Mid Sweden University

In 2018 the Swedish government approved a SEK 350 million grant to increase the municipal implementation and use of welfare technologies in areas such as health care, care, and social service. Welfare technologies have been criticized for their effects on care workers’ work environment, such as increased stress due to time and performance demands. Research also points to how eldercare organizations are becoming victims of technological determinism as a result of the constant pursuit of the latest technologies. From this critique, this thesis uses Feenberg’s work ‘questioning technology’ as a philosophical lens and investigates, on a discursive level, the values and assumptions among the actors related to welfare technologies with the purpose of achieving a greater understanding of these negative effects. Using an exploratory research approach, the first part of this thesis investigates the conceptions among actors related to welfare technologies, represented by designers (engineers), decision makers (managers), and users (care workers). This is followed by a value identification study comparing values among actors to definitions of welfare technologies. The second part of this thesis takes a more solution-oriented approach by creating an evaluation methodology called Technology Implementation Evaluation Score (TIES), which has as its purpose to, as a combination of traditional positivistic methodologies, include users in the technology evaluation by incorporating qualitative data such as opinions and assessments to a greater extent. The thesis then performs a sensitivity analysis on TIES using extreme values, which shows that the methodology succeeds in making users’ experiences and opinions better heard during evaluation then they have been in the past, thereby reducing the validity problem that contributes to unintended consequences of performance indicators. Conclusions highlight the fact that the actors involved in the design, implementation, and use of welfare technologies have different perspectives influenced by their knowledge traditions and professional norms, and that these affect the assumptions that are made regarding the users of welfare technologies. Welfare technologies are today designed and implemented by professions led by techno-economic rationality or management values, which provide ill-designed technologies, as the users’ needs are not identified before the technology is implemented.  To counteract this TIES provides a way to evaluate the effects of welfare technology and by that include the needs important to provide a successful welfare technology solution for the users, which is the care profession.

In the name of efficiency, performance measurement has gained traction in public welfare organizations. The idea of performance measurement originates from views of all organizations rooted in scientific management notions that emerged during industrialization, as kinds of production units, according to an industrial logic. However, the primary objectives of public welfare organizations are to meet situational needs of individuals. Thus, applying performance measurement in public welfare organizations has resulted in tensions between social and scientific perspectives that have led to devaluation of welfare professionals’ reasoning and judgement in relation to performance measures. The purpose of the thesis is to unravel the sociotechnical tensions between performance measurement and public welfare practice by addressing the underlying logics in theory and praxis. In addition, the knowledge acquired from theory and praxis used to reflect on a practical case of performance measurement design, to advance the design of performance measurements in public welfare organizations and avoid dysfunctional effects. All six papers have contributed to elucidation of important aspects of the socio-technical tensions. First, they have provided theoretical insights regarding underlying logics and values (Paper I), and constructive and deconstructive approaches (Paper II) in public performance measurement research. Second, they have provided practical lessons showing how industrial values have obtained precedence in design, decision-making and management, as well as in the choice of data. In this sense, although they are based on a welfare logic, public welfare organizations are haunted by the ghost of industrialization, which has fueled anxiety among welfare workers, with dysfunctional consequences, as they have had to adjust to a measurement regime that does not sufficiently value their reasoning and judgement. Thus, welfare logic needs to be integrated into definitions of performance and its measurement.  Third, they have informed reflections on the design of performance measurements from an empirical case study. Together with the theoretical insights and practical lessons, the reflections reveal in detail how a welfare logic can be easily subordinated in the construction of performance measurement as welfare workers are often only involved in the use stage. In summary, this thesis makes a multi-level contribution to unraveling the socio-technical tensions of performance measurement in public welfare organizations, which I hope will be useful for public welfare performance measurement researchers, measurement practitioners, welfare professionals, and managers.