworkers.

Findings - The results show that to initiate improvement, work based on Lean first-line managers ask for own managers who are assured about Lean, include them in discussions and ask for follow-ups and results about Lean. Concerning first-line managers' relation to their coworkers they experience themselves as responsible for leading toward creating a culture where problems and mistakes are viewed as possibilities to improve, for encouraging that new work procedures are tested and for creating commitment and inspiration in relation to their coworkers.

Originality/value - The questions can be used separately or as part of an entire questionnaire before and along the Lean process to highlight organizational issues such as shared responsibility and supportive relations when developing health care.

Keywords
Quality management practices, Quality of health care, Lean principles and practices, Lean, Leadership, Health care, First-line managers, Improvement work
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-37218 (URN)10.1108/IJQSS-06-2019-0088 (DOI)000530066100001 ()
Available from: 2019-09-25 Created: 2019-09-25 Last updated: 2020-05-25Bibliographically approved
Ingelsson, P., Sten, L.-M., Bäckström, I. & Häggström, M. (2019). Assessing Quality Management culture in order to develop ICU transitional care. In: Su Mi Dahlgaard-Park (Ed.), 22nd QMOD conference: Quality and Service Sciences ICQSS 2019. Paper presented at 22nd QMOD conference on Quality and Service Sciences ICQSS 2019, 13-15 October : Leadership and strategies for Sustainable Quality and Innovation in the 4th Industrial Revolution.
Open this publication in new window or tab >>Assessing Quality Management culture in order to develop ICU transitional care
2019 (English)In: 22nd QMOD conference: Quality and Service Sciences ICQSS 2019 / [ed] Su Mi Dahlgaard-Park, 2019Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Purpose - The purpose of this paper is to present and analyse the result from using a questionnaire measuring the presence of a number of QM values, as well as the use of Appreciative Inquiry (AI) and the feeling of pride in a healthcare setting focusing on transitional care.

 

Methodology/approach – Co-workers at two different hospital’s intensive care units answered a previously developed and tested questionnaire. A new factor was developed in order to measure customer focus in the healthcare context. The result was analysed using SPSS with the aim of finding areas to improve the patient transfer process from intensive care to general ward.

 

Findings – The questionnaire can be used to create an understanding of the existing culture in an organization but it needs to be analysed qualitatively. The result from the examined organizations show a common culture in the two units even though they are located in different hospitals and cities. The result further shows some differences between professions but overall, the result points at a relatively high agreement to the QM values in the organization indicating the presence of a quality culture.    

 

Practical implications – Using a QM value survey in the healthcare context could help developing the care from a different point of view then ordinary. It could help to shift focus from individual to group and system.

Keywords
Quality Management, QM values, ICU, patient transfer, transitional care
National Category
Reliability and Maintenance
Identifiers
urn:nbn:se:miun:diva-37912 (URN)
Conference
22nd QMOD conference on Quality and Service Sciences ICQSS 2019, 13-15 October : Leadership and strategies for Sustainable Quality and Innovation in the 4th Industrial Revolution
Funder
The Kamprad Family Foundation
Available from: 2019-12-06 Created: 2019-12-06 Last updated: 2019-12-06Bibliographically approved
Mårtensson, A., Ingelsson, P. & Bäckström, I. (2019). Co-creation - making it happen. In: Su Mi Dahlgaard-Park & Jens J. Dahlgaard (Ed.), 22nd QMOD conference: ON QUALITY AND SERVICE SCIENCES ICQSS 2019, 13-15 OCTOBER. Paper presented at 22nd QMOD conference 13-15 October 2019, Krakow, Poland.
Open this publication in new window or tab >>Co-creation - making it happen
2019 (English)In: 22nd QMOD conference: ON QUALITY AND SERVICE SCIENCES ICQSS 2019, 13-15 OCTOBER / [ed] Su Mi Dahlgaard-Park & Jens J. Dahlgaard, 2019Conference paper, Published paper (Refereed)
Abstract [en]

Organisations continuously meet different challenges, often ones that are both difficult and complex. Identified challenges include, for instance, costumers becoming more changeable and volatile as well as organisations needing to become more sustainable in several dimensions and to having a structured and systematic method for working with quality. Municipalities are not excluded from these challenges and need to face the challenge of demands from citizens as well as be efficient and effective at the same time.New ways of working and doing things need to be developed and adapted to meet and fulfil organisational challenges. Co-creation, which is a collaborative process to identify and shape the desired goals, can be a method that allows organisations to establish new ways of working and creating supportive methods. In addition, a collaborative process facilitates the adoption of new ways of working since it is easier to do that through actions rather than thinking oneself into a new way of acting.

Purpose: The purpose is to describe the process of co-creating a dialogue model that aim to increase citizen value in a municipality organisation. The purpose is also to present the results from the development process and evaluate the chosen model.

Methodology/Approach: A dialogue model was developed through a co-creation process conducted through a series of workshops, discussions and interactive tasks. The whole process was carried out in three steps. In the first step, success factors for a constructive dialogue emanating from citizen value were identified. In the second step, several dialogue models were developed, tested and evaluated, and one model was chosen. In the third step, the chosen model was evaluated.

Findings: Evaluating the real-life use of the model supports the statement that the process has delivered a model that enables the requested prerequisites for constructive dialogues such as, for example, the opportunity for preparation, structured and transparent documentation and enabling a holistic view in the dialogue model. Co-creation that has involved co-workers have contributed to develop the dialogue model to be adapted to their own context.

Value of the paper: Using a co-creative process when developing and realising a dialogue model enhances the possibilities for an organisational adaption to its own context.

Type of paper: Case study

Keywords
co-creation, citizen value, dialogue model, A3, holistic view
National Category
Reliability and Maintenance
Identifiers
urn:nbn:se:miun:diva-37910 (URN)
Conference
22nd QMOD conference 13-15 October 2019, Krakow, Poland
Funder
Interreg Sweden-Norway, 20201304 SMICE
Available from: 2019-12-06 Created: 2019-12-06 Last updated: 2019-12-06Bibliographically approved
Bäckström, I., Ingelsson, P., Johansson, C., Hamrin, S. & Bergman, S. (2019). Communicative Leadership development conduction to impact on   Quality culture and co-worker health. In: Su Mi Daahlgard-Park, Jens J. Dahlgaard, (Ed.), 22nd QMOD conference on Quality and Service Sciences ICQSS 2019, 13-15 October: Leadership and strategies for Sustainable Quality and Innovation in the 4th Industrial Revolution. Paper presented at QMOD conference on Quality and Service Sciences ICQSS. Lund, 22
Open this publication in new window or tab >>Communicative Leadership development conduction to impact on   Quality culture and co-worker health
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2019 (English)In: 22nd QMOD conference on Quality and Service Sciences ICQSS 2019, 13-15 October: Leadership and strategies for Sustainable Quality and Innovation in the 4th Industrial Revolution / [ed] Su Mi Daahlgard-Park, Jens J. Dahlgaard,, Lund, 2019, Vol. 22Conference paper, Published paper (Refereed)
Abstract [en]

Purpose – The purpose of this paper explore effects of a communicative leadership development program in an organization and to present and discuss results from assessing Quality Culture and co-worker health in the same organization.

 

Methodology/approach –  In a company conducted a communicative leadership developing program, a questionnaire measuring QM values and co-worker health has been handed out to leaders and co-workers. Leaders conducted a communicative leadership developing program have been interviewed and observation studies have been conducted. 

 

Findings – The interviewed and observed leaders are working with communicative leadership in a structured way, The measured factors, assessing quality culture and co-worker health showed rather high mean values.

 

Practical implications – The communicative leadership developing program seams to help leaders to communicate in a structured way.

Place, publisher, year, edition, pages
Lund: , 2019
Keywords
QM values, quality culture, co-worker health, communicative leadership, leadership development and leadership training
National Category
Reliability and Maintenance
Identifiers
urn:nbn:se:miun:diva-37561 (URN)978-91-7623-086-2 (ISBN)
Conference
QMOD conference on Quality and Service Sciences ICQSS
Funder
Knowledge Foundation
Available from: 2019-10-21 Created: 2019-10-21 Last updated: 2019-10-29Bibliographically approved
Kahm, T. & Ingelsson, P. (2019). Creating a development force in Swedish healthcare: a focus on the first-line managers’ perspective when applying Lean. International Journal of Health Care Quality Assurance, 32(8), 1132-1144
Open this publication in new window or tab >>Creating a development force in Swedish healthcare: a focus on the first-line managers’ perspective when applying Lean
2019 (English)In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 32, no 8, p. 1132-1144Article in journal (Refereed) Published
Abstract [en]

Purpose The purpose of this paper is to present the results from a study that investigates first-line healthcare managers' views on their role and the conditions that influence their ability to drive improvement work based on Lean. Design/methodology/approach A questionnaire was sent to all first-line managers in a healthcare organization to investigate their views on their role, conditions and ability to create change according to Lean. The results from four of the questions are presented, which focus on how crucial they consider their role to be for managing improvement work based on Lean, what work tasks their time is spent on, what factors they consider to be important to their ability to drive change and what factors best describe what Lean provides. Findings The results show that first-line managers claim that their role is crucial in improvement work, but when they defined their work tasks, the time spent on improvements was not frequently described. Time, support from coworkers, and a clear vision and clear goals were the three factors that they considered to be most important to their ability to drive improvement work. Considering their leadership, Lean contributed to the structure with tools and supportive methods. Originality/value The questions can be used separately or as part of the entire questionnaire before and along a Lean process to obtain a better understanding of how to create a sustainable Lean approach in healthcare. Understanding the factors that first-line managers consider supporting their ability in improvement work and what they consider Lean provides is important in creating a development force in Swedish healthcare.

Keywords
Healthcare, Lean; Leadership, First-line managers, Improvement work
National Category
Reliability and Maintenance
Identifiers
urn:nbn:se:miun:diva-37217 (URN)10.1108/IJHCQA-01-2019-0017 (DOI)000488244900002 ()31566512 (PubMedID)2-s2.0-85072745663 (Scopus ID)
Available from: 2019-09-25 Created: 2019-09-25 Last updated: 2019-11-14Bibliographically approved
Häggström, M., Sten, L.-M., Bäckström, I. & Ingelsson, P. (2019). How to improve the transfer process from intensive care to general wards - listening to the co-workers. In: Leadership and strategies for Sustainable Quality and Innovation in the 4th Industrial Revolution. Lund: . Paper presented at I 22nd QMOD conference on Quality and Service Sciences ICQSS 2019. Lund
Open this publication in new window or tab >>How to improve the transfer process from intensive care to general wards - listening to the co-workers
2019 (English)In: Leadership and strategies for Sustainable Quality and Innovation in the 4th Industrial Revolution. Lund, Lund, 2019Conference paper, Published paper (Refereed)
Abstract [en]

Background - Many errors and threats to patient safety are caused by deficiencies in the organization, such as inadequate procedures, inadequate planning and lack of information or communication. A specific danger to patient safety is the various gaps in the continuity of care. An example of the gap is the transfer of patients from the high-tech intensive care environment to the less frequent personnel ward environment, a process called ICU transitional care. ICU-nurses, ward-nurses, physicians, and other healthcare professionals, may provide this care. The effects of a poorly coordinated discharge can lead to readmission to the ICU and avoidable deaths.This study is a part of a research project financed by The Kamprad Family Foundation, with a purpose to gain new knowledge about how efficiency and quality in patient transfers within healthcare care can be improved. The purpose will be achieved through cooperation between the two research subjects Quality Management and Nursing science.Purpose - The purpose of this paper was to gain knowledge about how to improve patient transfers from intensive care to the general ward, by describing the intensive care co-workers generated suggestions.Methodology/approach – Six interdisciplinary focus groups interviews were conducted with co-workers at two hospitals in Sweden. The interviews were taped, verbatim transcribed and analysed with a mixed method. The QM values: ‘customer focus’, ‘leadership commitment’, ‘participation of everybody’, ‘continuous improvement’, ‘process focus’ and ‘base decisions on facts’ were used as an analytic framework.Findings - The co-workers suggested that the process should be defined and structured. The analyses showed a total of 94 suggestions that mainly were focused at following areas; planning, information, and communication, interest in the transfer process, enough resources, standardize and create routines, learning, follow up and evaluate.Practical implications - ICU transitional care is multifaceted and needs a holistic, system thinking solution. The findings indicate that the process could be safer, and more efficient by implementing the co-worker generated suggestions. The suggestions can be used to improve patients’ transfers in many contexts in healthcare, not only ICU transitional care.

Place, publisher, year, edition, pages
Lund: , 2019
Keywords
Continuous improvement, Continuity of Patient Care, ICU, Nursing, Patient transfer, QM, QM values
National Category
Reliability and Maintenance
Identifiers
urn:nbn:se:miun:diva-38271 (URN)
Conference
I 22nd QMOD conference on Quality and Service Sciences ICQSS 2019
Projects
Ökad effektivitet och kvalitet i vårdkedjor, Kampradstiftelsen
Available from: 2020-01-24 Created: 2020-01-24 Last updated: 2020-01-27Bibliographically approved
Mårtensson, A., Snyder, K. & Ingelsson, P. (2019). Interlinking Lean and Sustainability: How ready are leaders?. The TQM Journal, 31(2), 136-149
Open this publication in new window or tab >>Interlinking Lean and Sustainability: How ready are leaders?
2019 (English)In: The TQM Journal, ISSN 1754-2731, E-ISSN 1754-274X, Vol. 31, no 2, p. 136-149Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this paper is to explore evidence of interlinkages between Lean and sustainability among organisational leaders in the early stages of Lean implementation.

Design/methodology: A multiple-site case study was conducted to study the connections between Lean and sustainable development during the implementation stages of a Lean practice. In-depth interviews were conducted with managers about their knowledge and understanding of the interlinkages between Lean and sustainable development. The findings were then used as an analytic frame to determine whether these interlinkages were present in the organisation.

Findings: Evidence of interlinkages between Lean and sustainable development was found; however, their presence was incomplete and inconsistent across clinics.

Research implications: Insights from the research can help organisations plan for the implementation of Lean practice, particularly when a sub-goal is to achieve sustainable development.

Originality/value: The study shows the importance of focusing on managers’ knowledge and understanding of the interlinkages between Lean and sustainable development when implementing Lean in order to utilise Leans full potential to achieve sustainability.

Keywords
Organisational development, Lean, sustainability, operational management
National Category
Reliability and Maintenance
Identifiers
urn:nbn:se:miun:diva-32047 (URN)10.1108/TQM-04-2018-0046 (DOI)2-s2.0-85058112136 (Scopus ID)
Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2019-11-21Bibliographically approved
Bäckström, I., Ingelsson, P. & Mårtensson, A. (2019). Slutrapport ”Resultatstyrning för medborgarnytta”: Ett samverkansprojekt mellan Sundsvalls kommun och Kvalitetsteknik vid Mittuniversitetet. Mid Sweden University
Open this publication in new window or tab >>Slutrapport ”Resultatstyrning för medborgarnytta”: Ett samverkansprojekt mellan Sundsvalls kommun och Kvalitetsteknik vid Mittuniversitetet
2019 (Swedish)Report (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Mid Sweden University, 2019. p. 15
National Category
Reliability and Maintenance
Identifiers
urn:nbn:se:miun:diva-37560 (URN)
Available from: 2019-10-21 Created: 2019-10-21 Last updated: 2019-11-21Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-5610-2944

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